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Homebirths on the Rise
In the context of increasingly public physician opposition to women’s choice for a home birth, the number of home births in the United States rose 20 percent from 2004 to 2008, according to research publishing in the journal Birth. According to the study, 27 states saw significant increases in the number of home births during that time period, while only four states saw declines. With a national cesarean rate of 34%, the incidence of home births is likely to increase. Read the abstract. Read a news article.
Check out this terrific interview with Robbie David-Floyd about homebirths.
To find out more about home birth, visit the Citizens for Midwifery’s website where you can:
- Download the CfM TOOLKIT: Stand Up for Healthy Birth & Home Birth, a tool for grassroots organizing and advocacy.
- Download the Home Birth Annotated Guide to the Literature, April 2011.
- Download the Power Point presentation or view the archived video, Home Birth and the Public Health Response: Promoting Informed Choices and Healthy Outcomes, by Eugene DeClerq and Mairi Breen-Rothman from the John Hopkins-Bloomberg School of Public Health.
Each Wednesday, our Birth & Parenting News blog highlights the latest news items, research results, consumer alerts, and legislative action alerts of interest to expectant and new parents and the professionals who work them.
OB/GYNS Call for Fewer Cesareans
In an ominous editorial in the August 2011 issue of Obstetrics & Gynecology, Dr. John T. Queenan’s commentary, How to Stop the Relentless Rise in Cesarean Deliveries, warns readers that with almost one in three first-time mothers having a cesarean and decreasing VBAC rates since 1996, the U.S. cesarean rate is likely to reach 50% very soon. Dr. Queenan makes several suggestions as to how to reduce the cesarean rate including: achieving an obstetric department commitment to lowering cesareans; better evidence-based patient education on the risks and benefits of cesareans; achieving tort reform; using more nurse midwives; providing equal reimbursement rates for cesarean and vaginal birth and higher reimbursement for supporting VBACs. He also advocates for re-establishing the teaching and training for breech and operative vaginal births. “As of now,” he writes, “the problem is ours to solve. If cesarean delivery rates spiral upward, our profession will lose both credibility and the opportunity to determine our direction, as third-party payers and the government will become involved.”
In the September 2011 issue of Obstetrics and Gynecology, Dr. Howard Blanchette of New York Medical College urges physicians to “reduce the primary cesarean delivery rate, and avoid the performance of a uterine incision unless absolutely necessary.” His commentary, The Rising Cesarean Delivery Rate in America: What Are the Consequences?, concludes that the dramatic rise in cesareans has not resulted in improved outcomes in neonatal morbidity or maternal health. In fact, he corroborates the evidence that has been accumulating for years. The rise in cesareans has led to increasing adverse outcomes for mothers and babies. Dr. Blanchette outlines the changes needed to reverse the rising cesarean rate in America and makes the following recommendations:
- Promote trial of labor in women with one previous low transverse cesarean.
- Provide extensive counseling on the risks of elective primary cesarean delivery on maternal request.
- Avoid cesarean delivery for dystocia until the active phase of labor is firmly established, particularly in nulliparous women, and in induced labor.
- Nurses, obstetricians and midwives must remain competent and current in their knowledge of fetal heart rate monitoring interpretation, given that the sensitivity of non-reassuring fetal heart tones as an indication is only 50%.
- Compensate obstetricians at the same level for both labor after cesarean and elective repeat cesarean delivery.
Dr. Tami Michele agrees with Dr. Blanchette, and states that women themselves can take an active role in lowering their chance of having a primary or repeat cesarean section. “An experienced doula is essential in lowering the cesarean rate, and I encourage every woman to have one. Both doulas and childbirth educators provide education on avoiding induction of labor, methods to avoid labor dystocia, and effective pushing techniques for second-stage. While continuous fetal monitoring is mandatory in a hospital which supports labor after a cesarean, women without a prior cesarean can request intermittent fetal monitoring. When continuous monitoring is necessary, many hospitals have ambulatory monitors with the capacity to also be used under water.”
The Doula Business Advisor blog is designed to support the establishment and long-term sustainability of private doula businesses. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.
Breastfeeding Protective Against SIDS
A recent meta-analysis of 288 studies confirms that exclusive breastfeeding helps protect against Sudden Infant Death Syndrome (SIDS). The research was published in the journal Pediatrics. The authors’ concluded that “Breastfeeding is protective against SIDS and this effect is stronger when breastfeeding is exclusive. The recommendation to breastfeed infants should be included with other SIDS risk-reduction messages to both reduce the risk of SIDS and promote breastfeeding for its many other infant and maternal health benefits.”
Doulas and doula programs, with an aim to reducing infant mortality, should be promoting breastfeeding and increasing breastfeeding support for all new mothers. This article can serve as evidence-based justification, when making the case to funders of doula programs, that doulas can play a role in the prevention of SIDS.
The Doula Programs blog provides a forum for doula program visionaries and implementers to consider common challenges, ask questions, and learn from each other. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.
Child Passenger Safety Training Classes
Child Passenger Safety Technician Certification training classes are intended for persons interested in becoming a certified child safety seat technician. Go to Safe Kids to find a CPS instructor in your area or to discuss plans for upcoming local or regional trainings. This additional certification would be a great addition to your doula resume!
The Doula Business Advisor blog is designed to support the establishment and long-term sustainability of private doula businesses. Patty Brennan is the author of The Doula Business Guide: Creating a Successful MotherBaby Business.
Family Paws Parent Education Webinars
Led by dog professionals who have chosen to specialize in dog and baby safety, these monthly free webinars offer positive and practical resources that increase safety and decrease stress for families with dogs. Great resource for expectant parents to plan ahead for the new baby as well as for doulas to share with parents.
Each Wednesday, our Birth & Parenting News blog highlights the latest news items, research results, consumer alerts, and legislative action alerts of interest to expectant and new parents and the professionals who work them.