Center for the Childbearing Year, LLC

More Business of Being Born

Patty Brennan — Tue, 15 May 2012 06:00:58 +0000

Friends of Michigan Midwives will be hosting a benefit screening of “Down on the Farm: Conversations with Legendary Midwife Ina May Gaskin” at Center for the Childbearing Year, Thursday, May 17 at 7 pm. We would love to see any and all birth workers there! I hope you can join us.

Reducing Elective Deliveries: A Success Story

Patty Brennan — Thu, 10 May 2012 06:00:43 +0000

From the CIMS April e-newsletter: Research has shown that early elective delivery (between 37 and 39 weeks of gestation) without medical or obstetrical indication is associated with neonatal morbidities with no benefit to the mother or infant. Induction of labor doubles the risk for cesarean section in first births thereby exposing mothers to harms associated with a major abdominal surgery.

The Leapfrog Group, a national organization with a focus on improving the safety and quality of healthcare has made a point of publically posting hospital-specific elective delivery rates on its website. A 2010 Leapfrog Group survey of hospitals who chose to report their data, showed that elective delivery rates varied widely with no evidence that higher rates led to better outcomes. For example, in California individual hospital elective delivery rates ranged from 1.2%. to 46.8%.

Leapfrog’s 2011 survey results showed that hospitals have already made progress on reducing early elective newborn deliveries. The Leapfrog Group data showed that 39% of reporting hospitals kept their early elective delivery rate to 5% or less, compared to 30% of reporting hospitals last year.

Since some hospitals were able to keep their elective deliveries before 39 weeks to 5% or less, effectively reducing costs without compromising maternal and newborn outcomes, Leapfrog set its own benchmark in 2011 for elective deliveries to 5%. U.S. Hospitals will need to be at or below this target to earn credit from Leapfrog on this measure. The National Quality Forum also supports fewer elective deliveries.

Hospital-specific elective delivery rates for 2010 and 2011 are available from
http://www.leapfroggroup.org/for_consumers/tooearlydeliveries#State.

The Centers for Medicare and Medicaid Innovation in partnership with medical professional associations, business groups, consumer advocate groups and quality improvement organizations have joined to educate the public, state health departments, and maternity care organizations about how best to improve the health of mothers and newborns by focusing on reducing elective deliveries. The Strong Start for Mothers and Newborn initiative is a rich resource for establishing best practice models and funding opportunities for reducing preterm births.

Citizens for Midwifery has published a fact sheet for families on tips to avoid early elective induction.

Our bi-weekly 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. From Center for the Childbearing Year.

More Women Than Ever Are Choosing Home Births

Patty Brennan — Tue, 08 May 2012 06:00:55 +0000

From the CIMS April e-newsletter: According to recent data on home births published by the U.S. Centers for Disease Control (CDC) (based on 26 states, comprising 50% of U.S. births), reporting data on planning status of home birth in 2009, there were 29,650 home births in the United States, the highest level since data on home births began to be collected in 1989. After a decline from 1990 to 2004, the percentage of U.S. births that occurred at home increased by 29%, from 0.56% of births in 2004 to 0.72% in 2009. The percentage of home births in 2009 was three to five times higher for non-Hispanic white women than for any other racial or ethnic group.

Louisiana and the District of Columbia had the fewest number of home births, 0.2% and Oregon, 2.0% and Montana, 2.6% had the highest. In 2009, 62% of home births were attended by midwives: 19% by certified nurse midwives and 43% by certified professional midwives or direct-entry midwives. Home births are more common among women aged 35 and over and women with several previous children. The report found that home births have a lower risk profile than hospital births, with fewer births to teenagers or unmarried women, and with fewer preterm, low birthweight, and multiple births.

In a ground-breaking Home Birth Consensus Summit that took place last October in Virginia, supporting home birth as a safe option for women was validated by maternity care stakeholders including medical, midwifery and nurse professionals, consumer advocates, researchers, hospital administrators, health insurance liability providers, public health and policy makers.

Timothy J. Fisher, MD, FACOG, the chair of Women’s Health services at Cheshire Medical Center/Dartmouth-Hitchcock Clinic in Keene, New Hampshire, who participated at the Summit, stated, “I believe it is time for us to look critically, with open hearts and minds, at how and where to provide women with safe, high quality maternity care at reasonable cost. With rising rates of intervention, a shrinking physician workforce and unsustainable costs of hospital-based care systems, it is time we did some out-of-the-box thinking!” Dr. Fisher also spoke recently at the CPM Symposium, held March 16-19 in Washington D.C.

The safe option of home birth also received quite a boost among policy makers on November 16, 2011 when Congresswoman Lucille Roybal-Allard (CA-34) recognized the importance of the Home Birth Consensus Summit on the House Floor. The California Representative encouraged professional care providers and maternity care consumer advocates to affirm the Home Birth Consensus Statement. A video of her address on the Home Birth Consensus Summit to Congress is available at Youtube.

Preemie Parent Alliance Website Launch

Patty Brennan — Wed, 02 May 2012 19:38:34 +0000

The Preemie Parent Alliance (PPA) has launched their new website, created by parents of premature babies for other parents of preemies. PPA represents organizations that provide support to parents of babies born too small and too soon and is committed to helping its members provide quality information, resources, and support efficiently and effectively for the families they serve. The PPA website includes information about member organizations, member benefits and upcoming events.

Car Seat Safety website

Patty Brennan — Thu, 26 Apr 2012 06:00:55 +0000

The Children’s Hospital of Philadelphia (CHOP) has announced the launch of a new website, Car Seat Safety for Kids.” The site reflects current best practices and child passenger safety tech training and also includes CHOP’s popular videos Keeping Kids Safe in Crashes which have been fully updated based on current American Academy of Pediatrics (AAP) recommendations.

Study: Early Language Development

Patty Brennan — Tue, 24 Apr 2012 06:00:21 +0000

A study published online in the Proceedings of the National Academy of Sciences questions common assumptions about language development in infants. The study authors report that it is widely accepted that infants begin to learn language by discovering features of speech including consonants, vowels, and combinations of these sounds. Learning the meaning of words (rather than just perceiving their sounds) has been said to come later, usually between 9-15 months of age. However, the study authors found that infants aged 6-9 months already know the meanings of common words for certain foods and body parts through their daily exposure to language. The study authors encourage parents to talk to their babies at this age–babies can understand many words much sooner than they can actually say them.

Fish, Mercury and Nutrition: The Net Effects

Patty Brennan — Thu, 19 Apr 2012 06:00:26 +0000

A new documentary educates pregnant and nursing mothers on why two ocean fish meals a week during the critical window of development can safely give their babies lifelong benefits. “Fish, Mercury and Nutrition: The Net Effects” presents the many benefits of eating ocean fish and the risk of mercury exposure for the population with the most to gain (or lose): the unborn and young children. Including ocean fish in a healthy diet is also important for the rest of the population. The documentary was developed by The Energy and Environmental Research Center. It explores the question, “How much fish should we eat?” via a who’s who of experts.

My Safe Home website

Patty Brennan — Tue, 17 Apr 2012 06:30:54 +0000

A new interactive website helps families identify dangers in their home and provides simple steps to fix them. My Safe Home was developed by Safe Kids Worldwide and uses 360-degree interactive technology to allow parents to explore all areas of a home or specific risk, like carbon monoxide poisoning. Safety information is available in both English and Spanish.

“Admission Strip” increases cesarean rate by 20 percent

Patty Brennan — Thu, 12 Apr 2012 06:00:27 +0000

Continuous heart rate monitoring upon admission to a hospital (usually 20 minutes for an “admission strip” in triage) not only shows no benefit for low-risk women, but increases the cesarean rate by 20 percent, as compared to intermittent monitoring with a doppler. That’s according to a new review from the Cochrane Collaboration, published online February 15. The reviewers stated: “The findings of this review support recommendations that the admission protocol used by most hospitals not be used for women who are low risk on admission in labor. Women should be informed that the decision to comply is likely associated with an increase in the incidence of caesarean section without evidence of benefit.” Read the Cochrane Review, or analysis from Lamaze International’s blog Science and Sensibility.

Study links induction with cesarean birth, NICU care

Patty Brennan — Tue, 10 Apr 2012 06:06:00 +0000

Yet another study has shown that induction for non-medical reasons at full-term increases a woman’s risk of cesarean birth and other adverse outcomes. Induction of labor for non-recognized indications was associated with a 67 percent increased relative risk of cesarean section, compared with spontaneous labor. Induction also significantly increased the chance of the newborn needing care from the Neonatal Intensive Care Unit, compared with infants born after the onset of spontaneous labor. The study’s authors concluded, “Caution is warranted with a liberal policy of induction of labor at term in an otherwise uncomplicated pregnancy.” Read the news article.