The AllTrials Campaign

If you aren’t already familiar with the AllTrials Campaign, I’d urge you to check out the website and learn more today. In a nutshell, this campaign is about ensuring that the results of all clinical drug trials are released. Currently, many results are being withheld, meaning that doctors and consumers are not able to properly make informed decisions about treatment options. Click the button below to sign the petition and get involved.

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The Motherbaby Dyad: Can maternity care ever truly be ‘baby-friendly’ without first being ‘mother-friendly’?

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Most people now acknowledge that close physical proximity between mothers and babies during the first hours, days, weeks and even months of life is ideal for both. We know that being skin-to-skin encourages the baby’s oxygen levels to remain stable, that it regulates her temperature, that it encourages bonding between the two, that it stimulates milk production in the mother’s breasts and that babies held skin-to-skin for long periods tend to cry much less often (and have lower levels of stress hormones as a result). We know that breastfeeding on-demand helps both mother and baby adapt to life after birth; that room- and even bed-sharing helps everyone get more sleep, can prevent SIDS and make breastfeeding easier; that picking up a crying baby rather than letting them ‘cry it out’ keeps stress levels low and tends to lead to less anxiety later in life. Basically, the goal in all of these things is to allow the newborn to live outside of the womb in a manner that resembles life in the womb as closely as possible. Human babies are born essentially premature when compared to other mammals. While the calf can walk at birth and the baby chimp can cling to it’s mother’s back while she climbs, human babies are still essentially foetal. Why? Simply put, we walk upright, which affects the size and shape of our pelvic bones and we have big brains, which require large skulls to keep them in. In order for our human skulls to fit through our human pelvises (which they do very well, thank you very much – remember, as Ina May says, “Your body is not a lemon.”) we must be born early relative to other mammals. This works out ok, as long as we are prepared to care for what is essentially a foetus living outside of the womb. Doing so is even more demanding than pregnancy and requires support systems, maternity leaves, lots of encouragement and the ability to pick oneself up again time and time again (i.e. self-compassion). I have written before about the importance of community and social support systems for new parents but today I am thinking about the process of labour and birth and how they affect both mom and baby (or, motherbaby as many people are now referring to newborns and their moms to signify the importance of caring for them as a single entity). We accept that what happens after birth affects both mother and baby, but the evidence also shows that how a mother is treated prenatally and during labour and birth affects both individuals as well. So what does it mean for a hospital to be considered “mother-friendly” or “baby-friendly” and why are these two separate sets of considerations? Continue reading

It’s MINE! Shared decision-making and evidence-based practice in childbirth

This is a brief, but interesting interview with Maureen Corry, MPH, Executive Director of Childbirth Connection on the subject of shared decision making.

Right off the bat, Corry mentions exactly what came to mind for me when I was confronted with the term “shared decision making”. She says,

…we’ve heard some concerns from women that shared decision making means giving up some control of decision making to the care provider – essentially a move away from informed consent and refusal. Because of the history of childbirth in the United States, and many troubling practices that still happen today, childbearing women are justified in being concerned about their rights.

Continue reading

Why Doula?

“Do you have any children of your own?”

This is a question that sometimes comes up when I talk about my work, whether I’m talking with a potential client or just chatting with someone at a party. Sometimes, when I respond with, “no, not yet.” and a smile, I’m met with a puzzled look. On a few occasions, the puzzled person has come right out and asked me, “so, why did you become a doula then?”

In honour of International Women’s Day today I thought I’d take a stab at answering that question. Continue reading

Don’t Believe the Hype

This article from The Wall Street Journal provides some great historical information that connects meaningfully with my previous post (Home)Birth is Safe.

The author, Nathaniel Johnson notes that,

In 1923, Mary Breckinridge started the Frontier Nursing Service in rural Appalachia….Within a decade, the astonishing impact of that care was apparent. The women the Frontier Nursing Service cared for, who were desperately poor and usually gave birth at home, were 10 times less likely to die in childbirth than the average American at the time. The nation as a whole wouldn’t catch up until the 1950s, after the widespread acceptance of antiseptic and the discovery of antibiotics.

Given that antiseptic practices and the use of antibiotics are available and in use in midwife-attended home births today, it makes sense that, as Sheila Kitzinger has argued, it is not a high level of medicalization that makes birth safer – it is overall health: access to good pre-conception, prenatal and postpartum healthcare, good quality nutrition, access to clean water and access to skilled birth attendants. This has been borne out the world over, regardless of whether women are typically birthing at home or in hospitals. Access to medical interventions for the few women who actually need them is important, which is why midwives are thoroughly trained to detect possible complications before they become problematic and why they only support home births for women who are not at risk. Obstetricians are trained to deal with problems when they arise, but midwives are far more likely to be able to prevent them in the first place. Continue reading

You Can’t Beat Mother Nature

I’m always excited to read about good hard science that reveals more about the awesome power of women’s and babies’ bodies. Check out this article about the hundreds of different bacterial microorganisms that have been identified in breast milk through DNA sequencing.

In addition to the further confirmation that a mother’s milk can’t be duplicated in its richness and complexity, this article also lends support for minimizing interventions in labour where possible:

The type of labour also affects the microbiome within the breast milk: that of mothers who underwent a planned caesarean is different and not as rich in microorganisms as that of mothers who had a vaginal birth. However, when the caesarean is unplanned (intrapartum), milk composition is very similar to that of mothers who have a vaginal birth.

These results suggest that the hormonal state of the mother at the time of labour also plays a role: “The lack of signals of physiological stress, as well as hormonal signals specific to labour, could influence the microbial composition and diversity of breast milk,” state the authors.

Our bodies truly are amazing.

Take Action!

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Since April 1, 2011, 25 000 babies have been caught by midwives in Ontario. Since then, the midwives of this province have been working without a contract. Today is the Social Media Day of Action. Email the Minister of Health and Long-Term Care, tweet #backtothetable and urge @DebMatthews to restart negotiations with @OntarioMidwives! For more information and ideas on how to make an impact today, visit http://www.ontariomidwives.ca/support/backtothetable