In Babymoon’s 5-week Lamaze series, we discuss at length the six “Healthy Birth Practices” that have been linked to better outcomes for moms and babies. One of these healthy birth practices is to avoid unnecessary interventions.
But how does one determine when an intervention is necessary or unnecessary? We recommend using your BRAIN – examining the Benefits, Risks, and Alternatives to an intervention, and then asking yourself what your Intuition says and what happens if we do Nothing (right Now).
In the first of series of her blogs on her web site, Sarah Buckley begins to examine the benefits and risks of an epidural and shares some of the research surrounding this common intervention. Buckley, a physician who also authored Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices, says:
“Obviously, the main benefit of an epidural is the very effective pain relief that most women experience. Because of this effective analgesia, epidurals also reduce stress, and stress hormones, in labour. This can be beneficial when women are experiencing very high levels of stress and pain, which can slow labour progress.”
To understand some of the risks or side effects of an epidural, we first must understand oxytocin. As we discuss in our Lamaze series, the hormone oxytocin – also known as the “love hormone” – is a key player in the process of labor and birth.
“Receptor cells that allow your body to respond to oxytocin increase gradually in pregnancy and then increase a lot during labor. Oxytocin stimulates powerful contractions that help to thin and open (dilate) the cervix, move the baby down and out of the birth canal, push out the placenta, and limit bleeding at the site of the placenta.”
Buckley explains that within the oxytocin “positive feedback cycle” (as illustrated in the diagram), uterine sensations lead to oxytocin release which contributes to stronger contractions, more sensations, and more oxytocin. The cycle continues and helps baby to be born quickly and easily. Oxytocin also activates reward and pleasure centers in the brain.
When epidural analgesia is introduced into the equation during labor, there are no longer sensations to trigger oxytocin release, and therefore levels will decline.
Buckely will explore the consequences of a lack of oxytocin in Part 2 of her series, coming soon.
Anyone who has experienced parenting a baby with colic will tell you how challenging it is. And they will all likely be able to offer some advice, some comfort techniques, or at the least a shoulder to cry on. But it turns out you’ll find more of these parents in countries like Italy, the U.K., and Canada, as a new study reports that babies in these countries cry more than babies elsewhere.
“In the U.K. 28% of babies 1 to 2 weeks old had colic, for example, while the average prevalence for that age was only 17.4%. And 34.1% of babies in Canada had colic at 3 to 4 weeks, while the average percentage was 18.4%. On the other hand, the study found 6.7% of babies in Denmark at 5 to 6 weeks had colic, much lower than the average 25.1% for that age.”
Along with Denmark, the study found that babies in Japan and Germany cried the least. Wondering why the large discrepancy between countries? Unfortunately, we don’t know yet.
“The study did not determine a reason for the variation in crying time by country, but the scientists said there should be more research into potential cultural and genetic influences.”
What are your thoughts? Why are some countries reporting such high rates of colic in their babies?
Did you have to convince your friends and family that having your baby in a birth center was not only safe, but the safest place to have your baby? What is common is not necessarily always the best practice. Many of the interventions we commonly see in labor and delivery room are not only unnecessary, but even harmful.
The American Congress of Obstetricians and Gynecologists (ACOG) recently released a committee opinion recommending different approaches for limiting interventions during labor and birth for low-risk women. Their conclusion?
Many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor. In addition, some women may seek to reduce medical interventions during labor and delivery. Satisfaction with one’s birth experience also is related to personal expectations, support from caregivers, quality of the patient–caregiver relationship, and the patient’s involvement in decision making (57). Therefore, obstetrician–gynecologists and other obstetric care providers should be familiar with and consider using low-interventional approaches, when appropriate, for the intrapartum management of low-risk women in spontaneous labor.
While families, midwives, birth centers, and care providers are celebrating this statement, Childbirth Connection released an excellent fact sheet summarizing ACOG’s opinion, as well as a reminder that:
Unfortunately, it often takes many years before health care providers reliably carry out the recommendations of professional organizations. So, it is important for pregnant women themselves to become informed and take an active role in securing high-quality care for themselves and their babies.
After collecting data from 4,749 women, researchers determined that women who had begun menstruating before age 11 were 51% more likely to have gestational diabetes than those who started menstruation at 13 years.
The investigators believe their findings illustrate that young age at the start of menarche may be a way of identifying women who are higher risk of developing GDM. They say that further studies are needed to confirm these initial results and to illuminate the role of early start of menarche and later risk of GDM.
Does your experience line up with the research? Wondering what you can do to decrease your risk of developing gestational diabetes? Ask your midwife at your next appointment.
Last fall, a few Babymoon staffers were lucky enough to attend a day-long seminar with Penny Simkin, renowned author, physical therapist, childbirth educator and doula. The day was chock-full of knowledge and “Penny-isms,” including Penny’s long-time insistence that parents-to-be sing to their babies in utero.
As usual, Penny was spot on with her advice, as new research from the University of Milan suggests that babies who are sung to in the womb will cry less during the newborn period. Author Henry Bodkin, summarized the study in the Telegraph:
A study of 160 women found that those who sang lullabies both during pregnancy and after giving birth had babies who spent significantly shorter periods crying. Around 170 pregnant women were split between those who were told to sing lullabies in the months immediately before and after birth and those who were not.
The babies in the singing group generally cried 18.5 per cent of the time compared to 28.2 per cent of the time in the group who were not sung to. Meanwhile for those with colic – excessive or frequent crying where there is no ill health – the babies who had enjoyed prenatal lullabies tended to cry for about a quarter of the time.
So let’s get singing! What songs will you serenade your your little one with before he or she arrives?
Another study with shocking results. Midwives all over are stunned. KIDDING! Take this entire study to your friends who ask you about evidence based care and the standard treatment of newborns in a traditional inpatient setting. Here is the conclusion:
The proportion of newborns transferred to the NICU for observation was significantly different and lower after implementing skin-to-skin contact immediately after cesarean birth (Pearson’s χ2 = 32.004, df = 1, p < .001). These results add to the growing body of literature supporting immediate, uninterrupted skin-to-skin contact for all mother–newborn pairs, regardless of birth mode.
Babymoon Inn is a full-scope midwifery practice and wellness center with locations in Phoenix and Tucson. Our team is committed to improving maternal outcomes and providing personalized, evidence-based care to all people.