In new study by Dr. Jason Wright and colleagues of Columbia University in New York, it is found that of 717 common OB-GYN practice recommendations from ACOG (American College of Obstetricians and Gynecologists), just 30% are based on top-notch research. Another 38% are based on observational studies, and another 32% are just expert opinion.

The study is a call for better evidence and, as it relates to you, the consumer, can be an alert to the fact that the jury is still out on many of the common practices that are perceived as ‘the only way’ childbirth operations can work in the US. Here is the link to the full article from it’s original publisher.

The c-section rate is still on the rise, up to 34%, and Dr. John Queenan predicts the rate will soon approach 50% in his article “How to Stop the Relentless Rise in Cesarean Deliveries,” published in August in Obstetrics and Gynecology. Queenan is deputy editor of said publication, and his editorial is a call to care providers to rein in the rate before stakeholders or governmental action take them by force. Queenan offers two solution to his complex question: 1)”make VBAC more accessible and more desirable” and 2)”prevent primary deliveries in the first place.”

His strategies include

• implementing hospital quality improvement programs,
• increasing utilization of midwives,
• addressing problems in the liability system, and
• improving shared decision making.

Woman, take note. The decision makers are hearing the alarms, too.

This is relatively an old article. As in over a year, but less than two. To me, the layman, the argument makes sense. The interviewee, Katy Bowman, is a biomechanical scientist, who applies her knowledge to the human body. I started paraphrasing Bowman’s argument here, but it is such a step by step, thorough argument, that a quote does it better justice (an better understanding for you!)

A kegel attempts to strengthen the PF, but it really only continues to pull the sacrum inward promoting even more weakness, and more PF gripping. The muscles that balance out the anterior pull on the sacrum are the glutes. A lack of glutes (having no butt) is what makes this group so much more susceptible to PFD. Zero lumbar curvature (missing the little curve at the small of the back) is the most telling sign that the PF is beginning to weaken. Deep, regular squats (pictured in hunter-gathering mama) create the posterior pull on the sacrum. Peeing like this in the shower is a great daily practice, as is relaxing the PF muscles to make sure that you’re not squeezing the bathroom muscle closers too tight. Just close them enough…An easier way to say this is: Weak glutes + too many Kegels = PFD.

To see the full article from the blogger Mama Sweat: Pelvic Floor Party: Kegels are NOT Invited.

And now, another informational resource for the preggers among us. The Organization of Teratology Information Specialists (let’s call them OTIS, and as if either of these titles have given you any clue as to what they do) has a wealth of information for us to, as they say “raise mom’s awareness and reduce baby’s risk.” And here’s your factoid for the day: Teratology is the study of birth defects caused by exposures during pregnancy.

So how can OTIS help you? Have you been wanting to get to the bottom of the caffeine confusion for pregnant women? Can you remember which over the counter drugs are safe during pregnancy or for lactation? What about a disease that you’ve been exposed to while pregnant? You can read factsheets written in layman’s terms on OTIS’ comprehensive website. Their factsheets cover medications, herbal remedies, infections and vaccines, medical conditions in the mother, illicit substances and common exposures, such as alcohol, caffeine, hair products, etc. Overall, I’m impressed and love this resource.

To answer one of my hypotheticals above, see this blog post on caffeine consumption. “ACOG concluded that moderate caffeine intake, no more than 200mg of caffeine per day, during pregnancy does not seem to be a factor in increasing a women’s risk for having a miscarriage or a preterm delivery.”

And how much is 200 mg? Here are your common caffeine amounts per the USDA:

Dark Chocolate 1.45 oz = 30mg
Milk Chocolate 1.55 oz = 11mg
Coffee 8oz = 137mg
Tea 8oz = 48mg
Soda 12oz = 37mg
Hot Cocoa 12oz = 8-12mg

Our local health writer writes about some of our mother-friendly options, Certified Nurse Midwives, Certified Professional Midwives, and class instructors. A neglected topic in news, Sanchez writes that “about 10 percent of births attended by midwives result in cesarean sections, compared with 31 percent with obstetricians.” She also compares costs of midwifery care vs. obstetrical care. If you are low-risk, have you considered your options for your pregnancy and birth? And no, a midwife attended birth may not be like what you think. Read this article.

On a personal note, one of these women is my midwife, one of these women is my client, and one of these women is one of our local leaders of the Nashville Birth Network.

Are you thinking about becoming pregnant, and checking our your options about birth, which is why you’re here? Are you less than 9 weeks pregnant or hoping to become pregnant? Join Right From the Start, a Vanderbilt research study concerned with studying how a woman’s diet, behaviors, health, medical history affect her ability to become pregnant. There are no medicines to take and there are no changes to lifestyle to be able to join this study. Find more information or to enroll, go to mom2be.org.

Happy Earth Day! In honor of this beautiful day, and all the meaning behind it, I post this in honor of our future children. What are you doing in the present to help protect the future? Here’s a short list of ideas that are easy to implement to take small steps to make an impact: read all »

Alpha is a faith-based comprehensive childbirth class to prepare you for the birth of your child whether it is at home, a hospital, or a birth center. Registering now! Check out the website: alphachildbirth.com.

This Monday, March 22, come to Bongo East for a very informative and well researched meeting about the biggest causes of cesareans. Any expectant mama or future expectant mama should make it a point to be here.

“Does (Birth) History Repeat Itself?

CPD (aka baby-too-big/mama-too-small) and Failure To Progress are some of the most common reasons for cesareans today. We’ll discuss how the CPD and FTP labels can be wrong, examine some extenuating circumstances that could lead to these diagnoses, look at some research, and discuss questions you can ask your provider about your case history. Come learn why a previous diagnosis of CPD/FTP should NOT preclude you from a VBAC attempt.

Cost: Free, though donations of any amount to our ICAN treasury are greatly appreciated. Better yet, become a subscriber at the meeting!

Who Should Come: Anyone interested in learning more about healthy pregnancy, birth, and recovery is welcome to attend. First-time moms are especially encouraged to come! While childcare is not provided, children with quiet toys and babes-in-arms are welcome.”

Monday, March 22, 2010
Time: 7:00pm – 8:30pm
Location: Bongo Java
Address: 2007 Belmont Blvd Nashville, TN

For more information: http://icanofnashville.webs.com/meetingsandactivities.htm

There are always choices, and using Hibiclens instead of routine antibiotics during labor is proven as effective as antibiotic use. Here is the regimen that US midwives use, patterned after European nations Hibiclens standard. Hibiclens is available over-the-counter. You can also use Hibiclens before a GBS swab to test negative. Learn more about the use of Hibiclens: Chlorhexidine (Hibiclens) Protocol for Labor Among GBS Positive Women. As always, discuss the use of Hibiclens with your care provider as your alternative to antibiotics. To learn more about GBS, this is a well researched article from the same blog: Treating GBS (Group B Strep): Are Antibiotics Necessary?