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End of pregnancy patience is important for providers and mamas-to-be, as inductions of labor double the likelihood of caesarean birth.

In yesterday’s New York Times, Denise Grady reported on a recent study published by the American Journal of Obstetrics and Gynecology. In the article, A Majority of Caesareans Are Done Before Labor, Ms. Grady highlights the latest research about why the caesarean rate continues to rise, despite no evidence of increased maternal or newborn well-being. The three main reasons identified in this study were:

1) Increased inductions of labor (44% of the study participants were induced) which are twice as likely to result in caesarean deliveries

2) Obstetric decision to proceed to a caesarean vs waiting for labor to take its course

3) Elective repeat caesarean deliveries

I agree that all of these factors contribute to the incidence of caesarean section, and have written about what a holistic mama-to-be can do to positively influence these and other road bumps that can get in the way of a healthy, empowered vaginal delivery. Here are three posts I recommend if you are looking for a smooth ride into motherhood:

Bishop Score: Induction Math Mamas-To-Be Need To Know

I have written a few times about induction of labor and believe that elective induction of labor is not worth the risk to mama or baby. This is my most popular post on the topic, and includes links to other posts on the issue as well.

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The organization Best for Babes was started to help moms beat the “Booby Traps“–the cultural & institutional barriers that prevent moms from achieving their personal breastfeeding goals. Click the pic for great resources and information!

Yesterday’s New York Times article, Breast Milk Sugars Give Infants A Protective Coat, is a must read, and an important reminder that nature knows best, and is often driven by reason and rationale to which we are not yet hip. My belief that nature is inherently intelligent is a large part of why I think it wise to stick as close to nature as possible in terms of birth, health, food, lifestyle, etc…. I am one who cringes at the commercials for pills to give women just four periods a year (or none whatsoever) and I feel anxious every time I hear a colleague tell a patient, “you don’t need a period every month.” Hmmm, really? How do you know? Do you really think that we have discovered every single thing there is to know about the periods, and as such can manipulate them at will with complete confidence there will be no unwanted consequences? Not me.

I trust that by and large, the way things work naturally is for a very good reason, even if I have no idea what that reason is. And this is why it has always just made sense to me that breast is best. Never mind the fact that we haven’t yet been able to make a formula that is a perfect stand in for mother’s milk. In my bones, I have the sense that even if we could, it wouldn’t be the same. And now Researchers Bruce German, Carlito Lebrilla and David Mills at the University of California, Davis have discovered part of the reason why feeding a baby formula is not the same as breast feeding (despite the long held “food is food” argument). It turns out,

“A large part of human milk cannot be digested by babies and seems to have a purpose quite different from infant nutrition — that of influencing the composition of the bacteria in the infant’s gut.”

This undigestible portion of breast milk, despite comprising 21% of the milk, was previously believed to serve no purpose. This is an incredibly good reminder that having no purpose, and having a purpose science has not yet discovered are two totally different things. Something to keep in mind regarding other natural occurrences we’ve been told are unnecessary: tonsils, appendixes, foreskins, menopause, normal household germs, food in its natural state, and on and on. So please, start your day by reading the rest of this fantastic article, and by passing on the non-fat half-caf latte with sweet and low and fat-free muffin, yikes!

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Remember reading this post back on July 1 detailing the passage of the Midwifery Modernization Act (MMA) by both the NY state senate and house? And how the only step left was for the MMA to be signed into law by Governor Patterson? Well it was! This is wonderful, amazing, important news–confetti all around!

Click the pic to go to the original post about the MMA.

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I have an exciting update to last week’s post about the Midwifery Modernization Act. The Act was indeed put to a vote, and it passed! Below are all of the details from freeourmidwives.org, a coalition that was instrumental in making this happen. Thank you to all who worked together to ensure women’s access to midwives and homebirth!

Across the state last night, the champagne flowed as women and their families celebrated the passage of the Midwifery Modernization Act!

Why did this bill pass during such a difficult time in New York State politics?  Because women – and those who love and support them – stood shoulder-to-shoulder with midwives despite formidable opponents, limited resources, and little time to get organized.

Together, women strategized, fundraised, spread the word, and gathered supporters.  The result was a truly grassroots effort that was able to stand up to established and powerful opponents.  Thanks to your time on the phone, writing e-mails, and sending faxes, legislators were able to learn the truth about the importance of birth choices for women.

Thanks to your efforts, women will continue to have access to midwives in New York.   Before this law was passed, many currently practicing midwives were in jeopardy – now they can continue to care for women.  In other areas of the state, midwives will now be able to practice, thanks to your hard work.   There are women pregnant today who will now receive the high quality prenatal care a midwive can provide, thanks to you.

Time to give thanks!

Please take a moment to thank your Senator and Assemblyperson for supporting the bill.   The Senate vote was unanimous, so please thank yours ASAP!  Check here for your Assemblyperson’s vote to see if they supported the bill.  Find your Assemblyperson here and your Senator here and thank them for supporting the Midwifery Modernization Act.

Watch for any last steps

This bill has now been passed by the Assembly and Senate and must go to the Governor’s desk to be signed.  If we need to contact the Governor’s office to encourage him to take action, we’ll let you know!

Keep this victory going

We’ve all learned so much about how to make an impact on the legislative process and the lives of women.  Keep up the good work!  Join your local BirthNet, tell the story of your amazing midwife-supported birth, and stay connected – there is still much to be done to ensure all women have a full range of birth options in New York State.

On a personal note – we cannot even begin to express our gratitude to each and every person who made a call, wrote a letter, or sent in faxes, all while juggling children, jobs, and day-to-day life.   Those of us at Free Our Midwives are filled with awe at the power of women and their families working together.  Thank you.

from freeourmidwives.org

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Very important update! New York midwives are back business and homebirth is again available for interested mamas. Check out this post for all of the details.

These are very strange times for birth in NYC. In a city that has been as inspired as any other by the wisdom of films like The Business of Being Born and Orgasmic Birth, women’s choices for their own best births have diminished exponentially virtually overnight. If you believe in a woman’s right to choice in every sense of the word, you owe it to yourself to get up to speed on the latest threats to choice in pregnancy and birth.

Despite this development you do still have options besides delivering in the hospital with an Ob/Gyn. Some homebirth midwives will continue to practice and feel it is their moral, ethical, and professional duty to do so. Do your research and find someone you trust if you go this route–NY politics aside, the research stays the same, and it tells us that homebirth is a safe option for low-risk women. Another option is to deliver at the Brooklyn Birthing Center. Finally, you can also seek out the care of a hospital based midwife.

Here’s the bottom line: become informed and take action if you feel the latest developments in NY birth options are not in the best interest of mothers, babies and families, but don’t give up on using a midwife for your birth if it is your desire. There are plenty of wise, skilled, educated midwives in this town available to support your birth in the midwifery tradition!

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This video from GritTV was inspired by the recent closing of Bellevue Birth Center, the only birth center in New York City serving women on Medicare. Bellevue Birth Center had a <4% cesarean delivery rate vs. the greater than 30% rate in other New York City hospitals. In addition to discussion of the birth center, this video includes discussion of induction of labor, our topic of the week, doula labor support, and many other topics that are popular here.

Key takeaway (one of many): Inductions don’t work if the cervix isn’t ready anyway. (Google “Bishop Score” for more information on how cervix favorability is measured)

Great quote from Elan McAllister, president and founder of Choices in Childbirth when describing a natural birth center, ”You’re gonna be surrounded by a staff that fully supports your choice to birth naturally….Every face that you look into believes in you. Everyone who’s in that room knows that you can birth this baby. Culture of confidence and belief and faith that is, I believe, the single most important ingredient. You can pretty up a room, and that’s one thing, but it’s that culture of faith…”

By the way, the movie clip at the very beginning is from the documentary Orgasmic Birth, an HDNYC top 6 book and dvd pick. It is an amazing film with great information and positive, realistic images of natural childbirth.

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Link | Problems with New Induction Brochure

by Andrea Crossman, RN, BS, BA on December 11, 2009

in Labor & Birth,Latest News,Must Know Info

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Interesting critique of a new brochure about labor induction by the Agency for Healthcare Research and Quality (AHRQ). Questioning the rational for induction and exploring it’s increase is reasonable given that the labor induction rate in the US has more than doubled since 1990. In 2006, 22% (more than 1 in 5) of all pregnant women had their labor induced. Although there are appropriate indications for induction, there are also risks associated with labor induction. Pregnant women need to understand the benefits, risks, and alternatives related to induction of labor so that they can give truly informed consent for this (and all) medical procedures.

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This is a link to the list of 83 US hospitals and birth centers that have implemented the UNICEF-WHO baby-friendly hospital initiative. In the NYC area, the one hospital that made the cut is Harlem Hospital.

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Link | Secrets of the Womb

by Andrea Crossman, RN, BS, BA on September 2, 2009

in Latest News

In a prize-winning essay, Jacqueline Maybin says the female body could hold the key to a medical revolution.

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