Archive for the ‘pregnant’ Category

Cesarean vs. VBAC: A dramatic Difference

Wednesday, July 22nd, 2009

I have been invited to share with you an intimate and challenging (and graphic) journey of a mother from an unexpected primary cesarean, physician decided repeat cesarean and a home water birth after those two cesareans.

Before you watch it, take a deep breath and have an open mind. A box of tissues may be in order as well.

Cesarean vs. VBAC: A Dramatic Difference from Alexandra Orchard on Vimeo.

Watch how a baby is delivered in a cesarean birth and see the dramatic difference of what both the mother and baby experience in a home water birth after cesarean.


Thank you Alex for allowing me to share your story!  Many blessings to you and yours.

For more information on cesarean recovery, support, prevention and VBAC information go to www.ican-online.org.

ACOG refines guidelines for fetal monitoring in labor

Wednesday, July 22nd, 2009

ACOG recently updated guidelines for fetal monitoring in labor.  They call it a refinement.  Very interesting.

Directly from the press release “Since 1980, the use of EFM has grown dramatically, from being used on 45% of pregnant women in labor to 85% in 2002,” says George A. Macones, MD, who headed the development of the ACOG document. “Although EFM is the most common obstetric procedure today, unfortunately it hasn’t reduced perinatal mortality or the risk of cerebral palsy. In fact, the rate of cerebral palsy has essentially remained the same since World War II despite fetal monitoring and all of our advancements in treatments and interventions.” That is an increase in use by 89% with what benefit to mothers and babies? More cesarean?  More interventions and managed labors? Perinatal mortality hasn’t decreased.  Shocking really.   So for the needs and most likely benefit of the truly high-risk moms and babies all women have been subjected to more and more electronic monitoring in labor resulting in more morbidity for mothers and babies.

Apparently a big issue is that there are huge discrepancies in interpretation when assessing the FHT strips by physicians. There was a group of 4 physicians who initially assessed 50 FHT tracings and only agreed 22% of the time. Then two months later the same 4 physicians were asked to re-assess the same 50 tracings and their own evaluations varied nearly 1 in 5.   I have heard this over and over anecdotally from labor and delivery nurses through the years.  That no one can agree.  That the variance is so great.  Better to treat just in case whether by interventions or a cesarean.  I have been told that even a 40 hour course on FHT assessment leaves one without any clear advancement of skill or knowledge. The training actually left one individual less inclined to trust assessment.  So how does this comfort the expecting woman? Knowing that the machine that rules so much of labor and delivery in combination with the human element is so fallible.  Now that is non-reassuring in real life application.

So what can be done?  Unless there is a real high-risk situation that needs to be addressed, ask for intermittent auscultation with a handheld doppler or even better with a fetascope.  When a nurse, midwife or doctor actually listens personally to a baby with a fetascope there is no machine interpreting sound. It is with their own ear and skill assessing your baby.

The other thing to remember is keeping away from routine use of  induction, narcotic use, and epidural use in labor can greatly improve the opportunity to remain low-risk and healthy.  Thus not requiring continuous fetal monitoring.

I only touched on a few aspects of the new guidelines.  For a more complete breakdown of the refined guidelines, the NY Times did a nice piece.

Molly Ringwald births twins – Congratulations!

Monday, July 13th, 2009

It has been reported that Molly Ringwald naturally birthed her twins (son Roman and daughter Adele) on July 10th, 2009.  Her babies arrived within minutes of each other.  No other details were given.

She had previously spoken publicly in a Fit Pregnancy interview about her desire for a vaginal birth.  Also that she would not schedule a cesarean due to expecting twins alone.  This is no small feat in today’s maternity world.  Women today nearly always deliver twins and other multiples via planned cesarean without labor (unless both babies are head down and the mother agrees to a tethered labor).

Something else stands out to me.  She appears to have bucked the trend of advanced maternal age obstetrics based on this study ama study.  You see Molly Ringwald is a gorgeous, healthy 41 year old!

Though Molly Ringwald is a celebrity, she is like all the rest of us, a  childbearing woman.   If she can do it, so can you!

Congratulations to Molly and her family.