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Monday, August 31, 2009


To: HMHB Members
Date: August 31, 2009, Volume 11, Edition 35

News from National
It's the last day of National Immunization Awareness Month and time to get ready for flu season!  For a limited time, HMHB is offering bulk quantities (up to 200 copies) of the latest addition to our FAST FACTS for Families series -- free!  "What You Need to Know About Influenza and Pregnancy" is designed to help women have a dialogue with their health care provider so that they will be adequately protected from seasonal influenza.  The production and distribution of this resource is made possible through generous support from CSL Biotherapies.  We thank our partners in health for their help in educating moms-to-be about this especially important topic!

Judy Meehan
Executive Director

This Week:
1) Webcast on H1N1 and Pregnant Women and New Mothers
2) Perinatal Health Disparities Conference
3) From CPSC:  Stroller Recall
4) National Environmental Public Health Conference
5) From HHS:  Teen Survival Guide
6) Study:  Autism and Gastrointestinal Symptoms

During a recent Webcast from the Centers for Disease Control and Prevention (CDC), an expert panel discussed how pregnant women and new mothers can prepare for the H1N1 flu.  Email questions were answered by the panel during the broadcast.  Originally aired on August 27th, the Webcast is part of CDC's "Know What to Do About the Flu" series.  Access it online at
New Jersey's 10th Annual Perinatal Health Disparities Conference will address the issue of racial disparities in mental health among African American women, children and families.  Participants will learn potential causes, contributors and strategies to reduce mental health disparities during the preconception/interconception, prenatal and postpartum periods.  Scheduled for September 22 at UMDNG Newark, the conference will include speakers with a variety of viewpoints, including medicine, nursing, psychology, midwifery and medical ethics.  The conference is sponsored by the Black Infant Mortality Reduction Resource Center, along with the New Jersey Department of Health and Senior Services, Office of Minority & Multicultural Health and Reproductive & Perinatal Health.  For more information, or to register, go to
This past week, the US Consumer Product Safety Commission (CPSC) announced a voluntary recall of the Baby Jogger Citi Mini Stroller, due to concerns that the stroller's restraint buckle could break or unlatch, allowing a child or infant to fall out.  The recall involves both single and double strollers.  The stroller was sold in stores and on Web sites from November 2007 through July 2009.  Consumers should immediately stop using the recalled strollers and contact Baby Jogger to receive a free replacement restraint buckle and installation instructions.  For additional information, contact Baby Jogger at 1-877-506-2213, email them at, or visit the firm's Web site at  For more information, including how to locate the item number and date codes of strollers involved in the recall, go to the CPSC Web site at
The 2009 National Environmental Public Health Conference:  Healthy People in a Healthy Environment is scheduled for October 26-28, 2009 in Atlanta, GA.  The conference will improve the nation's environmental health capacity by enhancing the expertise of public health, health care and environmental professionals, academic researchers, and representatives from communities, organizations, and advocacy and business groups with a primary interest in environmental public health.  The six conference tracks are:  healthy places; environmental health science and practice; sustainability and public health; environmental systems and public health; public health and environmental exposures; and environmental health emergencies.  The conference is organized by the Centers for Disease Control and Prevention's National Center for Environmental Health and the Agency for Toxic Substances and Disease Registry, in conjunction with the National Environmental Health Association.  For more informa
tion go to
The Teen Survival Guide:  Health Tips for On-go Girls is a 78-page, pocket-sized publication for girls.  Created by the Department of Health and Human Services, the Guide is available for free on their Web site at  It teaches girls about their health through activities, fun quizzes, glossaries of new words, and questions from young women.  The Guide answers teens' questions, including, "Does chocolate cause pimples?" and "Can I get a sexually transmitted disease from kissing?"  An online version of the Guide is available at  Or, to order a free copy, call 1-800-994-9662.
A study published in the July edition of the journal Pediatrics examined whether children with autism have an increased incidence of gastrointestinal symptoms compared with matched control subjects in a population-based sample.  Children were followed until the age of 18 years.  Significant differences were identified between autism case and control subjects in the cumulative incidence of constipation (33.9% vs. 17.6%) and feeding issues/food selectivity (24.5% vs. 16.1%)  However, no significant associations were found between autism case status and overall incidence of gastrointestinal symptoms.  The authors conclude that their "data suggest that a neurobehavioral rather than a primary organic gastrointestinal etiology may account for the higher incidence of gastrointestinal symptoms in children with autism."  To access the study online, go to
Information is reported as provided and does not necessarily represent the view of or the endorsement by the National Healthy Mothers, Healthy Babies Coalition. A complete copy of HMHB's disclaimer is available on the HMHB Web site at

Friday, August 28, 2009

The nature of natural birth | MNN - Mother Nature Network


3 YouTube videos win top honors in contest to promote natural childbirth education.

Birth Matters Virginia recently sponsored a video contest in the style of The Business of Being Born to get Americans thinking about natural childbirth and the misconceptions surrounding it. With the U.S. ranking 41st in maternal mortality and our Cesarean rate surpassing 30 percent, it is more important than ever for women to be educated about their options. The organizers asked contestants to submit short videos about evidence-based maternity and delivery. Ricki Lake and Abby Epstein (from The Business of Being Born) joined other moms from various backgrounds in the judging. 

The entries ranged from personal birth journeys, the role a doula plays, midwifery care, Cesarean sections, birthing in the Amish culture, birth in Ireland, and more. Each video carried a message of the understanding that change needs to occur in our culture related to pregnancy and birth for the well-being of both mothers and babies. Here are the three videos that took top nods:

The nature of natural birth | MNN - Mother Nature Network

Tuesday, August 25, 2009

Physician Group Pulls the Plug on Women’s Autonomy


Issued: August 25, 2009

Physician Group Pulls the Plug on Women’s Autonomy



Issues Policy Statement About What Women in Labor Will Be "Allowed" to Eat and Drink


WASHINGTON, D.C. (August 25, 2009) – Displaying a stunning lack of regard for patient autonomy, the American College of Obstetricians and Gynecologists (ACOG) issued a statement this week declaring that the group will "allow" laboring women to drink "modest amounts" of clear fluids during labor while continuing to prohibit access to solid food.
"Once again ACOG has issued a position statement with little regard for the evidence or for the ability of women to make decisions for themselves," said Susan Jenkins, Legal Counsel for The Big Push for Midwives Campaign. "It's insulting that ACOG actually believes that laboring women should be grateful that they will now be 'allowed' to have more than just ice chips, when we have long known how vital nutritional sustenance is to mothers and babies not only during pregnancy, but during labor as well."
Hospitals routinely adopt ACOG position statements as standard policy governing the treatment of pregnant and laboring women, despite the fact that a number of the organization's position statements do not acknowledge all of the risks and benefits associated with common procedures.
"ACOG is asking laboring women to do the physical equivalent of a marathon on the power of a 'modest' amount of clear liquid," said Sabrina McIntyre, mother of two. "Thanks but no thanks. I'll stick with my midwife and her wisdom of keeping up my physical stamina for such a monumental event."
Policies restricting food and liquid intake date from an era when laboring women were routinely given general anesthesia and risked aspirating food into the lungs. Modern anesthetic techniques have virtually eliminated this risk, which is further reduced by the fact that only a tiny minority of laboring women, even among those who deliver via cesarean section, actually receive general anesthesia.
"The women I care for eat when they are hungry and drink when they are thirsty, all without asking for ACOG's permission first," said Elizabeth Allemann, MD. "Women deserve to be fully informed about what the evidence actually shows, and it's time that the medical profession abandoned policies based on the outdated and paternalistic idea that patients should play no role whatsoever in the decision-making process."
The Big Push for Midwives Campaign represents thousands of grassroots advocates in the United States who support expanding access to Certified Professional Midwives and out-of-hospital maternity care. The mission of The Big Push includes educating national policymakers about the reduced costs and improved outcomes associated with out-of-hospital birth and advocating for including the services of Certified Professional Midwives in health care reform. Media inquiries: Katherine Prown (414) 550-8025,

The Big Push for Midwives Campaign | 2300 M Street, N.W., Suite 800
Washington, D.C. 20037-1434 |

Please direct comments and feedback to

  © Copyright 2009 The Big Push for Midwives  |  Produced by Clarity Connect, Inc.

Nursing professor earns top service honor in field - News

UConn Board of Trustees Distinguished Professor Cheryl Tatano Beck recently received the 2009 Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) Professional Service Award.
The award, which Beck said she was thrilled to receive, is the top honor given by AWHONN, a non-profit organization that promotes the health of women and newborns. It also works to 'strengthen the nursing profession through the delivery of superior advocacy, research, and education,' according to
Beck, who has a Doctorate of Nursing Science (D.N.Sc), is a Certified Nursing Midwife (C.N.M), and a fellow in the American Academy of Nursing, received the award at the annual AWHONN convention on June 28 in San Diego...

Nursing professor earns top service honor in field - News:

Monday, August 24, 2009


To: HMHB Members
Date: August 24, 2009, Volume 11, Edition 34

News from National
Late last week an MMWR from the CDC summarized the recommendations from the Adisory Committee on Immunization Practices (ACIP) regarding the use of vaccine against infection with novel influenza A (H1N1) virus.  The report is available at

Judy Meehan
Executive Director

This Week:
1) Treatment Recommendations for Depression During Pregnancy
2) Rise in Age of First-Time Motherhood
3) Pediatricians Answer Vaccine Questions
4) Call for Presentations:  AMCHP Annual Conference
5) Breastfeeding Facts for Fathers
6) FDA Committee to Discuss HPV Vaccine - Public Comment Guidelines

The American College of Obstetricians and Gynecologists (ACOG) and the American Psychiatric Association (APA) have released a report offering recommendations for the treatment of women with depression during pregnancy.  Published in the September 2009 edition of "Obstetrics and Gynecology" and the September/October 2009 edition of "General Hospital Psychiatry," the report attempts to help doctors and patients weigh the risks and benefits of various treatment options.  Depression is common during pregnancy, with 14 to 23 percent of pregnant women experiencing depressive symptoms.  In 2003, approximately 13 percent of women took an antidepressant at some time during their pregnancy.  Pregnant women with depression face complicated treatment decisions because of the risks associated with both untreated depression and the use of antidepressants.  For more information, go to
In the United States, the average age of first-time mothers rose from 21.4 years in 1970 to 25 in 2006, according to an August 2009 data brief from the National Center for Health Statistics.  Data from the Birth Data File in the National Vital Statistics System show that the average age at first birth increased in all states and the District of Columbia.  Massachusetts (5.2 years) and the District of Columbia (5.5 years) had the largest increases since 1970.  Age at first birth influences the total number of births that a woman might have in her life, which impacts the future growth of the population.  The mother's age (both younger and older) also plays a role in a range of birth outcomes, including birthweight, multiple births and birth defects.  For more information, go to
Parents have many questions about the vaccines their children need.  To answer these questions, the American Academy of Pediatrics (AAP) Sound Advice Web page features a collection of audio interviews with pediatricians, researchers, advocates and other parents.  August is National Immunization Awareness Month (NIAM), a perfect time to remind people of all ages about the importance of timely vaccination.  The interviews include a conversation with former First Lady Rosalynn Carter, who discusses her crusade to ensure all children receive life-saving vaccines, Dr. Harvey Karp, the pediatrician who has coached thousands of new parents through his book and DVD, "The Happiest Baby on the Block," who explains in clear, easy-to-understand language why vaccines are not related to autism, and many more.  Specific questions answered on the Sound Advice Web page include:  why is it important to vaccinate on time; why do children need the flu shot; and what vaccines do adolescents need?
  To access the interviews, go to
The Association of Maternal and Child Health Program (AMCHP) has issued a call for presentations for its 2010 annual conference, scheduled for March 6-10, 2010.  The deadline for presentations is August 31, 2009.  Accepted presentations will be notified by October 13, 2009.  The meeting, which will be held at the Gaylord National Convention Center and Hotel just outside of Washington, DC, is the largest annual gathering of state maternal and child health programs.  The 2010 AMCHP conference will focus on topics such as health equity; quality improvement and instituting quality for improving performance; family, family-professional and public and private partnerships; social marketing messages, tools and resources, and much more.  Go to for guidelines for submission and online submission form.  For more information, contact or phone Colleen Campbell at 703-964-1240 Ext.
Platypus Media has created an abridged version of its popular booklet, "Breastfeeding Facts for Fathers."  Designed to meet the needs of low literacy readers, the abridged publication is half the length of the original publication, and highlights the crucial role men have in encouraging their partners to breastfeed.  Platypus Media is offering a FREE copy of "Breastfeeding Facts for Fathers" to all readers of the Monday Morning Memo.  To request your copy, send an email with your mailing address to  For more information about the publication, go to
On the morning of September 9, 2009, the Food and Drug Administration (FDA) Vaccines and Related Biological Products Advisory Committee will discuss and make recommendations on the safety and effectiveness in females of a vaccine against Human Papillomavirus (HPV) manufactured by GlaxoSmithKline.  That afternoon the committee will also discuss and make recommendations on the safety and effectiveness of vaccinating males with Gardasil, a vaccine against HPV manufactured by Merck & Co.  Interested persons may present data, information, or views, orally or in writing, on issues pending before the committee.  Written submissions may be made on or before September 4, 2009.  Those interested in making a formal oral presentation must submit a brief statement of the general nature of the evidence or arguments they wish to present, the names and addresses of proposed participants, and an indication of the approximate time requested to make their presentation on or before August 27, 20
09.  For more information, access the FDA Web site at
Information is reported as provided and does not necessarily represent the view of or the endorsement by the National Healthy Mothers, Healthy Babies Coalition. A complete copy of HMHB's disclaimer is available on the HMHB Web site at

Saturday, August 22, 2009 - FDA Approved Body Support Products Offer Relief to Women Undergoing Postpartum Cesarean Recovery


“There are many shapewear products on the market designed to make a woman look slimmer after pregnancy. My focus in developing my maternity and postpartum line was not on how a woman looks after having a baby, but rather addressing her discomfort during the postpartum recovery period,” said Veronica C. Smith, CEO and Design Director for Design Veronique. Ms. Smith adds, “Many women I’m close to have struggled with recovery from a Cesarean surgical procedure, which led me to use my years of medical compression garment experience to develop a body product that addresses both the surgical aspect of a woman’s recovery, as well as the physiological changes associated with the postpartum recovery process.”
Design Veronique’s new line of maternity and postpartum support products include additional options for women who give birth vaginally, as well as a line of pregnancy and nursing bras. The line is priced from $39.90 to $99.90 and is available on the company’s website at - FDA Approved Body Support Products Offer Relief to Women Undergoing Postpartum Cesarean Recovery

Making a difference with YOUR help!

Dear friend of ICAN:
It is an exciting time to be a part of ICAN!  We are coming up on the first anniversary of the birth of the ICAN Forums, which have attracted over 2100 members in only one year.  We have launched online courses for those looking to make informed decisions during pregnancy and birth.  ICAN's online VBAC Ban Database is the only one of its kind and is helping women all across the United States figure out their hospital VBAC options. The International ICAN Conference this past April brought together dedicated mothers and birth professionals who are passionate about normal birth.
I encourage you to sign up for ICAN's August 25 webinar ICAN Birth Class: Cesarean Prevention. Educate yourself...and a friend! Get half off a second registration for this webinar only, between now and August 25. Invite your doula, sister, mother-in-law or anyone else who you think might benefit. Proceeds go to support ICAN's mission.
We want to hear from our supporters!  Please consider making a submission to the Clarion, ICAN's quarterly subscriber newsletter.  Contact the Clarion Editor at The deadline for submissions for the fall issue is September 1.  ICAN Subscribers: look for the current issue in your mailboxes next week.
Don't miss the chance to purchase the new 2010 ICAN Calendar!  We have limited quantities of this beautiful calendar featuring powerful photos of ICAN women during pregnancy, birth and beyond.  Calendars are available at  ICAN Subscribers: don't forget to use your subscriber discount code!
Have you visited your local chapter lately? Check for a chapter near you.

Desirre Andrews, President
Be THE change.  Ask me how! 

Thursday, August 20, 2009

Removing Financial Incentives for Unnecessary C-Sections | Our Bodies Our Blog


In a piece for Seattle’s Crosscut, “Take away the incentives for too many c-sections,” Carolyn McConnell makes a case for reducing the seemingly ever-increasing rate of c-sections (currently ranging from 14-48% in that state) by reducing the financial incentives that may encourage physicians to perform them more than necessary.

McConnell explains that beginning this month, Washington state, through Medicaid reimbursements, will pay hospitals the same amount for an uncomplicated C-section as for a complicated vaginal birth. She notes that “Almost half of all births in Washington are paid by Medicaid, so this measure will have a significant effect on the economics of birth in the state.” …

Removing Financial Incentives for Unnecessary C-Sections | Our Bodies Our Blog

Wednesday, August 19, 2009

Agony and Ecstasy and PTSD | Anxiety and OCD Exposed


A few recent studies have introduced a new way to perform exposure. The patient is given 3,4-methylenedioxymethamphetamine (MDMA) during the exposure. Although the studies are preliminary, it appears that MDMA may facilitate exposure.

MDMA, aka, Ecstasy, is known for its positive effects on mood and empathy. The behavioral treatments with exposure and MDMA take no longer (usually 10-12 sessions) than standard behavior therapy. The drug is given under medical supervision only during the session and is discontinued after exposure is complete. Considerably more research is required before we can wholly endorse this approach. However, we thought you might find it interesting to know what’s in the pipeline of possibilities for treating PTSD.

Finally, this should not be tried at home! Nor are we recommending MDMA for other purposes. And we recommend that you avoid Raves as well…

Agony and Ecstasy and PTSD | Anxiety and OCD Exposed

Childbirth Connection Supports H.R. 3200 Health Reform Legislation

childbirth connection newsletter

August 19, 2009

Health Care Reform Bill, H.R. 3200, An Important Step Toward Health Care Reform and Better Care for Women, Babies, Families and the Nation
Dear Friend,
Childbirth Connection is pleased to recognize the leadership of the House Energy and Commerce Committee for passing a comprehensive health care reform bill, America's Affordable Health Choices Act (H.R. 3200). This bill takes a big step toward widening access to evidence-based maternity care that is safer and more effective than the prevailing style of care pregnant women experience in the U.S.

In particular, the bill will:

  • Prohibit the use of pregnancy as a pre-existing condition by health insurance providers;

  • Widen access to certified nurse-midwives by eliminating inequities in how they are reimbursed under Medicare;

  • Measure and report publicly the performance of maternity care facilities and providers and use results to improve care;

  • Pay for home visits by nurses for families during or after pregnancy by Medicaid;

  • Expand access to primary maternity care by improving Medicaid coverage of freestanding birth centers;

  • Provide incentives to maternity care providers under Medicaid to provide care to underserved women and their families.

This legislation goes a long way toward achieving our eight steps to reform maternity care. It also expands access to primary maternity care that supports a woman’s innate capacity for birthing, breastfeeding and attachment, avoids overuse of medical services, and gives priority to prevention and wellness.

On another note, we give heartfelt congratulations to Justice Sonia Sotomayor! Justice Sotomayor, confirmed as the 111th U.S. Supreme Court Justice, served on our board of directors in the 1980s when we were known as the Maternity Center Association.

Thank you for your continued support,

maureen_corry signature.JPG
Maureen Corry
Executive Director
Childbirth Connection

Please donate now and help us keep the momentum going!

Donate Online

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left arrowPress Release: Childbirth
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Listening to Mothers II

Tuesday, August 18, 2009

Violation of Woman's Rights! |


Recently many internet bloggers have been going back and forth about the “Home Birth Debate”. I saw Jennifer Block post a great piece about home birth, which was immediately challenged by Dr. Amy Tuteur via her internet blog. Whether or not Jennifer Block agreed to a “debate” over the subject is completely irrelevant in what I have to say.

Whether or not home birth is safe, as safe as hospital births, or more dangerous than hospital births doesn't matter when it comes down to it. What does matter is that a woman should be able to legally choose where she wants to give birth, and with whom to managing her care, and deliver her baby.

Violation of Woman's Rights! |

Midwifery Today E-News 11:17 - Breech Birth


In This Week’s Issue:

E-News 11:17 - Breech Birth

Monday, August 17, 2009


To: HMHB Members
Date: August 17, 2009, Volume 11, Edition 33

News from National
Is your national meeting on our conference calendar?  Be sure to visit our website,  Let us know if you have an event of interest to our national network of maternal and child health advocates. 

Judy Meehan
Executive Director

This Week:
1) National Infant Mortality Awareness Month
2) Prenatal Substance Use Training DVD
3) Financial Assistance for RSV Prevention
4) New Polio Vaccination Recommendations
5) From NAPNAP:  Resources for Disasters and Traumatic Events
6) Bathtub and Shower Injuries Among Children

September has been designated as National Infant Mortality Awareness Month.  The month is designed to raise awareness and promote the effectiveness of programs and efforts to reduce infant deaths, low birth weight, preterm births and disparities in perinatal outcomes.  Look for more information about the observance in coming months, and visit the Office of Minority Health website,,
for more information about the campaign "A Healthy Baby Begins with You."
The Indiana Perinatal Network has produced a unique training DVD to educate health care providers on proper screening and treatment for pregnant women using tobacco, alcohol and other drugs.  "Integrating Screening and Treatment of Substance Use into Prenatal Care" incorporates practical role-play scenarios with clinical and research-based materials and interventions.  It also emphasizes the importance of taking a supportive and empathetic approach with pregnant women as opposed to a shame-based approach.  The DVD has been approved for CME's, nursing contact hours and social work CEU's.  For more information about the DVD and how to order copies, visit and look under Latest News.
MedImmune has expanded access for eligible premature infants to receive medication administered to high-risk infants for the prevention of serious lower respiratory tract infections caused by respiratory syncytial virus (RSV).  The MedImmune Assistance Program is designed to provide the medicine for free to qualifying patients who lack health insurance and whose family household income is within a certain range of the federal poverty level (FPL) guidelines.  The company recently increased the eligibility for the program to 400 percent of the FPL (e.g. a household of four with an income up to $88,200, and without health care coverage or medical insurance could receive medication at no cost).  This is an expansion of the program's previous eligibility ceiling.  The MedImmune Assistance Program is administered as part of the Synagis Reimbursement Hotline and can be reached by calling 1-877-778-9010.  More information about additional help available for RSV prevention and treatme
nt can be found by visiting  For more information about RSV, go to
The Advisory Committee on Immunization Practices (ACIP) has released updated recommendations for routine polio vaccination.  The updates emphasize the importance of the booster dose of polio vaccination at four years of age; extend the minimum interval from dose 3 to dose 4 of the vaccine from four weeks to six months; add a precaution for the use of minimum intervals in the first six months of life; and clarify the polio vaccination schedule when specific combination vaccines are used.  Access the recommendations in the Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report (MMWR) at
The National Association of Pediatric Nurse Practitioners (NAPNAP) has created a compilation of links and resources designed to help children, parents and health care providers prepare and cope with disasters and traumatic events such as hurricanes, fires, acts of terrorism, violence and war.  NAPNAP's Web page contains information on helping children cope with these types of events as well as valuable information for health care providers about planning for and responding to a mass casualty event.  For more information go to
A study in the August edition of the journal Pediatrics examines the epidemiological features of injuries associated with bathtubs and showers among children in the US.  The study authors conducted a retrospective study using nationally representative data from the US Consumer Product Safety Commission National Electronic Injury Surveillance System from 1990 through 2007 for children under 18 years of age.  They report that there were nearly 800,000 bathtub and shower-related injuries among children during this time period.  The largest number of injuries involved children two years of age, with children four years of age and younger making up 54.3 percent of the injuries.  81 percent of cases were caused by a slip, trip or fall.  For more information, access the study online at
Information is reported as provided and does not necessarily represent the view of or the endorsement by the National Healthy Mothers, Healthy Babies Coalition. A complete copy of HMHB's disclaimer is available on the HMHB Web site at

Advocates Spotlight Absence of “Beginning-of-Life” Provisions in House Bill


Issued: August 17, 2009

Advocates Spotlight Absence of “Beginning-of-Life” Provisions in House Bill

If you have difficulty viewing this message, please visit the PushNewsroom.


Maternity Care Crisis Ignored as Controversy about End-of-Life Issues Continues


Monday, August 17, 2009
WASHINGTON, D.C. (August 17, 2009) – As the controversy over the inclusion of end-of-life provisions in the House health care reform bill continues, questions emerged about the lack of "beginning-of-life" provisions in the bill that would expand access to maternity care providers and settings and ensure that patients receive adequate care across their life span.
"The U.S. has one of the worst infant and maternal mortality rates in the developed world," said Elizabeth Allemann, MD. "The cesarean section rate has skyrocketed to more than a third of all births in the country, and with nearly half of all births being paid for by Medicaid, taxpayers are getting hit hard. We have a crisis on our hands and we need to start paying as much attention to beginning-of-life issues as we do to end-of life-issues."
Among the measures being promoted by advocates seeking to reform the maternity care system is the addition of a provision to the House bill that would provide access to out-of-hospital birth and the services of Certified Professional Midwives, who are specially trained to provide it, for women receiving Medicaid.
"We know that women cared for by Certified Professional Midwives experience significantly reduced rates of low birth weight and preterm births, two of the leading causes of cost increases and growing racial and ethnic disparities in birth outcomes," said Jane Peterson, LM, CPM. "Moreover, Certified Professional Midwives are able to produce these outcomes at a fraction of the cost of traditional maternity care. The House bill represents a golden opportunity for us to embrace maternity care reforms that truly can make a positive impact on our health care system and on the lives of mothers and babies."
David A. Anderson, Professor of Economics at Centre College, calculates that if the rate of births that take place in private homes and in freestanding birth centers increased by less than ten percent, we would realize an annual savings of more than $9 billion. A 2008 study commissioned by the state of Washington found that its licensed midwife program generates a savings of more than $3 million to private and public insurers each biennium.
"With all of the talk about the importance of end-of-life issues," said Dr. Allemann, "It's time for us to also recognize that giving everyone a good start at the beginning of life has far-reaching implications for our health care system. Including out-of-hospital maternity care and Certified Professional Midwives in health care reform is a small but very important first step."
The Big Push for Midwives Campaign represents thousands of grassroots advocates in the United States who support expanding access to Certified Professional Midwives and out-of-hospital maternity care. The mission of The Big Push includes educating the public and policymakers about the reduced costs and improved outcomes associated with out-of-hospital birth and Certified Professional Midwives, the maternity care providers trained to provide that service. Media inquiries: Katherine Prown (414) 550-8025,

The Big Push for Midwives Campaign | 2300 M Street, N.W., Suite 800
Washington, D.C. 20037-1434 |

Please direct comments and feedback to

  © Copyright 2009 The Big Push for Midwives  |  Produced by Clarity Connect, Inc.

e-CIMS News: Coalition for Improving Maternity Services Newsletter


e-CIMS News
August 17, 2009

In this edition...

ACOG Issues Controversial New Guidelines for Induction of Labor

Venerable Speakers to Headline the 2010 CIMS Forum

Sweeping Healthcare Reform Package Includes Critical Maternity Care Provisions

Upcoming Conferences

Honor Birth!

Transforming Maternity Care in New Jersey

For Expectant Families

ACOG Issues Controversial New Guidelines for Induction of Labor

The American College of Obstetricians and Gynecologists (ACOG) recently revised its 2003 guidelines for induction of labor.  The

ACOG Practice Bulletin, Number 107, published in the August 2009 issue of Obstetrics & Gynecology serves as a resource to help medical practitioners make decisions about appropriate methods of cervical ripening and induction of labor and their effectiveness.  At least two of the ACOG recommendations, inducing labor for "psychosocial" (non-medical) reasons and cervical ripening with the synthetic prostaglandin misoprostol (trade name Cytotec), differ from labor induction practice guidelines issued by the Society of Obstetricians and Gynaecologists of Canada (SOGC) and the National Institute for Clinical Excellence (NICE), which drafts clinical guidelines in the U.K.
Induced labor puts women and babies at risk.  Compared to women who go into labor on their own, women who have an elective induction are at increased risk for intrapartum fever, instrumental birth, cesarean section, and are more likely to use analgesia including epidurals. Babies are at risk for irregular heart rate patterns, shoulder dystocia, neonatal phototherapy to treat jaundice, neonatal resuscitation and admission to a neonatal intensive care unit.  These risks are documented in CIMS' "Evidence Basis for the Ten Steps of Mother-Friendly Care" (see Step 6, pages 42-43).  According to the white paper "Idealized Design of Perinatal Care" published by the Institute for Healthcare Improvement, "Based on a review of U.S. medical malpractice claims, [the labor-inducing drug] oxytocin is involved in more than 50 percent of the situations leading to birth trauma."
These complications of labor also impact mother-infant attachment and the initiation and continuation of breastfeeding.  See "Breastfeeding is Priceless" (PDF). 
Although ACOG approves of "psychosocial" induction, NICE clinical guidance (PDF) warns that induction of labor has a significant impact on the health of women and their babies; it should be clinically justified and should not routinely be offered on maternal request except under extraordinary circumstances.  SOGC advises that there is no benefit to elective induction (PDF).  Because it is associated with potential complications, elective induction should be discouraged and only provided after women have been fully informed of the risks and of the inaccuracy of establishing gestational age.  ACOG approves of inducing labor at 39 weeks while SOGC states gestational age should be at least 41 completed weeks, and NICE guidelines state induction for non-medical reason can be considered at or after 40 weeks.
Misoprostol, an inexpensive synthetic prostaglandin, was developed and is marketed to prevent and treat gastric and duodenal ulcers.  The use of misoprostol for cervical ripening and induction of labor (off-label use) is approved by ACOG, but not recommended by either SOGC or NICE.  Misoprostol, also known as PG1, is not approved by the manufacturer for use in pregnancy (PDF).  Misoprostol is associated with excessive uterine contractions, fetal heart abnormality, hemorrhage, hysterectomy, and sometimes fetal death.  Both SOGC and NICE recommend its use be restricted to clinical trials.  For a more detailed discussion of the use of misoprostol for induction of labor, see Science &
Nearly one in four births in the U.S. is induced (PDF) and according to the Agency for Healthcare Research and Quality (AHRQ), although it is not entirely clear what proportion of these inductions are elective (i.e. without a medical indication), the overall rate of induction of labor is rising faster than the rate of pregnancy complications that would lead to a medically-indicated induction.  According to Childbirth Connection's report, "Evidence-Based Care: What it Is and What It Can Achieve," the most common gestational age at birth among single babies in the U.S. is now 39 weeks rather than 40 weeks.

Consumer information on induction of labor is available from:

Venerable Speakers to Headline the 2010 CIMS Forum

The 2010 CIMS Forum will be held at the Radisson Hotel & Suites Austin-Town Lake, Feb. 26-27, in Austin, Texas.

As the U.S. stands at a crucial juncture for achieving national healthcare reform, CIMS will dedicate a significant portion of its 2010 Mother-Friendly Childbirth Forum to educational sessions that examine the current social-political climate and how maternity care is impacted by proposed healthcare reform policies.  In addition, several sessions will highlight evidence-based clinical practices that can improve maternal-fetal outcomes.  Confirmed speakers include Maureen Corry, MPH, Nancy K. Lowe, CNM, PHD, FACNM, FAAN, Penny Simkin, PT, Judy Norsigian, Raymond De Vries, PhD, Stefanie Antunes, LCCE, CD(DONA), Henci Goer, BA, Amy Romano, CNM, MSN, and Susan Jenkins, JD.

CIMS Forum participants will enjoy networking and socializing during a Welcome Reception on Friday evening and between educational sessions spanning two full days.  When not in session, conference participants will appreciate the Radisson's downtown Austin location, convenient to area businesses, the world famous 6th Street and many other area attractions. 
2010 Forum Save The DateStart planning now to attend this important conference! Online registration to open in Fall 2009. For travel and lodging details, advertising and exhibiting opportunities, and to view presentations from our 2008 and 2009 conferences, visit

Sweeping Healthcare Reform Package Includes Critical Maternity Care Provisions
What is being done to improve the care of America's birthing women?

As the healthcare reform debate heats up in town hall meetings across the country, far too few Americans are asking about the Congress' plans to improve the quality and value of healthcare for birthing women.  CIMS and many of its members and supporters are working to ensure that reform measures include critical maternity care provisions.

Here's a run-down of how CIMS' supporters are advocating on behalf of childbearing women:

  • The American College of Nurse-Midwives (ACNM) recently announced
  • its endorsement (PDF) of the America's Affordable Health Choices Act of 2009, stating "H.R. 3200 takes positive steps toward ACNM's seven principles of health reform, particularly universal coverage, the reduction of health disparities, and the improvement of maternal and infant health."
  • America's Affordable Health Choices Act of 2009 (HR 3200) is also endorsed by Childbirth Connection, a national organization advocating for high quality maternity care for women, babies and families.  "This legislation goes a long way toward achieving Childbirth Connection's eight steps to reform maternity care (PDF) and ensures that all pregnant women and babies receive high quality, affordable health care," says Maureen Corry, Executive Director, Childbirth Connection. "This bill expands access to primary maternity care that supports a woman's innate capacity for birthing, breastfeeding and attachment, avoids overuse of medical services, and gives priority to prevention and wellness."
  • The American Association of Birth Centers is leading the charge in support of the Medicaid Birth Center Reimbursement Act (HR 2358/S 1423) to ensure Medicaid birth center facility fee payments to states.  Without payment of the birth center facility fees, birth centers in all states could be pushed to the brink of closure -- threatening access to this vital safety net for Medicaid mothers across the U.S.
  • The MAMA Campaign is a collaborative effort by the National Association of Certified Professional Midwives (NACPM), Midwives Alliance of North America (MANA), Citizens for Midwifery (CfM), International Center for Traditional Childbearing (ICTC), North American Registry of Midwives (NARM), and the Midwifery Education Accreditation Council (MEAC).  This partnership is now at work to gain federal recognition of Certified Professional Midwives so that women and families will have increased access to quality, affordable maternity care in the settings of their choice.
  • As a member of the National Quality Forum (NQF) and its advocacy alliance Stand for Quality, CIMS is helping to ensure that quality is at the heart of the healthcare reform debate. Stand for Quality, which includes more than 200 supporting organizations, recently noted that HR 3200 includes "multiple provisions that can support significant delivery system reform."  CIMS and others in Stand for Quality will continue to promote the findings and recommendations in the report "Building a Foundation for High Quality, Affordable Health Care: Linking Performance Measurement to Health Reform."  The recommendations are also supported by the American Association of Birth Centers, American College of Nurse-Midwives, and Childbirth Connection.
  • Upcoming Conferences (listed by date)

    American Association of Birth Centers Annual Birth Institute "Change in Childbirth: Hope for a New Generation"

    Sept. 3-6, Savannah, GA
    Lamaze International 2009 Annual Conference "Celebrating the Magic of Normal Birth"
    Oct. 1-4, Walt Disney World, FL
    March of Dimes Symposium on Quality Improvement to Prevent Prematurity

    Oct. 8-9, Washington, DC

    International Childbirth Education Association 2009 ICEA International Convention
    Oct. 15-17, Oklahoma City, OK
    Birth Works International Conference "Primal Health: Global Lessons From the Womb"
    Oct. 16-18, Portland, ME
    Midwives Alliance 2009 "Rising Tide: Women, Midwives and the Future"
    Oct. 22-25, Asilomar, CA
    CIMS Mother-Friendly Childbirth Forum & Annual Meeting
    Feb. 26-27, 2010, Austin, TX
    Select presentations from the 2009 CIMS Forum are now available on our website.

    Honor Birth!

    Because pregnancy, birth, and the postpartum period are milestone events in the continuum of life...

    Belly HeartHonor Birth was created as a way for you to honor a mother, her baby, her family, and anyone who gave her strength in her amazing journey to motherhood. Who inspires your passion for Mother-Friendly Care? 

    Transforming Maternity Care in New Jersey

    In 2007, New Jersey had a 38.3% cesarean rate--the highest in the nation.  CIMS has written a letter in support of Mother-Friendly Childbirth advocate Stacey Gregg and supporters of

    New Jersey Maternity Care Worst to First 2010, a state-wide campaign to transform New Jersey's maternity care from the worst in the nation to the first by 2010.

    For Expectant Families

    Have a safe and healthy birth

    New website offers free evidence-based materials for expectant parents and childbirth educators.

    InJoy Birth and Parenting Education recently announced the launch of, a new website that provides free, easy-to-use information to help expectant parents have safer and healthier births.  Healthy Birth Your Way: Six Steps to a Safer Birth is the first product available and was co-produced with Lamaze International. A printable18-page booklet and seven online video clips teach parents how to have a better birth experience through six simple steps that have been shown to reduce intervention and cesarean surgery rates.  Lamaze's Six Healthy Birth Practices are based on recommendations by the World Health Organization and backed by extensive research that supports a woman's natural ability to give birth.  Mother's Advocate is a not-for-profit service of InJoy Birth & Parenting Education, Inc.  All products are provided at no charge and may be freely duplicated, distributed and used by individuals and educators in any teaching environment.

    Both Lamaze International and Injoy Birth and Parenting Education are part of the CIMS Organizational Members Collaborative. The Collaborative was created to make a greater Mother-Friendly impact on maternity care by promoting and supporting CIMS' Organizational Members' projects.

    ICAN Birth Class: Cesarean Prevention

    Take charge of your birth and learn how you can reduce your risk of cesarean surgery by attending this 2-hour online session sponsored by International Cesarean Awareness Network (ICAN).

    • Tuesday, Aug. 25, 9:00 pm (Eastern) / 6:00 pm (Pacific)
    • $20 registration fee benefits ICAN
    • Click here for additional details or to register

    National Guide To A Healthy Birth

    The 2009-2010 edition of Choices in Childbirth's National Guide to a Healthy Birth is now available.  A woman's choice of care provider for her pregnancy and birth is the single most important decision she can make to determine the type of birth experience she will have. The guide was created to help expectant women and families learn about their rights and options. Choices in Childbirth also publishes the New York Guide to a Healthy Birth and the Philadelphia Guide to a Healthy Birth.

    Saturday, August 15, 2009

    University at Albany - SUNY - Study: Bottle Feeding Mimics Child Loss


    Supplemental Document AvailableRead the complete document

    Mothers who do not breastfeed risk postnatal depression

    Contact(s):  Catherine Herman (518) 956-8150


    ALBANY, N.Y. (August 14, 2009) -- Mothers who bottle feed their infants in lieu of breastfeeding put themselves at risk of developing postpartum depression, according to a team of University at Albany psychologists.
    In the August issue of Medical Hypotheses, evolutionary psychologist Gordon Gallup and graduate researchers Nate Pipitone, Kelly Carrone, and Kevin Leadholm contend that for most of our evolutionary history the absence or early cessation of breastfeeding would have been occasioned by the miscarriage, loss, or death of an infant, and, at the level of basic biology, a mother's decision to bottle feed rather than nurse unknowingly simulates that loss. The UAlbany researchers concluded that bottle feeding triggers biological and other reactions to loss, and is a significant risk factor for postpartum depression…

    University at Albany - SUNY - Study: Bottle Feeding Mimics Child Loss

    Coventry Telegraph - News - Coventry News - Mum sets up a helpline for Birth Trauma Association (BTA) charity


    Warren Manger, Coventry Telegraph

    A WARWICKSHIRE mum whose baby died during childbirth has launched a hotline to help other women through the heartbreak.

    Deborah Linster Ali has suffered more than her share of trauma as a mother. Her baby Jacob was delivered stillborn at Warwick Hospital in 2004 after midwives failed to alert doctors to his plummeting heart rate.

    And just last month Deborah’s three year-old son Noah died in her arms after a long battle with the rare disease, Edward’s Syndrome.

    Despite all this the 38-year-old recently set up a helpline for charity the Birth Trauma Association (BTA).

    She also plans to launch a West Midlands branch of the support group later this year. Deborah said: “After the birth of Jacob I felt incredibly isolated.

    “Becoming involved with the BTA has really helped me talk through a lot of my feelings.

    “The great thing about the charity is that it is run by parents for other parents who have suffered or witnessed traumatic births.”

    Deborah, from Cawston near Rugby, has launched the helpline ready for National Birth Trauma Awareness Day today…

    Coventry Telegraph - News - Coventry News - Mum sets up a helpline for Birth Trauma Association (BTA) charity

    Friday, August 14, 2009

    Beyond Baby Blues - Health News Story - WSOC Charlotte


    The UNC Program

    When postpartum depression symptoms are severe, women may be referred to an in-patient program. However, Meltzer-Brody says most in-patient psychiatric units are caring for patients with many different mental health problems. The women are separated from their babies and become frightened by the in-patient experience. So, in many instances, the “treatment” ends up making the women feel worse rather than better.

    Administrators at UNC Chapel Hill recently opened the Perinatal Mood Disorders Inpatient Unit. Meltzer-Brody says it’s the first of its kind in the U.S., and it’s designed specifically for women with postpartum depression. The unit has hospital grade lactation equipment (for breastfeeding moms who want to save their milk) and refrigerators. Doctors also keep up with medication guidelines to ensure the drugs they prescribe are safe for women who are breastfeeding. There are extended visiting hours for the babies so moms have bonding time with their infants. The rooms have a glider for comfort and rest. Patients are offered psychotherapy, group therapy, family therapy, biofeedback and relaxation therapy.

    Meltzer-Brody says the length of stay depends upon the severity of a patient’s symptoms and how much an insurance company will pay. Some women stay three to five days, while others remain for two weeks or longer. Meltzer-Brody cautions that postpartum depression is not a condition that can be cured with a few weeks of treatment. Patients typically need follow-up therapy for some time after leaving the hospital.

    All of the clinics affiliated with UNC now screen women for signs of postpartum depression. The program is open to women from anywhere in the country, as long as they have insurance coverage or are willing to pay the costs of the program…

    Beyond Baby Blues - Health News Story - WSOC Charlotte

    Wednesday, August 12, 2009

    South Dakota Mother to Walk Across the State for Access to CPMs


    Issued: August 12, 2009

    South Dakota Mother to Walk Across the State for Access to CPMs

    If you have difficulty viewing this message, please visit the PushNewsroom.

    Hundreds to Join Her in Show of Support for Change in State Law to Increase Access to CPMs
    Wednesday, August 12, 2009
    CENTERVILLE, SD (August 12, 2009) – Beginning on August 21, local mother Debbie Pease will walk four miles in 11 communities across South Dakota, completing the 44th mile of her journey on her 44th birthday just six days later in Sioux Falls. She and hundreds of citizens from across the state, who are joining her along the way, are walking to raise awareness about the need to change state law to authorize Certified Professional Midwives, who are specially trained to provide out-of-hospital maternity care, to practice legally.
    "Families in Minnesota, Montana, and Wisconsin have been benefiting from the services of Certified Professional Midwives for years," said Ronda Kvigne, who was forced to cross state lines in order to deliver her last baby under the care of a Certified Professional Midwife. "It is high time that South Dakota families had the same opportunities."
    Certified Nurse-Midwives are trained to provide hospital-based care and are legally authorized to practice in all 50 states. Fewer than 1% of nurse-midwives nationwide provide maternity care in private homes or freestanding birth centers, and only one nurse-midwife in South Dakota provides out-of-hospital care. As a result, families in most parts of the state who choose to give birth outside of the hospital—most often for religious, cultural or financial reasons—are left with no access to legally-practicing midwives with expertise in out-of-hospital delivery.
    "The first step is to license and regulate Certified Professional Midwives so that families who choose out-of-hospital delivery have access to providers who have met the appropriate educational, training, and credentialing standards," said Travis Brink of SD Safe Childbirth Options, Inc, a consumer advocacy group that is working to expand maternity care options in the state.
    Demand for the services of Certified Professional Midwives is on the rise throughout the country, while The Big Push for Midwives, a national campaign to license them in all 50 states, has been making steady progress. Since 2005 six states have passed legislation legally authorizing Certified Professional Midwives to practice, and last year Idaho became the 26th state to do so. Legislation is pending in an additional 18 states.
    "The research consistently shows that Certified Professional Midwives have excellent outcomes at significantly reduced costs," said Pease. "The state of Washington commissioned a study that found a biennial savings to public and private insurers of more than $3 million. My hope is that the incredible outpouring of energy generated by the Walk for Midwives will compel policy makers in South Dakota to take notice and to recognize the need to change our laws so that families in our own state have access to the safe, proven, and cost-effective care offered by Certified Professional Midwives."
    Pease will begin her walk at 8 a.m. on Friday, August 21 in Spearfish at WomanKind Midwifery located at 544 N 7th Street. Everyone is invited to walk a distance that is comfortable for them and learn more about this issue. There is no fee to join the Walks, but everyone is encouraged to buy a T-shirt and/or make a donation to SD Safe Childbirth Options, Inc.
    For more information about each of the 11 Walks and to download photos, please visit

    If you would like to Walk for Midwives in your state, check out Debbie Pease's PushTips for how to plan your event here.

    Please direct comments and feedback to

      © Copyright 2009 The Big Push for Midwives  |  Produced by Clarity Connect, Inc.

    10 U.S. Hospitals Added to Baby-Friendly List | Our Bodies Our Blog


    During last week’s World Breastfeeding Week, we learned via Women’s eNews that 10 additional U.S. facilities have been added to the list of Baby-Friendly Hospitals so far this year.

    To be included on the list, facilities must meet 10 criteria demonstrating a commitment to improve institutional breastfeeding policy, training and practices. The ten steps for successful breastfeeding outlined by UNICEF/WHO for the Baby-Friendly Hospital Initative include helping mothers initiate breastfeeding, appropriately training all staff, avoiding non-breastmilk food unless medically indicated, allowing “rooming in,” and other practices. The steps are also included among the Ten Steps for Mother-Friendly Care outlined for the Mother-Friendly Childbirth Initiative.

    The ten new qualifying hospitals (bringing the current number up to 83) are in California, Missouri, and Texas. Visit the BFHI site for a complete list of the qualifying U.S. facilities.

    10 U.S. Hospitals Added to Baby-Friendly List | Our Bodies Our Blog

    Parenting 101: Where to find postpartum depression support groups in Detroit


    You spent months preparing for the arrival of your baby.  But you weren't prepared for how emotionally drained you would be after your baby was born. You've probably asked yourself why you're crying all the time, why you dread feeding or diapering or even just holding your beautiful baby, and why you just can't seem to function normally even after several weeks or months.  Looking at other mothers smile and coo at their babies just makes you feel even more anxious, isolated and alone.  Some well-meaing friends just say you have the "baby blues" but you know deep down it is something more serious.

    Seeking help might just be the hardest part of treating postpartum depression.  So it is important to know what type of help exists for you in the Metro Detroit area.  Other than a doctor, one of the best places to go with questions or to seek support is the Tree of Hope Foundation.  The Tree of Hope's goal is to provide easily accessible support to people currently in the throes of postpartum depression, as well as increase postpartum depression awareness, education, and research.

    If you are looking for other people who understand what you are going through, the Tree of Hope Foundation is there for you.  Whether you are experiencing clinically-diagnosed postpartum depression or you're just having an extremely difficult, emotional time adjusting to your new life, the support groups are a place of solace, comfort, and understanding.  Their groups are offered every week, at locations throughout the Metro Detroit area.  The groups are free of charge, and no referral is required.  All you have to do is show up--it's that simple…

    Parenting 101: Where to find postpartum depression support groups in Detroit

    Tuesday, August 11, 2009

    What is post adoption depression?


    Depression among adoptive parents is in fact so common that the name Post Adoption Depression Syndrome, or PADS, was coined. According to one study, up to 65 percent of adoptive mothers suffer fromPAD.

    So what does that mean for sufferers?

    It means that the newly adoptive parent is exhausted and overwhelmed. Coupled with this is often a child who is not a newborn, and therefore has some vast needs and wants. Toddlers and older children need to be fed, sometimes constantly. They are also mobile, so a newly adoptive parent doesn’t get that chance to sleep when the baby sleeps. They have no fear and also no attachment figure, so they need to be watched constantly.

    Newly adoptive mothers don’t get any downtime. They often have to go back to work because there is no medical leave. They are thrilled at having this child, and dismayed by the feelings that it is bringing up. They may feel loss, hopelessness, ambivalence towards the child and anger. They don’t know where this is coming from…

    What is post adoption depression?

    Sunday, August 9, 2009

    Cesareans: At the cutting edge of birth | Health | Jerusalem Post


    For millennia, cesarean sections were performed for only one purpose - to deliver a baby just before or just after its mother died. Only 500 years ago was the first reported case of a woman who survived the ripping open of her abdomen and uterus and sewing them closed. But today, a growing number of healthy women around the world request a cesarean rather than a vaginal delivery because they fear the pain or want to be "in control." And many physicians go along to avoid lawsuits.

    Cesareans can be a lifesaver for women and their babies if labor does not proceed, the fetus remains in a feet-down or horizontal position or is suffering from distress. But cesarean delivery on maternal request (CDMR) has become a medical, ethical, financial and legal dilemma in both the developed and developing worlds.

    THE WORLD Health Organization has recommended that the cesarean rate be no higher than 15% of all deliveries. While the rates are very low - under 5% - in countries like Haiti, Nigeria, Uganda, Eritrea and Uzbekistan, 20-30% is today considered "moderate" in the United Kingdom, Canada, Ireland, Germany, Switzerland, Cuba and Portugal. One-fifth of deliveries in Israel and nearly one-third in the US are cesareans, while high rates are found in Italy (36%), Mexico (39%), China (40%) and Brazil (where it is an astonishing 80%).

    As the rates among countries vary so wildly, it is clear that there are cultural, psychological, legal, medical, technological and other reasons for why some societies have many CDMRs and others have few…

    Cesareans: At the cutting edge of birth | Health | Jerusalem Post

    What is a doula: an interview with Jasmin Cromwell of Pathway Partner


    What are the advantages of using a doula?
    There are many advantages to working with both birth and postpartum doula's. For women who don't have family or other postpartum support, working with a postpartum doula is exactly what they need. There's much evidence based information that show working with a postpartum doula reduces the risk of postpartum depression by at least 25%. Postpartum doulas are very helpful especially to first time moms, mother's of multiples, adoptive families and families with siblings.

    What advice do you give to clients who are considering using a doula?
    Sometimes people want to hire a doula but they aren't sure why or in what capacity. I recommend siting down with your partner and writing down all the reasons you think you'd want a doula. I have assessment sheets on my website,, which will help make this an easier task. Also, hiring a doula is so very personal, make sure you interview them on the phone and in person. You want to feel good about who you hire. After all, you'll be working with them on a very personal level and in your home.

    What is a doula: an interview with Jasmin Cromwell of Pathway Partner

    The distorted reality of postpartum psychosis


    …As the tragedy unfolds we will learn more about Ms. Sanchez’s mental health history and the stressors to which she was exposed. There will also undoubtedly be posturing by the district attorney about whether Ms. Sanchez knew the difference between right and wrong, because in Texas being profoundly mentally ill is apparently not much of a defense. A woman with postpartum psychosis may technically know the difference between right and wrong, but fueled by paranoia and delusions her reality is warped and she is incapable of rational behavior.

    Otty Sanchez deserves our pity and appropriate medial care. Family members, health care providers, and the community must also take a long, hard look at their own culpability as undoubtedly there were missed warning signs. Ms Sanchez should be remanded to a psychiatric facility where she can receive appropriate care. Once she is treated appropriately and her psychosis resolves the reality of her actions will be a jail term far worse than one society could impose.

    The distorted reality of postpartum psychosis


    To: HMHB Members
    Date: August 10, 2009, Volume 11, Edition 32

    News from National
    Last week HMHB participated in the annual meeting of the National Fetal and Infant Mortality Review Program (NFIMR).  NFIMR is a collaborative effort between the American College of Obstetricians and Gynecologists and the Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau.  This successful program has made great strides in helping communities examine the causes of infant mortality while strengthening prevention efforts.  For more information, go to

    Judy Meehan
    Executive Director

    This Week:
    1) Update on H1N1 and Pregnant Women
    2) Postpartum Women and Use of Contraception
    3) Impact of Seafood Consumption During Pregnancy on Depression
    4) HIV Prevention Conference August 23-36
    5) Resources for Child Passenger Safety Week
    6) Study:  Reducing Immunization Discomfort in Children

    A report in the August 8, 2009 edition of the Lancet suggests that pregnant women might be at increased complications from pandemic H1N1 influenza virus infection (also known as swine flu).  The report's authors summarized cases of infection and deaths associated with H1N1 in the US during the first months of the outbreak.  From April 15 through May 18, 2009 there were 34 confirmed or probable cases of H1N1 in pregnant women reported to the Centers for Disease Control and Prevention (CDC) from 13 states.  Eleven women were admitted to the hospital, and the estimated rate of hospital admission for H1N1 was higher in pregnant women during that month than in the general population.  Between April 15 and June 16, 2009 there were six deaths in pregnant women with H1N1.  All were in women who had developed pneumonia and acute respiratory disease.  Data included in the report support the current recommendation to treat pregnant women with H1N1 influenza virus with anti-influenza dru
    gs.  To access the report online, go to  For more from the CDC on H1N1 in pregnant women, go to
    The August 7th edition of the Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report (MMWR) features data on contraceptive use among postpartum women.  To estimate the prevalence and types of contraception being used by women 2-9 months postpartum, CDC analyzed data from the 2004--2006 Pregnancy Risk Assessment Monitoring System (PRAMS) from 12 states and New York City.  This report summarizes those results, which indicated that 88% of postpartum women reported current use of at least one contraceptive method; 61.7% reported using a method defined as highly effective, 20.0% used a method defined as moderately effective, and 6.4% used less effective methods.  Rates of using highly effective contraceptive methods postpartum were lowest among Asian/Pacific Islanders (35.3%), women who had wanted to get pregnant sooner (49.9%), women aged greater than or equal to 35 years (53%), and women who had no prenatal care (54.5%).  To access the report onli
    ne, go to
    A study published in the July 2009 edition of the journal Epidemiology examines the hypothesis that low seafood intake during pregnancy is associated with an increased prevalence of depressive symptoms.  Women who were 32 weeks pregnant completed a questionnaire that included symptoms of depression and a food frequency questionnaire.  Using information from the food questionnaire, the amount of omega-3 fatty acids from fish was calculated.  The study authors report that unadjusted and adjusted analyses showed lower maternal intake of omega-3 from seafood was associated with higher levels of depressive symptoms.  To access this study online, go to
    The 2009 HIV Prevention Conference:  Promoting Synergy Between Science and Program will convene HIV prevention experts and advocates from various backgrounds and communities nationwide on August 23-26 in Atlanta, GA.  The purpose of the conference is to share effective prevention approaches and research findings among governmental, community, and academic partners in HIV prevention.  The conference is also intended to strengthen collaborations between program practitioners and researchers in areas including behavioral interventions, biomedical interventions, monitoring the epidemic, implementing rapid and reliable tests for early HIV diagnosis, and improving access to early treatment and prevention services for persons with HIV.  For more information, go to
    September 12-18 is Child Passenger Safety Week, kicked off by National Seat Check Saturday on September 12th.  Motor vehicle crashes are the leading cause of death for children age 3 to 6 and 8 to 14.  In 2007, 6,532 passenger vehicle occupants age 14 and younger were involved in fatal crashes.  Parents and caregivers are encouraged to get their child safety seats inspected and make sure their children are properly restrained every time they are in the car.  For resources for planning a campaign or event in your community, access the National Highway Traffic Safety Administration Child Passenger Safety Week Planner online at  Materials for all of NHTSA's traffic safety campaigns are available at
    A study in the August 2009 edition of the journal Pediatrics examines the effectiveness of a multifaceted distraction method designed to reduce immunization discomfort in school-aged children.  A clinical trial evaluated children ages 4 to 6 who were given three standard prekindergarten immunizations.  Half of the children were the control group, and half received an intervention intended to reduce injection-associated pain.  The intervention included verbal suggestions of diminished sensation and a visual focusing activity in addition to the use of ethyl chloride, a known pain-reducing measure.  According to the study authors, children in the intervention group showed "highly significant reductions in pain and discomfort, compared with the control group."  To access the study online, go to
    Information is reported as provided and does not necessarily represent the view of or the endorsement by the National Healthy Mothers, Healthy Babies Coalition. A complete copy of HMHB's disclaimer is available on the HMHB Web site at