Mother pleas for people to learn from her daughter's postpartum suicide

By Barb Pacholik, Leader-Post

The founder of the Melanie Stokes Foundation, Blocker was in Regina Wednesday to speak at the Unmasking Postpartum Depression Conference. Regina-based CNT Management Group teamed up with the authors of The Smiling Mask — three moms from Regina and Moose Jaw who met while struggling with postpartum depression — to present the conference. CNT’s president Claire Parker-Belanger said after attending the launch of the book and having had her own difficulties following the birth of her twins in 1984, she saw the need for a conference that would bring together both experts and women, who could share their stories…

Mother pleas for people to learn from her daughter's postpartum suicide

Destigmatizing Depression - Science Careers - Biotech, Pharmaceutical, Faculty, Postdoc jobs on Science Careers

 

By Karyn Hede

It's not easy being the poster child for depressed physicians, but Alice Flaherty wears the role with aplomb. She relishes the opportunity to share her experiences with the world. Flaherty was featured in a recent article in The New York Times and in a documentary film on depression among medical professionals produced by the American Foundation for Suicide Prevention (AFSP), and she openly discussed a major depressive episode that eventually hospitalized her in her 2004 best-selling book, The Midnight Disease: The Drive to Write, Writer's Block, and the Creative Brain.

Flaherty speaks in a rapid-fire staccato about her still-born twin sons, lost after a difficult pregnancy more than 10 years ago, as she was about to start the residency portion of the Harvard-MIT M.D.-Ph.D. program. A postpartum depression morphed into mania and an eventual diagnosis of bipolar disorder. As a psychiatrist in training, Flaherty was fascinated by her own disease and began speaking publicly about her travails. During that time, she was approached by her peers and discouraged from talking about her mental illness…

Destigmatizing Depression - Science Careers - Biotech, Pharmaceutical, Faculty, Postdoc jobs on Science Careers

Midwifery Today E-News 11:20 - Traditional Midwifery

 

In This Week’s Issue:

• Quote of the Week
• The Art of Midwifery: Food-based Iron Source
• Research: Risks of Iron Supplementation
• Stories of Extraordinary Central American Midwives
• Featured Products
• Web Site Update
• Advertising Opportunities
• Question of the Week: Obama's Health Care Plan
• Question of the Week Responses: Broken Coccyx
• Think about It
• Letters
• Classified Advertising

E-News 11:20 - Traditional Midwifery

Providers’ Liability Concerns Limit Women’s Birth Options | Our Bodies Our Blog

 

Among the findings, 59.2% (of 5,644 respondents) reported having made one or more changes to their practice since 2006 for reasons related to the availability and affordability professional liability insurance. Of those reporting making changes for this reason, 19.5% reported increasing the number of cesarean deliveries and 19.5% indicated they stopped performing or offering VBACs.

In addition to making changes based on the availability and affordability of insurance, many ob/gyns report having made changes to their practices because of fear of professional liability or litigation (in other words, out of fear of being sued or being held responsible for a negative outcome). 62.9% (of the 5,644) reported having made one or more changes to their practice for this reason. Of those, 29.1% reported increasing the number of cesarean deliveries, and 25.9% stopped offering and performing VBACs. 20-30% (depending on whether the question was about availability of liability insurance or fear of liability claims) also reported decreasing the number of high-risk obstetric patients they cared for…

Providers’ Liability Concerns Limit Women’s Birth Options | Our Bodies Our Blog

Could a Smart Retort on Maternity Care Help Build Support for Comprehensive Health Care Reform? | Our Bodies Our Blog

 

…Sen. Debbie Stabenow (D-Mich.) argued that under a new system, insurance companies should be required to cover basic maternity care. According to Kaiser Family Foundation, only 18 states mandate maternity coverage, and that number falls to 14 when applied to individual insurance markets.

Women who seek insurance on these open markets face other barriers, too; they can be disqualified for having had a previous c-section — or even for having been pregnant. Yes, pregnancy is a pre-existing condition. You can read more frustrating facts about the open insurance market — like how it’s still legal in nine states and the District of Columbia to deny a woman coverage because she’s been the victim of domestic violence — in this report by the National Women’s Law Center (covered here in October 2008)…

Could a Smart Retort on Maternity Care Help Build Support for Comprehensive Health Care Reform? | Our Bodies Our Blog

Turn to Freud's psychoanalysis for postnatal depression | Life and style | The Guardian

 

 Oliver James

Four in five mothers suffer some sort of "baby blues" in the first months after giving birth, but 10% develop a full-blown depression. If this hits, it has massive implications for the whole family, as well as you. Assuming you have a choice, which therapy should you opt for?

The main alternatives are antidepressants, cognitive behavioural therapy (CBT) and psychodynamic psychotherapy. The pills rule out breastfeeding, and in the great majority of cases, even if they do have an effect it is a placebo – people given chalk pills but told they are antidepressants are almost as likely to claim to feel better as people given the real thing.

Regarding the talking therapies, in one study depressed new mothers were randomly assigned to eight sessions of CBT, or to counselling, or to psychodynamic psychotherapy. Eighteen weeks later, the ones given dynamic therapy were most likely to have recovered (71%, versus 57% for CBT, 54% counselling)…

Turn to Freud's psychoanalysis for postnatal depression | Life and style | The Guardian

Risk of Postpartum Bleeding Higher After Cesarean - Study suggests induction also increases risk of severe hemorrhage - Modern Medicine

 

Study suggests induction also increases risk of severe hemorrhage

Publish date: Sep 24, 2009

 

 

 

 

 

THURSDAY, Sept. 24 (HealthDay News) -- The risk of severe postpartum hemorrhage increases after induction and pre-labor cesarean section, according to a study in the September issue of the American Journal of Obstetrics & Gynecology.

Iqbal Al-Zirqi, M.D., from the University of Oslo in Norway, and colleagues analyzed data on 307,415 Norwegian mothers to determine the risk of severe postpartum hemorrhage (defined as a visually estimated blood loss of greater than 1500 mL within 24 hours after delivery or the need for a blood transfusion) based on labor onset and delivery mode…

Risk of Postpartum Bleeding Higher After Cesarean - Study suggests induction also increases risk of severe hemorrhage - Modern Medicine

Predicting Postpartum Depression May Be Possible - US News and World Report

 

Spanish researchers report 80 percent success with their method

WEDNESDAY, Sept. 23 (HealthDay News) -- Spanish researchers report that they've developed ways to detect 80 percent of cases of postpartum depression, which is estimated to affect more than one in 10 women who give birth.

"Early diagnosis of postnatal [or, postpartum] depression would make it possible to intervene to prevent it from developing among women at risk," Salvador Tortajada, a researcher at the Polytechnic University of Valencia and lead author of a new study on the methodology, said in a news release from the Scientific Information and News Service in Spain…

Predicting Postpartum Depression May Be Possible - US News and World Report

CTV Calgary- Pregnant women needed for study - CTV News, Shows and Sports -- Canadian Television

 

…The researchers will investigate how nutrients impact the physical and mental health of mothers and their babies on a microscopic level.

"Maternal mood is very important and also the temperament of the children," said Bonnie Kaplan, of the University of Calgary," for women we are interested in depression and anxiety throughout pregnancy so not just post partum but perinatal depression and anxiety as well."

Post partum depression and nutrition is another one of the focuses of the study.

For more information on the study and how you can join click on the Alberta Pregnancy Outcomes and Nutrition Website.

CTV Calgary- Pregnant women needed for study - CTV News, Shows and Sports -- Canadian Television

Pregnant and Depressed | Psych Central News

 

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on September 22, 2009

Depression accompanying pregnancy is a topic that receives less discussion than the well-documented postpartum depression.

Depression is not uncommon in pregnant women. Between 14 and 23 percent of pregnant women will experience a depressive episode while pregnant.

In 2003, approximately 13 percent of pregnant women took an antidepressant at some point during their pregnancy. According to background information in an article in the journal General Hospital Psychiatry, this rate has doubled since 1999. Many women go untreated due to concerns regarding the safety of treating pregnant women.

Pregnant and Depressed | Psych Central News

Gena Lee Nolin Opens Up About Battle With Postpartum Depression – Celebrity Baby Blog – People.com

 

In an new interview with Life & Style, Gena Lee Nolin, 37, opens up for the first time about her long struggle with postpartum depression (PPD).

“It’s a roller coaster of emotion,” she says. “It’s so intense and comes on so quickly. Your hormones are completely out of whack.”

Unfortunately, the feelings of despair that came with her third delivery — daughter Stella Monroe arrived last December — were painfully familiar: Gena had experienced PPD following the birth of her sons, Spencer, 12, and Hudson Lee, 3.

“It was really hard with the first one because I didn’t see it coming,” Gena explains. “I couldn’t figure out why I was so sad when I had this beautiful, healthy baby and a great job. Baywatch was the No. 1 show in the world at that time. I had nothing to be upset about. I thought I was nuts.”

But when her uncontrollable crying didn’t stop after six months, Gena, who was married to Greg Fahlman at the time, knew she needed help. So the actress sought guidance from a counselor and spent seven months on a low dose of antidepressants…

Gena Lee Nolin Opens Up About Battle With Postpartum Depression – Celebrity Baby Blog – People.com

Almost half of obstetricians back C-section by request

By Sharon Kirkey, Canwest News Service

Forty years ago in Canada, five per cent of babies were delivered by caesarean. Today the rate is 28 per cent nationally, and more than 30 per cent in B.C. and P.E.I. More than 78,000 C-sections were performed in Canada last year.

The Society of Obstetricians and Gynaecologists of Canada says a C-section should not be offered to a pregnant woman unless there is a valid medical reason to perform one.

But the University of B.C.-led study found that 42 per cent of obstetricians were in favour of a woman's right to choose a C-section for herself, even in the absence of a medical indication.

Overall, 549 obstetricians, 897 family physicians, 545 nurses, 400 midwives and 192 doulas from across Canada were surveyed in 2008-2009 on their attitudes toward labour and birth. The study was done against a background of a "technological transformation of birth," the researchers say — rising C-section rates, more induced labours and routine use of epidural analgesia, or local anesthetic…

Almost half of obstetricians back C-section by request

More data on revamped online obstetrics guide | Richmond Times-Dispatch

 

By Tammie Smith

www.vhi.org

Moms-to-be searching for hospitals with the lowest charges for childbirth or for doctors with lower cesarean rates can find that information in a revamped obstetrics guide from Virginia Health Information.

The expanded Web-based guide lets users enter a ZIP code and view details about nearby providers or enter a doctor's name and view information.

"We have been asking years and years for an update," said Mary Callender of the Richmond chapter of the International Cesarean Awareness Network. "It's a good tool for women to use when determining what provider they want to go with in having their baby."

The guide lists average hospital charges for vaginal and cesarean births by doctor and hospital. Women also can check, for instance, whether a hospital has nurse midwives or features such as birthing balls or hydrotherapy for laboring in water.

The guide is compiled from data from multiple sources, said Michael Lundberg, executive director of Virginia Health Information, a private agency that receives state funds to collect and report health data.

He said hospitals were sent a 160-item survey to complete. Other information was pulled from state vital records, hospital discharges and the Virginia Board of Medicine.

"The information is very extensive," Lundberg said.

When users click to see hospital information, the first page that pops up includes cesarean-birth rates. About 34 percent of births in Virginia are by cesarean delivery, higher than the national average of 31.8 percent, Lundberg said.

The guide shows what percentage of a doctor's patients are first-time and repeat cesareans -- important information for women trying to have a vaginal birth after a previous cesarean birth.

Callender said it is often difficult to get information by just calling a doctor or hospital. "Now it's right there on the page," she said…

More data on revamped online obstetrics guide | Richmond Times-Dispatch

Jenny's Light Newsletter - Volume 2, Number 7

Jenny's Quote of the Month:

Laughter is an instant vacation.

~Milton Berle

In this issue...

1. $10,000 Jenny's Light  Grant Update

2. Postpartum Support International Conference Recap

3. Charity Golf Event Recap

4. Charity Swim Meet raises over $3,000!

5. Use Causeworth for your insurance needs

6. Shop for Jenny's Light Merchandise

7. Follow Jenny's Light on Facebook and Twitter!

8. Website Update- Many new features!

9.  Mailbag

10.  Forward to a Friend- Amanda Martin is our latest winner!

---

1. Jenny's Light To Award $10,000 in Grants this Year!

We are currently in the process of reviewing almost 20 great applications that are in the running for our first grant award.  Our Program Director Jesse Kuendig has created a review and scoring process that will help us decide where our money will go.  Thank you to everyone who applied.  We will contact the winner(s) on or around October 15th.  We will feature each of the winner(s) in our next newsletter and website in late October.

Jenny's Light is committed to our mission and will also be announcing another grant and the deadline in the next newsletter as well.

---

2. Jenny's Light Attends PSI Conference in Los Angeles

Jenny's Light board members Becky Lavelle, Bob Gibbs and Karen Jennings along with our Executive Director Randy Gibbs attended the two-day conference in August. 

The event was very well organized and it was great to meet and see people with whom we usually only contact through email or a phone call.  We came back with a greater knowledge of what people are doing all over the world regarding treatment, detection and spreading awareness of all perinatal mood disorders.  They presented a special sneek-peek of their new educational DVD that will be available this Fall.  Jenny's Light is planning to play a major role in funding the production and distribution of this great tool.  More details to follow in our next newsletter.  Check out their website to learn more about PSI.

---

3.  Charity Golf Tournament Recap

Inaugural Jenny's Light Minnesota Charity Golf Tournament

Presented by

This event was held on Monday, August 10th at Indian Hills Golf Club in Stillwater, MN.  We had perfect weather and a great turnout! 72 golfers and 20 volunteers made this an amazing first year event.   A special thanks goes out to our two presenting sponsors, The Minnesota Timberwolves and Go Home Gorgeous for their tremendous support.  We would also like to thank our two volunteer event co-directors Kari Strauman and Mary Bohmbach who spent many hours helping put this event together.  Helping make this an incredibly special day for all of us was KFAN's "The Common Man" Dan Cole, KSTP's Patrick Hammer and Rebekah Wood, as well as Ananda and Bob from Acoustic Roots who helped make this a special day.

Next year's event promises to be bigger and better.  We are currently working hard to secure everything and are hoping to announce the date and venue in our next newsletter.

---

4.  Wayzata High School Alumni Meet Raises over $3,000!

Held August 29^th in Plymouth MN. With the gracious help of alumni swimmer Karen McKinley, the event raised over $3,000 for Jenny’s Light through raffle tickets and silent auction items. A huge thank you to Karen and to all who participated and supported the event! We hope to continue this tradition for many years to come.

We would also like to give special thanks to the following people for so kindly donating proceeds from their summer events to Jenny’s Light…

· Splash-and-Dash Race Series (on behalf of Andy Ferguson), Cupertino CA, www.adfsportsmarketing.com

· She Rocks! Triathlon (on behalf of Olympian Sheila Taormina), Waterloo MI, http://www.estevents.com/race- sherocks-1.htm

· Santa Cruz Sprint Triathlon (on behalf of Penni Bengston) , Santa Cruz CA, www.finishlineproduction.com

· Treva & Jason Vogt’s baby shower

---

5. Jenny's Light Teams Up with Causeworth

Jenny’s Light has partnered with www.causeworth.com, insurance services that give up to 30% of gross revenue to support the non-profit organization of your choice. Check out their website for rates and help support Jenny’s Light today!

---

6. Shop For Jenny's Light Merchandise

We have teamed up with Gear West Bike & Triathlon to bring you the official Jenny's Light clothing line. Gear West Bike and Triathlon has been serving the "tri-geek" and "roadie" community for over 13 years. Our friendly and knowledgeable  staff is here to serve you and your needs! Feel free to stop in, or shop online.  All proceeds go directly to Jenny's Light!!!

We now offer the following items:

1. Jenny's Light T-Shirt
2. Jenny's Light Winter Thermal
3. Jenny's Light Kid's T-Shirt and onesies
4. Jenny's Light Candle
5. Jenny's Light Water Bottle

Short-sleeve tee as seen on Jenny's twin-sister Becky Gibbs Lavelle in the October 2008 issue of Glamour Magazine.

Also, visit the Jenny's Light Shop to see all of our items, including our candle, jewelry, stamps, mugs, etc...

---

7.  Facebook & Twitter

Facebook Update

We currently have over 6,000 members of our Jenny's Light "Cause Page" and have raised almost $18,000.  We are currently working on raising money to produce and distribute our informational cards directly to new mothers and families at the hospital.

Special thanks to everyone who has donated on Facebook as well as those who've raised money through the Facebook birthday fundraising application. If you have a Facebook profile, please join our cause, set-up your own birthday fundraiser and help us grow by recruiting your friends!

Thank you for your support!!!!

You Now Also Follow Us On Twitter

Jenny's Light is now on Twitter.  Sign-up today to follow our weekly (and sometimes more) "tweets".  It's easy and free to join.  This is just another way we are trying to reach out to as many people as possible with our message.  Click here to get started.

---

8.  Website Update

Please visit our site and take a look around.  You will notice several new features and additions.  We are working on many more for October so be sure to check back often!

Website Stats:

Overall (Since website launched on April 1, 2008)

Visits: 55,410 from 111 countries

Absolute Unique visitors: 43,690

Pageviews: 229,711

Pages/visit: 4.15

Avg. time on site: 3:42

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9.  Mail Bag

We greatly appreciate your letters and emails of support, feedback and personal PPD stories. This month, we'd like to pass along these kind words:

"My name is Clarice Grens, I am from CT.  I had my son 2 months after Graham. I suffered from PPD pretty significantly and I still have some residual from it. After I started getting better ,I did a lot of research on the topic, and I came across Jennys light, despite not knowing your sister, I feel I have a connection with her. Not a day goes by where I do not think about her and the pain and suffering she most of been going through, because I know how I felt.
Because of her and my own battle with PPD, I am running in a Marathon on 10/10, and all the donations will go to Jennys light. We have special shirts made,  I cannot wait to wear the shirts, I will send you the pictures. My heart goes out to you and your family."

Sincerely,
Clarice and all the woman running with me for this cause

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10.  Forward to a Friend- Amanda Martin Is Our Latest Winner!

Amanda will receive a Jenny's Light short-sleeve vintage t-shirt for forwarding last month's newsletter to the most people using the Forward To A Friend feature at the bottom of each newsletter.  Thanks Amanda!

Pass It On!  Please use the Forward To A Friend feature at the bottom of this newsletter to forward to your friends and loved ones.  Every month we will send a special gift to the person who forwards that month's newsletter to the most people.  Thank you!

Eye on Health - Postpartum Depression | KXNet.com North Dakota News

 

KXMCTV Minot

It can be the most amazing moment of a woman's life the birth of a child.
But for some women that moment of joy can be followed by a time of trouble.
In this week's Eye on Health, Postpartum Depression is the topic.
Mark Bell sees it and he wants all healthcare workers to be on the lookout for it...postpartum depression. Last week he discussed the topic with medical personnel at Trinity Health's 30th annual Symposium on Perinatal Medicine and Women's Healthcare...His message was for them to be watching for it...but also for everyone to do the same...

Eye on Health - Postpartum Depression | KXNet.com North Dakota News

Postpartum Depression – Is Food the Cure? HealthNewsDigest.com

By Jo-Ann Heslin, MA, RD, CDN, Food and Nutrition Columnist - HealthNewsDigest.com

Research shows that people in general who suffer from depression often have poor diets and limited intakes of necessary nutrients. Dietary inadequacy can be a trigger for depression. Some researchers believe that poor nutrition negatively effects mood both during pregnancy and breastfeeding. In pregnancy nutrient demands are high to insure the health of the woman and the proper development of her baby. Therefore it is logical to assume that if nutrients are depleted in pregnancy and there isn’t adequate recovery postpartum a woman’s risk for depression may increase.
Depression is a condition with many factors – genetic, environmental, social and psychological. Food is just one of these factors but it is something that can be altered to potentially lower the risk. Though research is limited on how nutrients affect a woman’s mental health while pregnant and after delivery, we do know that many pregnant women do not meet their nutritional needs and that poor nutrition can be a trigger for depression. Simply eating well may lower the incidence of maternal depression.
A number of studies have shown that pregnant women do not consume enough calcium, iron, folic acid and omega-3 fats. Increasing the intake of these nutrients will not only assure the health of both mother and baby, but it may decrease the risk of depressive episodes during and after pregnancy. It is a strategy with little risk and possible rewards…

HealthNewsDigest.com

Emotional Symptoms in Children: The Effect of Maternal Depression, Life Events, and COMT Genotype

 

Early adversity, such as exposure to maternal depression or to stressful life events, often precedes childhood emotional disorders, which in turn are frequently followed by major depression and anxiety disorders in adulthood. However, it is a common observation that individuals vary in their sensitivity to adversity. One explanation for this is innate variation in vulnerability (or conversely resilience), arises from the effects of alleles that have been transmitted to the child. The child’s genotype may exert effects by, shaping environmental exposures themselves (gene–environment covariance) or, variation in response to the environment (gene–environment interactions). In fact both processes may operate. Twin studies of depression in adolescents have found that genetic variation not only correlates with environmental mediators of depression such as life events but also interacts with them to increase the risk of depression…

Emotional Symptoms in Children: The Effect of Maternal Depression, Life Events, and COMT Genotype

Midwifery Today E-News 11:19 - International Updates

 

In This Week’s Issue:

• Quote of the Week
• The Art of Midwifery: Modeling Breathing
• Research: Breastfeeding and School Performance
• COHI and Coexistence in the Middle East
• Featured Products
• Web Site Update
• Advertising Opportunities
• Question of the Week: Shoulder Dystocia
• Question of the Week Responses: Autism, Uterine Prolapse
• Think about It
• Letters
• Classified Advertising

E-News 11:19 - International Updates

ICAN eNews

In the news

Do women choose or consent to caesarean delivery?

University of Technology Sydney professor and registered midwife Jennifer Fenwick discusses her research finding that fear is a predominant motive for women to have a cesarean section. Her research indicates that "most women were in favour of natural birth until convinced otherwise." Read Full Article.

The great caesarean section debate

Ireland's cesarean rate has risen significantly in the last 15 years and the cause for this trend is undetermined. Dr. Jo Murphy-Lawless identifies four possible reasons, including the "use of foetal heartbeat monitoring" and the "perception that Caesarean section is a safe and trouble-free intervention."Read Full Article.

Midwives: A Safe, Cost-Saving Alternative

Massachusetts nurse-midwife Peggy Garland weighs in on the high cost of maternal care and the access to midwifery care in the state. Read Full Article.

In the research

Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician

Study indicates that a planned home birth attended by a registered midwife is as safe as a hospital birth. Adverse maternal outcomes and infant trauma proved lower in the homebirth group than the hospital group.  Read Full Article.

Decision making in patient-initiated elective cesarean delivery: the influence of birth stories

Exploratory study examines the motives of women who choose an elective cesarean delivery without medical indication. Paramount to the decision making process for many women are birth stories from friends, family, and the media.  Read Full Article.

Quality and equality in obstetric care: racial and ethnic differences in caesarean section delivery rates

A University of California research project shows that racial disparities in cesarean section rates exist. Read Full Article.

From the women of ICAN

Benefits of Cesarean? Think Again!

The women of ICAN respond to an anonymously written article from The Pregnancy Zone which touts cesarean birth as a safe procedure that is also painless, easy, and private. Amber Piller of ICAN in Omaha highlights the errors and misconceptions represented in The Pregnancy Zone's article. Be sure to read the comments and responses from other ICAN members as well! Read Full Article.

Informative Birth Videos

Watch three birth-related videos, including one that compares cesarean birth to a vaginal birth after cesarean. Read Full Article.

Get active!

Upcoming Webinar: Journey to VBAC

Gretchen Humphries will host the first part of this two-part webinar series on September 27th at 9 pm EDT. The issues surrounding vaginal birth after cesarean will be addressed and common questions such as "Am I a good candidate for a VBAC?" will be answered. This event is free to ICAN subscribers! Read Full Article.

Midwives: A Safe, Cost-Saving Alternative | CommonHealth

 

Peggy Garland, a certified nurse-midwife and Coordinator of the Massachusetts Coalition for Midwifery, says the state acts against the interests of women and mothers by limiting access to midwifery services:

Did you know that almost a quarter of all hospital discharges involves maternity care (mother and newborn)? That six out of fifteen of the most common hospital procedures involve maternity care? That Cesarean section is the most commonly performed surgery? Why are so many procedures being performed on essentially healthy people? It’s the same reason behind sky-rocketing costs in all other sectors of health care: reimbursement is procedure-driven…

Consider this:

In 2006, in Massachusetts there were 26,141 Cesarean sections (out of 77,670 births.) If we could reduce this surgery by 1% we would experience a cost savings of nearly $1.5 million. Boston itself provides a good example of the magnitude of the potential cost savings: the three Boston hospitals with the most midwife-attended births saved the Commonwealth nearly $3 million in Medicaid reimbursements in 2006 by reducing Cesarean sections, compared to the Boston hospitals that had few midwives…

Midwives: A Safe, Cost-Saving Alternative | CommonHealth

Grassroots Network Message: TODAY show in bed with ACOG

Dear Friends,
Friday morning’s TODAY show included a segment about the
“perils of home birth.” The show included a sad home
birth (with a nurse-midwife) where the baby died of a cord
accident, without mentioning that such deaths can happen in the
hospital also, or addressing the US’s high perinatal
mortality rate. Representatives of ACOG described home birth as
“the equivalent of a spa treatment”! Definitely not
even-handed reporting, but looks like ACOG is out to get media
for their biased beliefs.
You can watch the segment at
http://today.msnbc.msn.com/id/26184891/vp/32795933#32795933
You can read comments about the show (and add your own) at:
http://www.newsvine.com/_question/2009/09/11/3252633-is-choosing-\
a-home-birth-with-a-midwife-worth-the-potential-risk
Almost all of the comments are pro-midwife.
And if you want to e-mail the Today show and let them know the
real reasons more women are choosing home birth, or that
you’d like to see an HONEST segment on home birth, you can
write to them at Today@NBCUNI.com .
Finally, true to form, the Big Push has fired off an eloquent
Push Alert, which is pasted below.
As the saying goes, any attention is good attention, or at least
a great opportunity for getting more and better attention!
Thank you to the several individuals who brought this to my
attention, including the links.
Sincerely,
Susan Hodges, “gatekeeper”
==============================================
http://www.thebigpushformidwives.org/pushnews
PushNews from The Big Push for Midwives Campaign
CONTACT: Katherine Prown, (414) 550-8025,
katie@thebigpushformidwives.org
FOR IMMEDIATE RELEASE: Friday, September 11, 2009
Physicians Take Anti-Midwife Smear Campaign to the Airwaves
Home Birth Mothers, Celebrities, Insulted on National TV
WASHINGTON, D.C. (September 11, 2009)­Referring to women who
choose to give birth in out-of-hospital settings as
“hedonistic” and likening childbirth to a “spa
treatment,” members of the American College of Obstetricians
and Gynecologists, a trade group representing the professional
and financial interests of OB/GYNs, took their anti-midwife
campaign to the airwaves in a Today Show segment
<http://today.msnbc.msn.com/id/26184891/vp/32795933#32795933>
rife with insults, stereotypes, and misinformation, using one
family’s tragedy as a platform for the organization’s
well-funded assault against choices in childbirth.
“About the only thing ACOG has right is that women are
choosing out-of-hospital deliveries in record numbers,” said
Steff Hedenkamp of The Big Push for Midwives Campaign. “What
Erin Tracy and other apologists for the group’s anti-midwife
position fail to see is that one of the forces driving women to
seek out-of-hospital care is the paternalistic, profit-driven
model of maternity care that far too many of its own members
provide.”
During the segment ACOG reiterated its claim, which has been
thoroughly debunked by a large and growing body of medical
literature, that out-of-hospital delivery is unsafe. Describing
women who choose to give birth in private homes and freestanding
birth centers as “hedonistic” mothers who knowingly put
the lives of their babies at risk for the sake of an
“experience” they believe will be like a “spa
treatment,” members of the group echoed last year’s
position statement
<http://www.acog.org/from_home/publications/press_releases/nr02-0\
6-08-2.cfm> claiming that women who choose out-of-hospital
deliveries base their decisions on what’s
“fashionable” or “trendy.”
“ACOG clings to this ridiculous fantasy that women choose to
deliver their babies outside of the hospital because they want to
be like Ricki Lake, Demi Moore or Meryl Streep and that if women
would only watch enough fear-mongering stories on morning
television they’ll be brainwashed back into hospitals,”
said Katherine Prown, Campaign Manager of The Big Push for
Midwives. “Insulting our intelligence and promoting policies
that deny us choices in maternity care are not exactly winning
strategies for stemming the tide of women seeking alternatives to
standard OB care.”
Earlier this year, a New York City couple lost their baby during
a planned home birth under the care of a Certified Nurse-Midwife.
Licensed and regulated in all 50 states, Certified Nurse-Midwives
are trained to provide hospital-based maternity care. By
contrast, Certified Professional Midwives, who undergo
specialized clinical training in out-of-hospital birth, are
legally authorized to provide care in 26 states, although
outdated regulations effectively prevent them qualifying for
licensure in the state of New York.
Legislation to license and regulate Certified Professional
Midwives is currently pending in an additional 18 states, despite
staunch opposition from the American Medical Association, which
has joined with ACOG in adopting position statements
<http://tinyurl.com/lpkutq> that would deny families who choose
out-of-hospital maternity care legal access to nationally
credentialed midwives with specialized training to provide it.
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, katie@thebigpushformidwives.org
#####
The Big Push for Midwives Campaign | 2300 M Street, N.W., Suite
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Dads can get postpartum depression, too

 

One-tenth to one-quarter of new dads get depressed

By Judy Fortin

HOUSTON, Texas (CNN) - Rob Sandler comforted his infant son as he lifted him out of the crib, cooing in his ear while he walked to the living room.

If his baby had needed to be soothed three months ago, Sandler, 36, of Houston, Texas, might have handed the baby off to his wife and then found an excuse to leave the house.

"Honestly, it felt like when I was at home, the walls became very, very close in. I wouldn't say claustrophobic, but very cabin feverish," Sandler said.

It turned out that Sandler, a medical device salesman, had more than cabin fever. He recently got an official diagnosis: He has a male version of postpartum depression…

Dads can get postpartum depression, too

Physicians Take Anti-Midwife Smear Campaign to the Airwaves

 

 

 

 

 

Home Birth Mothers, Celebrities, Insulted on National TV

FOR IMMEDIATE RELEASE
WASHINGTON, D.C. (September 11, 2009) – Referring to women who choose to give birth in out-of-hospital settings as "hedonistic" and likening childbirth to a "spa treatment," members of the American College of Obstetricians and Gynecologists, a trade group representing the professional and financial interests of OB/GYNs, took their anti-midwife campaign to the airwaves in a Today Show segment rife with insults, stereotypes, and misinformation, using one family's tragedy as a platform for the organization's well-funded assault against choices in childbirth.
"About the only thing ACOG has right is that women are choosing out-of-hospital deliveries in record numbers," said Steff Hedenkamp of The Big Push for Midwives Campaign. "What Erin Tracy and other apologists for the group's anti-midwife position fail to see is that one of the forces driving women to seek out-of-hospital care is the paternalistic, profit-driven model of maternity care that far too many of its own members provide."
During the segment ACOG reiterated its claim, which has been thoroughly debunked by a large and growing body of medical literature, that out-of-hospital delivery is unsafe. Describing women who choose to give birth in private homes and freestanding birth centers as "hedonistic" mothers who knowingly put the lives of their babies at risk for the sake of an "experience" they believe will be like a "spa treatment," members of the group echoed last year's position statement claiming that women who choose out-of-hospital deliveries base their decisions on what's "fashionable" or "trendy."
"ACOG clings to this ridiculous fantasy that women choose to deliver their babies outside of the hospital because they want to be like Ricki Lake, Demi Moore or Meryl Streep and that if women would only watch enough fear-mongering stories on morning television they'll be brainwashed back into hospitals," said Katherine Prown, Campaign Manager of The Big Push for Midwives. "Insulting our intelligence and promoting policies that deny us choices in maternity care are not exactly winning strategies for stemming the tide of women seeking alternatives to standard OB care."
Earlier this year, a New York City couple lost their baby during a planned home birth under the care of a Certified Nurse-Midwife. Licensed and regulated in all 50 states, Certified Nurse-Midwives are trained to provide hospital-based maternity care. By contrast, Certified Professional Midwives, who undergo specialized clinical training in out-of-hospital birth, are legally authorized to provide care in 26 states, although outdated regulations effectively prevent them qualifying for licensure in the state of New York.
Legislation to license and regulate Certified Professional Midwives is currently pending in an additional 18 states, despite staunch opposition from the American Medical Association, which has joined with ACOG in adopting position statements that would deny families who choose out-of-hospital maternity care legal access to nationally credentialed midwives with specialized training to provide it.
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, katie@thebigpushformidwives.org

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

Please direct comments and feedback to Steff@TheBigPushForMidwives.org.

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

StoryCorp Wenatchee: Heidi and Elora Kloss-Nobel

 

Heidi Koss-Nobel was interviewed by her daughter, Elora. Heidi suffered postpartum depression after Elora's birth and feels it impacted her daughter as a baby.

Posted: Wednesday, Septemeber 9 ,2009

For many women, motherhood is a time of new discoveries, excitement and feelings of love so deep it is hard to describe. It is also a time of sleepless nights, lifestyle adjustments and enormous responsibility. Sometimes the experience is made difficult by postpartum depression as in the case of Heidi Koss-Nobel. She was interviewed by her 14-year-old daughter, Elora, about her postpartum depression in today’s Storycorps Wenatchee.

Elora: “So mommy, how was your life after having me?”

http://www.nwpr.org/07/HomepageArticles/Article.aspx?n=6064

New Home Birth Studies | Our Bodies Our Blog

 

…The authors’ primary outcome of interest was the rate of perinatal death, defined as stillbirth after 20 weeks’ gestation or death in the first 7 days of life, although stillbirths occurring before the onset of labor or in women who gave birth before 37 weeks were excluded from all groups.

The outcomes were analyzed by planned place of birth. Specific information on reasons for transfer does not seem to be available, but 78.8% of those women who planned a home birth with a midwife had one, and 96.9% of those who planned to be attended by a midwife in a hospital did so.

The authors found no statistically significant differences in the low risk of perinatal mortality between the 3 groups, at 0.35/1,000 for planned home birth, 0.57/1,000 for planned hospital birth with a midwife, and 0.64/1,000 for planned hospital birth with a physician. There were no deaths from 8-28 days of life. The authors also observed lower rates of obstetric interventions for planned home births with midwives than with either hospital group – the full text with tables of these secondary outcomes is freely available online.

The authors note the ability to compare place of birth without confounding from the type of provider (assuming physicians are more likely to conduct interventions than midwives), a strength of the Dutch study as well. But the authors also explain that “our findings do not extend to settings where midwives do not have extensive academic and clinical training.” They also note the possibility that some unknown difference between groups that influenced choice of birth place may have affected the outcomes, but that “our data indicate that screening for eligibility by registered midwives can safely support a policy of choice of birth setting.”

Amy Romano at Science & Sensibility and Lauredhel at Hoyden About Town have both written about the study, with a fair bit of discussion at both places.

New Home Birth Studies | Our Bodies Our Blog

Yoga Alleviates Postpartum Depression

 

…(NaturalNews) Recently a study (conducted at the University of California, Irvine) suggesting that postpartum depression is the result of hormonal imbalances has made news. Postpartum depression is a common condition affecting women in the days after childbirth. It has also been suggested that Yoga potentially holds the key to alleviating this condition. Here is why.
Stress induced hormone release is considered normal when the brain discharges minute amounts of Corticotropin-releasing hormone, or CRH, to help the body cope with the stress. During pregnancy, however, the brain could potentially release copious quantities of CRH to help the mother during labor and thereafter drastically reduce the production of this hormone by contrast. This sudden rise and fall of hormonal levels can cause the endocrine system to behave abnormally and create havoc for the mother, during the postnatal phase.
It is also a fact that the levels of this hormone can be detected at around 25 weeks of pregnancy, exposing the mother's propensity towards postpartum depression. Naturally, therefore, if levels are high it can be concluded that the risk of postpartum depression is also proportionately high…

Yoga Alleviates Postpartum Depression

A randomized clinical trial of exercise to allevia... [J Psychosom Obstet Gynaecol. 2009] - PubMed result

 

OBJECTIVE: To evaluate whether a 12-week home-based exercise program is more effective than usual care for alleviating depressive symptomology in the postpartum. METHODS: Eighty-eight women experiencing postpartum depressed mood were randomly assigned to a 12-week home-based exercise program or usual care. Outcomes assessed immediately post-treatment and 3-months post-treatment were the Hamilton Rating Scale for Depression (HAM-D) and Edinburgh Postnatal Depression Scale (EPDS). RESULTS: In the intention-to-treat analysis, the effect of the intervention on EPDS did not change from 3 to 6 months evaluations, but was modified by the baseline EPDS score, with subjects with greater depression at baseline (EPDS > 13) in the intervention group having a significantly lower postbaseline EPDS score compared with the usual care group (mean difference 4.06 points, 95%CI 1.51-6.61, p < 0.001). After adjusting for baseline HAM-D, subjects in the intervention group had a significantly lower HAM-D score at post-treatment compared with subjects in the usual care group (mean difference 1.83 points, 95%CI 0.24-3.41, p = 0.02). The difference in HAM-D became non-significant at 3-months post-treatment. CONCLUSIONS: Home-based exercise is a feasible nonpharmacological intervention with the potential to alleviate postpartum depressive symptoms, especially in women with higher initial depressed mood scores as measured by the EPDS. These findings may guide the design of future exercise clinical trials with postpartum depressed women.

A randomized clinical trial of exercise to allevia... [J Psychosom Obstet Gynaecol. 2009] - PubMed result

Care Plan After a Cesarean Birth

 

By: Constance Rock & Aleksandra Evanguelidi
Published: Thursday, 3 September 2009

Recovering from a cesarean birth requires much attention and support in order for you to heal properly and within a shorter period of time. A cesarean birth is traumatic to the tissues, muscles, and fascia, and to your emotional body as well. Most women express the after-effects of the experience as like being “hit by a train.” However, following these instructions and nutritional guidelines can truly make the difference in quickening up the healing process and having you feel better physically and emotionally.

Try to refrain from bending over, going up and down stairs, lifting or pulling, or exerting force of any kind for a least one week postpartum. The recommendation is to stay in bed for a two-week period, eating a diet of very nourishing warm teas and soups, the richer the better. Avoid cold beverages or foods that can constipate you like pasta and bread.

Natural Ways to Help You Heal
All of the supplements mentioned below can be taken for any length of time and do not affect breast milk in any negative way…

Care Plan After a Cesarean Birth

Mothers with postpartum depression with suicidal thoughts and their infant interactions

 

Contact: Ronald Rosenberg
ronrosen@bu.edu
617-358-1240
Boston University Medical Center

Mothers with postpartum depression with suicidal thoughts and their infant interactions

(Boston) -- The joys of motherhood for many women can also lead other new moms to experience postpartum depression and even worse – ideas for committing suicide.

For these women contemplating taking their own lives, the mother-infant relationship and development was a negative experience, with greater mood disturbances, cognitive distortions, low maternal self-esteem, negative perceptions of their effectiveness as a new parent and noticeably less responsiveness to their infants' cues.

Those are the findings of a new two-year study by Ruth Paris, Ph.D., Assistant Professor of Clinical Practice at Boston University's School of Social Work, Rendelle E. Bolton, a graduate student at the BU School of Social Work and M. Katherine Weinberg, Ph.D., a psychologist and an infant development specialist. Their research "Postpartum Depression, Suicidality and Mother-Infant Interactions appears in the September 3rd online edition of Archives of Women's Mental Health. Postpartum depression, they note, occurs in an estimated 19 percent of new mothers and ideas of suicide is considered a common part of this serious mental health problem.

The team worked with clinicians at the Jewish Family and Children's Service Early Connections program, a home-based mother-infant psychotherapy intervention that specializes in the treatment of postpartum depression (PPD) and mood disorders. The program's key goal is to increase the mother's ability to be affectively present in her interaction with the child and to address issues that arise as result of becoming a mother.

The participating women -- most of them first-time mothers in their 30s – had a wide range of suicidal thinking, as the study examined the phenomenon of suicidality and its relationship to maternal mood, perceptions and mother-infant interactions.

All the new mothers in the study suffered from depression, isolation and extreme difficulties in parenting infants. They responded to a series of pre-treatment questionnaires, self-report symptom inventories and parenting stress indices. Each of the 32 participants was also observed and videotaped twice – the first to evaluate a structured task-oriented (asking the parent to guide the infant in following a rattle) and later an unstructured interaction (how they interacted with their baby without the use any toys or other props).

To evaluate the clinical levels of the new mothers' maternal mood and psychological functioning, the women were each given the Post Partum Depression Screening Scale that assessed their postpartum psychiatric difficulties. It also included a suicidal thoughts subscale that assessed the degree to which the mother felt her baby would be better off without her, wished she leave this earth, wanted to harm herself, felt that death was the only way out and thought she would be better off dead.

Seventeen of the 32 participants (53 percent) comprised the high suicidality group and the study found that those women were experiencing more sleeping and eating problems along with greater severity in overall struggles attributable to postpartum depression.

"These mothers… were also feeling more anxious, emotionally labile, mentally confused, had experienced a greater loss of self and felt greater guilt about their experience," the study states.

Examining maternal perceptions, the researchers found that mothers with suicidal ideas had poorer self esteem than women who had few suicidal thoughts and experienced less distress in the parenting role. The high suicidality group also perceived they were less prepared for mothering and expected a poor relationship with their infants. Observers also found these women "less able to demonstrate sensitivity and reciprocity with their infants during unstructured interactions…[they] were less aware of their babies' social signals and showed poorer ability to respond to them consistently."

In turn, the infants of the more suicide-prone mothers exhibited less positive behavior in the form of fewer smiles and more fussing. "Infants of highly suicidal mothers were somewhat more passive and less engaged in the interactions," the study notes.

Researchers also found that most of the women in the highly suicidal group held jobs before becoming mothers – a significant life changing experience where they left behind their working identity in a predictable and controlled environment where they felt competent, to the unpredictability of caring for a newborn. This dramatic change could have been enough to catapult them into severe post partum depression.

"Given that the highly suicidal women also felt less prepared for motherhood, it is possible that these women had grave doubts about their abilities to parent long before they became mothers, possibly because of difficulties in the way they were parented, problems in shifting to the mother role or because of their own histories of depression.," the study states, adding that spouse and extended family support are also important to consider.

For mothers with suicidal ideas, their difficulties in unstructured tasks call for interventions that would augment the structure for their interactions with their child. Examples include the mother structuring her day, identifying tasks that need to be accomplished, offering guidance in how to attune to the baby's needs when the baby is awake, alerting a spouse or other family member to step in when she is most vulnerable and gaining support from a person close by in moments of high anxiety.

"For these depressed women with suicidal ideas, they may have prepared for the birth of their babies in some ways, but there was a paucity of emotional preparation and anticipation of some of the difficulties ahead, particularly regarding how they and their partners lives would change," said Paris. "The treatment of PPD should include the mother with the infant -- not the mother alone -- to best remediate the relationship where depressed mothers are often less able to be sensitive and responsive to their babies."

###

Founded in 1839, Boston University is an internationally recognized institution of higher education and research. With more than 30,000 students, it is the fourth largest independent university in the United States. BU consists of 17 colleges and schools along with a number of multi-disciplinary centers and institutes which are central to the school's research and teaching mission.

Mothers with postpartum depression with suicidal thoughts and their infant interactions

Midwifery Today E-News 11:18 - Homebirth

 

In This Week’s Issue:

• Quote of the Week
• The Art of Midwifery: Birth
• Research: Bottle-feeding and Postnatal Depression
• Breech Birth Learning Opportunity—A Note from Jan
• Not Among Strangers
• Featured Products
• Web Site Update
• Advertising Opportunities
• Question of the Week: Changes in Midwifery and Birth Practices
• Question of the Week Responses: Infertility, LEEP
• Think about It
• Classified Advertising

E-News 11:18 - Homebirth

ICAN eNews

In the news

Studies explore how mode of delivery affects postpartum brain

Studies show that the absence of naturally released oxytocin during a cesarean delivery impacts the postpartum brain. ICAN Canada's president, Claudia Villeneuve, comments on the emotional impact of cesarean delivery on mothers: "If that experience was demeaning in any way, or if you felt helpless, there is a lot of internal conflict." Read Full Article.

Birth Wars: Who's really winning the homebirth debate.

Jennifer Block examines the hostile relationship between home birth advocates and hospital obstetricians. Scientific evidence remains at the core of the debate because no randomized controlled trials exist. The ACOG claims that studies on homebirth vs. hospital birth "have not been scientifically rigorous." However, Block observes that "most labor interventions became routine without any study whatsoever, and several, like continuous electronic fetal monitoring and episiotomy, continue to be used even though copious evidence has proved them unnecessary and potentially harmful." Read Full Article.

Take Away the Incentives for too many C-Sections

Medicaid in Washington State now pays hospitals the same amount for uncomplicated cesarean sections as for complicated vaginal births. The removal of financial incentives for hospitals will reduce health care costs as well as improve maternal care. Currently, about 11,000 cesareans each year in Washington State are deemed unnecessary. Read Full Article.

In the research

Vaginal Delivery of Breech Presentation

The risks and benefits of a trial of labor for frank or complete breech fetuses versus a planned cesarean section are examined. Researchers indicate that a "planned vaginal delivery is reasonable in selected women with a term singleton breech fetus." Read Full Article.

Neonatal Outcomes After Elective Cesarean Delivery

NICU admissions rates are higher for babies born by elective repeat cesarean than VBAC babies.  Read Full Article.

UCSF/Standford team finds labor induction need not increase cesarean risk

Team finds that elective induction of labor at or after 41 weeks of gestation lowers the risk of a cesarean by 22% if induction of labor is given time to work. Dr. Aaron Caughey of UCSF notes, "We're concerned that our findings may not translate to many hospital settings in the United States." Read Full Article.

From the women of ICAN

Less Cesareans with Induction of Labor? Read the Fine Print!

ICAN blogger responds to the UCSF study and concludes that "women must be aware of the risks associated with any obstetrical intervention and have the freedom to make choices that they believe are best for themselves and their babies, not doctors’ protocols and hospital time clocks." Read Full Article.

Guest Blogger: Gail Tully

Gail Tully of "Spinning Babies" describes how lunging through contractions can help an asynclitic baby descend for birth. Read Full Article.

Get active!

2009 ICAN Conference Speaker and Author Seeking Survey Respondents

Sandy Jones, co-author of Great Expectations: Your All-in-One Resource for Pregnancy & Childbirth, is seeking ICAN members to participate in a survey entitled "What Led You to a Cesarean?".
Ms. Jones is preparing a PowerPoint presentation/slide show for the internet called "How NOT to Have a C-Section" which aims to educate first-time pregnant moms on how to recognize and respond to pressures from healthcare providers to have medically unnecessary cesareans.
All responses will be kept strictly anonymous.  
If you are interested in participating in this quick survey, please answer the following two questions:
What words or actions did your healthcare provider use to convince you to have a c-section.
What week did that happen in your pregnancy? (Or during labor?)

(Examples of responses: "I was in labor and didn't want a c-section. My obstetrician said that he couldn't be responsible for what happened to my baby if I didn't comply." "He had his appointment secretary schedule a c-section as soon as he established by due date, which was around 10 weeks or pregnancy." "She warned me that I had a big baby during my 3rd trimester, and that I might have to have a c-section." "He told me when I was 37 weeks pregnant that my baby would be breech, and I would need to have a c-section.")
Your response can be e-mailed or mailed to Ms. Jones at the following addresses:
Sandy Jones, MA
150 W. Southwood Dr.
Brevard, NC 28712
Tel: 828-884-4442
Primary e-mail: JonesBabyExpert@aol.com
Sharing your experience may help prevent another woman's unnecessary cesarean!

ACOG’s Home Birth Survey | Our Bodies Our Blog

 

Earlier this week, the American College of Obstetricians and Gynecologists posted a survey, Complications Related to Home Delivery, at its website. The survey, designed for OB/GYNs, has raised the hackles of home birth and midwifery advocates, who question the intent of the survey and limitations inherent in the design.

In the introduction to the survey, ACOG explains:

The American College of Obstetricians and Gynecologists is concerned that recent increases in elective home delivery will result in an increased complication and morbidity rate. Recent reports to the office indicate our members are being called in to handle these emergencies and in some instances have been named in legal proceedings. To attempt to determine the extent of the problem, a registry of these cases will be maintained at ACOG on a year-by-year basis.

The intro language strongly suggests that the organization is looking for bad examples (an “increased complication and morbidity rate”) to use in defending its stance against home birth. While OB/GYNs were asked to complete the survey “even if there was no adverse outcome,”  I wonder how many would bother to fill out the form when the stated purpose is to “determine the extent of the problem.”

In addition, I have concerns about the type of information collected by the survey. The survey was initially viewable and completable by the public – a cached version is available, and makes apparent that it included no identifying data that could be used to follow-up with the person reporting the cases or to confirm that the person completing the survey is actually an OB/GYN. There was (and is) no way to confirm or examine the details of any case, unlike real registries of patient data and outcomes.

The survey is still available, but is now behind password protection to limit it to ACOG members. Of course, even behind password protection, this is not a random sample of OB/GYNs capable of determining how often these providers encounter home birth transfers – it now excludes OB/GYNs who are not members, and would include information only from those providers who were motivated enough to respond.

Such a survey can produce anecdotes about provider experiences, but is unlikely to add much to the knowledge base about home birth and transfers in the absence of more comprehensive data collection – it’s simply not a well-executed scientific survey. As a Big Push for Midwives press release [PDF] notes, some suspect that the submitted stories – likely to represent the worst outcomes of home birth – are intended to be used by ACOG “to support its ongoing state and federal lobbying campaigns aimed at denying women access to out-of-hospital maternity care and Certified Professional Midwives.”

In response, home birth advocates – acting via Facebook, blogs, Twitter, and the like – encouraged the submission of positive home birth stories to the site before it was password-protected. Jill at the Unnecesarean provides an example of one of the calls that was going around, which includes the express intent to force the survey into the members-only area of the site.

On a related note, am I the only one who thought of pizza given the repeated “home delivery” language ACOG used? Think that tells us anything about the organizational perspective on birth?

ACOG’s Home Birth Survey | Our Bodies Our Blog

MedEdPPD.org September 2009 Newsletter

September 2009

Dear Colleague,
The final verdict on health care reform is still out but the most recent version of the controversial bill (America's Affordable Health Choices Act, H.R. 3200) holds promising changes that will affect the care that pregnant women receive in the United States. Childbirth Connection, a not-for-profit maternal health care advocacy group, recently released their endorsement for this bill and identified several improvements of care, including:

• Medicaid will pay for home visits by nurses both before and after birth
• Insurance companies may no longer consider pregnancy a pre-existing condition
• Insurance coverage parity for care by nurse-midwives
• Addressing health disparities by offering incentives to providers who care for perinatal women in underserved populations

Poorly delivered or inaccessible maternal health care can contribute to negative outcomes such as poor diet and self-care while pregnant; preterm births; and heightened parental stress, all of which can affect the physical and mental health of both mother and baby. According to the Centers for Disease Control, our infant mortality rates rank 29th (nearly 7 deaths per 1000 births), and the percentage of our preterm birth rates rose by 9% between 2000 and 2005. And it's not that we don’t spend enough: The World Health Organization says that US health expenditures per capita are the highest in the world.
Childbirth Connection is a national not-for-profit group that has educated about and advocated for high-quality maternity care since 1918. MedEdPPD supports their endorsement of this legislation. Please visit their site to learn more.

Medical Updates
Prenatal social support, postnatal social support, and postpartum depression.
Xie RH, He G, Koszycki D, Walker M, Wen SW. Ann Epidemiol. 2009 Sep;19(9):637-43. Epub 2009 May 13.
This study examined the correlation between social support and rates of PPD in a Chinese population.
Bottle feeding simulates child loss: Postpartum depression and evolutionary medicine.
Gallup GG Jr, Nathan Pipitone R, Carrone KJ, Leadholm KL. Med Hypotheses. 2009 Aug 8. [Epub ahead of print]
Researchers believe bottle feeding and separation in the hospital may trigger a biological response in the mother that mimics the response to infant death.
Transdermal estradiol for postpartum depression: a promising treatment option.
Moses-Kolko EL, Berga SL, Kalro B, Sit DK, Wisner KL. Clin Obstet Gynecol. 2009 Sep;52(3):516-29.
This paper presents the scientific background supporting possible therapeutic benefits of synthetic estrogen to treat PPD.
View More»
In The News
Physicians issue guidelines on antidepressants and pregnancy
Newsday.com, August 21, 2009
The American Psychiatric Association and the American College of Obstetricians and Gynecologists have issued guidelines for treating pregnant women with depression, stressing talk therapy but stating that the risks of major depression or other major mental disorders are greater than the risks of using antidepressants in pregnancy.
Coping with postpartum depression — for dads
msnbc.com, August 13, 2009
Sex therapist and relationship counselor Ian Kerner, PhD, describes some of the warning signs for PPD in men and his own experience with depression after the birth of his son.
National Academy Urges Changes in Screening and Treatment of Depression
Psychiatric Times.com, August 11, 2009
A National Academy of Sciences advisory committee has made recommendations for depression care that include extending Medicaid coverage postpartum and expanding mental health care services for both women and their children.
View More»
Events Calendar
New Jersey's 10th Annual Perinatal Health Disparities Conference: Improving Mental Health among Black Women, Children & Families
When: September 22 Where: Newark, NJ
Unmasking Postpartum Depression
When:September 29-October 1
Where: Regina, SK, Canada
Reproductive Health 2009
When: September 30-October 3
Where: Los Angeles, CA
Med Ed Resources
Women's Behavioral HealthCARE
Women's Behavioral HealthCARE is an intellectual and strategic leader in Women's Behavioral Health, offering gender-based medicine and advocacy for women, their families, and communities.
Postpartum Progress
Promoting progress in treatment and comfort among sufferers of postpartum mood disorders, this blog is written by a woman diagnosed with postpartum obsessive-compulsive disorder after the birth of her son.
National Institute on Alcohol Abuse and Alcoholism
The National Institute on Alcohol Abuse and Alcoholism provides leadership in the national effort to reduce alcohol-related problems.
This Month's Poll
As a health care provider, are you in favor of a public insurance option as part of national health care reform?
To participate in this month's poll click HERE.

Spread The Word
Click here to tell a colleague.
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