Join the Birth Trust!

 http://us1.campaign-archive.com/?u=fdca9cd2503447d59cfe59beb&id=7ae4efeb97&e=a09efe6269

Are you committed to changing maternity care?

At the 2010 MANA Conference in Nashville, FAM launched the Birth Trust. We have decided that YOU should choose who receives grants to advance midwifery and the gentle birth movement. The Birth Trust is a transparent fund  where its Birth Trustees vote on grant-making every year. Birth Trustees make a minimum contribution of $33 a month for one year in order to vote. 

We are advertising the Birth Trust to the readers of Mothering, Midwifery Today, and we plan to reach out to doulas, childbirth educators, lactation consultants so that this effort is not limited to the financial resources of midwives alone. We must do this together.

For about a $1 a day, don't you want a say in the projects that promote midwifery policy, research, access, and public education? Make your voice heard! Join us!

If you become a Birth Trustee by 12/31, we will mail you a Birth Trust T-shirt! Include your size: M, L, XXL in the comment section. 

Progress!

We have found nearly 100 Trustees, and are well on our way to our goal of 250 trustees for its first year. This would mean $100,000 to grant to midwifery causes. Midwives at the beginning and peak of their career, students, friends, and family have signed on for change in maternity care.

The midwifery movement has never lacked passion or ideas, merely the financial resources to enable them. Let's change that!

Please forward this email to those you know who are passionate about midwifery. If every one of you who subscribe to our newsletter became or found a Birth Trustee, we would have $336,000 to grant.

Our collective power to change is immense. Please join us!

 

 Copyright (C) *|2010||* All rights reserved.

Jodi L. Kluchar
www.ptsdafterchildbirth.org

Reasons not to kill yourself by Mari Collings

REASONS NOT TO KILL YOURSELF
by Mari Collings ©


Because you deserve to live.
Because your life has value, whether or not you can see it,
Because it was not your fault,
Because you didn't choose to be battered and used,
Because life itself is precious, because they were and are wrong,
Because you are connected to each and every other ritual abuse survivor, and so your daily battle automatically gives others hope and strength.
Because you will feel better, eventually
Because each time you confront despair you get stronger .. you can't know now what you will ultimately be able to do with this new morsel of strength, what future battles you will be able to win,

Because if you die today you will never again feel love for another human being, or trust, or gratitude; because you will never again see kindness and compassion in another's eyes.

Because if you die today you will never again see sunlight pouring through the leaves of a tree, or a bird take flight, or feel the quality of light in winter,

Because the seconds do not cease their passing, because even if it feels like time has become an unbearably heavy stone, it has not, and you only have to endure,

Because you have already won .. you have known the cleverness and resiliency and courage and stubborn will to make it this far, and no one can take that away,

Because the will to live is not a cruel punishment, even if it feels like that at times: it is a priceless gift.

Because your inner children need you, they have no one else and their need is so great, and because they deserve more than anyone to be healed and comforted; they are true heroes against impossible odds.

Because you owe your inner children, they are the reason you are here. If you die today you will erase the meaning of their suffering and incredible endurance, and that is too great a loss,

Because you already have the skills to find your healing path; you have proven this over and over again,

Because we need more warriors against this evil,

Because we need survivors to offer testament against this horror and despair,

Because no one knows better than you the meaning of suffering, and agony deepens the heart,

Because you deserve the peace that will come after this battle is won, and it will be won, but only minute by minute .. we must learn to let go of the unconquerable,

Because we can all come together in later years to laugh in their faces; because we will be able to show them that even though they had all the power and strength and ruthless cunning, even though we were only helpless, innocent, dependent children, we will have beaten them at the game they so smugly thought they had mastered,

Because I am furious that we have to suffer the pain of another's evil and filth,

Because you too will one day feel fury,

Because it is critical that you survive.

© Mari Collings

Jodi L. Kluchar
www.ptsdafterchildbirth.org

"Reframing Birth and Breastfeeding: Moving Forward"--Join us March 11-12, 2011, in Chapel Hill, NC, for this collaborative event!

	Bulletin from the cause: Join the Coalition for Improving Maternity Services (CIMS) - www.motherfriendly.org Go to Cause
Posted By: Denna Suko
To: Members in Join the Coalition for Improving Maternity Services (CIMS) - www.motherfriendly.org
"Reframing Birth and Breastfeeding: Moving Forward"--Join us March 11-12, 2011, in Chapel Hill, NC, for this collaborative event! For nearly a decade, the CIMS Annual Mother-Friendly Childbirth Forum has been recognized for offering the most authoritative and up-to-date research information pertaining to the Ten Steps of Mother-Friendly maternity care. For our 2011 conference, we've teamed up with UNCG's Center for Women's Health and Wellness and UNC's Carolina Global Breastfeeding Institute who for five years have presented their "Breastfeeding and Feminism Symposium," an exploration of opportunities to reposition breastfeeding as a valued part of women's (re)productive lives and rights. This collaborative event, "Reframing Birth and Breastfeeding: Moving Forward," will be held March 11-12, 2011, at the Sheraton Hotel in Chapel Hill, NC. Online registration will open soon. Watch the CIMS website (http://www.motherfriendly.org) for details. Confirmed speakers include: • Eugene Declercq, PhD, MBA, Assistant Dean for Doctoral Education at Boston University School of Public Health, providing an update on national advances in improving maternity care. • Susan M. Ludington, PhD, CNM, FAAN, Professor of Pediatric Nursing, Frances Payne Bolton School of Nursing at Case Western University, presenting "Kangaroo Care for All and All for Kangaroo Care". • Miriam H. Labbock, MD, MPH, FACPM, IBCLC, FABM, Director of the Carolina Global Breastfeeding Institute, and Professor, Department of Maternal and Child Health at University of North Carolina at Chapel Hill • Bettina Lauf Forbes, Co-founder and President of Best for Babes, in "Beating the Breastfeeding Booby Traps" will explore the cultural & institutional barriers that prevent moms from achieving their personal breastfeeding goals. • Geradine Simkins, CNM, MSN, President and Interim Executive Director at Midwives Alliance of North America, presenting "What Really Matters: Using Midwives' Stories for Social Change". • Robbie E. Davis-Floyd, PhD, Fellow, Society for Applied Anthropology, and Senior Research Fellow, Department of Anthropology at University of Texas Austin, presenting "The International MotherBaby Childbirth Initiative (IMBCI): Current Implementation Projects and Preliminary Results". Additional hot topics to be covered: • The new federal "MOMS for the 21st Century Act", and joining us will be Debbie Jessup, CNM, MS, MA, PhD(c), Health Legislative Specialist in the Office of Congresswoman Lucille Roybal-Allard (CA-34) • Consistent with Childbirth Connection's Transforming Maternity Care Partnership for Blueprint Implementation, providing examples of excellence in maternity care will be Warren Newton, MD, MPH, William B. Aycock Distinguished Professor and Chair UNC Dept. of Family Medicine and Executive Associate Dean for Medical Education at UNC School of Medicine, Michele Lauria, MD, MS, Professor Obstetrics & Gynecology and Radiology at Dartmouth Hitchcock Medical Center and the Northern New England Perinatal Quality Improvement Network, and Morgan Martin, MHA, Project Coordinator at Michigan Health & Hospital Association along with Tami Michele, DO, Ob/Gyn representing the Keystone Center for Patient Safety & Quality. Don't miss these pre-conference workshops on Thursday, March 10: • "The Art of Mother-Friendly Labor Support for Nurses," featuring ICEA President Jeanette Schwartz, RNC, MA, ICCE, LCCE, CD, IAT, and Marilyn Hildreth, RN, ICCE, LCCE, FACCE, CD(ICEA,DONA). Seven contact hours. • "HUG Your Baby", an innovative approach to helping parents understand their baby's body language in order to prevent and solve problems around a baby's eating, sleeping, crying, and parent-child attachment, presented by Jan Tedder, BSN, CS, FNP. Six contact hours. Watch the CIMS website (http://www.motherfriendly.org) for additional program details and online registration as they are announced.

Jodi L. Kluchar
www.ptsdafterchildbirth.org

Join the Coalition for Improving Maternity Services (CIMS)

 

Jodi L. Kluchar
www.ptsdafterchildbirth.org

	Bulletin from the cause: Join the Coalition for Improving Maternity Services (CIMS) - www.motherfriendly.org Go to Cause
Posted By: Denna Suko
To: Members in Join the Coalition for Improving Maternity Services (CIMS) - www.motherfriendly.org
Ensuring Access to Safe, Healthy Childbirth Options: You Can Help! It's not too late to add your name or your organization's name to our "One Voice" letter to Dr. Richard Waldman, president of the American College of Obstetricians and Gynecologists (ACOG). Visit http://www.motherfriendly.org today! More than 550 co-signing individuals and organizations have already joined CIMS in urging ACOG to remove additional barriers to VBAC (vaginal birth after cesarean). This request follows the March 2010 National Institutes of Health (NIH) Consensus Statement on VBAC, which found that VBAC is a reasonable choice for the majority of affected women. Specifically, we're urging ACOG to revise its current recommendation that VBACs should take place in hospitals where emergency cesareans are "immediately available," which the NIH concluded was not based on strong support from high-quality evidence and had influenced about one-third of hospitals and one-half of physicians to stop providing care for women who wanted to plan a VBAC. For additional information and resources, visit the CIMS website. Add your name or your organization's name now at http://www.motherfriendly.org. CIMS will collect the names of additional organizations and individuals in support of this request through October 31, 2010, and will send the updated list of co-signers to Dr. Waldman.

Jodi L Kluchar wants you to see this item at Amazon.com

	Jodi L Kluchar <purpledragon1976@gmail.com> requested that we send this e-mail. If you have questions about Amazon.com, please visit our Help Department From: Jodi L Kluchar   Beyond the Birth: What No One Ever Talks About by Dawn Gruen Not in stock; order now and we'll deliver when available Price: $6.00
The Doula Book: How a Trained Labor Companion Can Help You Have a Shorter, Easier, and Healthier Birth by Marshall H. Klaus The Birth Partner, Third Edition: A Complete Guide to Childbirth for Dads, Doulas, and All Other Labor Companions (Birth Partner: A Complete Guide to Childbirth for Dads, Doulas, &) by Penny Simkin Pregnancy, Childbirth, and the Newborn: The Complete Guide (medically updated) by Janet Whalley Explore similar items
Jodi L Kluchar <purpledragon1976@gmail.com> requested that we send this e-mail. If you have questions about Amazon.com, please visit our Help Department Amazon.com 1200 12th Ave. S. Suite 1200 Seattle, WA 98144-2734 http://www.amazon.com

Couple launch legal battle against Dorset County Hospital

Couple launch legal battle against Dorset County Hospital (From Dorset Echo)

A COUPLE whose daughter suffered severe disabilities at birth have launched a legal battle against Dorset County Hospital.

A traumatic birth left Honey Arnold-Jones, now four, fighting for her life and she now has severe cerebral palsy.

The family has recently launched a legal fight against the Dorchester hospital, attributing Honey’s disability to failings in her delivery.

Simon and Jane Arnold-Jones admit they feel incredibly lucky to have little Honey in their lives.

And the devoted parents from Creech, near Wareham, insist theirs’ is not a sad story.

Simon said: “We have a beautiful girl who survived. It just means life is different – but it is for anyone with children.

“Our problems are just technicalities.”

Honey is every inch the four-year-old, but her complex needs mean she is unlikely to ever walk, talk or see properly.

The family’s bid for damages has only been launched to ensure Honey is supported later in life.

It was only when Simon and Jane began asking questions about the birth that they realised errors may have been made.

Their claim states Jane, 44, at the time, was not induced as planned and Honey then became asphyxiated during the birth.

Jane was also lucky to survive post-birth, and both mother and daughter subsequently spent many weeks in hospital.

“I’ve always been a great believer in the NHS, but there has to be accountability,” says Simon.

Read more: http://www.dorsetecho.co.uk/news/localnews/8257611.Couple_launch_legal_battle_against_Dorset_County_Hospital/

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Veterans Seek Medical Marijuana for PTSD Patients in Colorado

Opposing Views: Veterans Seek Medical Marijuana for PTSD Patients in Colorado

DENVER --- Tomorrow, Wednesday, July 7, the medical marijuana advocacy group Sensible Colorado and local veterans will hold a press conference and rally to coincide with the official submission of a petition to the Colorado Department of Public Health and Environment that would add post-traumatic stress disorder, or PTSD, to the list of conditions eligible for medical marijuana recommendations in Colorado.

Read more: http://www.opposingviews.com/i/veterans-seek-medical-marijuana-for-ptsd-patients-in-colorado

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Parents sue doctors after baby's death

Parents sue doctors after baby's death | Louisiana Record

Two Louisiana parents are accusing the doctors who delivered their baby of causing his death.

Ashley Robinchaux and Harris Irvin, individually and on behalf of their deceased son, filed suit against the state of Louisiana, through the Louisiana State University Medical Center, Health Sciences Center and the Medical Center of Louisiana at New-Orleans University Hospital Campus, the Administrators of the Tulane Educational Fund June 23 in Orleans Parish District Court.

Robinchaux and Irvin argue that a cesarean section delivery was needed but was not performed. They say the physicians who delivered the baby also failed to perform appropriate resuscitation techniques after the birth.

Two other LSU resident physicians are accused of not providing the newborn with adequate oxygenation via bag and mask ventilation during their prolonged intubation attempts. According to the suit, the baby was eventually intubated, by a respiratory technician, ten minutes after delivery.

Read more: http://www.louisianarecord.com/news/228044-parents-sue-doctors-after-babys-death

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Alive! Mental Health Fair

Kristin Brooks Hope Center - Hopeline

The Alive! Mental Health Fair is the Hope Center's newest program; it was created to provide an interesting educational program aimed at college students to help them learn how to prevent suicide.

Most people do not know that suicide is the second leading cause of death for college students.

The Hope Center created this program in partnership with Postsecret . There is an art therapy exhibit and a hands-on graffiti exhibit where each student is able to create their own art expression on a large canvas which is pre-populated with a theme customized for each campus. We screen A Reason To Live Documentary which depicts young suicidal adults grappling with life and death issues and how crisis interventionists help them. In addition, there is a PostSecret Exhibit, where blank Postsecret cards are sent to each campus in advance of the fair's arrival so that students can create their own PostSecrets which are then put on display at the fair. Lastly, there is a one hour training course in QPR, Question Persuade and Refer, on how to ask a friend or someone you are concerned about if they are suicidal, how to persuade them to get help, where to find that help and take them there. Counselors invited from the host college will be on hand to meet and speak to the students.

Read more: http://www.hopeline.com/alivemhf.html

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Medical group pushes awareness of PTSD in veterans

Medical group pushes awareness of PTSD in veterans - chicagotribune.com

INDIANAPOLIS —
The Indiana State Medical Association is working to raise awareness of post-traumatic stress disorder to ensure that returning soldiers receive the help they need.

The group recently distributed information about the disorder to 1,300 primary-care physicians across the state, who experts say are often the first line of defense for troubled veterans.

"The family doctor is going to be more likely to be able to talk to them than anybody else," said Silouan Green, a former Marine who suffered PTSD after a stateside jet crash and now travels the U.S. helping others deal with the condition. "There's a natural fear and cynicism among soldiers' families of the VA."

Camille Pond, who led the Indiana effort to distribute PTSD information to doctors, says medical providers who don't have contact with the military might not have experience with PTSD.

"A whole host of things might bring a patient into the doctor's office, and they need to be able to connect the dots, that this is in response to stress," said Pond, whose husband, Dr. William Pond, is a colonel in the Indiana Air National Guard.

The awareness effort could benefit thousands. Indiana has about 27,000 National Guard members, and statistics estimate that 15 percent to 25 percent of returning soldiers suffer from PTSD.

Many of the symptoms commonly associated with the disorder, such as nightmares, flashbacks and fear of crowds, often pass with time. But those with PTSD may require multiple medications and therapy to help them cope with the condition.

People with the disorder are more likely to recover the sooner their condition is diagnosed and treatment is started, experts say. But diagnosing the disorder can be difficult.

William Pond, a Fort Wayne anesthesiologist, interviews returning Guard members to assess their physical and mental health. Some don't show signs of PTSD until weeks after their return.

"What we found was that we were doing a pretty good job of getting people initially, but after they leave, we felt that we needed to have a better ability to keep track of them," he said. "That's why we wanted to ... make this more of a communitywide approach."

The push could help people like Indiana Air National Guard Maj. David Cox, who spent months wrestling with PTSD symptoms before finally being diagnosed.

Read more: http://www.chicagotribune.com/news/chi-ap-in-soldiers-ptsd,0,907324.story

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Local veteran's suicide reflects troubling trend

Local News | Local veteran's suicide reflects troubling trend | Seattle Times Newspaper

High suicide rate

During nine years of war, suicide rates among active-duty soldiers, once far below the civilian population, have been on the rise. From January through June 10 of this year, 115 soldiers had taken their lives. The even higher rate of veterans taking their own lives after leaving the military also has raised major concerns.

More than 35,800 Washington state veterans have served in the Iraq and Afghanistan war era. If the national veteran suicide rates also are representative of the state level, then more than a dozen young Washington veterans kill themselves each year.

These veterans can turn to a network of hospitals, clinics and counseling centers that have benefited from increased federal funding. Washington state has developed a network of 37 counselors who offer free services to veterans, while King County voters approved a 2005 levy that expanded services to veterans.

These efforts have aided plenty of people.

But the failures are wrenching.

In the summer of 2008, for example, two 25-year-old Iraq veterans in Washington state killed themselves: Timothy Juneman, who was attending school in Spokane, hung himself in his apartment. Tim Nelson, who was working at a Bellingham veterans center, shot himself at his home.

"As I've often asked, mostly of myself, but also of others from time to time, why do we know so much about suicides but so little about how to prevent them?" said Eric Shinseki, a retired Army general who now heads the Department of Veterans Affairs.

Read more: http://seattletimes.nwsource.com/html/localnews/2012287375_orrin06m.html

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Veteran suicides: Families haunted - Depression follows tragedy

Veteran suicides: Families haunted

Daniel V. Ryan, public affairs officer for the Canandaigua, N.Y.-based Department of Veterans Affairs, said while there are no official statistics on veteran suicides, there are on the number of telephone calls made to the VA’s National Suicide Prevention Hotline.

Since the summer 2007, he said, 281,679 calls were received as of June 21. Of those callers, 9,192 were rescued.

“These were people with guns in their hand or ropes around their neck,” Mr. Ryan said.

Mr. Lucey contends there are more veteran suicides than troops killed in action.

“Suicide is one of the major problems in the U.S, and the number of military suicides is increasing every year,” Mr. Lucey said. “And for every suicide, there are at least five attempted suicides.”

He said his son did not show overt signs of depression until Christmas Eve of 2003, when he did not want to join the annual family celebration at his nearby grandparent’s house, something out of character for him. At one point, Jeff flung his dog tags at his younger sister, with whom he shared some of his dark war memories. But on Christmas Day, Jeff seemed back to normal. However, as his March 18 birthday approached — which coincided with the anniversary of the Iraq invasion — Jeff began spiraling down. His father said he was not sleeping or eating well, drinking heavily, and isolating himself.

The family tried to get him to go to the Northampton VA hospital, but Jeff refused, fearing a mental health record would end his dream of becoming a state police trooper.

Memorial Day rolled around and things were worse. Mr. Lucey got Jeff involuntarily committed to the hospital for three days, but said Jeff was not assessed for post-traumatic stress disorder during his stay, even though he had threatened to kill himself three times. Mr. Lucey said the family was told Jeff needed to be sober for a certain period of time before he could be assessed.

“The system itself is broken,” he said.

A week after his release, Jeff crashed his car between two trees, but was not seriously injured. Two days after that, he was taken to the VA hospital by his grandfather, but was not admitted. On June 15, Jeff’s mother, Joyce Lucey, called the VA and told whoever would listen that they were “watching our son die.” Three days later, Jeff was assessed at the hospital but not admitted. The family then took him to Camp Sunshine, a camp for terminally-ill children and their families in Maine, because Jeff had volunteered there previously, and enjoyed it.

They returned on Fathers Day. That night, an exhausted and emotionally drained Mr. Lucey yelled at his son, telling him how angry he was. They later made up.

On the evening of June 21, Jeff suddenly asked if he could sit in his father’s lap.

“I felt really awkward about it, but I had never given up,” Mr. Lucey said. “He was trying to say goodbye, but I did not know that.”

He soon found out. At 6:45 p.m. the next day, Mr. Lucey walked by his son’s room and saw the dog tags on his bed. Then, he noticed the cellar door was ajar and the lights were on. He got a glimpse of some sort of shrine made out of family photographs.

“I walked down the stairs, and then I saw the blood. And that was the last time I held my son in my lap,” Mr. Lucey said.

A year later, a letter arrived for Jeff. It was from the state police, informing him of his acceptance into its academy.

According to Michael M. Lawson, medical director of the VA Boston Healthcare System, 45 percent of returning troops are receiving health care from the VA, and mental health care is the most sought-after form of treatment. Furthermore, Mr. Lawson said, mild concussions and more serious traumatic brain injuries, very common in the Iraq and Afghanistan conflicts, can produce the same symptoms as post-traumatic stress disorder. Also, repeated tours of duty in these conflicts increase the likelihood of post traumatic stress, he said. Mr. Lawson, a Vietnam combat veteran, said while new medications and increased mental health services can lessen the effects of stress, veterans need jobs.

Read more: http://www.telegram.com/article/20100706/NEWS/7060417/1116

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Book looks at stress disorder

Book looks at stress disorder | TriCities

“The PTSD Workbook” by Mary Beth Williams and Soili Poijula, 2002, New Harbinger Publications, Inc., $21.95, softbound, 237 pages: Survivors of traumatic events often have a condition known as post-traumatic stress disorder, or PTSD. The idea behind this book is to help these survivors do the work of recovery themselves, rather than relying on professionals to help them all the time.
The authors tell us that there are three major kinds of factors which determine the development of PTSD: pre-event factors (including previous exposure to trauma or victimization, lack of social support and genetics); event factors (such as age, the length of the trauma and physical proximity to the event); and post-event factors (like being passive, developing acute stress disorder or being unable to glean meaning from the trauma).

Read more: http://www2.tricities.com/tri/news/local/article/book_looks_at_stress_disorder/48356/

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Opinion: G8 nations need to stem the vast tide of deaths in childbirth

Opinion: G8 nations need to stem the vast tide of deaths in childbirth - San Jose Mercury News

By Kate Grant

Special to the Mercury News
Posted: 07/03/2010 08:00:00 PM PDT

If you're a mother-to-be in the United States, one of your rites of passage on your way to a safe delivery is to attend a childbirth class. During the class I took, the discussion at times seemed fixated on the goal of "natural" childbirth, meaning, of course, drug-free labor. I did exercises like holding an ice cube while counting to 60 and being taught to breathe deeply.

I have to admit, little of that diligent training worked with me. After 10 hours of labor, and literally unbearable pain that felt nothing like holding an ice cube, I pleaded for drugs. My son was born healthy by cesarean section 12 hours later.

Had I been like the majority of women in Southern Asia and sub-Saharan Africa, I would have delivered at home, without a trained attendant and postpartum care for my son. Forget the painkilling meds. Forget the C-section, and likely forget giving birth to a healthy child. The result: more than 300,000 maternal deaths, and the deaths of 3.5 million newborns.

The biggest threat to the lives of teenage girls and young women in the developing world is pregnancy and childbirth. According to the World Health Organization, a woman living in sub-Saharan Africa faces a lifetime risk of dying due to pregnancy of 1 in 16. And for every woman who dies, another 20 suffer from illness and disability, like obstetric fistula, that without surgery to repair it leaves its victims incontinent social outcasts.

The tragedy does not end there. The children of these mothers are much more likely to die, too.

Read more: http://www.mercurynews.com/opinion/ci_15423268?nclick_check=1

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Thoughts on Birthrape

Thoughts on Birthrape « Birth a Miracle Services

Women, mothers, girls, please! Protect your bodies! Birth leaves you vulnerable, which is good, but you must choose your care provider with extreme caution! If you are hesitant about your doctor or midwife prior to birth, if you find yourself defending him or her but know deep down you can’t trust them, listen to your intuition! Respond to that voice inside you because pregnancy is the only chance you have to choose birth attendants who will protect you in your vulnerability. You can’t protect yourself while you’re giving birth. That’s how you end up with the fight or flight response causing your labor to not start or to stall or your baby’s precious heart to show signs of stress during labor – because you don’t feel safe! Please, listen to your birthing voice and obey it. It may not be easy to change care providers like this woman did (also see June Favorites), but you’ll thank yourself during and after your birth.

If you have experienced birth rape, felt manipulated or cheated, or forced to do something you didn’t want during your birth, please read this post, and talk to someone about it. You don’t have to protect your abuser, and it is good to stand up for yourself.

Read more: http://birthamiracle.wordpress.com/2010/06/30/thoughts-on-birthrape/

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Assistance available for postpartum issues

Assistance available for postpartum issues | nbs.gmnews.com | North South Brunswick Sentinel

The New Jersey Department of Health and Senior Services wants residents to know that help is available for women who are suffering with postpartum mood issues.

Among the babies born in the United States every year, 35 percent are born from the beginning of June through the end of September. For every eight in 10 births, new mothers will experience at least a brief episode of the “baby blues” — feelings of sadness, anxiety, loneliness, or moodiness — within the first few days of giving birth.

After a few weeks these symptoms typically disappear. When symptoms persist or deepen in intensity, however, they may be a sign of postpartum depression (PPD) or another perinatal mood disorder (PMD).

PMDs include anxiety disorder, obsessive compulsive disorder, post-traumatic stress disorder, bipolar disorders and postpartum depression. The depression may be mild, moderate or severe.

In New Jersey, women have numerous resources available to help them overcome the effects of PMD. The disorders can be serious, but they are highly treatable. Help is available, and it is important that a mother get the support and treatment needed to recover so that she can enjoy her baby. The first step is to ask for help.

Read more: http://nbs.gmnews.com/news/2010-06-29/Front_Page/Assistance_available_for_postpartum_issues.html

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Study shows impact of brain injury on women's health

Health News - Study shows impact of brain injury on women's health

Appears to affect menstrual cycle, postpartum health

After a brain injury, women often ask how the injury will affect their fertility, pregnancy and postpartum health. Now a new U of T/Toronto Rehab study provides some much-needed answers.

Published in the June issue of the Journal of Women’s Health, the study is the most comprehensive investigation to date of women’s health issues after traumatic brain injury.

“Traumatic brain injury is a major public health problem, yet little is known about its long-term effect on women’s reproductive health,” said Professor Angela Colantonio of occupational science, a senior scientist at Toronto Rehab and principal author of the study. “Our findings provide important information for women who have experienced a traumatic brain injury, and for health professionals working with these women.”

The study, which examined the health outcomes of 104 premenopausal women five to12 years after moderate to severe brain injury, found that:

* women with traumatic brain injury (TBI) were more likely to experience menstrual disturbances, including irregular cycles and amenorrhea (not having a period)
* women with TBI did not appear to have significantly more problems with getting pregnant when compared to women without brain injury
* women with TBI had fewer children
* significantly more women with TBI experienced postpartum difficulties, compared to women without brain injuries
* women with TBI reported lower levels of perceived health, including mental health, physical function, perceived support, and income.

“These findings inform prognosis after TBI for women and provide evidence for long-term monitoring of health outcomes and increased support after childbirth,” the authors write.

Read more: http://www.healthcanal.com/brain-nerves/8997-Study-shows-impact-brain-injury-womens-health.html

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Birth injury girl gets £4million injury compensation for future care

Birth injury girl gets £4million injury compensation for future care | Injuries Direct

A girl who was left disabled for life after a traumatic birth has been awarded a £4million injury compensation package.

Six-year-old Holly Nixon from Kidderminster has cerebral palsy after she was starved of oxygen during her birth at the Worcestershire Royal Hospital in 2003.

Doctors decided that Holly would need to be delivered by emergency caesarean, but this process was delayed to such an extent that her condition seriously deteriorated.

When she was finally delivered she was suffering from severe oxygen starvation, which caused permanent brain damage and left her quadriplegic. She is now unable to move independently, and has limited speech and vision.

Read more: http://www.injuriesdirect.com/news/birth-injury-girl-gets-4million-injury-compensation-for-future-care-2562

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Pregnant and terrified: It's maternity's biggest taboo, but antenatal depression is very real

Pregnant and terrified: It's maternity's biggest taboo, but antenatal depression is very real | Mail Online

For as long as I can remember, I hoped I would have children. In my late teens and 20s, I imagined I'd have four. When I reached 30, I readjusted my expectations downwards to two or three.

By 35 and still single, I began quietly to panic as I tried to get my head around the possibility that it might never happen. Then, two-and-a-half months ago, at the age of 39 and after a miscarriage last November, I discovered I was pregnant.

I was momentarily elated, as was my partner. But for me the joy and excitement quickly and surprisingly disappeared. In its place was fear, often verging on terror.

I tried to reassure myself that part of it was normal - physical and hormonal. The constant nausea, the ever-present feeling of exhaustion and the complete loss of appetite are horrible.

As is having such a heightened sense of smell that I can no longer apply moisturiser or open my fridge without feeling sick.

I was also struck by an absolute terror of the birth. I reminded myself that I was not the first person in the world to get pregnant and that nearly 500,000 women worldwide give birth every single day.

This didn't, however, make me any less terrified. Nor did my well-intentioned friend who, in response to my plea for the honest truth, told me that on a scale of one to ten, if two is having your foot run over by a car and five is having your jaw reset without anaesthesia, then childbirth hovers between nine-and-a-half and ten.

But, she tried to assure me, you do forget how awful it is. And I know the birth is not the end of the story; it's only the beginning.

Read more: http://www.dailymail.co.uk/femail/article-1290139/Pregnant-terrified-Its-maternitys-biggest-taboo-antenatal-depression-real.html?ito=feeds-newsxml

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Post-traumatic stress disorder? Logon for help

Post-traumatic stress disorder? Logon for help

(PhysOrg.com) -- People with post-traumatic stress disorder (PTSD) will have the chance to take part in a pilot study of an internet-based education program.

Participants will be able to log on to a secure website and complete the program at convenient times. There are six lessons over an eight-week period and those involved will have access to a clinical psychologist who will monitor their progress and be available for phone and email support.

The pilot, run by UNSW and St Vincent’s Hospital, follows other online programs that have proven just as effective as face-to-face therapies for a wide range of common mental disorders.

“In this program people will learn to recognise and challenge the symptoms of PTSD, and with practice, we hope they will gain control over those symptoms,” says Mr Jay Spence, a clinical psychologist who is developing the online treatment as part of his PhD at UNSW. “Recovering from PTSD is hard work, but good education is the cornerstone of learning to manage the symptoms.”

Read more: http://www.physorg.com/news197292733.html

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Use Of Doulas Sparks Debate At Columbus-Area OB-GYN

Use Of Doulas Sparks Debate At Columbus-Area OB-GYN | NBC 4i

COLUMBUS, Ohio --

Catie Mehl is a certified birth doula. She says she helps women and their partners during the labor and birth process with emotional and physical support. "We suggest position changes, we offer suggestions on different comfort techniques, we help with breathing, we just help them to feel a little bit more comfortable during the birthing process," she said.

Mehl helped Margaret Murphy with the birth of Murphy's daughter three years ago. At the time, Murphy was a patient at Kingsdale Gynecologic Associates, which no longer uses doulas.

"Because I did have such a good experience, it disappoints me that other women that go through that practice will not have the option to have that experience again," Murphy said. "I would never birth a child without a doula, ever. So that affects me in the choice I make and in the practice that I select for my next child," she said.

Read more: http://www2.nbc4i.com/news/2010/jul/01/6/use-doulas-sparks-debate-columbus-area-ob-gyn-ar-129467/

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Did I Really Need to Have a C-Section? The problem with doctors, not moms, picking the birth method.

Did I really need to have a c-section?

In the homestretch of my first pregnancy, I imagined childbirth would involve some shouting, a fair amount of blood, and in the end a baby. As it turned out — not so much.

I had a C-section. I know women who’ve given birth surgically whose feelings fall somewhere on the spectrum between neutral and ecstatic. I am not one of those women. I am angry.

Labor was a nightmare — the kind where you know you’re having a bad dream but you can’t wake yourself up. It took a night and a day of five-minutes-apart contractions to get a labor room and an epidural (I was progressing, but painfully slowly). The pain eased, but then the nightmare closed in. I was tethered to my IV pole and fetal monitor. The lights were dim. I imagined babies being born in rooms around me in the rush and light and heat that I craved for myself.

At dawn on day two, I’d reached 10 centimeters. I pushed for an hour but it was fruitless, dry and bloodless. The doctor offered a C-section, and I acquiesced. What I’d been through seemed to have no end. Surgery, though I didn’t want it, held out the promise of an end. An hour later, I had my son.

Though his unending needs didn’t at first leave me the brain space to indulge in shoulda-coulda-wouldas, I eventually came to regard my incision, as it hardened into a scar, as a badge of dishonor. The first moments of my son’s life remain at a frustrating remove. I remember the bright lights; the odd, painless tugging at my abdomen; the conversation between doctors and nurses. But I wasn’t really there.

I didn’t want it to happen again. When I got pregnant 16 months later, I discovered that VBAC (vaginal birth after C-section) was no longer the default position. In fact, it was actively discouraged. Caesarean rates, which had dipped in the late 80s and 90s, were on a steep incline. The year I had my second son, 2004, 29.1% of all births in America were surgical — and it rose to over 30% just a year later, according to the National Center for Health Statistics. An increasing number of women request surgery for convenience or fear of labor. Many OBs, whether wary of malpractice or eager to maintain their schedules, seem more inclined take up a scalpel than to try to ease a troubled labor through to a natural conclusion.

Read more: http://www.babble.com/pregnancy/giving-birth/did-i-really-need-a-c-section/

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Postpartum Mental Illnesses - Postpartum depression and psychosis support! - A very quick, 3-question survey

A very quick, 3-question survey

Posted by: "tsnm278"

Wed Jun 23, 2010 3:03 pm (PDT)

Hello everyone!

As I posted before, I've recently started up a website called SOS: Sisterhood of Strength at http://sisterhoodofstrength.wordpress.com. It aims to empower women with mental illness (both permanent and temporary) to express themselves through art and writing. I publish art, poetry, fiction, and non-fiction that women who struggle with mental illness send me.

To better understand the needs of my target audience, I've come up with a survey. It's only 3 questions, and will take less than 5 minutes of your time to complete. By participating, you'll be helping not only me, but women everywhere. Please pass on this link to women you know. Remember, not everyone is forthcoming about their mental illness, and almost half of people in the U.S. have a mental illness of some sort!

To start, you can copy and paste the following link to your browser: http://www.surveymonkey.com/s/D5B3RLR

Thank you so, so, so much for your help and participation.

Sandhya

To members of Birth Trauma Association

Facebook | Messages - BTA - Birth Experience Survey - Please Help!

Julie Orford June 29 at 3:20pm Reply
Hi All
We are looking for mums to complete a very brief, literally a couple of minutes, survey about their birth experience. This can be both GOOD and BAD experiences.

If you have a spare minute, please can you fill in the survey to help us, we do have an optional prize draw on offer too for £50.00.

If you have had more than one child, please feel free to fill the survey in for each of your births.

http://www.surveymonkey.com/s/YBBGJNS

Thank you!
Jules - BTA Chair

Read more: http://www.facebook.com/?tid=1368499527846&sk=messages#!/?page=1&sk=messages&tid=1368499527846

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Secretary of State Hillary Clinton Announces Innovative International Partnership Focused on Maternal Child Health

Secretary of State Hillary Clinton Announces Innovative International Partnership Focused on Maternal Child Health - EmpowHER.com

Arlene Remick, MPH, released this exciting news about text4baby, a mobile health messaging program from Healthy Mothers, Healthy Babies which includes-- among other important health information for pregnant and new moms-- messaging related to maternal mental health and postpartum depression. This historic and groundbreaking program has become the centerpiece of a major international and innovative partnership.

Remick said, “Last week, Secretary of State Hillary Clinton announced a partnership between the National Healthy Mothers, Healthy Babies Coalition (HMHB) and the Healthy Russia Foundation to launch text4baby internationally. The announcement was made in tandem with the Obama-Medvedev Presidential Summit in Washington, D.C. about our plans to share strategies for success in mobile health with our Russian counterparts.”

Read more: http://www.empowher.com/postpartum-depression/content/secretary-state-hillary-clinton-announces-innovative-international-par?extsrc=coi-digest

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Preterm Births Rarely Discussed With Doctors

Preterm Births Rarely Discussed With Doctors - EmpowHER.com

WEDNESDAY, June 30 (HealthDay News) -- Even though one in eight babies in the United States are born preterm each year, most new or expectant mothers and their doctors don't discuss preterm birth, a new survey shows.

Conducted by the March of Dimes and BabyCenter, the poll included more than 1,000 participants, including new or expectant mothers, mothers who've experienced preterm birth and their obstetricians/gynecologists.

Despite the fact that prior preterm birth is a major risk factor for delivering another baby prematurely, nearly 40 percent of women who had a previous preterm delivery were not informed of this by their doctors...

Read more: http://www.empowher.com/pregnancy/content/preterm-births-rarely-discussed-doctors?extsrc=coi-digest

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What is Mandated Screening for Postpartum Depression?

What is Mandated Screening for Postpartum Depression? - EmpowHER.com

There has been a great deal of confusion and misinformation around the concept of mandated screening for perinatal mood disorders. Who is mandated to offer screening? And are mothers required to receive it?

The answer is, there is no law in any state or federal bill that mandates mothers to receive screening for postpartum depression. While New Jersey has a law mandating health care facilities to offer screening to new mothers prior to discharge, mothers are not required to receive it. There is no such law in any state in the union. As with any other medical test, the patient must consent to participate.

Read more: http://www.empowher.com/mental-health/content/what-mandated-screening-postpartum-depression?extsrc=coi-digest

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April Ambassadorial Support Call: Getting Maternity Care Providers on Board

CIMS GAC Ambassadors

High Impact Birth Activists....Together Making Mother-Friendly Care a Reality

A message to all members of CIMS GAC Ambassadors

With the increasing consumer demand for transparency, there is also a widespread belief that sites like The Birth Survey contain unfair assessments that the public may take out of context. Yet on the contrary, The Birth Survey can work for the benefit of those on the maternity care front lines! Moreover, health care professionals can open many doors to promoting The Birth Survey and supporting transparency.

Join us for our monthly conference call as Jenne Alderks presents on how to partner with maternity care providers in getting the word out about The Birth Survey. Also, whether you’re gathering data or promoting The Birth Survey, project leadership will also be on hand to hear your updates and address any questions or concerns.

April Ambassador Support Call
Date: Tuesday, April 6, 2009, Time: 9:00-10:00PM Eastern

Conference Dial-in Number: (218) 339-4600
Participant Access Code: 408936#

Visit CIMS GAC Ambassadors at: http://grassrootsgrapevine.ning.com/?xg_source=msg_mes_network

Midwifery Today E-News “Amish Birth”

In This Week’s Issue:

• Quote of the Week
• The Art of Midwifery: Potato for Hemorrhoids
• Jan’s Corner: Amish Birth
• Research: Report on Out-of-Hospital Births in US
• Just a Plain Birth
• Featured Products
• Web Site Update
• Advertising Opportunities
• Question of the Week: Fetoscope or Doppler for Prenatal Exams?
• Question of the Week Responses: Seaweed as Suturing Alternative?
• Letters
• Classified Advertising

 

Read more: http://www.midwiferytoday.com/enews/enews1207.asp

There are Too Many Preventable Deaths among New Moms

Posted by Dr. Mercola

Why are So Many New Moms Dying?

There are likely a number of contributing factors, but one glaring contributor is most certainly the excessive number of cesarean childbirths.

A woman’s risk of death during delivery is three to five times higher during cesarean than a natural delivery, her risk of hysterectomy four times higher, and her risk of being admitted to intensive care is two times higher.

There are other risks that come with this major surgery as well, including:

• Infection to various organs including the uterus, bladder or kidneys
• Increased blood loss
• Increased risk of complications in future pregnancies
• Decreased bowel function
• Respiratory complications
• Longer hospital stay and recovery time
• Adverse reactions to anesthesia
• Risk of additional surgeries such as hysterectomy or bladder repair

Despite the steep risks, cesarean section is actually the most common operation performed in the United States, and accounts for a whopping 31 percent of births.

This is a rate that even The American College of Obstetricians and Gynecologists admits is worrisome. It’s also the highest rate ever reported in the United States, and a rate higher than in most other developed countries.

For comparison, according to the World Health Organization, no country is justified in having a cesarean rate greater than 10 percent to 15 percent!

If the cesarean rate were to go down, it’s virtually guaranteed that the maternal death rate would follow…

Read more: http://www.foodconsumer.org/newsite/Non-food/Miscellaneous/many_preventable_deaths_among_new_moms_3003100728.html

The Difference between Depression and Premenstrual Dysphoric Disorder

The Difference between Depression and Premenstrual Dysphoric Disorder

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on March 31, 2010

A new study addresses premenstrual dysphoric disorder (PMDD), a severe mood disorder which affects five to seven percent of all women of reproductive age in the United States.

Unfortunately, the disorder is often misdiagnosed as major depression or other mood disorders.

In the study, PMDD is determined to be a biologically different form of premenstrual syndrome. Women with PMDD who have experienced depression may make up a subset.

The findings are important because they give physicians more reason to search for a more specific diagnosis and could possibly lead to more precise treatments. There currently are few good choices, said Susan Girdler, Ph.D., professor of psychiatry at the University of North Carolina at Chapel Hill School of Medicine. Girdler led the study…

Read more: http://psychcentral.com/news/2010/03/31/the-difference-between-depression-and-premenstrual-dysphoric-disorder/12485.html

New Health Bill Helps Postpartum Depression (PPD)

New Health Bill Helps Postpartum Depression (PPD)

By John M Grohol PsyD

The historic passage of the federal health care legislation last week included a provision for a new national postpartum depression (PPD) program. It leaves out the federal screening program so feared by the bill’s opponents, but it includes more money for greater education outreach and more research into this condition. The Melanie Blocker Stokes Mother’s Act passed in watered down form…

Read more: http://psychcentral.com/blog/archives/2010/03/29/new-health-bill-helps-postpartum-depression-ppd/

Massage may help lift depression

Reuters Health
Tuesday, March 30, 2010

NEW YORK (Reuters Health) - Massage therapy may help relieve symptoms of depression, a new review of the medical literature hints.

The authors of the review, however, acknowledge difficulties with research on the effects of massage, including the fact that it's impossible to "blind" study participants or care providers to whether a person is receiving massage or a comparison treatment.

Nevertheless, they say there is "good evidence to suggest that massage therapy is an effective treatment of depression."

Depression is a huge public health problem, and treatment is often inadequate, Dr. Wen-Hsuan Hou of I-Shou University in Kaohsiung, Taiwan and colleagues note in their report.

While massage can ease stress and tension and may have emotional benefits, the use of massage therapy in depressed patients is "controversial," the investigators note, and "there is no qualitative review of the treatment effect of massage therapy in depressed patients."

To investigate further, they searched for randomized controlled trials of massage therapy in depressed patients. They identified 17 studies including 786 people in all. In 13 of the trials, massage therapy was compared to another active treatment such as Chinese herbs, relaxation exercises, or rest, while four compared massage to a "no treatment" control group. Investigators also used a range of methods for evaluating mood and depression in study participants.

Overall, the studies, which were of "moderate" quality, showed that massage therapy had "potentially significant effects" in alleviating symptoms of depression, the researchers report in the American Journal of Psychiatry.

It's not clear from the analysis, they emphasize, whether a person would need to undergo regular massage therapy for benefits to persist.

There are a number of ways through which massage could help people with depression, the researchers note, for example, by reducing stress and inducing relaxation; building an "alliance" between the therapist and patient; and by causing the body to release the "trust hormone" oxytocin.

"Further well-designed and longer follow-up studies, including accurate outcome measures, are needed," they conclude.

SOURCE: Journal of Clinical Psychiatry, online March 23, 2010.

Reuters Health

Related News:

• More News on Complementary and Alternative Medicine
• More News on Depression

Washington State Bans Shackling of Incarcerated Women in Labor and Post-Delivery

March 29, 2010

Washington State Bans Shackling of Incarcerated Women in Labor and Post-Delivery

Posted by Rachel

Washington state Gov. Chris Gregoire last week signed into law a bill [PDF] that forbids the routine shackling of pregnant women in and after labor, making it one of a handful of states that ban the practice.

The law, which takes effect June 10, states that no restraints of any kind may be used on a pregnant woman during transporation to and from medical visits or court proceedings during the third trimester of pregnancy or during postpartum recovery. It also stipulates that “no restraints of any kinds may be used” during labor or childbirth…

Read more: http://www.ourbodiesourblog.org/blog/2010/03/washington-state-bans-shackling-of-incarcerated-women-in-labor-and-post-delivery

Interpreting Health: Cultural Barriers at New York City Hospitals

by Sarah Kate Kramer

On Christmas Eve, a 31-year-old woman from Yemen, wearing a traditional black robe decorated with red embroidery, walked into Attieh’s office for help with a Medicaid application. Halima (who did not want to use her real name because she didn’t want her community to know about her struggles), has eight children. The first five were born in her village in Yemen, where it’s traditional for women to give birth in their homes while kneeling on a special mat placed on the ground.

“My father’s father, he cut the umbilical cord and cleaned everything, he took care of everything,” Halima tells Attieh, in Arabic.

But when giving birth to her first American-born child at Kings County Hospital in Brooklyn, Halima found herself lying immobile on her back, hooked up to an IV, feeling helpless and exposed. She wanted to be in her customary position, on her knees. So she asked the nurses, but they refused. “This is our business, not yours,” Halima remembers them telling her.

Not knowing hospital rules or her rights as a patient, Halima found childbirth in Brooklyn frightening and traumatic…

Read more: http://www.wnyc.org/news/articles/152614

Postpartum depression

What is postpartum depression?

Postpartum depression is an illness that you can get after having a baby. It's just like depression, which you can get at other times. But it comes at a time when you are expected to feel happy. If you get postpartum depression, you may find it hard to enjoy being with your baby and find it difficult to care for him or her.

Postpartum depression nearly always gets better on its own. But if the depression goes on for a long time, you may not bond properly with your baby. And your baby may not develop as well as he or she should. There are treatments that may help you feel better faster. So, it's important to see your doctor and get treatment early.

Key points for women with postpartum depression

• It's normal to feel low, irritable or anxious for a few days after your baby is born. But if these feelings don't go away or they get worse, you may have postpartum depression.
• Postpartum depression is common. About 10 to 15 in every 100 new mothers get it.
• Postpartum depression is an illness. It is not a sign that you don't love your baby or can't look after him or her properly.
• There are lots of treatments that may help.
• It's important to see your doctor early on. The sooner you get help, the sooner you are likely to feel better and start enjoying being a mother.
• If you have strange thoughts and feelings about your baby, or hear or see things that aren't real, you may have a more serious illness called postpartum psychosis. You will need to be looked after in the hospital.

What's normal after having a baby?

To understand what goes wrong in postpartum depression, it helps to know a little about what feelings are normal after you have a baby…

Read  more: http://consumerreports.org/health/conditions-and-treatments/postpartum-depression/what-is-it.htm

Overcoming the Fear of Labor

Susan Schade

On the final day of my birthing class, I felt helpless as I stood in the hallway having a panic attack. It was shortly after seeing a graphic birth video that I began having a physical reaction to the fear that I was experiencing.

I was not naïve. I knew how babies were born but at that moment, I was overcome by anxiety. After darting out of class, I made my way to the end of the hall. I had one hand on the wall and the other on my belly as I concentrated on controlling my breathing. The back of my neck was damp with sweat. I closed my eyes and imagined the air entering and leaving my body at a slow pace through my nose and mouth. I finally managed to pull myself together and join my husband again in the classroom…

Read more: http://www.empowher.com/news/herarticle/2010/03/17/overcoming-fear-labor?extsrc=coi-digest

Amnesty International Issues Alert to Stop Pregnancy-Related Deaths

Anna Portela

On March 4, Amnesty International issued an alert to prevent world wide deaths due to pregnancy. The human rights organization said that across the globe, women are dying of these deaths at the rate of one per minute.
Amnesty is urging people to meet with their Senators and Representatives in their local districts to try to stop these deaths.

The Amnesty alert went on to say that it is, “appalling how many women are dying in the United States from complications due to pregnancy and childbirth.” According to Amnesty about half of these deaths can be prevented. Many of these deaths are because women do not have access to good health care or maternal care. About 13 million women between the ages of 15 and 44 have no insurance at all. Several of these women start their pregnancy with untreated conditions that only get worse with pregnancy. African-American women are almost four times more likely to die of pregnancy complications than white women. (I have written about this in other articles for this website.) If the pregnancies are high-risk, African-American are five and a half times more likely to die than white women…

Read more: http://www.empowher.com/news/herarticle/2010/03/11/amnesty-international-issues-alert-stop-pregnancy-related-deaths?extsrc=coi-digest

Vaginal Birth After Cesarean: New Insights

Vaginal Birth After Cesarean

March 2010

View or download Summary/Report

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Structured Abstract

Objectives: To synthesize the published literature on vaginal birth after cesarean (VBAC). Specifically, to review the trends and incidence of VBAC, maternal benefits and harms, infant benefits and harms, relevant factors influencing each, and the directions for future research.

Data Sources: Relevant studies were identified from multiple searches of MEDLINE®; DARE; the Cochrane databases (1966 to September 2009); and from recent systematic reviews, reference lists, reviews, editorials, Web sites, and experts.

Review Methods: Specific inclusion and exclusion criteria were developed to determine study eligibility. The target population includes healthy women of reproductive age, with a singleton gestation, in the U.S. with a prior cesarean who are eligible for a trial of labor (TOL) or elective repeat cesarean delivery (ERCD). All eligible studies were quality rated and data were extracted from good or fair quality studies, entered into tables, summarized descriptively and, when appropriate, pooled for analysis. The primary focus of the report was term pregnancies. However, due to a small number of studies on term pregnancies, general population studies including all gestational ages (GA) were included in appropriate areas.

Results: We identified 3,134 citations and reviewed 963 papers for inclusion, of which 203 papers met inclusion and were quality rated. Studies of maternal and infant outcomes reported data based upon actual rather than intended router of delivery. The range for TOL and VBAC rates was large (28-82 percent and 49-87 percent, respectively) with the highest rates being reported in studies outside of the U.S. Predictors of women having a TOL were having a prior vaginal delivery and settings of higher-level care (e.g., tertiary care centers). TOL rates in U.S. studies declined in studies initiated after 1996 from 63 to 47 percent, but the VBAC rate remained unimproved. Hispanic and African American women were less likely than their white counterparts to have a vaginal delivery. Overall rates of maternal harms were low for both TOL and ERCD.

While rare for both TOL and ERCD, maternal mortality was significantly increased for ERCD at 13.4 per 100,000 versus 3.8 per 100,000 for TOL. The rates of maternal hysterectomy, hemorrhage, and transfusions did not differ significantly between TOL and ERCD. The rate of uterine rupture for all women with prior cesarean is 300 per 1,000 and the risk was significantly increased with TOL (47/1,000 versus 3/1,000 ERCD). Six percent of uterine ruptures were associated with perinatal death. No models have been able to accurately predict women who are more likely to deliver by VBAC or to rupture.

Women with a prior cesarean delivery had a statistically significant increased risk of placenta previa compared with women with no prior cesarean, at a rate of 12 per 1,000 and risk increasing with the number of cesareans. Compared with previa patients without a prior cesarean delivery, women with one prior cesarean and previa had a statistically significant increased risk of blood transfusion (15 versus 32.2 percent), hysterectomy (0.7 to 4 percent versus 10 percent), and composite maternal morbidity (15 versus 23-30 percent). Perinatal mortality was significantly increased for TOL at 1.3 per 1,000 versus 0.5 per 1,000 for ERCD. Insufficient data were found on nonmedical factors such as medical liability, economics, hospital staffing, structure and setting, which all appear to be important drivers for VBAC.

Conclusions: Each year 1.5 million childbearing women have cesarean deliveries, and this population continues to increase. This report adds stronger evidence that VBAC is a reasonable and safe choice for the majority of women with prior cesarean. Moreover, there is emerging evidence of serious harms relating to multiple cesareans. Relatively unexamined contextual factors such as medical liability, economics, hospital structure, and staffing may need to be addressed to prioritize VBAC services. There is still no evidence to inform patients, clinicians, or policymakers about the outcomes of intended route of delivery because the evidence is based largely on the actual route of delivery. This inception cohort is the equivalent of intention to treat for randomized controlled trials and this gap in information is critical. A list of future research considerations as prioritized by national experts is also highlighted in this report.

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Download Report

Vaginal Birth After Cesarean: New Insights

• Evidence Report (Publication No. No. 10-E001): (PDF File, 4.3 MB) PDF Help.
• Original Evidence Report (Publication No. 03-E018, March 2003): (PDF File, 1.4 MB) PDF Help.

2010 Moms’ Run Offers Family Fun & Support for a Good Cause

On Saturday, May 8, 2010, it’s all about Mom and the people who love her. The Ruth Rhoden Craven Foundation will host the 2010 Moms’ Run, which will start and end at Blackbaud Stadium on Daniel Island. The 5K walk/run will begin at 8:30 a.m.

Participants are invited to stick around for post-race festivities: food from Daniel Island Grille and Brewer’s Bristro, live entertainment by Frank Royster and family-friendly vendors. The event is also sponsored by the Center for Women, Lowcountry Parent and The Mom Spa.

It’s $25 to register; $10 for children 12 and under. Strollers welcome! Visit www.ppdsupport.org for more information.

Long before Brooke Shields wrote a book about it and Tom Cruise sparred with Matt Lauer about it, Ruth Craven suffered from postpartum depression. On December 5, 1999, Ruth took her own life, just two-and-a-half months after the birth of her first child. She was 33 years old. Before PPD, friends and family say Ruth was a happy, positive and stable person. After giving birth, the sudden shift in Ruth’s mood took everyone by surprise.

Her mother, Helena Bradford, believes if Ruth had received proper treatment, she would be alive today. "Before Ruth was stricken with postpartum depression, I had never even heard of it. I want women and their families to be more prepared and informed than we were, so they won’t have to go through what we did," Bradford says.

In 2000, Bradford started the Ruth Rhoden Craven Foundation for PPD awareness. For the past 10 years, the non-profit organization has provided support groups for women and their families and has served as a resource to the medical community. Bradford wants the community to know that PPD is temporary and treatable, if properly diagnosed.

Risa Mason-Cohen, PsyD, licensed clinical psychologist and Executive Director of the Ruth Rhoden Craven Foundation says, "The 2010 Moms’ Run is dedicated to the proper screening, diagnosis and treatment of postpartum depression. There is a universal pulse that beats inside every woman’s soul; women across the globe can relate to the sense of imbalance, fatigue and other physical/emotional transformations that go hand in hand with early motherhood. This event is for all of the mothers, fathers, daughters, sons, sisters, brothers, girlfriends and husbands out there who have felt the sting of this illness. For the rest of the population, the Moms’ Run is a perfect opportunity to enjoy some family friendly fun while supporting a very worthy cause."

To register for the 2010 Moms’ Run, or to make a donation, visit www.ppdsupport.org. To schedule interviews, members of the media may call race coordinator Angie Mizzell at 843.452.0931.