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Tuesday
May192009

The Perinatal Paradox, Eli Manning, Czech News Magazines and More

You have undoubtedly already read this L.A. Times article entitled, “Childbirth: Can the U.S. Improve?” In case you haven’t, you should know that we’re going in the wrong direction.

“We’re going in the wrong direction,” said Dr. Roger A. Rosenblatt, a University of Washington professor of family medicine who has written about what he calls the “perinatal paradox,” in which more intervention, such as cesareans, is linked with declining outcomes, such as neonatal intensive care admissions. Maternity care, he said, “is a microcosm of the entire medical enterprise.”

 

I might start watching football after reading this on the NY Daily News site.

Eli and Abby Manning donate funds for new birthing center at St. Vincent’s Hospital

Eli Manning and his wife are bankrolling a new birthing center at St. Vincent’s Hospital Manhattan - but don’t worry, Jets fans are welcome, too.

The Giants quarterback and his wife, Abby, will announce plans today for a facility bearing their name - a state-of-the-art center focusing on natural childbirth and holistic care.

“We wanted to make it a special place to bring new life into the world,” the 28-year-old Super Bowl hero told the Daily News.

“For Abby and I, it’s about being part of that, to make sure all the parents have a comfortable experience.”

The Mannings - who don’t have children yet - have a relationship with St. Vincent’s and frequently visit patients to boost morale.

 

The Czech news magazine Respekt covered cesareans. The article was then regurgitated in English online by the Prague Daily Monitor. The lost-in-translation effect makes this excerpt sound interestingly blunt.

Some experts speak about “a stolen childbirth” over a caesarean section. It deprives women of the strong experience to witness their child coming into the world, especially in the hospitals where general and not only regional anaesthesia is applied during this surgery and mothers are automatically sent to the intensive care units afterwards, Respekt points out.

“Women have lost the ability of instinctive behaviour since they have been raised to suppress it and behave rationally for the whole life. Yet during a child delivery the irrational side must be used, which is almost impossible for many women,” doctor Helena Maslova, who deals with childbirth-related traumas, told Respekt, adding it was the result of the obstetrics’ technical development since the 1960s.

Though such a radical opinion has not been confirmed scientifically, supporters of natural child deliveries agree with it. But it is only a minority among women, and most mothers rather nod willingly to a doctor’s offer of a quick and painless surgery, the weekly writes.

 

From a random blog. Odd that the abdominal surgery and slicing through fascia didn’t get a Freaky rating, but the naked woman and her vernix covered baby were, like, totally grody! Uh mah gaw!

we saw two videos; one of several natural childbirths and one of a c-section. the natural childbirthing video was of women with no clothes on who had no medication for their deliveries. talk about freaking everyone in the room out! one of the babies came out with white stuff all over it and the mother said, “that doesn’t look like a baby!”

 

A senator in Wisconsin wants to take on the childbirth industry in her state, including lowering the c-section rate. I wish her much luck with that.

By my rough math, Wisconsin could save $7 million if we could drop the C-Section rate from almost a quarter of all Medicaid births to 17%. Iowa was able to drop Medicaid C-Section rates to 12% in some HMOs. And cost savings don’t end there. Almost one quarter of all Family Medicaid hospital costs are related to pregnancy, birth and neonate care. Let’s have fewer infants in intensive care and fewer moms with pregnancy complications.

 

Message board post from a woman who was induced for high blood pressure. I did not know that doctors could just keep the oxytocin going for several days. L&D readers, is that common?

We went in Sunday evening and I was given cervadil (not sure how to spell) and put on an all liquid diet. Boo….. Monday morning they started the pitocin. My doctor came in around noon to check to see if I dilated at all. Ha….. not even close to 1 cm. So they stopped the pitocin in the afternoon and the doctor came back to give me another cervadil. The nurse explained to us that usually the second day of pitocin has more of an effect. Tuesday morning the doctor came in took the cervadil out and my cervix had softened some more. They began the pitocin and we began to wait. Mind you I’m still on a liquid diet. Blah…. Noon thirty rolled around and my doctor came back to check on me. There was no good news this time. Doctor said my cervix became long and had not progressed any further. He said we can do a c-section this afternoon or we can do another day of pitocin but suggested the c-section would be more ideal since the third day of pitocin could cause complications.

What have you been reading or writing lately?

 

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Reader Comments (11)

I just heard a birth story last night that started like this:

My wife was due December 20

Guess how it ended: of course, the big c

He said the doctor said,"Let's get her started since it is right before Christmas. After 3 days, nothing happened so they did a c-section. She got an infection from the c-section so we were in the hospital for 7 days and the insrance company was having a fit."

In better news, we had a natural childbirth meetup here in Seoul last weekend and found a lot more options than previously thought like VBAC and vaginal breech deliveries. The next round of births scheduled to happen in my expat moms group are all mostly homebirth and birth center births so I hope they turn out well.

One doula/childbirth educator/hypnobirth instructor/lactation consultant is also building a website to put all the natural childbirth resources and options in one place to make it easier for both foreigners and Koreans to battle the more than 40% cesarean rate.

May 19, 2009 | Unregistered Commentermamaseoul

Let's hear it for Eli and Abby Manning! That's great news for NYC. And I just love the Czech article translation. Maybe more of what's written about cesarean should be translated by computers to cut through the BS? :)

May 19, 2009 | Unregistered CommenterAmy Romano

When I was being threatened with induction bc of "low amniotic fluid", my midwife told me that she had patients who went through days and days of being induced - she was assuring me that they didn't do time limits with inductions. oooog.

May 19, 2009 | Unregistered Commentercocoschmoco

Wow! Eli Manning and his wife get props from me, definitely. :)

I am active on a pregnancy community as an advocate for change, and we've seen quite a few people lately wondering about elective C-sections. One woman has been convinced not to do it: instead she'll get induced. I wonder not only about the physical effects of all this on the woman and child, but the effect of this on child-rearing. I wonder what the desire (even though it's minimal I know) to plan things like this means for how they raise their children. I mean, mine are very poor planners when it comes to illnesses, head trauma, remembering a major homework assignment due OMG the next day, etc. I wonder if there is - or will be - a study about that, although I don't think the sample size would be sufficient.

Also, why do people think that babies come out swaddled and clean? I've read several stories of women who don't look at their babies until they're all nice. Man, when my babies come out I want them up and getting snuggled and kissed and milkies. I'm selfish. :D

May 19, 2009 | Unregistered CommenterTara

Way to go Eli! He was always my favorite of the brothers haha. I wish more people had money to hand out to build places for natural and holistic births. It would make our country a safer place for pregnant women and their babies.

This is a great post!

May 19, 2009 | Unregistered CommenterKayce

Yeah, I've heard it's not all that unusual for an induction to take three days. I've read numerous stories of women who were induced one day, and then sent home when it didn't work, and came back a couple of days later to try again. As long as the amniotic sac is intact, they can do that; but once they break the waters, the baby's coming out one way or another.

May 19, 2009 | Unregistered CommenterKathy

Man, I feel dumb. They're usually in such a hurry to get women "out" of labor. I guess the rationale would be that, if there is a medical reason to induce, they'll try that aggressively before a c-section even if it takes a couple of days?

May 19, 2009 | Registered CommenterJill

How fabulous for a manly man type and his wife to promote natural childbirth. That to me is some serious progress. People think babies come out all clean, because that's what they see on TV and movies. Actually on TV, they never look like newborns. They always look 2-3 months old. I have also had moms who did not want to hold or see her newborn until it was wiped off. One mom refused to hold her newborn until we bathed it. Kinda sad.

May 19, 2009 | Unregistered CommenterReality Rounds

All of our football loving partners are going to wonder why we all suddenly hang up Eli Manning posters in the garage. They'll have no idea it's because we now recognize him as a fellow birth junkie.

May 19, 2009 | Registered CommenterJill

Great combination of info! I agree about the lost in translation from Czech. Eli Manning is awesome to fund a birthing center! He is a true Super Bowl star! As far as the several day inductions.. I have been trying to see an official position statement this morning but I can't seem to open the AWHONN link to their new release "Cervical Ripening and Induction and Augmentation of Labor, 3rd Ed"
"The most comprehensive monograph by undisputed expert Kathleen Rice Simpson."..... alas. I must move on. Thought I could give data. We see a lot of the several day inductions and for what it's worth, some of our docs will call MFM , get advised to induce a hypertensive mom and will follow a regimen of cervical ripening. Sometimes it's a total difference between day1 and day 2 or 3 in terms of mother's response to the pitocin. We (many nurses) do our best to encourage that 3rd day sometimes with good evidence of fetal well-being in mom who's condition is stable or non-worsening.

May 20, 2009 | Unregistered CommenterBirth_Lactation
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