Thursday, August 23, 2012

Rally to Improve Birth

Join the National Rally for Change! A full scale birth revolution on Labor Day


Support evidence-based maternity care! 

The National Rally for Change is to encourage and insist that all maternal healthcare providers practice evidence-based care. On average it takes 20 years for proven research to become practice. For the sake of mothers and babies everywhere, we can’t wait 20 years. The long-term effects of unnecessary inductions and cesareans are just starting to be realized. This matters for all people. Despite the dire situation, this is not a protest, but a public outreach event located where the vast majority of the population gives birth.


The Improving Birth rallies are taking place in more than 100 cities across the United States on Monday September 3rd from 10:00 am - 12:00 pm.


Why Rally to Improve Birth?

The results of Childbirth Connection's national "Listening to Mothers" survey show that high c-section rates don't come from maternal request, and that although most women want to make the ultimate decisions in their own care, they don't always have this option.  (If you'd like to read a summary of the findings of these surveys, I wrote one up a while back here.)

Improving Birth was founded with the vision of encouraging hospital administrators to review their birth-specific policies and procedures. We ask that they implement incentive programs for doctors and nurses to get up-to-date information and education about the most current care practices. The U.S. outspends every country in the world for maternity care, and yet we rank #49 for maternal mortality rates.

The U.S. has trailed behind most of the developed or industrialized world for many years and our maternal and infant mortality rates have gotten worse in the last few years. It's more dangerous to give birth in the United States than in 49 other countries. From Amnesty International:
Maternal deaths are only the tip of the iceberg. During 2004 and 2005, more than 68,000 women nearly died in childbirth in the USA. Each year, 1.7 million women suffer a complication that has an adverse effect on their health.

This is not just a public health emergency - it is a human rights crisis. Women in the USA face a range of obstacles in obtaining the services they need. The health care system suffers from multiple failures: discrimination; financial, bureaucratic and language barriers to care; lack of information about maternal care and family planning options; lack of active participation in care decisions; inadequate staffing and quality protocols; and a lack of accountability and oversight.
The facts speak for themselves.  The World Health Organization recommends cesarean rates should be no higher than 10-15% and that anything higher does more harm than good for moms and babies.  Despite this warning, 1 in 3 American women are giving birth surgically.  That equates to a high number of medically unnecessary surgeries.  Additionally, the recommended rate of induction is 10% or less but in an analysis of 19 hospitals across the country, it was found that 44% of women planning a vaginal birth were medically induced.

http://www.improvingbirth.org/the-evidence-shows/
An eye-opening study published in the journal Obstetrics and Gynecology examined the “quality of evidence that underlies the recommendations made by the American College of Obstetricians and Gynecologists.”  It was discovered that only 30% of these guidelines were based on “good and consistent scientific evidence” and that 32% were based simply on “consensus and opinion.”  When obstetric guidelines were looked at individually, a mere 25% was found to be based on quality science and nearly 35% based on opinion.

 Reducing medically unnecessary interventions will not only save lives, but also a huge sum of money.  Childbirth Connection and WHO report that the US could save an estimated $3.4 Billion dollars each year by reducing the cesarean rate to 15%, the rate recommended by WHO.  The Amnesty International report states “an estimated $1 Billion could be saved annually—mostly by reducing neonatal intensive care unit admissions—if early elective deliveries were reduced.”

RALLY TO IMPROVE BIRTH!






Monday, August 20, 2012

Does Choice Matter?

For more than 55 years, Pathfinder International has worked to expand access to quality sexual and reproductive health care to enable and empower individuals to make choices about their body and their future. 

At Pathfinder, they believe choice is everything. When people take charge of their life choices such as if or when and how often to have children, they gain confidence and strength. They can better pursue their education, contribute to the local economy, and engage in their communities. 

Pathfinder International has a new video to share:



No Joke. Choice Matters. Everywhere. 

The video is funny, but the circumstances are not. More than 220 million women still lack access to contraceptives.
 

Can you imagine walking 18 miles to get contraceptives? Or being told your clinic is out of stock? It seems absurd right? But in many countries, this happens every day. Doctors are overworked, under supported, and stressed out. Women struggle to care for their large families and access the services they need, sometimes waiting hours, even overnight to visit a clinic.

We try to make it funny in this video but the reality is no joke. Choice matters about if, when, and how often to have children; choice matters about getting tested for and STI or HIV; choice about sexual and reproductive health matters for all women, everywhere.
 


Even here in the United States, we see barriers to reproductive choice. However, oftentimes those barriers are even more challenging in developing countries. Shannon Wu, one of our donors said, “Most women in America have access to knowledge and health care when it comes to their sexual and reproductive life. But in other parts of the world, women’s health is almost always the last thing to be discussed or taken care of, if at all.”

Right now more than 220 million women want, but lack access to contraceptives. One woman dies every 90 seconds during pregnancy or childbirth because she lacks access to maternal care. And HIV is the number one cause of death for women of reproductive age in the developing world.

If you want to change these numbers, and improve the lives of women, take a simple action now: share the video. Help start an important conversation with your friends, family, girlfriends, boyfriends, husbands, wives, colleagues that reproductive health care is no joke. 

Choice matters. 



Want to help Pathfinder International spread the word? 

Sample Tweets or Posts:




Friday, August 10, 2012

Re-Blog: I Don't Think You Should

What a Doula is all about!
I'm re-blogging this because it is just that good.
Enjoy!

I Don't Think You Should
by Kristen at Birthing Beautiful Ideas
I’ve talked a lot about my individual pregnancy and birth experiences on this blog.
I’ve had a cesarean section.  I’ve planned two VBACs.  I’ve birthed two babies in the hospital, and one at home.  I’ve chosen to give birth twice with an obstetrician/gynecologist, and once with Certified Professional Midwives (CPMs).  I’ve breastfed all three of my babies.  Heck, I’ve even encapsulated my placenta.
With all of this sharing of my personal experiences, some people might worry that I am advocating for everyone else to make the same decisions that I have.  Perhaps, one might wonder, my goal is to create an army of HBAC-ing cyborgs whose babies will take over labor and delivery units with a vengeance.  [Sadly, I could not find a graphic to depict this bizarre yet intriguing image.]
But really, this couldn’t be further from the truth.  In fact, I don’t think you should make any of the same exact decisions that I’ve made.
Truly.
If anything, what I think you should do is far different from doing exactly what I’ve done.

For I don’t think you should have a home birth.
I think you should give birth in a setting where you feel respected by your care providers.

I don’t think you should have a hospital birth.
I think you should give birth where your birth site and your care providers make you feel safe.

I don’t think you should birth with an OB/GYN, a midwife, or unassisted.
I think you should birth with a care provider who is well-trained to serve your particular prenatal, birth, and postpartum needs and wishes.

I don’t think you should have a vaginal birth.
I think you should be given every chance to have the safest, healthiest mode of birth for you and your baby.

I don’t think you should have a cesarean section.
I think you should have access to discretionary and judicious use of medical technology if and when you and your baby need it.

I don’t think you should have an epidural.
I think you should be viewed as an autonomous woman who can make her own decisions regarding pain relief and comfort measures during labor.

I don’t think you should have an unmedicated birth.
I think everyone around you should reinforce just how powerful and amazing you are for bringing a baby into the world, no matter how you do it.

I don’t think you should have a VBAC.
I think you should have access to accurate and transparent information about your birth options, and that no one should use scare tactics to dissuade you from your choices.

I don’t think you should have a repeat cesarean.
I think you should make birth decisions that are right for you and your family–not anyone else.

I don’t think you should breastfeed.
I think you should have access to accurate and transparent information about baby-feeding options well before your baby is born, and that you should encounterall of the support you need to pursue your baby-feeding goals.

This is what my blog is about, what my advocacy is about, and what my doula work is about: I think you should do what is right for you.  Not anyone else but you.


Tuesday, August 7, 2012

Link Round-up: World Breastfeeding Week 2012

Here are a couple of links from this past week's world celebration of breastfeeding!

I really like Donna's (Banned from Baby Showers) post on why Breastfeeding would be the one topic she'd preach on, if she had to pick only one platform. She lists why this issue, over intactivism or natural birth, because of the multitude of benefits that you can't get any other way (and a few personal reasons).

Both Annie from PhD in Parenting and Rebecca from Public Health Doula wrote about the controversy over NY Mayor Bloomgberg's Latch On campaign to implement Baby Friendly hospital practices in NYC. Basically, there has been a lot of misunderstanding about why he wants the formula to be regulated more tightly in hospitals, and commentators have been up in arms about how babies are going to go hungry. What it's really about is changing staff practices such as limiting staff access to formula, not advertise formula, and not give free formula samples. Annie's post describes why this is important for moms who want to breastfeed, and Rebecca explains what this really looks like when a hospital follows these practices and how it does not harm women who want to formula-feed.

An article at Women's E-News on why Lactation Consultants need to Diversify:
"Black women often find it easier to speak to my black lactation consultants or nurses. They understand each other from a cultural perspective and can relate to them in a different way than they are able to relate to me," says Sylvia Edwards, manager of lactation services at the University of Alabama Birmingham hospital and co-chair of the Alabama Breastfeeding Coalition.
The Huffington Post blog - World Breastfeeding Week Sucks According to this Lactation Consultant:
I really hate World Breastfeeding Week because much of the media takes it as an opportunity to attack those who wish to support mothers who breastfeed rather than celebrate their efforts to improve infant feeding. Every year I hope I will not have to read more faux feminist manifestos that denigrate the value of women who enjoy their care-giving roles.

A new bill in Israel states that "hospitals will now have to purchase formula by tender and that the formula provided to mothers who choose not to breastfeed will NOT be limited to one specific brand."

The blog of the International Lactation Consultant Association posted each day this week on a breastfeeding in a different country - Breastfeeding in Papua New Guinea, Hmong Women in California, Breastfeeding in Ireland, and Donor Milk for Babies in Canada



Thursday, August 2, 2012

U.S. Breastfeeding Rates

In celebration of World Breastfeeding Week, the Journal of Human Lactation is available online  FREE for the month of August! And so is the Breastfeeding Medicine journal! Be sure to check it out.


The Centers for Disease Control and Prevention have release the U.S. date on breastfeeding from the cohort of babies born in 2008 and 2009 (some data still being collected for 2009).

The data show that breastfeeding rates have increased! yay! The CDC report card states:
Breastfeeding rates continue to rise, with increases of about 2 percentage points in breastfeeding initiation, and breastfeeding at 6 and 12 months. Breastfeeding initiation increased from 74.6% in 2008 to 76.9% in 2009 births. This improvement in initiation represents the largest annual increase over the previous decade. Breastfeeding at 6 months increased from 44.3% to 47.2%; breastfeeding at 12 months increased from 23.8% to 25.5%.
Further good news is that
The last few years also have seen acceleration in the percent of babies that are born in hospitals designated as Baby-Friendly, an international recognition of best practices in maternity care.  In 2008, less than 2% of births occurred in Baby Friendly facilities. In the last 4 years that number has more than tripled to 6%.

The number of infants who are supplemented with infant formula has eked downward by tenths of a percentage. The Healthy People 2020 goals haven't been met, but it's a step in the right direction. 


Of course these increases are not huge, and the vast majority of mothers and babies are not receiving the best quality of care to help them reach their breastfeeding goals, but it's still good news. I think it means that the hard work we are all doing in the lactivist world is paying off!

If you'd like to see the data charts, go to the CDC data site here.

The CDC Report Card lists how every state did on all of the study's indicators, including Average mPIScore, Percent of live births occuring at Baby Friendly Facilities, Percent of breastfed infants receiving formula before 2 days of age, Number of La Leche League Leaders per 1,000 live births, Number of IBCLCs per 1,000 live births, and  whether States child care regulation supports onsite breastfeeding.

If you'd like to find your state in the CDC Breastfeeding Report Card, go here.

New Jersey has the highest percentage of infants receiving formula, and New Hampshire has the least. Louisiana has the lowest percentage of babies breastfeeding at 6 months, and Oregon has the highest!


To access breastfeeding report cards from previous years, or to get more information about the CDC's survey, visit this website.






Wednesday, August 1, 2012

Happy World Breastfeeding Week 2012!


World Breastfeeding Week celebrates its twentieth anniversary in 2012.  This time it focuses  on the progress that has been made on the implementation of the Global Strategy for Infant and Young Child Feeding which was adopted by the World Health Organisation (WHO) and UNICEF ten years ago.  Implementing the Global Strategy effectively is essential to increase breastfeeding rates: especially exclusive breastfeeding for the first six months, and to reach Millennium Development Goal (MDG) 4 (to reduce under five mortality by two thirds).Twenty years ago the World Alliance for Breastfeeding Action (WABA) launched the World Breastfeeding Week campaign to focus and facilitate actions to protect, promote and support breastfeeding.  Since then, each year, WBW has put the spotlight on various breastfeeding issues.

The WBW holds a Photo Contest, and the beautiful photos of the winners are up here.
Here are some of my favorites:

Nursing twins

Initiating breastfeeding during a C-section

Nursing while working!







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