A Very Informative Video on Circumcision

So, I've just recently discovered Ryan McAllister, PhD and his videos on birth and circumcision, and I highly recommend you view his video on Child Circumcision (aka genital cutting). It is a lecture to a room of anthropology students, and he comes at the topic from an accessible academic perspective.

If you're ever wanted to know more about why you should think about or question circumcision or no, this is a great overview video (with a brief hard-to-watch clip of male genital cutting near the beginning).

He makes a number of excellent points. He covers culture, medicalization, the biology of the penis and the procedure, informed consent issues, ethics, the science behind common reasons for removing the foreskin, and more.

I love the comedic clip's quote... "so you can have this chopped off or you could wash it?"

The whole video really makes you question, do the supposed pros outweigh the known cons?




Note that this presentation includes graphic material to convey more complete information about the topic.

One thing he doesn't really touch on is the fact that the obstetricians who perform this procedure are also keen to have parents circumcise because it is a relatively quick and easy surgery that they make money from.

Ryan is the director of NotJustSkin.org.

One of NotJustSkin's primary missions is to educate the public about violations of informed consent or bodily integrity. In the U.S., male genital cutting, more often called circumcision, is commonly practiced even though parents rarely receive the information that would be required to give informed consent to any other procedure. Circumcision is the only procedure where a doctor can legally amputate part of a non-consenting child without any medical reason.


I was not an intactivist before viewing this video, but I may be one now...


To add, being a feminist from a Jewish background, I also encourage a perusal of an article called "Circumcision: a Jewish Feminist Perspective."

This is the first of Ryan's videos that I came across, but I plan to post on his other content, as well.

Happy Earth Day, Babies!

Today I am thinking of all the babies who will come into the world on Earth Day. I am thinking of all of the babies who will grow up in a world with less and less clean water and clean air every moment. I am thinking of all the garbage and waste that will one day take up more room than humans.

What mother or father wants their child to grow up in a world where there is no more clean soil to play in, clean water to bathe in, clean air to breathe, space to run around? We all imagine our children running and playing, healthy and happy. 

On this Earth Day, if you are conscious of your children's futures, and your children's children, take the time to conceptualize how much of an impact you have had on the Earth's health, and how much impact you can make to improve it.

Here are 4 easy ways to start today, on this Earth Day, to improve the planet for your children:

1. Breastfeed, encourage your wife/sister/friend to breastfeed, and support breastfeeding in all its forms.
• Breastfeeding reduces the amount of bottles and plastic and trash required to feed babies
2. Cloth diaper
• This is a growing trend that is going to seem a lot less weird to all of us down the line. Obviously, this is a lot less wasteful, as you wash the diapers and re-use them, rather than throwing each dirty diaper into a landfill.
3. Recycle children's toys
• Sure, we all love a brand new shiny toy, fresh from its packaging. But if you can stick to already-loved toys, you'll give that toy a longer life, save yourself money, and save the environment. Less packaging and plastic waste, fewer perfectly good toys not biodegrading in the landfill. Garage sales, freecycling, craigslist, or friends - Toys can be used for generations before they need to be thrown away! (and while we're on it, wooden toys!)
4. Buy local
• Not just for baby! Although going on Amazon.com is easy, purchasing local means less fuel is used to get the product to you. You can even get creative and make baby items yourself - clothing, wraps, nursery decor, etc! 

HAPPY EARTH DAY!

Now THAT'S a Big Baby!

I stumbled across this blog post of Hyper Realistic Sculptures today and just had to share.

Next time you talk about fear of/induction/c-section for "big baby," I hope you picture this! (Cause nobody's baby is as big as that!)

The artist, Ron Mueck, actually sculpted quite a few having to do with birth. Click over to the blog to view more photos of this pregnant woman (who could be in first stage of labor!) and of this woman in the third stage of labor:

How to Win Your Office Baby Pool

All right, I'm going to let you in on some secrets to help you win your next Baby Pool at your place of work.

In case you don't know what a baby pool is, or what it looks like, it is a game where everyone in your office guesses the date that they their pregnant co-worker will have her baby. Sometimes it includes the baby's weight and length, too. The person who comes the closest to guessing the correct date, wins!

Recently, my SO's office did a baby pool and he texted me to ask me what a good baby weight to guess might be. (I told him I'd guess between 7 and 8 pounds) He brought home a copy of the calendar with everyone's date (and length and weight) guesses on it so that I could see how much he knew about labor/birth from listening to me - he did not guess on the moms' actual EDD, but guessed a due date after the mom's due date. But what was interesting to me about the calendar is that every single person in the office guessed before the due date except my SO and one other gentleman who had 3 kids. However, the latest guess was only a couple days past the EDD. So I wrote on the calendar the latest guess date - exactly her 41 week mark. And I was right!

So, here are some tips for guessing in a Baby Pool, based on my knowledge of pregnancy and childbirth in the United States if your pregnant co-worker is a First Time Mother:

1. Weight: Go with 7.5 lbs. 

I even asked a perinatal epidemiologist about this one - for a first time mother this is the average. This is the hardest to guess, though - babies at term can range anywhere from 5.5 pounds to 10 pounds. 

2. Length: Go with 21 inches.

I'd say that the babies I've seen born have been between 19 and 22 inches, with the most common at 21 inches. 

3. Due Date: Guess exactly at their 41 week mark (one week after the estimated due date).

A. Most first time mom's have their babies past their due date. 

B. Most obstetricians get trigger happy and will find a reason that mom must be induced at 41 weeks. This is certainly true of the doctors in my area. Despite the fact that you're not "post dates" until after 42 weeks, and most first time moms have longer pregnancies, and induction on a first timer doubles the chance of a c-section, and many of the reasons give are not evidence-based (i.e. suspected "big baby"), most OB's will convince most mothers to agree to an induction at 41 weeks. 

Another bonus: Sometimes a mom who has her induction scheduled for the next day will spontaneously go into labor the night before. 

GOOD LUCK! 

World Prematurity Awareness Day

November 17th is World Prematurity Awareness Day

• In the United States, 1 in 8 babies is born prematurely.
• Worldwide, 13 million babies are born too soon each year. 
• Prematurity is the leading killer of America's newborns. Those who survive often have lifelong health problems.

You can find your U.S. state's 2011 Prematurity Report Card here via the March of Dimes:

As you can see, Vermont is the only state with an A (what are they doing right?).  Louisiana, Mississippi, Alabama and Puerto Rico all have F's. 

• There are now more babies born at 39 weeks than at full term. 
• The average time a fetus spends in the womb has fallen seven days since 1992. 
• In the last two decades, the number of babies born at prior to 37 weeks increased by more than 30 percent, and babies born at 37 and 38 weeks rose more than 40 percent. 
• In 2007, 9.6 percent of births were early – through scheduled inductions or C-sections – for non-medical reasons. 
• Deliveries at 37 and 38 weeks account for about 17.5 percent of total births in the United Statess.
• Of the 540,000 babies born before 37 weeks gestational age each year in the United States, approximately 75 percent are born between 34 and 36 weeks.

 Premature birth is a serious health problem. Premature babies are at increased risk for newborn health complications, such as breathing problems, and even death. Most premature babies require care in a newborn intensive care unit (NICU), which has specialized medical staff and equipment that can deal with the multiple problems faced by premature infants.

Premature babies also face an increased risk of lasting disabilities, such as mental retardation, learning and behavioral problems, cerebral palsy, lung problems and vision and hearing loss. Two recent studies suggest that premature babies may be at increased risk of symptoms associated with autism (social, behavioral and speech problems). Studies also suggest that babies born very prematurely may be at increased risk of certain adult health problems, such as diabetes, high blood pressure and heart disease.

Preterm birth is a serious health problem that costs the United States more than $26 billon every year, according to the Institute of Medicine. 


Any woman can give birth prematurely, but some women are at greater risk than others. Researchers have identified some risk factors, but providers still can't predict which women will deliver prematurely.  Three groups of women are at greatest risk for premature birth:

• Women who have had a previous premature birth
• Women who are pregnant with twins, triplets, or more
• Women with certain uterine or cervical abnormalities

There are other risk factors as well: click here for more information. 


More and more births are being scheduled early for non-medical reasons, and this is resulting in babies being born prematurely. The March of Dimes “Healthy Babies are Worth the Wait” campaign is an effort to eliminate preventable preterm births.

 
Babies born too early may have more health problems at birth and later in life than babies born full term. Here's why your baby needs 39 weeks:

• Important organs, like his brain, lungs and liver, get all the time they need to develop.
• He is less likely to have vision and hearing problems after birth.
• Babies born too soon often are too small. Babies born at a healthy weight have an easier time staying warm than babies born too small.
• He can suck and swallow and stay awake long enough to eat after he's born. Babies born early sometimes can't do these things.

All information is via the March of Dimes

Weekend Movie: Delayed Cord Clamping

Penny Simkin visually explains the benefits of delaying clamping of the umbilical cord after birth, with visual aids!



More information:

• Delayed Cord Clamping
• Wait to Cut Umbilical Cord, Study Says 
• Delayed Cord Clamping Among Aboriginal Babies
• Making the Case for Delayed Umbilical Cord Clamping: A Grand Rounds Lecture by Dr. Nicholas Fogelson

Meconium

I've done a post on vernix, and one on the "ring of fire," among other useful things to know about childbirth that you may not know about, and now its time to do a post all about meconium!

Meconium is the first poo of a newborn. It is thick, sticky, brown and sometimes dark greenish. It is made up of what the baby was ingesting inside mom's uterus (like water, amniotic fluid, cells, vernix, etc) and is pretty sterile. It usually passes after the first couple days of the infant's life, turning into the more liquidy poop of a milk-fed baby.

If you're going to be a parent, you'll be seeing a lot of this!

I also just learned this interesting information:

The term meconium derives from ancient Greek meconium-arion, or "opium-like." Aristotle developed the term because he believed that it induced fetal sleep.

I've been asked a couple times about whether the baby poops or pees inside the uterus before being born. The answer is generally "no," but also "sometimes."

Occasionally, the meconium will be present in the amniotic fluid when the membranes rupture (a.k.a. when the water breaks). About 15-20% of babies are born with meconium in the fluid among term-pregnancies, and is increased to 30-40% among post-date pregnancies.

There are a few reasons why this would occur:

1. Women who are truly post-dates are more likely to have a baby that has "meconium-ed" in-utero. This is because their digestive system and bowels have reached maturity and started working.
2. Cord or head is being compressed during labor, which can cause heart rate decelerations, and is a normal physiological response and can happen without fetal distress.
3. True fetal distress. One theory is that the baby either isn't getting oxygen (hypoxia) or is stressed for another reason and poops in response.

Fetal distress can be present without meconium, and meconium can be present without fetal distress. The best indicator of fetal distress is abnormal heart rate, especially if coupled with meconium, and especially if the meconium is thick rather than thin.

Unfortunately, any presence of meconium in the amniotic fluid is cause for alarm among hospital staff. If meconium is discovered in the fluids, the laboring woman will be confined to labor attached to the monitors, with her movement restricted, which reduces her ability to move with her contractions to help the baby down through the pelvis and also restricts her ability to walk or use the shower for comfort. A time limit is also placed on the labor, and the risk of augmentation, c-section, or instruments to speed along the birth are increased. Once the baby is born, the cord will be immediately clamped and the baby will be whisked away from mom, rather than placed on her chest, to be vigorously suctioned.

The suctioning is done for fear of meconium aspiration. Meconium aspiration is when the baby inhales her own meconium, which is extremely rare but can be fatal. It is unlikely that the baby will inhale meconium in utero, unless the baby is extremely hypoxic, in which case they are gasping for air and might inhale their own stool. So, once again, meconium alone may not be a problem, but an oxygen-deprived baby showing other signs of distress may have a problem.

So, if this newborn poo during labor and birth is such a cause for concern, don't you think that care givers would do everything they could to reduce this occurrence? Unfortunately, in the U.S. at least, they do not. It is common practice to do procedures that have been scientifically shown to increase the chance of hypoxia, fetal distress, and meconium aspiration syndrome. For example, (via Midwife Thinking blog):

• Inducing labour if the waters have broken (with meconium present) and there are no contractions or if labour is ‘slow’ in an attempt to get the baby out of the uterus quickly.
• Performing an ARM (breaking the waters) to see if there is meconium in the waters when there are concerns about the fetal heart rate.
• Creating concern and stress in the mother which can reduce the blood flow to the placenta.
• Directed pushing to speed up the birth.
• Having extra people in the room (paediatricians), bright lights and medical resus equipment which may stress the mother and reduce oxytocin release.
• Cutting the umbilical cord before the placenta has finished supporting the transition to breathing in order to hand the baby to the paediatrician.

To reduce chances for complications from meconium, try to avoid the above. For more suggestions on what to do when there is meconium in the amniotic fluid during labor, click over to the post linked above! She has even more information about how the airways are cleared during vaginal birth as the baby is squeezed through the birth canal!

The biggest piece of advice I would give is to avoid artificial rupture of membranes early on in labor unless there are other serious indications of fetal distress. Once meconium is discovered, the whole birth plan changes, even if the baby is doing fine!


References:
http://www.sciencedirect.com/science/article/pii/S1751721410001120
http://www.hon.ch/Dossier/MotherChild/labor_complications/birth_meconium.html
http://midwifethinking.com/2010/10/09/the-curse-of-meconium-stained-liquor/

Weekend Movie: Consequences of a Near Term Birth

RISK: Consequences of a Near Term Birth

Risk is a very human twenty minute educational film that helps patients and their providers experience potential outcomes of elective late preterm delivery through the stories of two moms.

More Reading than You'll Know What to Do With

Hello! Happy March!

I know that there are many followers of this blog who follow the blog itself, some who follow facebook only, and some who follow me only on twitter. I also realize that there are various combinations of the three; for instance, following the blog and facebook but not twitter, or just facebook and twitter, etc. I do different combinations of following of blog content, myself! But I just thought I'd let all my google friend/RSS reader followers what happens over on facebook in case you don't overlap.

Facebook is great because even though with a busy grad schedule I can still post interesting things and have discussions, even if I don't have time to write a whole blog update!

We had a great conversation on the facebook page about whether or not, and how, anthropologists should or can be Activists/Advocates.


Link Roundup: Wrapping up February Edition
Here are some great links that I shared recently, but didn't blog about, that are worth checking out (in chronological order):

Too Many Babies are Delivered Too Early - Hospitals Should Just say No via Time Healthland

The LeapFrog group recently released info on elective deliveries have soared 40% and more and more babies are being born TOO EARLY. The March of Dimes is working on a campaign to stop hospitals and doctors from ordering/performing inductions/c-sections prior to 39 weeks if not MEDICALLY INDICATED.

This is because babies are being born too early when elective deliveries are performed before 39 weeks. Inaccurate measures of gestational age is common, with ultrasound estimations done in the last trimester being off by up to 3 weeks.

Babies who are born before mom goes into labor naturally have more health problems: Risk having immature lungs and respiratory problems, cannot suck and swallow adequately, and are less alert (especially if born by c-section). They spend more time on ventilators and in NICU. If the baby is delivered at 37 weeks and it turns out the baby was actually only 35 weeks gestational age, the baby will have all these problems and more, such as birth defects, autism, learning disabilities, chronic health problems.... They are also more likely to die.

They also cost more. Even born at 37-38 weeks, premature infants cost 10 times more than a full-term newborn. Reducing early deliveries to under 2% could save close to $1 billion in health care each year.

J D Kleinke on Defensive Medicine, Obstetrics, and Women's Health

Fascinating post on the Health Care Blog on "Cultural norm-ing of Defensive Medicine."  Its pretty long, so the Unnecesarean has given us a few quick paragraphs of the main idea... But definitely read the full article if you can!

 The Doula's First Time Mama Advice Kit

Written by the Public Health Doula, this is an AWESOME MUST-READ. She has included everything in this advice kit!

 Is Breastfeeding Advocacy Anti Feminist? An essay by Katherine A Dettwyler

Anthropologist Katherine Dettwyler studies biocultural anth and breastfeeding and dicusses them in this article, and feminism!

The Blonsky Apparatus for Facilitating the Birth of a Child  via Unnecesarean

My boyfriend found these images of the Centrifugal force machine mentioned in the book "Pushed" and I was going to post them to my blog this week, but The Unnecesarean beat me to it! Check this crazyness out!

Pain, Suffering, and Trauma in Labor and Subsequent Post-Traumatic Stress Disorder: First of Two Posts by Penny Simkin  and
Part Two: Pain, Suffering, and Trauma in Labor and Subsequent Post-Traumatic Stress Disorder: Practical Suggestions to Prevent PTSD After Childbirth

The Fabulous and Famous Penny Simkin on Pain vs Suffering (important distinction!) and Birth Trauma and PTSD on Science and Sensibility blog.

Evolution and C-sections

I think it could happen over time, but I don't think its happened already. There are other factors contributing to the current small increases in birth weights. Wouldn't that be a scary thought, though - every single future birth ending in a cesarean section because everyone evolved to have cephalopelvic disproportion??

 Continuous Support for Women During Childbirth - Cochrane Systematic Review

Check out the new Cochrane Review on Continuous Labor Support "The good news about doulas just got better! Fewer cesareans, fewer instrumental vaginal births, less need for pain medicine, less dissatisfaction with birth and better Apgar scores for baby." Via Childbirth Connection

Anthropology Without Doctorates

More and more graduate students in anthropology are not completing their PhD and are working outside of academia. What happens to terminal MA's in anthropology?

Making the Case for Delayed Umbilical Cord Clamping: A Grand Rounds Lecture by Dr. Nicholas Fogelson

50 minute video lecture of Dr. Fogelson speaking to his peers about why umbilical cord clamping should be delayed.

Women in Control of Epidural in Labor Use 30% Less Anesthesia

Important find! If women could be in control of their anesthesia, they'd feel more in control of the whole experience! And if they end up using less anesthesia, all the side effects would be less. I think it would be a blessing for those who want an epidural but fear the potential side effects, like a groggy newborn or too much numbness.

 Incredibly Moving Birth Photography of a Home Water Birth


I hope this isn't too much reading... it definitely covers a whole range of potential interests!

If for some reason this is just not enough to satiate your appetite (if you're like me, ha), I do re-tweet even more interesting articles on Twitter. I also sometimes use Twitter to talk about being a doula or with other doulas. To get involved I encourage you to join in on #doulaparty every Friday and some Sunday afternoons, or simply search the #doulaparty hashtag and read up!

Weekend Movie: Newborn Birth Injuries

I apologize for going from an uplifting post about birth success stories right into one about birth injuries.

This is a very sad weekend movie, but I hope you watch the video and learn about the cause and prevention of brachial plexus birth injuries.

A brachial plexus birth injury is caused by the person who is attending the birth, aka iagtrogenic. 

"You would stop every brachial plexus birth injury if doctors would stop pulling heads."



"To reduce the risk of trauma and injury to your baby, GET OFF YOUR BACK!"

To read more about why current literature supports the fact that non-supine positions are more favorable when compared to the dorsal lithotomy position, read this piece from Science and Sensibility.

Race and Birth Weight Redux

A few months ago I posted an interesting excerpt on Racism and Birth Weight and I here I am going to bring up the topic again.

Jill of the Unnecesarean created a wonderful slide show full of graphs and charts on Racial and Ethnic Disparities in Infant Mortality and all the possible causes. I will be referring you to her slides throughout this post, where you can see a visual representation of the disparity in numbers.


African American infants are more than two times more likely to die during the first year of life than white infants (See Slide 1).

Preterm deliveries and low birth weight are the second leading cause of infant mortality in the United States. Low birth weight is defined as less than 2500 grams, and very low birth weight is defined as less tan 1500 grams. Among African Americans, it is the first leading cause. In fact, African American women are two to three times more likely than white women to deliver preterm, and their babies are three times as likely as white babies to die from prematurity/low birth weight. (See Slide 2)

For the past twenty years, workers and experts in the birth world have been fighting to bring these numbers down. There has been some success, with the overall number of preterm births reduced. However, this gain has been coupled with a widening black-white gap in infant mortality, with whites exhibiting a decline in preterm births at a much greater rate than blacks (CDC).

Why?

Is is genetics?

No. Birth weight distribution of African-born blacks is more closely related to US-born whites than to US-born blacks (See Slide 4)

Is it lack of prenatal care?

No. African American women are just as likely or more likely to receive prenatal care and yet still have higher rates of infant deaths than White Americans, including whites who receive little to no prenatal care (See Slide 6)


Is it a class issue? What about education level or socio-economic status?

No. See Slide 8


Many epidemiological studies have attempted to explain the difference in terms of factors such as maternal age, education, lifestyle, and socio-economic position. However, the results of these studies show that, at best, these factors can account for only a tiny portion of the difference. Studies show that college-educated black mothers are more likely to deliver low birth weight infants than white college-educated mothers.

Also, women who recently migrated to the United States are more likely to have infants of a higher birth weight than women in the same race/ethnic category born and raised in the United States, despite the majority of the migrant women falling into a lower socioeconomic class. These studies suggest “that growing up as a woman of color in the U.S. is somehow toxic to pregnancy, and imply a social etiology for racial/ethnic disparities in prematurity that is not solely explained by economics or education" (Rich-Edwards).

Its not even about maternal smoking during pregnancy.

African American non-smokers still had higher rates of infant deaths than White American smokers (See Slide 10).


Studies have shown that the common factor among African American women having preterm births and low birth weight babies may be a common, negative experience. Among all socioeconomic levels, African American women who reported experiences of racial discrimination at least three or more times proved to be at more than three times the risk for preterm delivery than women who have never experience racial discrimination (Lock).

Factors that might contribute to the disparity include racial differences in maternal medical conditions, stress, lack of social support, previous preterm delivery, and maternal health experiences that might be unique to black women (Hogan).

It would be beneficial to use a life course perspective to understand the effects of race and racism on birth outcomes. This would mean taking into account a person's biology, economics, psychology, sociology, history, etc (the sum total of a person's experience) in addition to that of their parents and grandparents.


Please enjoy these fascinating videos to help further understand what is going on between race and birth outcomes:

When the Bough Breaks: Kim Anderson's Story

When Atlanta lawyer Kim Anderson was pregnant with her first child, she did everything right: she ate a healthy diet, exercised, and got the best prenatal care. But her baby was born almost three months premature. How could this have happened? Some researchers believe that racism may play a role in unusually high rates of premature birth in the African-American community.

Excerpt from Episode 2 of "UNNATURAL CAUSES: Is Inequality Making Us Sick?", a ground-breaking documentary series that looks at how the social, economic and physical environments in which we are born, live, and work profoundly affect our longevity and health. The series broadcast nationally on PBS in spring 2008

How Racism Impacts Pregnancy Outcomes

UCLA obstetrician and gynecologist Dr. Michael Lu believes that for many women of color, racism over a life time, not just during the nine months of pregnancy, increases the risk of preterm delivery. To improve birth outcomes, Lu argues, we must address the conditions that impact women's health not just when they become pregnant but from childhood, adolescence and into adulthood.

This video is a Web-exclusive supplement to "When the Bough Breaks," Episode 2 of "UNNATURAL CAUSES: Is Inequality Making Us Sick?"

References: 
The Unnecesarean - "Racism and Low Birth Weight 101" http://www.theunnecesarean.com/blog/2010/9/28/racism-and-low-birth-weight-101.html
 

Center for Disease Control 2002. "Infant Mortality and Low Birth Weight Among Black and White Infants - United States, 1980—2000” in Morbidity and Mortality Weekly Report 51(27):589-592

Rich-Edwards, J; Nancy Krieger, J Majzoub, Sally Zierler, E Lieberman, M Gillman 2001. "Maternal experiences of racism and violence as predictors of preterm birth: rationale and study design” In: Paediatric and Perinatal Epidemiology. Vol 15:124-135

Lock, M and V. Nguyen 2010. Biomedical technologies in practice. In: An Anthropology of Biomedicine. Pp. 17-31

Hogan VK, Richardson JL, Ferre CD, Durant T, Boisseau M. 2000. A public health framework for addressing black and white disparities in preterm delivery. Journal of American Medicine Women’s Association, Vol. 56:177-80

News Link Roundup: Articles You Should Read!

The CNN Home Birth After Cesarean story everyone is talking about this week: Mom defies doctor, has baby her way

A mom has a VBAC at home. Shocking to those not in the birth world. Excellent that this story has started the conversation that it has! Yes, women should be able to attempt VBACs "in facilities with staff immediately available to provide emergency care," as the ACOG suggests, but unfortunately doctors will not agree to even allow women to attempt it. And so they turn to other options.


(Bonus: the doula in this article is the woman I shadowed when I first became a doula!) 
______________



Another highly talked-about article worth reading, all about how people are discovering that Kangaroo Care is the BEST: The Human Incubator

"Sometimes, the best way to progress isn’t to advance — to step up with more money, more technology, more modernity. It’s to retreat."


"Kangaroo care, however, is modern medical care, by which I mean that its effectiveness is proven in randomized controlled trials — the strongest kind of evidence. And because it is powered by the human body alone, it is theoretically available to hundreds of millions of mothers who would otherwise have no hope of saving their babies."
______________



Should Black Women Feel Guilty for Not Breastfeeding? on Blacktating

"Until we can change the circumstances for working class moms, how can we expect to convince them to breastfeed? Isn't energy better spent securing real paid maternity leave for women and laws to protect a woman's right to express milk at work, even at blue collar jobs?...When it comes to the working poor there is not even the guise of an even playing field. How do we expect breastfeeding rates to change when the life circumstances for these moms is still the same?"
______________

Birth Around the World at Stand and Deliver:

A Tale of Two Births in Canada and European Court of Human Rights Rules Home Birth Legal in Hungary

______________

U.S. Cesarean Rate Reaches Record High, Rises for 13th Consecutive Year at The Unnecesarean 

The national cesarean rate, according to The Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS) report Births: Preliminary Data for 2009, is now 32.9% (which is up from 32.3 in 2008) and is especially on the rise for Black Moms (via Time)

Possible factors, according to the Time article, are obesity and other health problems, maternal choice, patient education, and physician practice patterns. 

“The rate is going up but we are not really improving the health of babies or moms.”

______________

 

 

Vernix Caseosa

Vernix caseosa, also known simply as vernix, is the white waxy-looking substance covering a newborn baby. Many people say it looks kind of like cheese. This substance, made up of the skin oil and dead cells that the baby has shed in the womb, keeps the baby's skin hydrated and protected from immersion in the amniotic fluid. It also aids in the passage through the birth canal.

photo credit

Preterm babies are born with more vernix on their skin than at-term babies. 

Vernix is a wonderful substance that exhibits antioxidant, cleansing,  temperature-regulating and antibacterial properties. It colonizes the skin with microorganisms after birth and prevents peeling of newborn skin. Also, a baby that still has vernix on her hands will find the breast much easier all on her own by using smell.

A study published in The American Journal of Obstetrics and Gynecology in 2004 that found

that the innate immune proteins found in vernix and amniotic fluid are similar to those found in breast milk. As the baby prepares for extrauterine life, pulmonary surfactant (a substance produced by the maturing fetal lungs) increases in the amniotic fluid, resulting in the detachment of vernix from the skin. The vernix mixes with the amniotic fluid and is swallowed by the growing fetus. Given the antimicrobial properties of this mixture, the authors conclude that there is “considerable functional and structural synergism between the prenatal biology of vernix caseosa and the postnatal biology of breast milk.

Rather than bathing the newborn immediately after birth (routine practice in the hospital), moms should rub that wonderful vernix caseosa into baby's skin!

photo credit

Weekend Movie: "Infant Mortality: Causes and Prevention"

Reducing Infant Mortality and Improving the Health of Babies

Listen to Obstetricians, Doulas, Neonatologists, Midwives, Psychologists, Pediatricians, and other Physicians explain how our health care system is failing babies and mothers and what we can do about it. 

http://www.reducinginfantmortality.com/

Reducing Infant Mortality from Debby Takikawa on Vimeo.

"Of the most common procedures in the hospital the top 6 come out of maternity care" 

"We're making it more technologically advanced in our country and we're not doing any better, and we're actually getting worse."

"The rate of prematuriy in the US has increased by 36% since the 1980's"

"Where we get into problems is when we decide that other women then those that are clearly indicated to need them, need to have interventions."

"Most maternity practices that are commonly used in the hospital were never designed to be used at the frequency we're seeing them used now..."

"We have become a little bit cavalier..." 

"It is estimated that for every week that a baby is born before term that they double their risk of having problems..." 

"We know that the use of narcotics at any point interferes with breastfeeding"

"Studies now that show that when women have interventions there are deficits in maternal infant attachment and in breastfeeding as well..."

"Among African American women, breastfeeding numbers are the lowest" 

"Midwives and family doctors primarily are the providers that we've seen in the research have the best outcomes." 

"You do not need someone with the skills of a board certified OB/GYN to do a normal vaginal birth"

"The US is the only industrialized country in the world that uses surgeons to attend normal childbirth."

 "And then we look at those other countries and we see that their healthcare costs are lower..."

"If the system is set up properly where you have a there's a safety net where you work in collaboration and have a nice team effort I think it can be a safe process"

 "A collaborative process...will give patients a better opportunity to have better outcomes."

"There are entire states where midwives are unable to find an OB/GYN who is willing to be available should a woman need to go to the hospital and access those services."

Naming Traditions in World Cultures

Naming Traditions in Different World Cultures


Though a popular tradition among Americans and Europeans, naming a baby after a parent or grandparent almost never happens in Asian cultures. To call out a parent's first name is considered a sign of disrespect, which is why naming a child after an elder is considered inappropriate. Unlike other cultures, Asian traditions tend to be more low-key. For instance, the Japanese hold baby-naming ceremonies on the seventh day after a baby's birth. The simple tradition includes giving baby a first and last - but no middle - name. 

Jewish names often are given to honor family members. Ashkenazi Jews (Jews of Eastern European and German descent) traditionally name children after deceased relatives, while Sephardi Jews (Jews descended from the Iberian Peninsula) traditionally name children after their grandparents or other relatives, whether they are living or dead.

In America, Native American's traditionally have named their babies by something that has inspired them in nature. Many modern Native American's still follow this practice. Each tribal tradition varies, but the theme of nature is common to all.

In Japan girls are often named after virtues, such as purity, morality, dignity and so on. Boys have more inventive names or are named by the position they hold in the family. For example, Ichiro means "first son." 

In Greek families the children are named on the seventh or tenth day of birth. They have traditions of naming their children after relatives. The first born of either sex usually takes on the paternal grandfather's or grandmother's name.

For Hindus who practice the Namkaran or Hindu naming ceremony, the first letter of a baby's name is based on the time and place of the baby's birth. 

For the Gikuyu people in Kenya, the first-born boy is named after the paternal grandfather. The second-born boy is named after the maternal grandfather. Girls are named similarly, after grandmothers.

In Switzerland, many people believe it's bad luck to tell anyone the name you choose for your child before the birth.

A current trend in China is to take the five elements (gold, wood, fire, water, and earth) into account when choosing a name. According to the Chinese classic The Yi Jin, or I Chin, depending on exactly when a child is born, he'll be strong in certain elements, and this will shape his destiny.
Chinese characters, or letters, also bear characteristics of the five elements — a character may have the quality of wood, for example. Many parents believe that the characters in a name can compensate for elements that are lacking. If a baby "lacks water" because of his birth date, a character representing water in his name would make up for that shortcoming. Parents commonly pay an expert to help them identify the appropriate name for their baby.

 
People in Spain and other Latin countries have historically named their children according to Catholic tradition — "Maria" has always been a common name, for example. Boys are traditionally given their father's or grandfather's name.

Traditionally, Italian parents have chosen their children's names based on the name of a grandparents, choosing names from the father's side of the family first and then from the mother's side. 



What traditions inspired your baby naming choices? Did you/Would you follow any of the customs above?

Wait to Cut Umbilical Cord, Study Says

Another study says that delayed cord clamping is a good idea!


A review article from the most recent issue of the Journal of Cellular and Molecular Medicine was cited in the following MSNBC article [all emphasis mine]: 

Wait to cut umbilical cord, study says
Baby may benefit from not clamping until cord quits pulsing

Usually within the first minute of birth, the umbilical cord running between mother and infant is clamped. But this may be too fast, researchers say.

Waiting until the cord stops pulsing could give the newborn significant health benefits, suggests a review article in the most recent issue of the Journal of Cellular and Molecular Medicine. 

"Ob-gyns and parents should think about giving the cord blood to the baby," said lead researcher Paul Sanberg of the University of South Florida. "It only takes a few minutes." 

The umbilical cord carries nutrients and oxygen from mom-to-be's placenta to the developing infant's abdomen. (It leaves a life-long impression in the form of the belly button.) When the practice of immediate cord clamping first began about a half century ago, the value of cord blood, especially its stem cells, which can develop into a suite of other cells, was not known. But now we know that stem cells have many therapeutic properties, Sanberg told LiveScience. 

"It is not just regular blood going in," he said. "It is nature's first stem cell transplant." 

Common problems in newborns are usually related to their underdeveloped organs, which might be helped by the regenerative properties of stem cells, Sanberg theorized. 

After reviewing the majority of research in the field, Sanberg and his colleagues concluded that delaying cord clamping could reduce the infant's risk of many illnesses, including respiratory distress, chronic lung disease, brain hemorrhages, anemia, sepsis and eye disease. 

The risk of such problems, and thus the potential benefit of delaying cord clamping, is particularly significant for premature babies and those born malnourished or suffering from other complications.

Still, the researchers suggest delaying cord clamping may be beneficial for healthy, full-term babies as well — after all, it may be what we have evolved to do. 

"Evolutionarily, there is clearly value for this," Sanberg said, explaining that all mammals, including most humans through history, allow the maternal blood to finish being transferred before severing the cord. The squatting birthing position, only recently out of vogue in the West, may have even facilitated this transfer by harnessing gravity. 

"Only in the last half century or so has mankind started cutting the cord early," Sanberg said.

Evidence-based medicine, people! :) 

This makes me curious as to why doctors even began immediate clamping. I know there is the argument that not clamping the cord may deprive the baby of oxygen, but was lack of oxygen happening in such a way that doctors thought the cord was the connection? It seems like it may have just been more for convenience... if we disconnect mom and baby ASAP, the faster we can whisk baby away from mom to do our newborn checks, and the faster we can get on with our lives (or for legit emergencies). I guess it caught on because it didn't seem to have negative effects on the baby (babies still live, after all, despite quick clamping and cutting). But now that we know it an have positive effects, it is worth changing practices!

Maternal Impressions and Reincarnation Theory

Can a mother's experiences affect her fetus physically? What about the baby's soul? Mary Roach, author of Spook: Science Tackles the Afterlife explores some cultural beliefs about how a child ends up with birthmarks or birth defects, and what it means. Its very interesting!

Among cultures that believe in reincarnation, congenital abnormalities are commonly viewed as clues to the child's past life. Often they are tied in with the death of the supposed previous personality. Ian Stevenson's Reincarnation and Biology contains ten examples of children with birthmarks or birth defects corresponding to the place their alleged previous personality was shot or otherwise fatally wounded.

The birthmark business has a historical corollary of sorts in the theory of maternal impressions. A surprising majority of sixteenth and seventeenth-century physicians believed that a child's birthmarks or abnormalities are caused by the mother having undergone a memorable fright during pregnancy. A baby is born with a missing arm; the mother recalls being set upon by a one-armed beggar. A child's "fish scales" - a skin condition now known as ichthyosis - are blamed on the mother's fear of sea serpents. 

By some accounts, mom didn't need to be frightened but merely focused a little too long in one place. In a famous case detailed by Jan Bondeson in A Cabinet of Medical Curiosities, a thirteenth-century Roman noblewoman gives birth to a boy with fur and claws; the authorities lay blame on an oil painting of a bear on her bedroom wall. The event prompted Pope Martin IV, clearly a tad hysterical, to have all pictures and statues of bears destroyed. Crafty moms tried to work the phenomenon to their favor. In the early 1800s, Bondeson writes, it was common for pregnant noblewomen to be wheeled into the Louvre to spend an hour or so gazing at a portrait of some handsome earl of archduke of yore, in hopes of influencing their unborn progeny. 

Reports of maternal impressions peppered medical texts from Pliny and Hippocrates clear through to the 1903 edition of the American Textbook of Obstetrics, which cites maternal impression as the likely cause of John "Elephant Man" Merrick's deformities - as well as those of the lesser-known traveling spectacle, the Turtle Man. 

In many of the birthmark cases in Reincarnation and Biology, Stevenson points out that the mother saw the corpse of the slain man whose soul eventually turns up in her unborn child. Stevenson doesn't believe all birthmarks are caused by maternal impression, but he is open-minded to the possibility that some are.

Adherents of maternal impression theory hold that the skin is uniquely vulnerable to emotional imprinting. Stevenson describes a half dozen dermatological conditions thought to be open to psychological influence. These range from the relatively mainstream (emotionally induced wheals and blisters) to the distant borderlands of scientific acceptability (stigmata, wart-charming, hypnotically-induced breast enlargement). I suppose that if you believe that hypnotic suggestion can expand a bosom, it's not a big leap to suppose that a profound fright might affect the skin of a developing fetus.

I love stories about reincarnation - children remembering people, things and places that they never could have known about except from a paste life... spooky but cool! These stories about a mother's fright causing a baby's birth defect seem odd to us, but aren't so different from many pregnancy superstitions that we may hear coming from our own cultures or others.

My First Giveaway!

I am very happy to announce Doula Ambition blog's very first ever giveaway!
Hooray for reaching 200 blog posts!

A Boppy Pillow!

I'm moving in a few months, and as I began thinking about packing I realized I have a perfectly good brand new Boppy nursing pillow (still in packaging) that I haven't yet used. I realized that rather than packing it up and moving it, I should give it to someone who can get some great use out of it!


The Boppy is a infant support pillow for use when breastfeeding, bottle-feeding, or for baby to lounge on.

Features of the Pink Bubble Dots (pictured above) Boppy Pillow and Slipcover:

• The Boppy pillow supports baby as you nurse and also as your little one rests, plays and learns to sit up
• Expandable "Miracle Middle" to fit more waist sizes while still retaining its shape for the multiple other uses
• The pillow shell is a cottony soft fabric wrapped around polyester fill
• Boppy Bare Naked is the famous Boppy pillow in solid white; a removable slipcover simply goes in the wash when it needs cleaning
• This whimsical slipcover displays a mod dot print in hues of pink, lavender, yellow and more
• Both pillow and cover are machine wash

 

This Boppy would be great for personal use, to give a new mom as a baby shower gift, or even as a doula to help moms learn to breastfeed in a more comfortable position. 

The first time I ever heard of a Boppy was at a baby shower. When the pregnant mama opened the wrapped Boppy pillow, she was so excited because she had heard they were the best. Its true that the Boppy has won the America's #1 baby product Award six times.

RULES FOR ENTERING:

EACH OF THESE count as one entry. Make sure you leave a separate comment for every single entry opportunity. Remember to leave your email address in the comment or make sure it is available through your profile.  

Required initial entry:

• You must be or become a follower of my blog, either through Google Friend connect (in the sidebar) or another RSS feed, and leave a comment letting me know. 

Additional entries:

• Leave a separate comment telling me about why you'd love to win the Boppy (personal use? give as a gift? etc)
  
• Follow me on twitter @AnthroDoula and tweet about this giveaway.
• Become a fan of ("like") my brand new Anthro Doula Ambitions Facebook page! 
• Post a link to this giveaway on your facebook page or personal blog. Copy and paste a link to that in a comment here in my blog's comment's section.
• If you've used the Boppy before, tell me what you thought of it!
• Recommend a post topic for me to write about.
  

Entries will be closed on May 30th, at midnight - the EDD of my next doula client!