Julia Medew and Louise Hall
February 16, 2009
WOMEN who give birth in public hospitals are twice as likely to suffer serious complications and their babies are at greater risk of death, research shows.
An analysis of more than 780,000 full-term births in Australia between 2001 and 2004 found one in 1000 babies died in private hospitals, compared with three in 1000 in public hospitals.
It also concluded that women giving birth in public hospitals had twice the rate of severe perineal tearing. The rate of high-level resuscitation of babies in public hospitals was double that of private hospitals.
Obstetrician and co-author of the study, Associate Professor Stephen Robson of Australian National University, said the results, published in The Medical Journal of Australia today, were "startling", given the high rate of interventions in private hospitals. "Having a caesarean section, being induced and having an instrumental delivery usually increases complications, so we were staggered that in the private hospital group where these things happen more, the rate of complications was much lower," he said.
"We are loathe to draw too many conclusions, but it upends the orthodoxy that the more you intervene, the worse off the woman and her baby will be."
Professor Robson said he and his colleagues, Elizabeth Sullivan and Paula Laws of the Perinatal and Reproductive Epidemiology Research Unit at the University of New South Wales, took into account factors that would undermine fair comparison, such as smoking, diabetes and high blood pressure.
They also eliminated women with multiple pregnancies, premature deliveries and those with complications that were referred from private to public hospitals. "Our conclusion is that obstetrician-led care, the model of care where an obstetrician directly manages a woman's labour and delivery, confers quite an advantage," Professor Robson said, adding that experience may also contribute.
"If you look at the obstetricians who deliver babies in private hospitals they are generally highly trained, experienced people. If you look at public hospitals, there is more junior staff, midwifery-led care and a lot of trainees," he said.
The results are likely to spark debate as the Federal Government continues to assess different models of care as part of its review of maternity services.
Professor Robson said some factors not examined by the study, such as the socio-economic status of mothers, may have contributed, and urged more research.
But a spokeswoman for the Australian College of Midwives, Hannah Dahlen, said private hospitals tended to underreport adverse outcomes such as perineal tearing because of fear of medio-legal action.
President of the Maternity Coalition, Caroline McCullough, said the most important thing for women was to make informed decisions and have access to all types of care, regardless of the type of hospital in which they delivered.
"The medical lobby needs to pull its head in because it's not an either/or situation, it's about midwives and obstetricians and other health workers working together to support women in whatever choice they make," she said.
http://www.theage.com.au/national/public-hospital-births-double-risk-for-mother-and-baby-says-report-20090215-8861.html
Showing posts with label pregnancy. Show all posts
Showing posts with label pregnancy. Show all posts
Tuesday, February 17, 2009
A nice story about home birthing midwife
CHARLESTON, W.Va. -- Nurse midwife Angy Nixon hugged her way around a recent meeting of home-birth advocates and moms. She admired the healthy babies held by their beaming mothers and exclaimed over how much they'd changed since she last saw them at their birth.
She shares an intimate bond with these women, who trusted her with their pregnancies and the deliveries of their babies, most of them in their own homes. Since 2003, Nixon's midwifery practice has been mostly home deliveries. She spent her first five years as a midwife delivering babies in a birth center.
"Women choose home births for a variety of reasons," she said, listing the reasons in no particular order. "Some want to save money. They expect the birth to be normal and are not afraid. They appreciate the privacy of their own homes. They control who's in the room."
Continue Reading
She shares an intimate bond with these women, who trusted her with their pregnancies and the deliveries of their babies, most of them in their own homes. Since 2003, Nixon's midwifery practice has been mostly home deliveries. She spent her first five years as a midwife delivering babies in a birth center.
"Women choose home births for a variety of reasons," she said, listing the reasons in no particular order. "Some want to save money. They expect the birth to be normal and are not afraid. They appreciate the privacy of their own homes. They control who's in the room."
Continue Reading
Friday, February 13, 2009
Christian Group Opens Six Birth Facilities in Philippines
RICHMOND, Va., Feb. 11 /PRNewswire-USNewswire/ -- Access to high quality health care facilities is important for mothers to have healthy newborns. In the Philippines, six new birthing centers have made giving birth much safer and less worrisome for women in Pili, Camarines Sur.
"We want to emphasize the importance of bringing pregnant women to health care facilities, which is the most important factor in preventing maternal and newborn mortality," said Dr. Sadia Parveen, Christian Children's Fund reproductive health specialist.
Thanks to funding from the CCF's Sky Siegfried Fund, six new birthing centers were officially launched in Pili, Camarines Sur in September.
Elisa, 38, was the first resident to give birth in one of the new facilities, delivering a healthy 7-pound baby girl in October at the Kabukludan Birthing Center. The other birthing centers are operating smoothly, according to CCF staff in the region.
"The health attendant and the midwife took good care of me before and after delivery," Elisa said. "I will recommend this center to my relatives because I feel at home and safe."
CCF Philippines, partnering with Mt. Zion Family Development Association - Christ the King Center, initiated the project, "Saving Women's Lives Through Improved Maternal Care." Goals of the project include reducing vulnerability of women to the risks related to pregnancy; providing women access to safe maternal and newborn care; and improving community health.
"A primary objective of this project is to build partnerships with groups such as the provincial and municipal health offices, local government units and the communities," said Parveen.
Plans are under way to make these centers more comprehensive in their primary health care approach, in terms of broadening their reach to cater to not only pregnant women, but also to women and children in general, Parveen said. This would help take comprehensive primary health care to the community level, and thereby bridge the gap between the public health infrastructure and the communities.
Pili, Camarines Sur, is located in the Bicol Region of the Philippines. More than half of the pregnant women in this rural area have traditionally received care from traditional birth attendants, also known as hilots.
The new facilities allow pregnant mothers quicker access to health care. According to the Rural Health Unit of Pili, only 40 percent of total pregnancies in 2006 were attended by professional health workers. This is consistent with findings from the National Demographic and Health Surveys, which show that women residing in rural areas usually receive little or no care from health professionals and are not informed of the dangers of pregnancy, such as miscarriage and pre-term labor.
The facilities offer patients access to trained health care workers. As part of the nearly $200,000 project, pre- and post-natal obstetric and pediatric care training was conducted by specialists from the Bicol Medial Center to 16 health professionals composed of midwives and nurses. Midwives, rural health nurses and volunteer nurses also attended a five-day training workshop on community-managed maternal and newborn care. Five village pharmacies have been formed and are ready to operate as well to provide medicine to mothers and newborns if needed.
Assisted delivery by skilled and trained personnel is associated with lower levels of illness and infant mortality, Parveen said.
CCF believes that what happens in the first years of life is the cornerstone upon which the child grows and develops. These new birthing centers are critical to CCF's goal of having healthy and secure infants in its programs.
The Sky Siegfried Fund is an annual gift from the Siegfried family. The family donates $500,000 and challenges CCF donors to match the gift. The Sky Siegfried Fund supports health initiatives throughout the world.
http://sev.prnewswire.com/health-care-hospitals/20090211/DC6950311022009-1.html
"We want to emphasize the importance of bringing pregnant women to health care facilities, which is the most important factor in preventing maternal and newborn mortality," said Dr. Sadia Parveen, Christian Children's Fund reproductive health specialist.
Thanks to funding from the CCF's Sky Siegfried Fund, six new birthing centers were officially launched in Pili, Camarines Sur in September.
Elisa, 38, was the first resident to give birth in one of the new facilities, delivering a healthy 7-pound baby girl in October at the Kabukludan Birthing Center. The other birthing centers are operating smoothly, according to CCF staff in the region.
"The health attendant and the midwife took good care of me before and after delivery," Elisa said. "I will recommend this center to my relatives because I feel at home and safe."
CCF Philippines, partnering with Mt. Zion Family Development Association - Christ the King Center, initiated the project, "Saving Women's Lives Through Improved Maternal Care." Goals of the project include reducing vulnerability of women to the risks related to pregnancy; providing women access to safe maternal and newborn care; and improving community health.
"A primary objective of this project is to build partnerships with groups such as the provincial and municipal health offices, local government units and the communities," said Parveen.
Plans are under way to make these centers more comprehensive in their primary health care approach, in terms of broadening their reach to cater to not only pregnant women, but also to women and children in general, Parveen said. This would help take comprehensive primary health care to the community level, and thereby bridge the gap between the public health infrastructure and the communities.
Pili, Camarines Sur, is located in the Bicol Region of the Philippines. More than half of the pregnant women in this rural area have traditionally received care from traditional birth attendants, also known as hilots.
The new facilities allow pregnant mothers quicker access to health care. According to the Rural Health Unit of Pili, only 40 percent of total pregnancies in 2006 were attended by professional health workers. This is consistent with findings from the National Demographic and Health Surveys, which show that women residing in rural areas usually receive little or no care from health professionals and are not informed of the dangers of pregnancy, such as miscarriage and pre-term labor.
The facilities offer patients access to trained health care workers. As part of the nearly $200,000 project, pre- and post-natal obstetric and pediatric care training was conducted by specialists from the Bicol Medial Center to 16 health professionals composed of midwives and nurses. Midwives, rural health nurses and volunteer nurses also attended a five-day training workshop on community-managed maternal and newborn care. Five village pharmacies have been formed and are ready to operate as well to provide medicine to mothers and newborns if needed.
Assisted delivery by skilled and trained personnel is associated with lower levels of illness and infant mortality, Parveen said.
CCF believes that what happens in the first years of life is the cornerstone upon which the child grows and develops. These new birthing centers are critical to CCF's goal of having healthy and secure infants in its programs.
The Sky Siegfried Fund is an annual gift from the Siegfried family. The family donates $500,000 and challenges CCF donors to match the gift. The Sky Siegfried Fund supports health initiatives throughout the world.
http://sev.prnewswire.com/health-care-hospitals/20090211/DC6950311022009-1.html
Monday, February 9, 2009
Study links obesity with birth complications
Researchers found that they were at high risk of premature birth, having an underweight baby or suffering pre-eclampsia, a condition which can be fatal.
Obesity has previously been linked to a number of problems during pregnancy but researchers wanted to know if these were more serious during a first pregnancy.
The study, the findings of which were published in the American Journal of Obstetrics and Gynaecology, followed 385 obese women having their first child in Britain and the Netherlands.
The research found that almost four in 10 of the women, 39 per cent, had to have a Caesarean section, a rate they claim is the highest ever reported in the world.
Previous studies in obese women found that just one in five had to have the operation instead of a natural labour.
Obese first-time mothers were also almost twice as likely to have a underweight baby than women who were not obese, and a third more likely to have an overweight baby, the study found.
They were six times more likely than first-time mothers of healthy weight to develop pre-eclampsia and twice as likely as other overweight women.
The risk of premature birth was also twice the national average.
Pre-eclampsia is a potentially deadly syndrome in which blood pressure becomes raised because of significant amounts of protein in the urine.
Because of the complications the women spent longer on average in hospital compared to other new mothers, an average of 4.6 days compared to a national average of just three days.
The study was carried out by Tommy's, the baby charity, the Wellcome Trust, and the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre at Guy's & St Thomas' NHS Foundation Trust in partnership with King's College London.
Lucilla Poston, who led the research, said: "There are a number of findings which are very surprising. The large proportion of small babies was particularly unexpected as obesity is more often associated with the birth of overweight babies.
"The high number of cases of pre-eclampsia found in this group was very concerning, as this is a serious pregnancy complication which, in extreme cases, can result in maternal and or fetal death.
"We must now start to consider first-time pregnancy as an additional problem in obese pregnant women, who we know are already more likely than thinner women to have a complicated pregnancy."
Premature births and small babies are at risk of suffering brain damage, breathing difficulties, learning problems and infection.
Mervi Jokinen, from the Royal College of Midwives, said: "Obesity is an issue that is becoming increasingly prominent in maternity care and midwives are aware of the complexities and potential problems that obesity brings into pregnancy.
"We need to ensure that women get early access to a midwife so that she can get lifestyle and weight management advice as soon as possible, and that this continues throughout the pregnancy and after the birth of the baby."
http://www.telegraph.co.uk/health/healthnews/4557980/Obese-first-time-mothers-at-more-danger-of-complications.html
Obesity has previously been linked to a number of problems during pregnancy but researchers wanted to know if these were more serious during a first pregnancy.
The study, the findings of which were published in the American Journal of Obstetrics and Gynaecology, followed 385 obese women having their first child in Britain and the Netherlands.
The research found that almost four in 10 of the women, 39 per cent, had to have a Caesarean section, a rate they claim is the highest ever reported in the world.
Previous studies in obese women found that just one in five had to have the operation instead of a natural labour.
Obese first-time mothers were also almost twice as likely to have a underweight baby than women who were not obese, and a third more likely to have an overweight baby, the study found.
They were six times more likely than first-time mothers of healthy weight to develop pre-eclampsia and twice as likely as other overweight women.
The risk of premature birth was also twice the national average.
Pre-eclampsia is a potentially deadly syndrome in which blood pressure becomes raised because of significant amounts of protein in the urine.
Because of the complications the women spent longer on average in hospital compared to other new mothers, an average of 4.6 days compared to a national average of just three days.
The study was carried out by Tommy's, the baby charity, the Wellcome Trust, and the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre at Guy's & St Thomas' NHS Foundation Trust in partnership with King's College London.
Lucilla Poston, who led the research, said: "There are a number of findings which are very surprising. The large proportion of small babies was particularly unexpected as obesity is more often associated with the birth of overweight babies.
"The high number of cases of pre-eclampsia found in this group was very concerning, as this is a serious pregnancy complication which, in extreme cases, can result in maternal and or fetal death.
"We must now start to consider first-time pregnancy as an additional problem in obese pregnant women, who we know are already more likely than thinner women to have a complicated pregnancy."
Premature births and small babies are at risk of suffering brain damage, breathing difficulties, learning problems and infection.
Mervi Jokinen, from the Royal College of Midwives, said: "Obesity is an issue that is becoming increasingly prominent in maternity care and midwives are aware of the complexities and potential problems that obesity brings into pregnancy.
"We need to ensure that women get early access to a midwife so that she can get lifestyle and weight management advice as soon as possible, and that this continues throughout the pregnancy and after the birth of the baby."
http://www.telegraph.co.uk/health/healthnews/4557980/Obese-first-time-mothers-at-more-danger-of-complications.html
Welcome!
Hi my name is Mike. I am not a midwife. I work for Utah College of Midwifery as the IT guy. I started this page as a way of discovering the many facets of Midwifery and how it is important to the ongoing national health care discussion. I believe that natural birth, with well trained and qualified midwives will lower pre and post natal care costs, thus making our healthcare system more effective. We'll discuss many issues that you may feel passionate about. We'll also have resources where you can learn more about midwives, and the practice of Midwifery in the United States and Canada.
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