Thursday 29 October 2009

Maternity Matters: Choice, access and continuity of care in a safe service UK

MATERNITY MATTERS: Choice, access and continuity of care in a safe service - EQUALITY IMPACT ASSESSMENT is a NHS document

"Maternity Matters has been developed following the publication of the Maternity Standard of the National Service Framework (NSF) for Children, Young People and Maternity Services (October 2004). The NSF acknowledged the importance of addressing the needs of women and their partners before the woman becomes pregnant, throughout pregnancy, childbirth and beyond as they embark on parenthood and family life. Healthy mothers tend to have healthy babies, a mother who has received high quality maternity care throughout her pregnancy is well placed to provide the best possible start for her baby. A Department of Health Maternity Services Survey published in December 2005 showed that whilst 80% of women are pleased with the care they get when they have a baby they would prefer more choice about the type of care they receive and choice about where to have their baby".

dh_087081.pdf (application/pdf Object)

This report is a wonderful example of what people in power with a commitment to providing safe, equitable, satisfying and accessible maternity services can do.

Making it better: For mother and baby

Clinical case for change. Report by Sheila Shribman, National Clinical Director for Children, Young People and Maternity Services

The National Clinical Director for Children, Young People and Maternity Services, Sheila Shribman, outlines how services are being reconfigured to meet the needs of mothers and babies.
"Maternity services need to be safe and flexible - designed around the individual's needs and choices. Pre and post birth care will be available in community-based settings such as children's centres. Women will be able to go direct to a midwife for care rather than having to go to a GP. Depending on their circumstances women should be able to choose between having a birth at home, in a home-like unit or in a maternity hospital supported by obstetricians and anaesthesists. For some women with known risks giving birth in hospital will be the safest option".
This is the link to that report:

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_065128.pdf


"We know that the emotional wellbeing of new parents and the involvement of both mother and father can have an effect on a child’s life chances including their health and educational attainment. Pregnancy and the first three years are vital to child development. If we are going to give children the best start in life services must meet the social and emotional needs of new parents and parents-to-be. Our vision of joined up services delivered in the local community will not only improve access and support a family’s ability to choose but will allow for support for their health and social care needs from midwives, health visitors and the primary health care team"
"To meet this commitment, and the others I have already described, the NHS should offer women a range of settings to give birth in, appropriate to their needs and wishes, taking account of safety and any risks as a key priority.

All women should have a choice of the following services:
• a home birth supported by a midwife, or
• birth in a local facility under the care of a midwife such as a designated midwifery unit. The unit might be based in the community, or in a hospital; patterns of care will vary
across the country to reflect different local needs. These units typically promote a philosophy of “normal” and natural births
• birth supported by a local maternity care team that includes a consultant obstetrician. For some women, this type of care may be the only safe option. These teams are nearly all hospital-based".

Tuesday 27 October 2009

Outcomes for Caseload Midwifery at St Mary's UK

 This poster was presented at the June 2009 Normal Birth conference in the UK. The poster reports on a prospective cohort study on all live births at St Mary's Hospital in the Imperial College Healthcare Trust NHS. The study evaluated the caseload model in that health service.

Women who had caseload, or one to one relationship based midwifery care were found to have fewer interventions in labour and birth. These women were found to have a higher rate of births at home, higher rate of normal births, a reduced rate of both analgesia and epidural anaesthesia, higher breastfeeding rates and more normal births.  The rates of caesarean section and babies admitted to the nursery were the same for both groups of women.

caseload09.jpg (image)

Sunday 18 October 2009

YouTube - Monty Python - Hospital Sketch

The best social commentary on how the medical model (the Emperor has no clothes model) treats women and birth. This clip is from the Monty Python movie "The Meaning of Life". These people are/were geniuses. Although this movie was made in 1983, it is still relevant over thirty years later.






Cosleeping and Biological Imperatives: Why Human Babies Do Not and Should Not Sleep Alone « Neuroanthropology

Ah James McKenna, the voice of reason in a world sent spinning into nets of fear and worry by the 'risk' and 'threat' discourses that abound in our control freak society.

Cosleeping and Biological Imperatives: Why Human Babies Do Not and Should Not Sleep Alone « Neuroanthropology

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Saturday 17 October 2009

Science & Sensibility » Beyond Due Dates: How Late is Too Late?

The following is a quote on the Science and Sensibility blog by Rosie:

"Harmanni Boerhaave, a botanist who in 1744 came up with a method of calculating the EDD based upon evidence in the Bible that human gestation lasts approximately 10 lunar months. The formula was publicized around 1812 by German obstetrician Franz Naegele. There is one glaring flaw in Naegele's rule. Strictly speaking, a lunar (or synodic from new moon to new moon) month is actually 29.53 days, which makes 10 lunar months roughly 295 days, a full 15 days longer than the 280 days gestation we've been lead to believe is average."

The comment above is so important to think about. How do we right this crazy wrong?

The way that that the normal, physiological span for when labour begins has been contracted to the due date is unacceptable and wrong. The 'due date' was always an estimation, not a set in concrete date.

The feverishness with which the medical model approach to childbearing seeks to control women with babies on the inside is simply astonishing and, when you really think about it, deplorable.

We menstruate at different ages, we go through menopause at different ages. Children learn to speak, to crawl and to walk within wildly varying time frames. These time frames are normal. Everyone is different.

Can you imagine what it would be like if we suddenly imposed restrictions and curtailments on what was considered normal and acceptable in those domains of human development?

Such restriction would lead to inhuman and cruel procedures.

The medical control of birthing women's processes is often inhumane and cruel, although it positions itself as 'lifesaving', heroic and really, the only field which really cares about the baby. The medical model view has positioned mother and baby as competing entities and medicine is the advocate of the baby. Barbara Duden is a German historian who has written a great book called Disembodying Women. Barbara talks about how women have been depicted as a faulty ecosystem and the baby is depicted as an endangered species in modern medical discourse.

The rise in the rate of surgical birth, maternal depression and admissions of babies to neonatal intensive care units is the fallout from this crazy making 'emperor has no clothes' medical model approach to try to control women and childbearing.

The childbearing process has to be worked with, not worked on.

Science & Sensibility: Beyond Due Dates: How Late is Too Late?

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Why immune cells count in early pregnancy

"This research identifies immune system cells as critical determinants of normal ovarian activity and the maintenance of early pregnancy. This might be a key to helping prevent early pregnancy loss, such as recurrent miscarriage."

Ms Care says a number of factors - such as smoking, obesity, poor nutrition and stress - could all alter the way macrophages behave and may provide reasons for infertility or miscarriage in some women.

Why immune cells count in early pregnancy

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Facebook | 26th Homebirth Australia Conference 2010

Facebook | 26th Homebirth Australia Conference 2010

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Friday 16 October 2009

The food-energy cellular connection revealed

This article helps us understand why shift workers are more at risk of a raft of diseases. Night duty workers are more at risk of breast cancer. More reasons why changing the way that midwives work leads to better outcomes. This time it's midwives who benefit by coming off shift work and working one to one or in caseload models with childbearing women. Maternity service managers please take note.

"Shift workers face a 100 percent increase in the risk for obesity and its consequences, such as high blood pressure, insulin resistance and an increased risk of heart attacks," says Howard Hughes Medical Investigator Ronald M. Evans, Ph.D., a professor in the Salk Institute's Gene Expression Laboratory.

The researchers' findings, which are published in the Oct. 16, 2009, issue of Science, could have far-reaching implications, from providing a better understanding how nutrition and gene expression are linked, to creating new ways to treat obesity, diabetes and other related diseases. "It is estimated that the activity of up to 15 percent of our genes is under the direct control of biological clocks," says Evans. "Our work provides a conceptual way to link nutrition and energy regulation to the genome."

The food-energy cellular connection revealed

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Thursday 15 October 2009

How Diet Affects Fertility | Newsweek Health for Life | Newsweek.com

This is a great article. A must read for anyone who wants to get pregnant and anyone else who wants to stay healthy and live well.

Health, wellness and fertility all comes down to 'what you eat today, walks and talks tomorrow'. The overall message is
1. Eat whole foods
2. Avoid processed and modified products (which masquerade as food)
3. Eat quality protein
4. Include natural fats
5. Eat fresh foods

and of course, drink lots of fresh, filtered water, stop smoking, limit alcohol, move and enjoy your life!

The authors wrote:

"In a nutshell, results from the Nurses' Health Study indicate that the amount of carbohydrates in the diet doesn't affect fertility, but the quality of those carbohydrates does. Eating a lot of rapidly digested carbohydrates that continually boost your blood-sugar and insulin levels higher can lower your chances of getting pregnant. This is especially true if you are eating carbohydrates in place of healthful unsaturated fats. On the other hand, eating whole grains, beans, vegetables and whole fruits" all of which are good sources of slowly digested carbohydrates”can improve ovulation and your chances of getting pregnant."

The authors also talk about transfats. This article is excellent.

How Diet Affects Fertility | Newsweek Health for Life | Newsweek.com

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Tuesday 13 October 2009

Associations of drugs routinely given in labour with breastfeeding at 48nbsphours analysis of the Cardiff Births Survey - - BJOG: An International Journal of Obstetrics & Gynaecology

Associations of drugs routinely given in labour with breastfeeding at 48nbsphours analysis of the Cardiff Births Survey - - BJOG: An International Journal of Obstetrics & Gynaecology

S Jordan,a S Emery,b A Watkins,c JD Evans,d M Storey,G Morganf
BJOG: An International Journal of Obstetrics & Gynaecology, Volume 116, Issue 12 (p 1622-1632)
Accepted 4 May 2009. Published Online 1 September 2009.

Breastfeeding rates drop when labouring women are given epidurals, intramuscular narcotics and third stage oxytocics.  More evidence for maternity care that is mother friendly, that is, continuity of care by a midwife the woman knows, trusts and feels safe with. The hormones associated with feeling safe are prophylactic, that is, they keep women's physiology working well. When women feel safe, cared for and supporting in pregnancy and birth, they have their inner 'high' from healthy chemicals made by their own bodies. Amazing how the chemistry works. Bring on the changes to maternity care! It's a human rights issue for women and their babies

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Saturday 10 October 2009

South West Alliance of Rural Health (SWARH)

˜To know your midwife and be able to have as natural a birth as possible with minimal intervention is certainly something this hospital can brag about'

South West Alliance of Rural Health (SWARH)

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