Tuesday 1 September 2009
Saturday 29 August 2009
Looking glass Alice examines birth and parenting in our culture. - BlogNow
A must read for anyone interested in women's right to sovereignty
Looking glass Alice examines birth and parenting in our culture. - BlogNow
Looking glass Alice examines birth and parenting in our culture. - BlogNow
Midwifery' s Renaissance
This piece was written by Marsden Wagner in 2007 and is as valid today as then. Marsden is a very astute man, with a deep understanding about power and politics related to birthing women. His story of his experience with midwifery in his early career is an excellent example of his ability to see the way women's health and wellbeing have everything to do with how power is used and abused in western society.
Midwifery' s Renaissance
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Midwifery' s Renaissance
Shared via AddThis
Friday 28 August 2009
Sunday 23 August 2009
Review into male circumcision legality - Yahoo!7 News
Laws protect girls from genital surgery but parents wanting to circumcise boys can "go around willy-nilly chopping up bits of their sons", a state children's commissioner says.
Tasmania 's commissioner for children Paul Mason and the Tasmanian Law Reform Institute have embarked on what they say is the largest review into the legalities of male circumcision in Australia's history.
Mr Mason said a critical issue for any non-therapeutic circumcision is whether parental consent is sufficient to protect a surgeon from legal action if the child's genital autonomy is thought to have been infringed.
"The only thing that protects a doctor from an action for assault or a civil prosecution is the valid consent of the patient," he said.
"The law is getting pretty hazy about whether a parent can give a valid consent for a child's non-medical procedure."
Mr Mason said about 90 per cent of Australian male babies were circumcised in the 1970s, dropping to about two per cent these days.
Its infrequency nowadays only heightens the chance of a circumcised boy feeling aggrieved as an adult that his rights were ignored as a child, he said.
But High Court rulings andUnited Nations conventions on the rights of parents and children and legal consent in terms of bodily integrity argue against parental-consent circumcision, he said.
Read more:
Review into male circumcision legality - Yahoo!7 News
Mr Mason said a critical issue for any non-therapeutic circumcision is whether parental consent is sufficient to protect a surgeon from legal action if the child's genital autonomy is thought to have been infringed.
"The only thing that protects a doctor from an action for assault or a civil prosecution is the valid consent of the patient," he said.
"The law is getting pretty hazy about whether a parent can give a valid consent for a child's non-medical procedure."
Mr Mason said about 90 per cent of Australian male babies were circumcised in the 1970s, dropping to about two per cent these days.
Its infrequency nowadays only heightens the chance of a circumcised boy feeling aggrieved as an adult that his rights were ignored as a child, he said.
But High Court rulings and
Read more:
Review into male circumcision legality - Yahoo!7 News
Bullying and harrasment of Doctors who support women's choices
Welcome to my blog. Thank you for your support!
Please take a moment to read Dr Fischbein's blog. He is a medical doctor who supports women's right to autonomy and informed choice.
Please take a moment to read Dr Fischbein's blog. He is a medical doctor who supports women's right to autonomy and informed choice.
APHA: Breastfeeding Associated with Decreased Childhood Behavioral Problems
APHA: Breastfeeding Associated with Decreased Childhood Behavioral Problems
San Diego, October 29, 2008 – Children who are breastfed are less likely to suffer from behavioral or mental health issues than those who are not breastfed, according to new research.
The study, which was presented at the American Public Health Association’s 136th Annual Meeting & Exposition in San Diego, looked at whether breastfeeding is associated with decreased behavioral problems and psychiatric illness during childhood.
Using 2003 National Survey of Children's Health data from 102,353 interviews of parents and guardians on the health of their children, researchers found that parents of breastfed children were less likely to report concern for the child's behavior, and breastfed children were less likely to have been diagnosed by a health professional with behavioral or conduct problems and were less likely to have received mental health care. Additionally, parents of breastfed children were less likely to report concern about the child's ability to learn.
“These findings support current evidence that breastfeeding enhances childhood intellectual ability while providing new evidence that breastfeeding may contribute to childhood emotional development and protect against psychiatric illness and behavioral problems,” said Katherine Hobbs Knutson, MD, lead researcher on the study.
Session 5061.0 - Breastfeeding enhances childhood emotional and psychiatric development
Date: Wednesday, October 29, 2008 – 8:30 AM
Researchers: Katherine Hobbs Knutson, MD and Alexy Arauz Boudreau, MD, MPH
Saturday 22 August 2009
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.
Reducing Infant Mortality from Debby Takikawa on Vimeo.
Epigenetic modulation at birth – altered DNA-methylation in white blood cells after Caesarean section
Wiley InterScience :: Journal :: Article PDF
The report states:
"The stress of being born exceeds that of any other critical
life-event. It is fundamental for intact survival during the
transition from foetal to neonatal life. The massive sympathoadrenal
activation during labour (1) mobilizes fuel for the
hypoxic journey through the birth canal and triggers lungliquid
resorbtion (2), thereby facilitating air-breathing
immediately after birth. Labour also activates inflammatory
defence systems (3) and the central nervous system in such
way that the foetus is optimally prepared and adapted for
life outside the womb.
Timing and magnitude of birth stress are altered if delivery
is performed with CS. Infants delivered by elective CS
before onset of labour lack the catecholamine surge seen
after normal VD (1). As compared with normal birth, stress
in infants delivered by CS is also immediate rather than
gradually evolved as during labour. CS may therefore be
maladaptive for the newborn infant and has been associated
with increased short-term neonatal morbidity (4)."
The report states:
"The stress of being born exceeds that of any other critical
life-event. It is fundamental for intact survival during the
transition from foetal to neonatal life. The massive sympathoadrenal
activation during labour (1) mobilizes fuel for the
hypoxic journey through the birth canal and triggers lungliquid
resorbtion (2), thereby facilitating air-breathing
immediately after birth. Labour also activates inflammatory
defence systems (3) and the central nervous system in such
way that the foetus is optimally prepared and adapted for
life outside the womb.
Timing and magnitude of birth stress are altered if delivery
is performed with CS. Infants delivered by elective CS
before onset of labour lack the catecholamine surge seen
after normal VD (1). As compared with normal birth, stress
in infants delivered by CS is also immediate rather than
gradually evolved as during labour. CS may therefore be
maladaptive for the newborn infant and has been associated
with increased short-term neonatal morbidity (4)."
Thursday 20 August 2009
Sexual Abuse Linked to Somatic Disorders
From Medpage
By Chris Emery, Contributing Writer, MedPage Today
Published: August 19, 2009
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco.
Sexual abuse is associated with an increased risk of somatic disorders, in which patients report physical symptoms or complaints with no clear underlying cause, a review of nearly two dozen studies concluded.
Patients with a history of sexual abuse, as children or adults, were more likely to experience gastrointestinal disorders (OR 2.43; 95% CI 1.36 to 4.31), nonspecific chronic pain (OR 2.20; 95% CI 1.54 to 3.15), psychogenic seizures (OR 2.96; 95% CI 1.12 to 4.69) and chronic pelvic pain (OR 2.73; 95% CI 1.73 to 4.30), according the report in the August 5 Journal of the American Medical Association.
"Building greater awareness of the association between sexual abuse and somatic disorders may lead to improved health care delivery and outcomes for sexual abuse survivors," Ali Zirakzadeh, MD, of the Mayo Clinic, and colleagues wrote. "As a group, survivors of abuse have higher medical care use and incur greater costs compared with the general patient population."
Surveys have determined that the incidence of sexual violence in the United States is 2.5% for women and 0.9% for men, according to the review, and researchers have estimated that one in 15 adults has experience forced sexual intercourse. Studies have also estimated that 16% of men and 25% of women in the United States are survivors of childhood sexual abuse.
"To date, research on the long-term effects of sexual abuse has primarily focused on mental health outcomes," wrote Zirakzadeh and his coauthors. "Strong evidence supports a link between childhood sexual abuse and multiple psychiatric sequelae. However, studies investigating the association between sexual abuse and somatic outcomes have been less definitive."
The authors conducted a systematic literature search of electronic databases from January 1980 to December 2008, identifying 23 longitudinal studies that reported somatic outcomes in 4,640 people with and without history of sexual abuse.
The researchers categorized sexual abuse into two major groups. "Rape" was defined as penetration with a body part or foreign object, while "All forms of sexual abuse" captured the wide variety of definitions used to characterize sexual violence.
While analysis from the data in the studies indicated a relationship between sexual abuse and some somatic disorders, the researchers found no significant association between sexual abuse and a lifetime diagnosis of fibromyalgia, obesity or headache.
However, when they restricted the analysis to rape victims, they found a higher risk of fibromyalgia diagnosis (OR 3.35; 95% CI, 1.51 to 7.46). Like those classified under "all forms of sexual abuse," rape victims were also more prone to chronic pelvic pain (OR 3.27; 95% CI 1.02 to 1.53) and functional gastrointestinal disorders (OR 4.01; 95% CI 1.88 to 8.57).
The principal limitation of the study, according to the authors, was the inclusion of data susceptible to bias. Only two of 23 studies met at least 8 of the 10 maximum points of the Newcastle-Ottawa criteria for study quality. They also noted that their findings may not apply to men, since sixteen of the 23 studies in the review included only female subjects.
However, they also noted that the review used an exhaustive and reproducible search strategy and attempted to avoid bias by careful selection and extraction of data.
They also pointed out that sexual abuse remains prevalent and that doctors commonly encounter survivors in general medical practice.
They speculated that sexual abuse may be an early inciting environmental factor in a multistep process that culminates in physical dysfunction, and that the neuroendocrine system may mediate the connection between sexual abuse and the development of somatic dysfunction.
"Increasingly, it has been shown that survivors of sexual abuse face a spectrum of often challenging health concerns, resulting in greater health care use and cost and significant morbidity," they wrote. "Recognition of this association may have important clinical implications for patients coping with these disorders and their clinicians."
The authors reported no financial conflicts of interest.
No funding source for the study was reported.
Primary source: Journal of the American Medical Association
Source reference:
Zirakzadeh A, et al. "Sexual Abuse and Lifetime Diagnosis of Somatic Disorders" JAMA 2009; 5: 550-61.
The application of this information to pregnancy and birth for women who have been abused in childhood is well known to midwives. This information underscores the importance for women to feel in control and autonomous in their pregnancies and births.
Great to see this information becoming 'mainstream'.
By Chris Emery, Contributing Writer, MedPage Today
Published: August 19, 2009
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco.
Sexual abuse is associated with an increased risk of somatic disorders, in which patients report physical symptoms or complaints with no clear underlying cause, a review of nearly two dozen studies concluded.
Patients with a history of sexual abuse, as children or adults, were more likely to experience gastrointestinal disorders (OR 2.43; 95% CI 1.36 to 4.31), nonspecific chronic pain (OR 2.20; 95% CI 1.54 to 3.15), psychogenic seizures (OR 2.96; 95% CI 1.12 to 4.69) and chronic pelvic pain (OR 2.73; 95% CI 1.73 to 4.30), according the report in the August 5 Journal of the American Medical Association.
"Building greater awareness of the association between sexual abuse and somatic disorders may lead to improved health care delivery and outcomes for sexual abuse survivors," Ali Zirakzadeh, MD, of the Mayo Clinic, and colleagues wrote. "As a group, survivors of abuse have higher medical care use and incur greater costs compared with the general patient population."
Surveys have determined that the incidence of sexual violence in the United States is 2.5% for women and 0.9% for men, according to the review, and researchers have estimated that one in 15 adults has experience forced sexual intercourse. Studies have also estimated that 16% of men and 25% of women in the United States are survivors of childhood sexual abuse.
"To date, research on the long-term effects of sexual abuse has primarily focused on mental health outcomes," wrote Zirakzadeh and his coauthors. "Strong evidence supports a link between childhood sexual abuse and multiple psychiatric sequelae. However, studies investigating the association between sexual abuse and somatic outcomes have been less definitive."
The authors conducted a systematic literature search of electronic databases from January 1980 to December 2008, identifying 23 longitudinal studies that reported somatic outcomes in 4,640 people with and without history of sexual abuse.
The researchers categorized sexual abuse into two major groups. "Rape" was defined as penetration with a body part or foreign object, while "All forms of sexual abuse" captured the wide variety of definitions used to characterize sexual violence.
While analysis from the data in the studies indicated a relationship between sexual abuse and some somatic disorders, the researchers found no significant association between sexual abuse and a lifetime diagnosis of fibromyalgia, obesity or headache.
However, when they restricted the analysis to rape victims, they found a higher risk of fibromyalgia diagnosis (OR 3.35; 95% CI, 1.51 to 7.46). Like those classified under "all forms of sexual abuse," rape victims were also more prone to chronic pelvic pain (OR 3.27; 95% CI 1.02 to 1.53) and functional gastrointestinal disorders (OR 4.01; 95% CI 1.88 to 8.57).
The principal limitation of the study, according to the authors, was the inclusion of data susceptible to bias. Only two of 23 studies met at least 8 of the 10 maximum points of the Newcastle-Ottawa criteria for study quality. They also noted that their findings may not apply to men, since sixteen of the 23 studies in the review included only female subjects.
However, they also noted that the review used an exhaustive and reproducible search strategy and attempted to avoid bias by careful selection and extraction of data.
They also pointed out that sexual abuse remains prevalent and that doctors commonly encounter survivors in general medical practice.
They speculated that sexual abuse may be an early inciting environmental factor in a multistep process that culminates in physical dysfunction, and that the neuroendocrine system may mediate the connection between sexual abuse and the development of somatic dysfunction.
"Increasingly, it has been shown that survivors of sexual abuse face a spectrum of often challenging health concerns, resulting in greater health care use and cost and significant morbidity," they wrote. "Recognition of this association may have important clinical implications for patients coping with these disorders and their clinicians."
The authors reported no financial conflicts of interest.
No funding source for the study was reported.
Primary source: Journal of the American Medical Association
Source reference:
Zirakzadeh A, et al. "Sexual Abuse and Lifetime Diagnosis of Somatic Disorders" JAMA 2009; 5: 550-61.
The application of this information to pregnancy and birth for women who have been abused in childhood is well known to midwives. This information underscores the importance for women to feel in control and autonomous in their pregnancies and births.
Great to see this information becoming 'mainstream'.
Can words hurt? Patient–provider interactions during invasive procedures
In an article in the Journal PAIN (2005) 114 303-309 Lang et al had this to say:
Abstract
Patients are often prepared for procedural discomforts with descriptions of pain or undesirable experiences. This practice is thought to be compassionate and helpful, but there is little data on the effect of such communicative behavior. This study assesses how such descriptions affect patients’ pain and anxiety during medical procedures. The interactions of patients with their healthcare providers during interventional radiological procedures were videotaped during a previously reported 3-arm prospective randomized trial assessing the efficacy of self hypnotic
relaxation. One hundred and fifty-nine videos of the standard care and attention control arms were reviewed. All statements that described painful or undesirable experiences as warning before potentially noxious stimuli or as expression of sympathy afterwards were recorded. Patients’ ratings of pain and anxiety on 0–10 numerical scales (0 No Pain, No Anxiety at All and 10 Worst Pain Possible, Terrified) after the painful event and/or sympathizing statement were the basis for this study. Warning the patient in terms of pain or undesirable experiences resulted in greater pain (P!0.05) and greater anxiety (P!0.001) than not doing so. Sympathizing with the patient in such terms after a painful event did not increase reported pain, but resulted in greater anxiety (P!0.05). Contrary to common belief, warning or sympathizing using language that refers to negative experiences may not make patients feel better. This conclusion has implications for the training in medical communication skills and suggests the need for randomized trials testing different patient–practitioner interactions. q 2004 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
This study provides a perfect example of the way that hypnotic suggestion works.
When will health professionals realise that when they talk, their words are powerful. Pregnant women get this negativity all the time with the talk of 'risk' in relation to their normal, natural process of giving birth. The negative talk creates a self fulfilling prophecy for many women. Then the 'care' givers can use the outcome to reinforce what they think and say, not realising that they created what they believed to be true.
As the above article demonstrates, words are powerful. The sort of words that should be used around birthing women are words that foster a sense of normalcy, increase self efficacy, build self worth and self trust. Every health professional who has anything to do with birthing women should be working to build capacity for wellness and optimal psychophysiological functioning with every woman they interact with.
Abstract
Patients are often prepared for procedural discomforts with descriptions of pain or undesirable experiences. This practice is thought to be compassionate and helpful, but there is little data on the effect of such communicative behavior. This study assesses how such descriptions affect patients’ pain and anxiety during medical procedures. The interactions of patients with their healthcare providers during interventional radiological procedures were videotaped during a previously reported 3-arm prospective randomized trial assessing the efficacy of self hypnotic
relaxation. One hundred and fifty-nine videos of the standard care and attention control arms were reviewed. All statements that described painful or undesirable experiences as warning before potentially noxious stimuli or as expression of sympathy afterwards were recorded. Patients’ ratings of pain and anxiety on 0–10 numerical scales (0 No Pain, No Anxiety at All and 10 Worst Pain Possible, Terrified) after the painful event and/or sympathizing statement were the basis for this study. Warning the patient in terms of pain or undesirable experiences resulted in greater pain (P!0.05) and greater anxiety (P!0.001) than not doing so. Sympathizing with the patient in such terms after a painful event did not increase reported pain, but resulted in greater anxiety (P!0.05). Contrary to common belief, warning or sympathizing using language that refers to negative experiences may not make patients feel better. This conclusion has implications for the training in medical communication skills and suggests the need for randomized trials testing different patient–practitioner interactions. q 2004 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
This study provides a perfect example of the way that hypnotic suggestion works.
When will health professionals realise that when they talk, their words are powerful. Pregnant women get this negativity all the time with the talk of 'risk' in relation to their normal, natural process of giving birth. The negative talk creates a self fulfilling prophecy for many women. Then the 'care' givers can use the outcome to reinforce what they think and say, not realising that they created what they believed to be true.
As the above article demonstrates, words are powerful. The sort of words that should be used around birthing women are words that foster a sense of normalcy, increase self efficacy, build self worth and self trust. Every health professional who has anything to do with birthing women should be working to build capacity for wellness and optimal psychophysiological functioning with every woman they interact with.
Sunday 16 August 2009
Sunday 9 August 2009
Fish oil in pregnancy linked with reduced allergy risk fo children
A new study from Sweden published in the journal Acta Paediatrica [Acta Paediatr. 2009 Jun 1 ePub ahead of print] found at http://www.ncbi.nlm.nih.gov/pubmed/19489765 has found that Omega 3–rich fish oil supplementation during pregnancy and lactation may reduce the risk of food allergy and eczema in children.
The randomized, placebo-controlled, double-blind study, followed 145 pregnant women who had allergies or had partners or other children with allergies [which makes this group at high risk for having children with allergies.
From the 25th week of pregnancy until between 3 and 4 months breastfeeding, the women were randomly assigned to receive either:
1. daily fish oil supplements providing 1.6 g of eicosapentaenoic acid
(EPA)and 1.1 g of docosahexaenoic acid (DHA)
2. or placebo.
Children born to the group of mothers who were given Omega 3's had a 2% incidence of allergy, compared to a 15% rate for the babies in the control/placebo group.
Another finding was that the incidence of allergic eczema was reduced by 2/3rds (8% in the omega-3 infant group, compared to 24% in the placebo group).
How this works is because Omega-3 fatty acids compete with the Omega-6s therefore lessening the release of arachidonic acid (AA) and inflammatory prostaglandins, which create havoc in our cells.
Another example of how important nutrition is and how nutrition must be the first line of primary health care!
The randomized, placebo-controlled, double-blind study, followed 145 pregnant women who had allergies or had partners or other children with allergies [which makes this group at high risk for having children with allergies.
From the 25th week of pregnancy until between 3 and 4 months breastfeeding, the women were randomly assigned to receive either:
1. daily fish oil supplements providing 1.6 g of eicosapentaenoic acid
(EPA)and 1.1 g of docosahexaenoic acid (DHA)
2. or placebo.
Children born to the group of mothers who were given Omega 3's had a 2% incidence of allergy, compared to a 15% rate for the babies in the control/placebo group.
Another finding was that the incidence of allergic eczema was reduced by 2/3rds (8% in the omega-3 infant group, compared to 24% in the placebo group).
How this works is because Omega-3 fatty acids compete with the Omega-6s therefore lessening the release of arachidonic acid (AA) and inflammatory prostaglandins, which create havoc in our cells.
Another example of how important nutrition is and how nutrition must be the first line of primary health care!
Friday 7 August 2009
Senate Committee Meeting update
This is the message from Lisa Metcalfe from Maternity Coalition following the Senate Committee hearing yesterday on the midwives and nurse practitioner bills before the Senate.
The transcript from the Senate committee hearing will be available on
this link in the next 24 hours or so
http://www.aph.gov.au/Senate/committee/clac_ctte/health_leg_midwives_nurse_practitioners_09/hearings/index.htm
MC, HBA, HAS and ACMI all presented to the committee
some terrific advocacy by the consumers
Thanks to those who represented MC (Bruce Teakle and Makayla Macintosh)
Media monitoring from Heidi this morning
Great to see this in the Age!
http://www.theage.com.au/travel/mothers-irate-at-qantas-baby-bungle-20090805-ea45.html
Lisa
--
Lisa Metcalfe
NSW President
Maternity Coalition
29 Oceana Pde
Austinmer NSW 2515
Ph: 02 4268 1675
Mob: 0437 577 576
Em: nsw@maternitycoalition.org.au
Web: www.maternitycoalition.org.au
The transcript from the Senate committee hearing will be available on
this link in the next 24 hours or so
http://www.aph.gov.au/Senate/committee/clac_ctte/health_leg_midwives_nurse_practitioners_09/hearings/index.htm
MC, HBA, HAS and ACMI all presented to the committee
some terrific advocacy by the consumers
Thanks to those who represented MC (Bruce Teakle and Makayla Macintosh)
Media monitoring from Heidi this morning
Great to see this in the Age!
http://www.theage.com.au/travel/mothers-irate-at-qantas-baby-bungle-20090805-ea45.html
Lisa
--
Lisa Metcalfe
NSW President
Maternity Coalition
29 Oceana Pde
Austinmer NSW 2515
Ph: 02 4268 1675
Mob: 0437 577 576
Em: nsw@maternitycoalition.org.au
Web: www.maternitycoalition.org.au
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