24 Hour Virtual International Day of the Midwife Conference

An exciting event has been planned to celebrate International Day of the Midwife. Dr Deborah Davis from the University of Technology (UTS) in Sydney and Sarah Stewart Otago Polytechnic Education Development Centre in NZ have planned and coordinated a fabulous, innovative virtual conference.

 

International Midwives Day Virtual Conference

Presentations, discussions, chat room and webpage discussions, videos and podcasts are all planned to occur on the day.

Conference program

You can have a look at last year's event and explore the presentations there to get a sense of what you can expect this year.

You will learn all about working with a Wiki which is a website where people can create and edit pages about topics/areas that interest them together. Links can be made to resources and further pages.  People can work cooperatively on policy and guidelines development, research and networking on a Wiki. The 24 hour virtual International Day of the Midwife Celebration and Conference is all on a Wiki, with links to events, tools, videos and podcasts provided within the Wiki.

Going to conferences is always fun. I love them, but geography, finances and time zones prevent many midwives meeting on an international level. Online resources and tools such as Second Life, Elluminate and Skype overcome those limitations and enable midwives to meet, communicate, share information and resources in a far more flexible way than face-to-face meetings. This 24 hour virtual celebration of midwifery is a means of providing us with an opportunity to meet at some stage during the day either 'live' in real time meetings or at recorded events at a time that suits us individually.

Elluminate is a virtual meeting room. You can listen, watch, interact in the Elluminate meeting room. You will need to get familiar with Elluminate before the sessions you want to take part in. Sarah Stewart has kindly offered to take you through Elluminate and show you how it functions. Contact Sarah to book a time to do so if you would like that help. I'm certainly going to take her up on her generous offer.

Revamping the Blog

I've had a such a great time tonight, working with Sarah Stewart, the queen of using social media for updating about midwifery and education. Sarah has been wonderful, coaching me on getting the twitter link, the 24 hour virtual International day of the midwife link and putting the tags of my posts on the page.

Sarah's blog is well worth exploring as there are some great tips for anyone who wants to use this medium to get their message across. Sarah Stewart's blog  Sarah also has some timely advice for those of us who use Facebook and Twitter in terms of our professional responsibilities.  I think you will find what she has to say very thought provoking and useful.

I would love your feedback about the new look and any other suggestions you may have for my blog.

Writing Birth: Rainbows in the heart and other matters of importance

When Vicki Chan of Better Birth Workshops put a quote by Carl Sandburg on Facebook, followed up by this beautiful poem (below) written by Sandburg on their discussion page, my thoughts turned to the way that artists and mothers write about birth. 

Being born is important.
You who have stood at the bedposts
and seen a mother on her high harvest day,
the day of the most golden of harvest moons for her.
You who have seen the new wet child dried behind the ears,
swaddled in soft fresh garments,
pursing its lips and sending a groping mouth
toward the nipples where white milk is ready

You who have seen this love's payday of wild toil and sweet agonizing
You know being born is important.
You know nothing else was ever so important to you.
You understand the payday of love is so old,
So involved, so traced with the circles of the moon,
So cunning with the secrets of the salts of the blood
It must be older than the moon, older than the salt.

 

Carl Sandburg at 55 years of age

What an amazing poem and what an amazing man to write so eloquently about birth and how important birth is, not only to women, not only to babies, but all of us.

My thoughts then moved to "Harvest Day" a brilliant piece where writer and journalist, Anna Maria Dell'Oso explored her feelings and experiences about birth and mothering in a column for the Good Weekend Section of the Sydney Morning Herald newspaper. Anna Maria's column and others was published as a book called Cats, Cradles and Chamomile Tea in 1989. I highly recommend the book and in particular this chapter, for mothers, midwives, doulas, fathers, students, everyone.

Anna Maria wrote:

"Being with someone, murmuring along with their heartbeat, breathing with them is a lost art. The true midwives of birth and death, those who keep vigil at the bedposts are rare. They are people whose eyes are accustomed to darkness and light, who stand waiting by  night and by dawn, holding cloaks and soft wrappings at the cross roads and gateways; they stand at the threshold, at the breaking of the paths, watching the lights, the rain and the winds, welcoming and farewelling our journeying souls. The price of such people is above rubies. No machines that go ping can stand in their place. Yet so often that is all we have. Thank God it doesn't happen to me".

Poets and writers show us what's real, what's missing and what's possible. Their words and the images they evoke go straight to our heart and let us know if we are on track or need to change. They teach us if we are willing to listen and see with new eyes those things we adapt to and take for granted. 

A lovely quote by Sandburg, is to be found in engraved lengthwise horizontally in a finished split tree trunk in the lobby of Carl Sandburg Middle School, Neshaminy School District of lower Bucks County.

"MAN IS BORN WITH RAINBOWS IN HIS HEART AND YOU'LL NEVER READ HIM UNLESS YOU CONSIDER RAINBOWS"

As you would be aware, the word "man" was used at the time as the generic term for a human being. Carl Sandburg was obviously referring to all people when he wrote that statement. What does being born with rainbows in our hearts mean? What does it take to consider rainbows?  Our human spirit is ignored in what passes for maternity and newborn 'care' in this country and in most of the so called developed world. Indigenous people understand the rainbow in a person's heart, they consider rainbows and read each other well. 

What will make us wake up to the rainbows?

We are blessed to have the poets, artists and writers. They help us learn to consider rainbows and other signs of real life. They show us why birth is important when we have forgotten. 

Flashmob: Pregnant women breakdancing in London

"If you think this is dangerous, try giving birth in poor countries without a midwife,  hospitals or medicine. This flashmob is one of a series that is happening in Paris, Berlin..."  Oxfam

700,000 more midwives are needed globally. When a trained midwife is in attendance, a woman's chances of surviving childbirth dramatically increase.

Midwives create a clean environment for the delivery and deal with complications during birth. Midwives must be supported with decent, well-equipped hospitals nearby for emergency care.

Oxfam

Caesarean vs VBAC a dramatic difference

This is a very inspirational and moving video by Alexandra Orchard about her birth experiences.


Cesarean vs. VBAC:  A Dramatic Difference from Alexandra Orchard on Vimeo.


There are some very interesting comments on Alexandra's page. Click this link or cut and paste into your browser.

http://vimeo.com/5648654

Optimistic Expectancies and Cell-Mediated Immunity — Psychological Science

Having positive expectations is good for your immune system functioning and therefore good for your health.

"These results provide the first evidence that changes in optimistic expectancies are accompanied by changes in immunity, as well as the first evidence for a mechanism by which this effect occurs. Changes in expectancies about law school predicted changes in cellular immune function, and this relationship could be partially accounted for by positive but not negative affect. The results support the validity of psychological interventions to improve immunity and health (e.g., Andersen et al., 2007) and suggest that efforts to correct irrationally pessimistic expectancies may be warranted, particularly if these efforts also increase positive affect".

Interestingly, the authors conclude:

"Although optimistic expectancies are associated with both increased positive affect and decreased negative affect, it may be as important for immunological health for people to be happy as it is for them to lack anxiety".

That song "Don't worry, be happy" was on the mark!

Of course, childbearing women do have 'worries' and their anxieties can be alleviated by having a midwife to journey through their experience with.  Midwives can provide a sounding board and provide information and a safe space where worries and fears can be explored; strategies for self management developed and worries dissipated.  In such a supportive environment, women's cell-mediated immunity is obviously improved, which would 'fit' with the reduced numbers of women experiencing pre-eclampsia, gestational diabetes and premature labour that is associated with 1-2-1 midwifery care.


Optimistic Expectancies and Cell-Mediated Immunity — Psychological Science

Perception of effort, not muscle fatigue, limits endurance performance

"As recently as 2008, scientific research papers were citing the theory that endurance performance is limited by the capacity of the skeletal muscles, heart and lungs and that exhaustion occurs when the active muscles are unable to produce the force or power required by prolonged exercise.
Dr Sam Marcora, an exercise physiologist at Bangor University, has now disproved this for the first time and proposed an alternative - that it is your perception of effort that limits your endurance performance, not the actual capability of your muscles. He showed that the muscles were still able to achieve the power output required by endurance exercise even when the point of perceived exhaustion had been reached".

The idea that the perception of effort limits a person's endurance performance is relevant to any physical activity that requires endurance, not just the sporting arena.

For birthing women, their families and midwives, this information is very important. Perceptions around labour and birth are culturally constructed. Many women are apprehensive about giving birth because of the negativity they are subjected to on a daily basis from well meaning friends, associates and even total strangers. That apprehension that many women feel, coupled with also well meaning but negative, undermining comments when they are in labour, may lead many women to perceive that they are 'at the end of their tether' and unable to go on. Birthing physiology requires the woman to feel safe and loved to work optimally.

Many partners get frightened by the rawness and primal nature of labour and seek to make themselves feel better by sympathising/pitying and/or suggesting pain relief for the labouring woman. An example is regarding one of the couples, several years ago, who came back to an antenatal group to talk about their birth experience six weeks earlier. When they had told their story, the man said "I was so happy when she had the epidural, I couldn't stand it any longer".

Women do look to their partners and caregivers to check how they are 'doing' in labour. Women get feedback that way. Fear-filled or pitying faces trigger mirror neurons to create similar feelings in the women, disrupting their physiological functioning for birthing. Unless the woman's self talk is particularly strong and positively oriented, her mind will be filled with fearful reactive thoughts, further disrupting her birthing physiology.

On the other hand, in a similar way to what happens in sporting situations, when partners/family and midwives provide encouragement, words of praise, smiling faces and a firm belief in the woman's ability, women's self talk changes and they find the inner strength to continue, even getting a 'second wind' as the energy in the room picks up. That's where the analogy to sport ends because with birthing there is no competition. There is no one to beat. The wonder is that there is a beautiful baby and fabulous placenta to welcome into the world.

The recipe for enabling birth, as it is for any physically related endeavor requiring focus and endurance:

• believe you can 'do it'
• prepare yourself
• surround yourself with people who believe in you
• ask your partner/support people to say supportive messages and to smile at you in labour
• tell yourself that you 'can'
• do it

Perception of effort, not muscle fatigue, limits endurance performance

Stress During Pregnancy Linked to Higher Risk for Asthma in Offspring

The way that our physiology switches genes on or off in response to environmental circumstances/triggers/cues, a process now studied as 'epigenetics' or 'above the genes' is becoming increasingly understood. The way that stressors impact our lives, our genetic expression and our immune system is becoming more and more recognised and obvious as scientists seek to understand the role of the environment in disease profiles. The significance of the prenatal experience in setting the foundations for health and wellness or disease is now recognised as a reality for humans as well as other animal species.

What scientists are discovering as they study the role of the prenatal environment in health and disease, is that high levels of maternal stress during the prenatal period is associated with impaired immune modulation. This study gives further credence to the Barker hypothesis that the prenatal experience is programming the infant's physiology, including the immune system to respond to the environment it will be born into. In the case of children whose mothers experience chronic and high stress levels, they have immune systems that are more vulnerable and more highly triggered by adverse environmental factors.

"In the Urban Environment and Childhood Asthma Study, the investigators evaluated associations among prenatal maternal stress and cord blood mononuclear cell (CBMC) cytokine responses among 557 families in Boston; Baltimore, Maryland; New York City; St. Louis, Missouri, and other cities. Each child had a parent with history of asthma or allergy".

Cytokines are messenger molecules with a complex range of interweaving, intersecting pro inflammatory and anti inflammatory functions.

"This is the first study in humans to show that increased stress experienced during pregnancy in these urban, largely minority women, is associated with different patterns of cord blood cytokine production to various environmental stimuli, relative to babies born to lower-stressed mothers," lead author Rosalind Wright, MD, MPH, associate physician at Brigham and Women's Hospital in Boston, Massachusetts, said in a news release.

The obvious answer is take care of pregnant women. Reduce the environmental stressors that pregnant women have to negotiate on a day to day basis. Poverty, violence, poor nutrition, unwanted pregnancies, lack of preconceptual care, lack of meaningful, supportive care during pregnancy and birth etc are all environmental risk factors with huge implications for the health and wellbeing of mothers and their babies.

Midwifery care that is provided in a one to one relationship is very beneficial for helping a woman defuse her stress levels. As a woman feels safe with her midwife and as trust builds, discusses her fears, problems and life circumstances, emotional stress is releases and solution generating can begin. Our government needs to heed these studies and provide better care for pregnant women if they truly want better and healthier societies.



Stress During Pregnancy Linked to Higher Risk for Asthma in Offspring

Government sold out to the AMA

 "The new regulatory framework includes a request for midwives to form a collaborative relationship with doctors, requiring their sign-off to access Medicare insurance and pharmaceutical benefits"

This bit of legislation has put midwifery under the control of doctors and sold out women's choice to birth at home with her own midwife

 

and is it no wonder when our prime minister, the honourable kevin rudd, at the AMA's union dinner says:

"In particular, tonight I want to acknowledge the hard work of Andrew Pesce as President of the AMA. I've appreciated Andrew's input and his engagement with
the health reform agenda in the meetings that we have had together in recent weeks.

The Government and the AMA are both committed to tackling the long-term challenge of health reform, and we are both committed on the direction we need to take to tackle this challenge - in particular, on the need for stronger clinician leadership within our health system.

In July last year, the AMA told us about the sorts of things that they would like to see in health reform....

Andrew, we heard you."

Date: 10 March 2010
News Type: Speech
Title: Speech to the 2010 AMA Parliamentary Dinner


Senate passes controversial birth bill | Herald Sun

Miracle baby elephant makes public debut

Miracle baby elephant makes public debut

"Miller said the indications were the elephant would have no permanent problems despite being stuck in a position in the womb which experts considered would result in death to both mother and calf in the wild".

Interestingly, the mother gave birth alone, once everyone left her after the pronouncement that the baby elephant was dead in utero.  The experts do that shroud waving thing around birth quite a bit. Even with elephants. Just goes to show that experts are wrong across species. Mothers always know best

British fertility clinic raffling human egg

What do you think of this?

"A British fertility clinic said Sunday it was raffling off a human egg this week to promote its "baby profiling" service, which it insists is legal under UK law".

British fertility clinic raffling human egg

Private practice midwifery

I've been quiet on my blog for a couple of weeks. I've been thinking a lot.

Over the last two weeks, I have been contacted by more and more women wanting one to one midwifery care.

The  women who have contacted me include:
1. Women who live outside the boundary set by publicly funded homebirth services
2. Women who prefer to know their midwife and have one to one care, rather than take 'pot luck' on which midwife will be there at the birth
3. A woman having twins who is apprehensive about all the negativity around having twins and being 'routinely' done to -  you know, induction, epidural... etc. She wants a midwife to go to hospital with her because she doesn't trust the 'system'.
4. A woman who has had three births via caesarean and wants to birth normally.
5. A woman who has had two births via caesarean and wants to birth normally.

To me, this signifies a problem with the 'system' of maternity care in this country. Women's rights are still being ignored. The importance of birth and freedom of choice is still being ignored.

The mountain of research which demonstrates that pregnant women's emotional as well as physical needs must be met to enable optimal health and wellbeing of the mother and her baby is being ignored.

Now is the time to write to the government, the opposition and all your local members talking about these human rights issues. Write your letter. Send it by snail mail. I've been told that a letter from any person is seen as representative of 100 members of the community.  Google the various political parties and all the politicians and their addresses are easily found. Our lives are being over regulated and under serviced. Time for a change. Please make your voice heard.

Study finds genetic link between misery and death

Specifically, Cole analyzed transcription factor binding sequences in a gene called IL6, a molecule that is known to cause inflammation in the body and that contributes to cardiovascular disease, neurodegeneration and some types of cancer.

"The IL6 gene controls immune responses but can also serve as 'fertilizer' for cardiovascular disease and certain kinds of cancer," said Cole, who is also a member of UCLA's Jonsson Comprehensive Cancer Center and UCLA's Molecular Biology Institute. "Our studies were able to trace a biochemical pathway through which adverse life circumstances — fight-or-flight stress responses — can activate the IL6 gene.

Interleukin-6 (IL-6) is a protein that in humans is encoded by the IL6 gene.

IL-6 acts as both a pro-inflammatory and anti-inflammatory cytokine - an immune system messenger molecule. IL-6 is relevant to many disease processes such as diabetes, atherosclerosis, systemic lupus erythematosus, prostate cancer and rheumatoid arthritis. Advanced metastatic cancer patients have higher levels of IL6 in their blood.
Cytokines are regulatory signaling proteins, taking messages from cell to cell and influencing the behaviour and activity of the cells. Their pro-inflammatory behaviour is implicated in many of the processes that plague pregnant women, causing havoc for them and their babies.

This study is very exciting. Such clear linking of stress response and cytokine activation as described by these researchers is essentially providing more evidence that pregnant women need environments which are calm, relaxed, nurturing and supportive. Midwives are the obvious people to support, nurture and ensure calm and relaxed surroundings as they work with women to normalise their experiences of change on the journey to becoming a mother.

1. Kristiansen OP, Mandrup-Poulsen T (December 2005). "Interleukin-6 and diabetes: the good, the bad, or the indifferent?". Diabetes 54 Suppl 2: S114–24. PMID 16306329.
2. Dubiński A, Zdrojewicz Z (April 2007). "[The role of interleukin-6 in development and progression of atherosclerosis]" (in Polish). Pol. Merkur. Lekarski 22 (130): 291–4. PMID 17684929.
3. Tackey E, Lipsky PE, Illei GG (2004). "Rationale for interleukin-6 blockade in systemic lupus erythematosus". Lupus 13 (5): 339–43. PMID 15230289.
4. Smith PC, Hobisch A, Lin DL, Culig Z, Keller ET (March 2001). "Interleukin-6 and prostate cancer progression". Cytokine Growth Factor Rev. 12 (1): 33–40. PMID 11312117.
5. Nishimoto N (May 2006). "Interleukin-6 in rheumatoid arthritis". Curr Opin Rheumatol 18 (3): 277–81. doi:10.1097/01.bor.0000218949.19860.d1. PMID 16582692.
6. "Cancer Patients Typically Have Increased Interleukin-6 Levels". American Society of Clinical Oncology 2006 Annual Meeting, Abstracts 8632 and 8633. Medscape.com. 2006-06-26. http://www.medscape.com/viewarticle/537309.

Study finds genetic link between misery and death

The pheromone myth: Sniffing out the truth - 24 February 2010 - New Scientist

Fascinating read

Richard L. Doty is director of the University of Pennsylvania's Smell and Taste Center. His awards include the US National Institutes of Health's James A. Shannon award (1996), and the Association for Chemoreception Sciences' Max Mozell award for outstanding achievement in the chemical senses (2005). This essay is based on his book, The Great Pheromone Myth (Johns Hopkins University Press)

Richard Doty states:

"All in all, it looks as if "pheromonology" has become a modern-day phrenology, providing simple but false explanations for most chemically mediated social behaviours and endocrine responses, satisfying only those who seek simple answers to complex phenomena. Perhaps once the idea that mammals have pheromones is dispelled, we can work towards an appreciation of the real role chemicals play in their lives".

The pheromone myth: Sniffing out the truth - 24 February 2010 - New Scientist

Dirty tricks of the egg and sperm race - 24 February 2010 - New Scientist

The title of this article about gene expression from New Scientist is misleading. Not so much 'dirty tricks' but fascinating negotiations! New insights into how genes express and are modified by environmental factors, known as the field of 'epigenetics' provide provide a better understanding of how we become who we are.

"The imprinted genes include several with a role in embryo growth and development, most of which are also expressed in the brain, meaning that key traits like body size, cognitive ability and personality might be moulded by epigenetic inheritance".

Dirty tricks of the egg and sperm race - 24 February 2010 - New Scientist

The Reinvention of the Self § SEEDMAGAZINE.COM

"Elizabeth Gould overturned one of the central tenets of neuroscience. Now she’s building on her discovery to show that poverty and stress may not just be symptoms of society, but bound to our anatomy".

Brilliant article about the role of the environment in making us who we are:

"Subsequent experiments have teased out a host of other ways stress can damage the developing brain. For example, if a pregnant rhesus monkey is forced to endure stressful conditions—like being startled by a blaring horn for 10 minutes a day—her children are born with reduced neurogenesis, even if they never actually experience stress once born. This pre-natal trauma, just like trauma endured in infancy, has life-long implications. The offspring of monkeys stressed during pregnancy have smaller hippocampi, suffer from elevated levels of glucocorticoids and display all the classical symptoms of anxiety. Being low in a dominance hierarchy also suppresses neurogenesis. So does living in a bare environment. As a general rule of thumb, a rough life—especially a rough start to life—strongly correlates with lower levels of fresh cells.
Gould’s research inevitably conjures up comparisons to societal problems. And while Gould, like all rigorous bench scientists, prefers to focus on the strictly scientific aspects of her data—she is wary of having it twisted for political purposes—she is also acutely aware of the potential implications of her research".

The environment shapes us, from the very beginning to the very end.

"...As Nottebohm has said, “Take nature away and all your insight is in a biological vacuum.” Nottebohm discovered neurogenesis in birds learning to sing in their natural habitat". If he'd studied birds in cages, they would have been too stressed to sing and therefore wouldn't have grown new neurons.

The Reinvention of the Self § SEEDMAGAZINE.COM

The implications for midwifery work with childbearing women is that midwives create the right environment within which women can explore becoming mothers in an optimal way.

Hansard 23rd February 2010

This is from Sen Julian McGauran, Liberal Sen for Victoria (page 4), said:

"Rest assured that I know all about the incompetence of Minister Roxon, who has flown under the radar. It is not just this issue; a whole array of issues in her portfolio ought to be brought out.......

I was in Ballarat recently for the community cabinet; it was Mr Rudd's sideshow. That was all it was. You should have seen the glum faces on all of the ministers who turned up. What a joke. In this portfolio is the midwives issue, denying women the choice to have home births. That was what dominated the community
cabinet. I got a guernsey; I was there in the front row. I could not believe it. It was a sight to see the one ego on display. He really does have a big ego. You have to see it to believe it, and you are all compliant to it. It is a joke. When are you going to stand up and speak on an issue?

This Prime Minister is so frightened of the midwives issue he is not willing to meet the public outside of a controlled situation. When he had to unveil the Kevin Rudd bust in Ballarat ‹as many of you know, in
the gardens there there are busts of every Prime Minister‹ he did not turn up. He left the council, the Mayor and everyone else standing there waiting for him to appear at 11 am. He just did not turn up. He did not even ring ahead to say he was not going to turn up. Can you imagine the embarrassment and the frustration? Do you know why? Because there were midwives protesting there waiting for him and wanting to speak to him. Of course, they have dubbed it as 'cowardly'. That is the portfolio I want to speak on".

Writing Speeches For The Government

Writing Speeches For The Government

MYLES PETERSON

February 21, 2010

Midway through last year I was head-hunted by the federal Department of Health and Ageing to write speeches for their ministers - a surprise as I had no experience or qualifications. As far as the department was aware, my limited skills were derived from reviewing video games for The Canberra Times.
Perplexed and amused, I dusted off the suit and attended my one and only interview. ''I'll be writing speeches for who?''
''Minister Roxon,'' answered my interviewer.
''And you're going to pay me how much?''
''Eighty thousand a year. Will that be enough?''
So began my journey down the public service rabbit-hole. I would soon learn that swine flu and a raid on staff by another department were to thank for my recruitment.

Sigh! An article well worth reading. So this is what we are dealing with folks!

YouTube - Our bodies rally.wmv

On the 18th February, 2010 in 14 locations across Australia, 1000's of people rallied to register their protest at the Rudd Government policies that threaten to restrict options for women.

Jane Palmer's wonderful video montage of the rallies for women's right to choose what happens to their bodies in childbirth

And some media on the 'issue'


The Sunrise piece that seems to have stirred up the Government

http://au.tv.yahoo.com/sunrise/video/play/-/6819641/

a TV piece from Chan 7 yesterday

http://www.youtube.com/watch?v=LvZFZ0gd-Zw

http://www.facebook.com/l/64996;www.mybirth.com.au/19-02-2010/women-rally-at

Nicola Roxon's response to collaboration agreements.

http://www.abc.net.au/news/stories/2010/02/19/2824133.htm

Roxon says: "I'm unapologetically on the record as saying let's encourage people across the health services spectrum to work together and make sure that women can safely choose options that are good for them and suit them.." 

That's great in theory and obviously something that sounds very reasonable. 

The question then has to be asked: So why not restrict doctors work unless they collaborate - they are the ones who make things difficult! 

In reality, Roxon's 'encouragement' is only fueling the power imbalances and women are caught in the 'rip'.

 

 

 

Probing Question: Do emotions influence heart health?

Probing Question: Do emotions influence heart health?

"Can positive emotions like love, friendship and social connectedness improve health? It seems that way, suggests McDanel. Many studies have shown that patients who have caring support networks during health crises have better outcomes than those who do not, she said. A decade-long study on elderly Australians found that those with larger networks of friends were found to be 22 percent less likely to die during the study period than those with fewer friends.
"Friendships and supportive social networks can definitely help people through times of sickness or emotional hardship," McDanel said. "We have to treat people with a holistic approach, treating their physical maladies, improving their diet and exercise, but also working on their emotions and giving them the tools to manage them better."
Reducing stress, anger and loneliness, she said, is a recipe for good health"

Just goes to show, we need to be there for each other and be good to each other. Support and kindness are life saving.

Resilience therapy empowers family violence survivors

Resilience therapy empowers family violence survivors

"Thousands of men, women and children experience family violence each year, according to the U.S. Department of Justice. Traditionally, therapy for violence survivors has predominantly focused on evaluating their trauma and pain. In contrast, a University of Missouri researcher broadens the therapeutic focus to empower survivors through highlighting their resilience, resourcefulness, and ability to overcome adversity".

Compared to current approaches that emphasize diagnosing symptoms and mental health issues, the strengths-based approach helps identify survivors' abilities, such as perseverance and overcoming, and how those skills can be used in their present-day lives.

"What are normally regarded as negative traits in survivors of family violence might actually be their survival strengths," Anderson said. "Traits that practitioners often try to change may be extremely important to maintain and can help survivors thrive in environments where there isn't violence."

Focusing on a strengths based approach to working with people is totally congruent with contemporary understanding about how the brain and nervous system works. Such an approach is capacity building and particularly useful for midwives working with childbearing women negotiating the changes that come with being pregnant, labour and learning how to be a mother with a new baby.

There are lessons to be heeded here:

"The strengths-based approach trains social workers, mental health practitioners, educators and students to uncover the positive in survivors' life stories—the skills gained by enduring and coping with immense adversity. This facilitates a more collaborative process, where the professional and the survivor each utilize their individual expertise to develop solutions.

"Victims of family violence find it difficult to see their own strengths and self-worth because it's often colored by shame and blame," Anderson said. "Similarly, practitioners find it difficult because they tend to focus only on victims' problems. Instead, they need to cast a light on survivors' abilities to cope and overcome the adversity brought on by family violence. This reveals hope that they won't always be victims of violence and they can achieve what they want in their lives, whatever their dreams are.

Most people find it difficult to see their own strengths and self worth, both necessary attributes for living a life of happiness and wellbeing. Midwives would do well to read this book and integrate the information into their practice so that the women they work with feel better about themselves when they leave their presence than when they came. That way women will also come to believe they can achieve what they want for themselves and their children.

Right to breastfeed - Local News - News - General - Bunbury Mail

Western Australia doesn't have a law that protects women's right to breastfeed and babies right to be fed breastmilk!  That's about  to be changed by a young woman who knows what is right.

Jess and her son Oscar

A LOCAL mother is taking on the State Government after she was humiliated for breastfeeding in public recently.
Jess Beven was out to lunch with friends and family when she discreetly began breastfeeding her nine-month-old son Oscar.
Using a blanket to cover herself she was dismayed when a man approached her and told her to move elsewhere "to do that".
"He made me feel humiliated," Mrs Beven said.
"I couldn’t believe he said that."

Read the rest of the story here:    Right to Breastfeed

Medical News: Developmental Delay Linked to 'Flat Head' Syndrome - in Pediatrics, General Pediatrics from MedPage Today

from MedPage

"Babies with misshapen heads from lying on their backs too long may be at heightened risk for developmental delays, researchers said, although they stressed that infants should still sleep in the supine position"

The worry about SIDS (Sudden Infant Death) is understandable. Parents have been terrified about the possiblity of SIDs and it is heartbreaking when SIDS occurs. The Back to Sleep campaign has reduced the number of SIDs cases, but parents have become terrified to put their children in any other position than on their backs.

SIDS has been linked to low levels of a hormone called Serotonin and the enzyme that makes it in the baby's brainstem.  Brainstem circuits control breathing, blood pressure, and heart rate during sleep, Hannah C. Kinney, MD, of Children's Hospital Boston, and colleagues reported in the Feb. 3 issue of the Journal of the American Medical Association. A baby with an abnormality in control of these systems might not be able to respond to a life-threatening challenge like asphyxia by rousing from sleep or turning its head the researchers explained.

 These researchers suggest that the back to sleep campaign has saved those babies who would not have been able to move their heads or bodies in response to changing physiology. 

Now researchers are saying that flat heads from back lying are associated with neurodevelopmental delay. A fascinating and troubling finding. The authors are at pains to say that these babies may have developed plagiocephaly because they already had a problem and caution that parents should still ensure babies lie on their backs to sleep.

I wonder if we are not having a problem that is self perpetuating here.  Neurophysiologists like James Prescott (a hero of mine) tell us that the brainstem gets 'set' at birth by the environment the baby meets. If the baby gets skin to skin with his/her mother, the brain stem gets set for love, happiness and contentment - states associated with serotonin.  If babies are whizzed off to the resuscitaire, their brain stems are set for fear and distress. That state is associated with a lack of serotonin.

These days, with the back to sleep campaign, many children are not having any tummy time, they are not being carried and they are certainly not sleeping with their mother, all of which adds up to mean they are not having the stimulation from movement and touch that they get from being held, carried and laid in different positions. I suspect the brainstem issue could relate to how they are treated at birth and the neurodevelopmental delay that is associated with plagiocephaly could be due to lack of stimulation.

Babies need to be carried, they need to sleep with their mothers to get the stimulation necessary for optimal brain growth . One of my many heroes, Dr James McKenna at Notra Dame University has done many mother-infant sleep studies.

Go to  Dr McKenna's home page to find the latest research and information about the sleep studies.

Dr McKenna's sensible and baby/mother friendly suggestions for babies sleeping safely can be found at this link:    Babies Sleeping Safe



CO-SLEEPING RESEARCH

The psychophysiological effects of sleep-sharing are studied in sleep laboratories that mimic, as much as possible, the home bedroom. Over the past few years, over a million dollars of research money has been devoted to sleep-sharing research. These studies have all been done on mothers and infants ranging from two to five months in age. Here are findings based on mother-infant pairs studied in the sleep-sharing arrangement versus the solitary-sleeping arrangement (Elias 1986, McKenna 1993, Fleming 1994; Mosko 1994):

1. Mothers and babies who sleep together are more 'in sync' than those who do not: when either the mother or the baby moved, stirred, coughed or changed stages of sleep, the other would change in synchrony, without waking.

2. Both mother and baby generally spent more time in the same stage of sleep and for longer periods when they slept together.

3. Mothers sleep better even though their babies sleep deeply for shorter periods when they sleep together: thought to be a protective mechanism. Mothers tend to stir and babies follow if baby sleep is deep for any length of time.

4. Sleep-sharing infants arouse more and breastfeed more than babies who sleep separately; mothers to not report waking more frequently than those who slept separately.

5. Sleep-sharing infants tended to sleep more often on their backs or sides and less often on their tummies, a factor that could itself lower the SIDS risk.

6. Mothers and babies who sleep together, touch and interact a lot, even when sleeping: each affects the night time behaviour of the other.

Insightful mothers have always felt better sleeping with their babies. Babies suffer separation distress when they are apart from their mothers.

In my view, plagiocephally (flat back of head) is an iatrogenic problem. The neurodevelopmental delay associated with plagiocephaly results from the lack of stimulation caused by the 'lie your baby on its back dictum' is, also, in my view, iatrogenic.

Our culture is really weird. Anything that is good and wholesome, like birth at home with those you love, sleeping with your baby and attachment parenting is branded medically suspect. I guess the beneficiaries of the regular doctor visits, helmet makers and surgeons who correct misshapen heads have to make a living.

Promoting healthy behaviour in expectant mums / Current news / The University of Newcastle, Australia

Tuesday 16 February 2010
From the University of Newcastle website:

"Researchers at the University of Newcastle say many pregnant Australian women have difficulty exercising enough and consuming the recommended levels of nutrients.
A report on women's reproductive health — released by the Minister for Health and Ageing, the Hon Nicola Roxon MP — is the latest from the Australian Longitudinal Study on Women's Health (ALSWH). Now in its 16th year, the ALSWH has surveyed more than 40,000 women across three age groups.
"While women generally improve their diets when pregnant, many consume less than the recommended levels of folate and iron," report contributor, Jennifer Powers, said. “Many women quit smoking and stop drinking alcohol during pregnancy, but a small percentage of women continue to smoke and drink alcohol at levels considered unwise for pregnant women.
"Our research suggests there is an ongoing need for targeted public health messages that promote healthy behaviours during and after pregnancy."
The survey also showed that around 10 per cent of women who had given birth within a three-year period reported a diagnosis of post-natal depression.
"This diagnosis was less likely in mothers who had good social support networks," report contributor, Catherine Chojenta, said.
Ms Powers said the health and wellbeing of mothers could also be influenced by their attachment to the paid workforce.
"Women who took 12 or more weeks maternity leave reported higher energy levels than women who took less time off work.
"These findings support the Australian Government's initiative for a minimum amount of maternity leave for all women."
The ALSWH is funded by the Australian Government through the Department of Health and Ageing.
The report Reproductive Health: Findings from the Australian Longitudinal Study on Women's Health is available at the Women's Health Australia website and the Department of Health and Ageing website.
Jennifer Powers and Catherine Chojenta are members of the Hunter Medical Research Institute (HMRI) Public Health Research Program".
HMRI is a partnership between the University of Newcastle, Hunter New England Health and the community.



Promoting healthy behaviour in expectant mums / Current news / The University of Newcastle, Australia"

Birth: a woman's right to decide?

A sobering article on Essential Baby site

What Women Want's Founder Justine Caines shares her views on the proposed maternity reforms.
Soon after the 2007 election, Nicola Roxon announced maternity reform that would enable women to choose a midwife to care for them for their pregnancy, labour, birth and for up to six weeks postnatally. This was to be funded under Medicare. The fantastic part was that it would be one midwife, enabling a woman to form a relationship, knowing who would share her birth experience with her and also provide home based post-natal care. Maternity reform advocates were excited and heralded this as a landmark.

Over the last year, however, we've seen intense lobbying from the Australian Medical Association (AMA). Late last year, the proposed reform was altered. Medicare funded midwifery would not go ahead unless a doctor 'signed off' the practices of the midwife, giving an individual doctor veto power over a midwife's practice and woman's decision making.

Read the rest of the article by clicking this link
Birth: a woman's right to decide?

Founders of British obstetrics 'were callous murderers' | UK news | The Observer

Founders of British obstetrics 'were callous murderers' | UK news | The Observer

"They are giants of medicine, pioneers of the care that women receive during childbirth and were the founding fathers of obstetrics. The names of William Hunter and William Smellie still inspire respect among today's doctors, more than 250 years since they made their contributions to healthcare. Such were the duo's reputations as outstanding physicians that the clienteles of their private practices included the rich and famous of mid-18th-century London.
But were they also serial killers? New research published in the Journal of the Royal Society of Medicine (JRSM) claims that they were. A detailed historical study accuses the doctors of soliciting the killing of dozens of women, many in the latter stages of pregnancy, to dissect their corpses.
"Smellie and Hunter were responsible for a series of 18th-century 'burking' murders of pregnant women, with a death total greater than the combined murders committed by Burke and Hare and Jack the Ripper," writes Don Shelton, a historian. "Burking" involved murdering people to order, usually for medical research."
"Motivated by ego, personal rivalry and a shared desire to benefit from being acclaimed as the foremost childbirth doctors of their time, Hunter and Smellie sacrificed life after life in their quests to study pregnancy's physical effects and to develop new techniques, the author says. "Although it sounds absolutely incredible, the circumstantial literary evidence suggests they were most likely competing with each other in experimenting with secret caesarean sections on unconscious, or freshly murdered, victims, with a view to extracting and reviving the babies," Shelton told the Observer".
Another founder of obstetrics, Dr Marion Sims, who has the Sim's speculum named after him, was also callous about women and their bodies and performed hundreds of operations on black women slaves without anaesthetic.

          Sims contended that ‘Black women don’t feel pain'

Modern obstetrics evolved from this era.

When you consider the foundations of anything, the foundations do influence the structure of what comes after. Modern obstetrics imposes an impersonal, efficiency model onto women's organic, dynamic birthing processes. There are, of course, doctors who treat women individually and take into account what women want - they are however, not in the majority.

I'm not talking about those women-centred doctors here.

I'm talking about the 'cookie cutter' approach to labour and birth adopted by obstetrics generally. The process that women are subjected to has been linked to the industrial age Taylorist ideas of factory processing - speed, efficiency and cost containing - supposedly.

Many women emerge bruised and shattered from their birth experience having been 'done to' by the 'machine'.

Meanwhile, midwifery emerged from millions of years of women helping women during their life cycle events such as the birth of children. Midwifery remains woman focused and has sought and is seeking to keep birth normal, keep maternity care woman focused, accommodating women's individual needs, desires and dreams for her baby and her experience.

That is where the 'rip' is - the two tides of beliefs, attitudes, values, historical underpinnings, philosophy (etc) come together and create a field of dissension and distress for both women and midwives.

Many theorists are saying how invasion, genocide, penal colony origins, drunkenness, murder and mayhem were the foundations of contemporary Australia and underpin the rules, regulations and behaviours of 'mateship' - football culture, 'tall poppy' syndrome and other rather distasteful aspects of our culture.

In terms of modern maternity care and the 'turf wars' together with rising rates of surgical birth and maternal depression, as we look through the lenses of the foundations of medicine and midwifery - makes us think doesn't it.

          What do you make of all this?

          Update 25 August 2017 

          In the USA  Black Women are protesting Sims' statue

Medical News: Depression During Pregnancy Linked to Kids' Behavior Problems - in Psychiatry, Depression from MedPage Today

A study of the children of 120 disadvantaged mothers from South London, reported in the January/February issues of Child Development, provided more evidence of the compelling need to take care of childbearing women and in particular, to provide support for disadvantaged and marginalised women, who were more likely to be depressed and have experienced conduct problems themselves as children. Researchers found that children whose mothers were depressed were twice as likely to display antisocial behaviour than those whose mothers weren't depressed.

Medical News: Depression During Pregnancy Linked to Kids' Behavior Problems - in Psychiatry, Depression from MedPage Today

The researchers "explored several potential mechanisms for the link between maternal depression and a child's behavior problems:

• Direct effects on the fetus from biological correlates of the mothers' depressive symptoms
• Depression in pregnancy as a sign of environmental adversity
• Re-exposure to maternal depression after birth
• Indirect effects of depression on the developing fetus driven by mothers' smoking, drinking, and drug taking during pregnancy
• A genetic explanation whereby women who experience depression in pregnancy may also have a greater genetic risk for antisocial behavior, which they pass on to their offspring

Hay and her colleagues noted that these explanations are not necessarily mutually exclusive".

As the effect of the social environment upon the individual becomes more widely recognised and the way the building of a healthy sense of self in a baby/child is inextricably linked to the presence of a moment by moment, congruent, consistent, warm, responsive interactive relationship with the mother, it is no longer possible to ignore the responsibility of society to help childbearing women in every way possible. Apart from addressing basic economic necessities, a fundamental and important capacity building initiative is to provide one to one midwifery care. The provision of a trusting relationship with a known midwife in a continuity of care model, supports pregnant women's growth and development, providing the opportunity for early identification of potential problems and instituting remedial action and targetted solutions before the problems begin.  Authentic midwifery care, education, good nutrition, exercise and as already  noted, acupuncture all work together to alleviate and minimise depression and the associated problems with depression for childbearing women and their children.  Providing adequate resources for intervention in the beginning of life is an excellent public health strategy as it avoids the huge financial and societal cost of antisocial behaviour later on.

Ancient remains put teeth into Barker hypothesis from PhysOrg

"The Barker hypothesis is named after epidemiologist David Barker, who during the 1980s began studying links between early infant health and later adult health. The theory, also known as the Developmental Origins of Health and Disease Hypothesis (DOHaD), has expanded into wide acceptance.

As one of the founders of the field of bioarcheology, Armelagos studies skeletal remains to understand how diet and disease affected populations. Tooth enamel can give a particularly telling portrait of physiological events, since the enamel is secreted in a regular, ring-like fashion, starting from the second trimester of fetal development."

Da Vinci

Disruptions in the formation of the enamel, which can be caused by disease, poor diet or psychological stress, show up as grooves on the tooth surface.


Ancient remains put teeth into Barker hypothesis

Cognition in pregnancy and motherhood: prospective cohort study -- Christensen et al. 196 (2): 126 -- The British Journal of Psychiatry

Cognition in pregnancy and motherhood: prospective cohort study -- Christensen et al. 196 (2): 126 -- The British Journal of Psychiatry

Background
Research has reported that pregnant women and mothers become forgetful. However, in these studies, women are not recruited prior to pregnancy, samples are not representative and studies are underpowered.
Aims
The current study sought to determine whether pregnancy and motherhood are associated with brief or long-term cognitive deterioration using a representative sample and measuring cognition during and before the onset of pregnancy and motherhood.
Method
Women aged 20–24 years were recruited prospectively and assessed in 1999, 2003 and 2007. Seventy-six women were pregnant at follow-up assessments, 188 became mothers between study waves and 542 remained nulliparous.
Results
No significant differences in cognitive change were found as a function of pregnancy or motherhood, although late pregnancy was associated with deterioration on one of four tests of memory and cognition.
Conclusions
The hypothesis that pregnancy and motherhood are associated with persistent cognitive deterioration was not supported. Previous negative findings may be a result of biased sampling.


This study is interesting on many points. One interesting point is the way the researchers concluded their paper by stating:

"Obstetricians, general family doctors and midwives may need to use the findings from this study to promote the view that ‘placenta brain’ is not inevitable, and that perceptions of impairment may reflect emotional or other unknown factors. Not so long ago pregnancy was ‘confinement’ and motherhood meant the end of career aspirations. Our results challenge the view that mothers are anything other than the intellectual peers of their contemporaries".

 An important point to make!

 The researchers state that:

"one of the weaknesses of our study was our inability to link cognitive change with biological changes associated with pregnancy"

What would have been really interesting is to see the neurological changes that were taking place in women's brains as they were questioned by the researchers.  Emerging insights from neuroscience indicate that different attentional networks are operating, depending upon the task at hand.  Different attentional networks trigger different autonomic nervous system 'states' with correspondingly different biochemical responses and levels.

Pregnant women do not suffer cognitive 'impairment' that much the research has demonstrated, however, the researchers dismisses the fact that many women do forget things in pregnancy, relegating the 'forgetting phenomenon' to the basket of emotionally related factors.  Dismissing women's experience as merely emotionally driven is, in my view, dangerous thinking.

Emotions are powerful chemicals for one thing and have a great deal to do with day to day health and long term wellbeing for both mother and baby.

A far better conclusion is that the pregnant woman's body and subconscious processes are very busy building a baby.  Our innate intelligence has a way of rerouting attention from less important to more important activities. Nothing, in terms of nature's agenda (healthy reproduction) is more important than building a healthy baby.

With an understanding of neuroscience and attentional networks, the fact that a pregnant woman becomes forgetful about 'boring' tasks and 'work' related activities is perfectly understandable and has nothing to do with her intellectual ability and cognition. When a woman's attentional networks are triggered to pay attention, she will, demonstrating, as this study shows that her intellectual ability is 'normal'.

Pregnant women can be assured that forgetting mundane, wordly things is actually very normal and very understandable. Their body intelligence is very consumed in growing a baby and is not bothered or very interested in outside worldly pursuits.

Sweet! -- sugar plays key role in cell division

Scientists seeking to understand the complex interactions involving hundreds of proteins that enables a human cell to split into two, have found a layer of regulation, that up until now has been invisible, although they were aware in 2005 that sugar helped to control cell division.

http://www.physorg.com/news6643.html

A sugar-based signaling pathway has been found that works independently and seems to be the trigger for the phosphorylation signaling system, which has always been thought to be 'the' pathway that underpinned human cell division processes

Sweet! -- sugar plays key role in cell division

Ant feeding on sugar crystal Wikipedia

The discovery of the sweet switch is considered to be "paradigm-shifting in terms of signaling. Signaling is how a cell perceives its environment, and how it regulates its machinery in response to stimuli. The new sugar switches reveal that the cellular circuitry is much more complex than previously thought".

Ah yes, our biology, physiology and entire being is fascinating! Layers upon layers of interaction are being discovered - we are not a 'done deal' by any means.

To the scientists:

"Because these previously unrecognized sugar switches are so abundant and potential targets of manipulation by drugs, the discovery of their role has implications for new treatments for a number of diseases, including cancer".

However, what about the role of something incredibly simple, like good low GI (glucose index) nutrition to prevent the signaling switch being corrupted in the first place?

Low GI foods

 

Recipes

http://www.lowcarbiseasy.com/aboutlowcarb.htm#why

 This information is vitally important for couples wanting to have a baby. Nutrition in one of the key environmental contributors to a healthy pregnancy that couples can take control of before they get pregnant. We know how vitally important optimal sugar control is to a healthy baby's anatomy and development.

Medical News: SMFM: Gene Variants Linked to Preterm Labor - in Meeting Coverage, SMFM from MedPage Today

Fascinating article

Medical News: SMFM: Gene Variants Linked to Preterm Labor - in Meeting Coverage, SMFM from MedPage Today

"Some women and fetuses carry gene variants that predispose them to the early onset of labor," Romero said.

The question we need to be asking is "what turns these gene variants 'on'?" and how can we keep them turned 'off'.

My hunch is that CRH is key to the inflammatory processes that do things to genetic switches.

What gets CRH fired up?

Embodied reactions (both conscious and other than conscious) to environmental stressors!

Hmm. Ina May Gaskin's Farm statistics are interesting and I had to put this article here to illustrate my thinking explained below.

Ina May Gaskin, Bonny Reid and her son

http://www.guardian.co.uk/lifeandstyle/2009/sep/26/natural-birth-expert

My theory and I know there is a lot of work to be done to 'prove' this 'scientifically', is that this is where one to one midwifery work is so beneficial. Authentic midwifery care, such as provided by midwives like Ina May Gaskin is an 'anxiolytic'. The kindly, loving relationship with a midwife the woman knows and trusts, helps a woman to stay calm, relaxed and feeling loved and through conversations and information sharing encourages the woman to eat well, exercise appropriately and minimise environmental toxins of all kinds - all of which serves to keep CRH stable and therefore physiology stable for optimal growth and functioning. My take on why the incidence of all that plagues pregnant women and their childbearing experience, such as preterm labour, pre-eclampsia, gestational diabetes, desultory labour etc ad infinitum, is lessened with good, one to one midwifery care.

YouTube - matronas

Midwives and Matronas


YouTube - matronas

Delightful!

Healthy soil, truly nutritious food and profitable, sustainable farming: Key to health

This man is worth listening to:

"In 1999, Jerry was diagnosed with non-Hodgkin’s Lymphoma and given as little as six months to live without aggressive chemotherapy. He instead chose a holistic path of nutrition, detoxification and immune modulation and applied his vast experience with farming and animal nutrition to his own health. The links between healthy soil, truly nutritious food and profitable, sustainable farming are clearly evident in his personal and professional experiences and his skill for communicating this to people has won him extensive praise from holistic health professionals, sustainable farming organizations and many farmers and consumers".

Agri Dynamics Homepage

Jerry is interviewed here by Kathleen Slattery-Moschkau on The Kathleen Show

http://thekathleenshow.typepad.com/blog/2009/12/kicking-cancers-butt-with-natural-remedies.html

Ethics, AMA and that South Australian Homebirth 'study'

Barbara Katz Rothman, Ph.D,  Professor Department of Sociology,  City University of New York, is the author of fabulous books such as The Tentative Pregnancy and In Labour: Women and Power in the Birthplace. W.W. Norton and Company, 1982, now updated as Laboring On: Birth in Transition in the United States, With Wendy Simonds and Bari Meltzer Norman. Routledge, 2007.

Professor Katz Rothman famously said "Birth is not only about making babies. Birth is about making mothers - strong, competent, capable mothers who trust themselves and know their inner strength".

Barbara Katz Rothman made another great comment about how whenever there is a move to return power to women, patriarchal interests rise up in protest to reclaim their position. I haven't got the exact quote, but something along that line.

What is particularly interesting right now is that the negative voice of reproductive medicine headed by their president, is growing louder and louder, warning everyone that birth is dangerous!  The voice is getting louder, telling women and the community that birth at  home is dangerous, just as the Federal Government begins to move to increase women's birth choices and position midwifery as the health care profession most suitable and appropriate to provide primary health care for childbearing women.

Coincidentally, a report on homebirth in South Australia was published recently in the AMA medical journal.

Medical Journal of Australia article on SA homebirth

The president of the AMA Dr Andrew Pesce, wrote the editorial of the issue of the AMJ which published the 'study'. He listed his competing interests this way

"I am President of the Australian Medical Association, which is opposed to home birth in Australia".

The title of Dr Pesce's editorial is "Planned home birth in Australia: politics or science?"

Dr Andrew Pesce (Dr 3am)'s Editorial in the MJA

Good question, Dr Pesche, all looks good and transparent on the surface so far!

Dr Pesche discussed the controversy surrounding homebirth and midwifery practice and quoted the following 'facts' from the 'study' of SA homebirth statistics:

"planned home birth was associated with a sevenfold increase in risk of intrapartum perinatal mortality compared with planned hospital birth, and a 27-fold higher risk of death due to intrapartum asphyxia.6 These differences were significant despite a sample size of only 1141 home births. Overall perinatal mortality standardised for gestation and birthweight was more than double that of planned hospital births, but because of low numbers these differences were not statistically significant. Of course, not all severe adverse perinatal outcomes in labour can be avoided, but they are better avoided, statistically speaking, when birth is planned to take place in a hospital birth unit".

Deeper analysis of the 'data' reveals the statistics are somewhat skewed. I have written else where about the results of this 'study'.  As the old truism goes there are 'lies, damned lies and statistics' - it requires enormous rigor and willingness to look at one's blind spots when interpreting statisics.  One of the ways to assist with blind spot removal is to have independant reviewers go over the results of data interpretation. Everyone would presume the AMJ would do that to maintain credibility and transparency. A reasonable assumption given that the Journal’s website links to the World Association of Medical Editors Position Statement on “Conflict of Interest in Peer-Reviewed Medical Journals”: http://www.wame.org/conflict-of-interest-in-peer-reviewed-medical-journals

However, following various online articles debunking the analysis of the statistics, including an article by Melissa Sweet at Crikey.com  Don't believe the homebirth horror headlines galvanised Dr Pesche and the AMA to seek a right of reply.

In his reply to the criticism of both the article and his editorial, Dr Pesce said

"My editorial was primarily about the politics of home birth.  Most neutral commentators have commended me on the balance of the editorial".

As Croakey comments "Dr Andrew Pesce, for those who haven’t been following the story thus far, is the president of the AMA (which opposes homebirth), an obestetrician and gynaecologist, one of the reviewers of the new study, and also the author of the MJA editorial on the study".

Now wait a minute! Dr Pesce was one of the reviewers of the new study? Hmmmm  and wasn't Dr Mark Keirse, an obstetrician,  one of the authors of the discredited Bastion study also cited by Pesce as evidence of the dangerous nature of birth at home?

Uh oh.  Excuse me,  the bias is showing.

I'd love to know who the 'neutral commentators' were!

Using 'science' to back up biased opinions is hardly new or unique to this particular study and the rhetoric which surrounds it.  However, frightening childbearing women and the community about the safety of birth in any context is unethical, given what we know about the way that the hormones of fear impact upon both the fetus and the woman.

Dr Pesce also asks the reader

"...to be fair, my editorial did mention the lower intervention rates, the similar rate of post partum haemorrhage and other favourable outcomes of home births found in the study".

Dr Pesce needs to listen to the despairing voices of midwives and student midwives who struggle daily with the way that medicine interferes, disrupts and pushes the birthing process into places that women are not ready to go with disabling consequences.

for example

"So, after watching BOBB (The Business of Being Born) and doing my current reading about the history of midwifery/hospitals/medicine, my eyes have been opened, yet again (still!) as to how harmful the hospital environment can be towards childbirth and women.

Yes, hospitals, medicine and nursing care can save lives. However, ever notice the trickle down effect of us *causing* some of the problems in the first place?"

Some self loathing, some guilt, and a whole lot of venting

It's time Dr Pesce to stand back and look at who's interests are being served in this 'debate' and controversy?  This 'shroud waving' and 'spin doctoring' of facts is an 'emperor has no clothes' kind of situation. What do we make of it in light of the fact that over $2.11 million dollars of tax payer's 'safety net' money has been siphoned off into the pockets of some doctors?

Changes to obstetric safety net are fair, despite foul cries – Croakey

The big question is how do we get to work together so that the woman is in control of her body and reproductive process and we as health care professionals are there to support and encourage every woman to feel safe in her own body and respected for her evidence informed choices?  There are some great doctors who really respect women and believe that the natural brilliance of the birth process works well when women are informed and supported to labour and birth undisturbed in the place of her choosing. These doctors are there, respectfully supportive for the rare occasion when some kind of intervention is warranted.


Birth is as safe as life gets Dr Pesce.  The therapeutic use of self as a health care practitioner is what makes both life and birth safer. As Barbara Katz Rothman says "birth is about making strong and capable mothers". Time to stop pulling the rug from under women's sense of self with all this 'turf war' rhetoric!

What to do about the top 15 chemical additives in your food and other hazards

I found the article  Top 15 chemical additives in your food informative and concerning. We are the product of what we eat and we are affected by all the chemicals in our environment.  For pregnant women, what they eat today, walks and talks tomorrow - to borrow and adapt the advertising tagline of a bread manufacturer.

Some additives are said to enhance the nutritive value of the food. More information about what is safe and what is unsafe is available here http://www.cspinet.org/reports/chemcuisine.htm

Over 86,000 man made chemicals are now found in our environment, the number of synthetic chemicals has grown exponentially in 100 years. There were a little over 100 at the beginning of the 1900's. Our bodies are truly amazing that we maintain our health as well as we do, given the number of synthetic substances that our bodies process. Here's a report by the CDC on the measurements of 212 of these chemicals in human blood or urine

http://www.cdc.gov/exposurereport/

Many of the synthetic chemicals are hazardous to human health. One of the ways our bodies cope with toxic chemicals is to sequester them within fat cells. Chemical toxicity is said to be one of the components of the obesity epidemic. Obesity itself is associated with a burgeoning disease rate in the population. More worrying still is that up to 232 toxic chemicals have been detected in newborn cord blood (please see link below for report on umbilical cord blood report)

EWG Minority Cord Blood Report Executive Summary | Environmental Working Group

Even 'healthy' processed foods are suspect. Bonsoy, a popular soy milk drink was recalled in late December 2009 because of unsafe levels of iodine which caused illness in a cluster of people in NSW. Although iodine is necessary for optimal health, too much or too little is dangerous. Ironically , the Australian government was concerned with the drop in the use of iodised salt and has recently legislated for bread makers to add iodine to bread! Only organic bread is exempt.

http://www.recalls.gov.au/content/index.phtml/itemId/971373

What can we do to minimise the effects of these synthetic and natural chemicals?

For a start, eliminate and avoid the synthetic ones and ensure the right intake of naturally occurring vitamins and minerals. To do so makes sense from a biological and ecological perspective.

Some suggestions include:

1. If you smoke, stop!

2. Drink lots of purified water - get a good purifier one that also removes 'bugs' - if you want to know a good one, contact me for a recommendation

3. Avoid processed food

4. take high quality, natural, organic supplements, including Omega 3's and antioxidants. Contact me if you want the best brand

5. Eat whole foods - buy locally grown

  Recipes

6. Avoid out of season whole foods - transportation involves time and chemical preservatives

7. Eat fresh foods - lots of salads

  Recipes

8. When you cook, cook slowly - avoid microwaves - keep veges crisp - do not use bicarb to keep greens 'green' - cook for a short time only

9. Reduce calories

10. Reduce salt intake

11. Reduce sugar intake

12. Drink green tea - antioxidant

13. Avoid transfats

14. Reduce your dependence on plastics of all kinds - bisphenol A is proving to be a real menace

15. Reduce pesticide use - go for the natural ways as much as possible

16. Grow your own veges and companion plant them

Sustainable Gardening Australia

Companion planting guide

 
17. When you grow your own veges, use natural fertilisers, not chemicals.


18. Don't use talcum powder - irritates mucous membranes and is associated with lung and ovarian cancer

19. Don't burn incense - the smoke is an irritant, as menacing as tobacco smoke

20. Get regular, brisk exercise every day for at least 30 minutes - helps the lymph system move toxins along and out - along with all the other benefits of walking