Showing posts with label studies. Show all posts
Showing posts with label studies. Show all posts

Friday, January 17, 2014

Lamaze of Today


I've been wanting to organize my thoughts on the AMAZING organization that is Lamaze International for a while now.
Nothing like outside inspiration to get my fingers in gear. :)
I'm proud to be participating in a website database of all birth providers in the Myrtle Beach Grand Strand area. 
www.MyrtleBeachBirthServices.com
I will be linking articles from there to this blog, I'm sure. It is a strong and educated group of women.
But, on we go...




LAMAZE OF TODAY
by Amanda Hynes, CD(DONA), LCCE


HEE HEE HEE…
HOO HOO HOO….

That is what typically comes to mind when you say the word “Lamaze”.

“That thing with the breathing”

When I first began educating myself about childbirth, I was wary about the Lamaze philosophy, because I had heard they promoted this crazy breathing that had been proven to be detrimental. Like many people, I immediately linked this antiquated patterned breathing with the organization. Happily, with only a cursory amount of further investigation, I learned that *hee hee hoo hoo* has long been left in the past. Since it’s beginning in 1960, Lamaze International has evolved into a globally respected community of birth advocates and educators.

This isn’t your mama’s Lamaze!

The moment I began evaluating my options for formal training as a childbirth educator, Lamaze International stood head and shoulders above the rest. Why?
To put it simply…science, and a trust in the innate instincts and power of women in childbirth.

Today, the Lamaze Philosophy, along with every practice supported by the organization, comes from current evidence. Lamaze teamed up with The Cochrane Collaboration, which prepares and publishes the largest collection of randomized controlled trials in the world in the interest of putting the evidence in the hands of medical professionals, educators, and families (www.cochrane.org). Lamaze members have access to the Cochrane Library in order to develop their curriculum based on scientifically supported practices.

In order to make these (at times, complicated) studies more readily available to the public, Lamaze International created a blog called Science and Sensibility (www.scienceandsensibility.com) to relay the information in easy-to-read terminology, and help families educate themselves about the benefits and risks of the medications, procedures and interventions that are typically imposed during the birthing experience.

The people at Lamaze looked at the evidence, made the smart decision that the whole *hee hee hoo hoo* thing wasn’t working for women and babies, and began to put their time and resources towards honestly evaluating all birth practices.

That kind of mindful evolution is something I can get behind.

Lamaze Certified Childbirth Educator (LCCE)

When you see the LCCE credential, you know that your educator has completed a rigorous evaluation and education process, and has international support and the most current evidence on birth practices. Lamaze certification is the only childbirth educator program designed to meet the highest professional standards of the National Commission for Certifying Agencies (NCCA).

Lamaze of Today

Today, the Lamaze Philosophy revolves around Six Healthy Birth Practices which are a common sense approach to birthing that every pregnant woman can easily use to their advantage. In my experience, the truest things in life are usually the most simple. Each of the practices have resonated with my soul since the moment I pushed my son out into the world, and they are supported by science.


Lamaze Healthy Birth Practices


Lamaze Fundamentals

The goal of Lamaze is to demystify the birth experience and empower women to have confidence in their innate ability to give birth. Birth is normal, natural and healthy. There are many ways to manage the challenges associated with birth, including pain. Understanding how your body works and what you can do to benefit yourself and your baby during the childbirth process can help alleviate fears and manage pain. Each woman and each birth is different. There is no one-size-fits-all solution. Even when complications or medical necessity occurs, knowledge of the benefits and risks of medications and interventions are critical in order for them to be applied judiciously and appropriately.

Birth Satisfaction

Lamaze can help you achieve the safest and healthiest birth experience to facilitate high levels of lifelong birth satisfaction. Birth satisfaction is not a luxury. It is important. Women with high levels of birth satisfaction bond better with their babies, breastfeed more successfully and are less likely to view caring for their babies as difficult and challenging. The first steps to high levels of birth satisfaction are education, empowerment, and an active role in the decision making. The experience of childbirth has a profound affect on women, babies, and families. The decisions (or non-decisions) during pregnancy will have significant, resonating effects.

Education

Choosing a childbirth educator, doula, midwife or OB is a great responsibility, and much of the decision comes not from books, but from the gut. You must be able to trust that your chosen birthing team has your best interests at heart and the tools to support you. It is much like choosing a psychologist. You must be comfortable with these people if you are to bare your soul. If there is no chemistry, birth will be hindered. Optimal results cannot be achieved if there is lingering fear or distrust.


Sometimes you can’t explain it, but this is the first lesson in parenting, trust your instincts. When you have a gut feeling that there is something wrong with your infant, you must be your baby’s advocate. When you have an instinct that they are fine, you must protect them from that which could make them un-fine.  The families of Myrtle Beach, the Grand Strand, and extended coastal Carolina areas are lucky to have this amazing, ever-evolving, ever-expanding group of childbirth professionals at their service. A good educator and a good doula will refer you to two others of their own profession to ensure that you are completely empowered in your decision and you have every option at your disposal to decide what is right for you and your family. Take the time to have conversations with several educators, doulas, midwives and OBs. You have options. Empower yourself to have the birth experience of your dreams.


Tuesday, April 9, 2013

Hormones

More inspirational readings from my Lamaze Independent Study...
HORMONES!
Check out these amazing, powerful, interconnected chemicals that we generate naturally to facilitate birth, bonding, and breastfeeding with our babies...and then, the ways that drugs interfere and inhibit them. This is no judgement. These are the facts.

The Pituitary Gland (care of Healthtap.com)


The Adrenal Glands (care of Healthtap.com)

Oxytocin, the *love* hormone
  • associated with ejection reflexes (like sperm ejection, fetal ejection, placental ejection)
  • released from pituitary gland
  • descending baby stimulates the stretch receptors in mom, causing peak levels of oxytocin
  • protects against hemorrhage and ensures postpartum contractions
  • reduces stress

Endorphins *pleasure/transcendence*
  • naturally occuring opiate, similar to morphine and heroine, works same brain receptors
  • released from pituitary gland
  • creates pleasure, euphoria, mutual dependency
  • allows mom to reach an altered consciousness in an undisturbed birth
  • in breastmilk, induces pleasure and mutual dependencey for mother and baby

Epinephrine *excitement/adrenoline*
  • fight or flight hormones
  • released from adrenal glands on kidneys
  • released in response to fright, anxiety, hunger, cold, and excitement
  • at birth, it activates the fetal ejection reflex
  • rush of energy when it is time to push, mom gets upright and alert
  • this hormone is implicated in instinctive mothering (who wants to mess with that?!)
  • for baby, it protects against hypoxia/acidosis, and ensures baby is wide-eyed and alert at first contact with mom

Prolactin the *mothering* hormone
  • major hormone in breastmilk synthesis
  • activate mother's vigilence adn help put her baby's needs first 

Synthetic Oxytocin (Syntocinon)
Anyone ever hear of Pitocin? This is synthetic oxytocin.
It doesn't crosses the blood/brain barrier, so when injected with Pitocin, the mom does not experience above-mentioned benefits of the *love hormone*. However, the body does believe the hormone is present, and thus ceases to the natural production of oxytocin, thereby increasing the chance of hemorrhage (that natural oxytocin prevents).


Epidurals
Epidurals have major effects on all of the above-mentioned hormones.
  • INHIBITS endorphine production, thus restricting the natural shift in consciousness
  • INHIBITS oxytocin production since mom's stretch receptors are numb and cannot trigger natural oxytocin
  • No natural oxytocin, no natural ejection reflex, leading to increased second stage of labor.
  • INHIBITS Prostagladnin F2 alpha (which makes uterus contractible). 
One study showed women with epidurals and decreased PGF2 alpha had average labors increased from 4.7 hours to 7.8 hours.

One study showed mothers given epidurals spent less time with their babies in the hospital in inverse proportion to the dose of drugs they received during the second stage of labor. (lack of *love hormone* maybe?)

One study showed mothers with epidurals describe their babies as "more difficult to care for" one month after birth. (lacking that *mothering hormone* maybe?)

This hormone system is common to all mammals. For birth to proceed optimally, the mother must shift from her neocortex (rational) brain to her mammillian, or middle brain, also known as the limbic system. We as a society need to place some importance on this shift in consciousness and facilitate it.

I love this quote from a Dutch professor, G. Kloosterman, 

"Spontaneous labour in a normal woman is an event marked by a number of processes so complicated and so perfectly attuned to each other than any interference will only detract from the optimal character."

These innate chemical reactions are so powerful when allowed to proceed on their own.
Let's trust in ourselves, and our natural, untapped potential.


Information from:
Ecstatic Birth, The Hormonal Blueprint of Labor by Sarah J. Buckley
First printed in Mothering Magazine, March-April 2002.







Saturday, March 2, 2013

Science Behind Doulas

I fell in love with this book the moment I picked it up back in 2006. Henci Goer's "The Thinking Woman's Guide to a Better Birth." I'm reviewing it again as reference for the upcoming Hynes Childbirth Education Series. It is full of invaluable information.


“Randomized controlled trials produce the strongest kind of research evidence because researchers randomly assign participants to have the treatment or not, which eliminates all kinds of biases. We now have more than a dozen randomized controlled trials.

Various trials have shown that the continuous presence of a caring, experienced woman can reduce:

  • the length of labor
  • the use of pain medication
  • the need for IV oxytocin (Pitocin)
  • the likelihood of having an episiotomy
  • the percentage of instrumental vaginal deliveries (forceps/vacuum)
  • and the Cesarean Section rate

Doulas can reduce the number of babies:
  • born in poor condition
  • admitted to special-care nurseries
  • have prolonged hospital stays
  • who have evaluations for infection

These studies also show that women who have a doula
  • experience less pain and anxiety in labor
  • express greater satisfaction with the labor
  • feel that they coped better
  • have a heightened appreciation of their bodies’ strength and performance and themselves as women
  • breastfeed longer
  • experience less difficulty in mothering

They have:
  • have more positive feelings toward the baby
  • better self esteem
  • a better relationship with the father
  • and less postpartum depression

The fact that these studies took place in different countries with different populations of women under different circumstances and consistently found benefits further strengthens confidence in the validity of their results.”

This book should be issued with every uterus. :)

Tuesday, February 19, 2013

Studies Enforce Doula Benefits...AGAIN

"She was the blessing of my life."

A Unversity of Minnesota study, which looked at births among low-income families, found the odds of needing a cesarean were 40 percent lower when women had support from a doula.



Led by Katy Backes Kozhimannil, Ph.D., an assistant professor at the School of Public Health's Division of Health Policy and Management, the study shows:

  • Doula support may improve birth outcomes for diverse, low-income women
  • State Medicaid programs offering coverage for birth doulas could potentially save taxpayer dollars

http://www.health.umn.edu/healthtalk/2013/02/14/doula-care-for-low-income-women-could-save-taxpayers-money/

Thursday, February 18, 2010

Homebirth Outcome Study

Since I'm trying to gather as many scientific studies from credible journals as possible (as a result of being kicked off a mom/pregnancy board for posting a blog page of information/thoughts/options that only referred to the position of ACOG-American Congress of Obstetricians and Gynecologists and did not include long-term, double blind, scientific studies on the subjects)....I present a Canadian study published in the Canadian Medical Association Journal.

In summary...

"The study analyzed all planned home births attended by registered midwives from Jan. 1, 2000, to Dec. 31, 2004, in British Columbia, Canada (n = 2889), and all planned hospital births meeting the eligibility requirements for home birth that were attended by the same cohort of midwives (n = 4752).  We also included a matched sample of physician-attended planned hospital births (n = 5331)."  Meaning...these were not necessarily "high risk" patients in the hospital. Everyone started out on the same playing field.


"The rate of perinatal death per 1000 births was 0.35 (95% confidence interval [CI] 0.00–1.03) in the group
of planned home births; the rate in the group of planned hospital births was 0.57 (95% CI 0.00–1.43) among women attended by a midwife and 0.64 (95% CI 0.00–1.56) among those attended by a physician."

WOOT!

http://www.cmaj.ca/cgi/reprint/181/6-7/377

Thursday, July 9, 2009

Cochrane

I JUST glimpsed this amazing website and I am in love.

www.cochrane.com

Its all about evidence-based medicine and health care.

"Evidence-based health care is the conscientious use of current best evidence in making decisions about the care of individual patients or the delivery of health services. Current best evidence is up-to-date information from relevant, valid research about the effects of different forms of health care, the potential for harm from exposure to particular agents, the accuracy of diagnostic tests, and the predictive power of prognostic factors. Evidence-based clinical practice is an approach to decision-making in which the clinician uses the best evidence available, in consultation with the patient, to decide upon the option which suits that patient best. Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research."

It is chilling how much of birthing decisions are based on "what has always been done" rather than evidence-based information.

I can't wait to review this entire site further.