Monthly Archive for October, 2007

In the News – Volume III

A Cochrane Review found that Chinese Herbal Medicine is one way of treating painful menstural cramps effectively.  “All available measures of effectiveness confirmed the overall superiority of Chinese herbal medicine to placebo, no treatment, NSAIDs OCP, acupuncture and heat compression, and, at the same time, there were no indications that CHM caused any adverse events.”  A word of note: there are many causes of unusually painful cramping such as endometriosis, tumor or tubal pregnancy, and a visit to a gynecologist would be a good first step to rule out any more serious issues underlying the symptoms.

One of a doula’s main jobs is to make the experience of birth as positive as it can be, no matter what kind of birth a woman has.  Studies have shown repeatedly that the presence of a doula makes a real difference for the mother and the baby, both physically and emotionally, and that the experience a woman has in her birth is remembered and impacts her for the rest of her life.  A new study reveals that “a mother who gives birth and has severe obstetric complications (SOCs) is at a significantly greater risk of experiencing mental health problems and death, compare to women who give birth without complications”.  I wonder what a doula’s influence would be, statistically, for women with these SOCs?

A Cochrane Review proved that the hands and knees position during labor relieved back pain for laboring moms, however did not have a statistically significant finding that showed it put baby in a more favorable position for birth.  I especially liked this quote:  “In midwifery we have a saying, ‘Listen to women,’ said Stone-Godena. “Basically that means if you take your cues from the woman you will enhance her comfort, sense of control and well being. And unless there is evidence to demonstrate the woman wants to do something unsafe, she knows what she needs. Our job as a midwife is to help her identify it. That sometimes translates into us saying, ‘many women have found that this helps’ and then we suggest the hands-and-knees position.”  As a doula, my own philosophy for a posterior baby during delivery involves keeping mom moving as she as able and trying as many positions that use gravity to her advantage as possible.  In other words, hands and knees is only one position that might turn a posterior baby, but doulas tend to have many, many more techniques in our bag of tricks we can offer as ideas to try.

In the UK, there is a call to offer all expectant mothers a water birth option.  Using water as pain relief during labor is more effective than anything other than an epidural, according to guidelines issued by the National Institute for Health and Clinical Excellence (Nice).  “There is a perception that water is just nice,” said Dr Julia Sanders, a consultant midwife and member of the group which drew up the guidance. “But it is the most effective form of pain relief barring an epidural in labor. I would like to see more women using water and fewer women using the types of pain relief that are less effective.”

Remember to do your breast exams monthly – your life may depend on it.  “If a patient’s breast cancer is detected early enough, the five-year survival rate is well over 95%, say experts. In 2005 breast cancer caused 502,000 deaths worldwide. It is estimated that about 12% of all women either already have or will develop breast cancer during their lifetime.  Globally breast cancer is the fifth most common cause of cancer death, after lung cancer, stomach cancer, liver cancer and colon cancer.”

Cochrane completes study on AROM

The Cochrane Database is a great resource for gathering evidence-based information about different interventions associated with pregnancy and childbirth.  Actually, it’s a great medical resource for any cause.   Independent researchers review the latest studies according to their tough standards, then decide what the evidence has to say.

Recently, a systematic review was completed by Cochrane researchers on the effects of Artificial Rupture of Membranes (AROM, amniotomy, or breaking the bag of waters) during childbirth.  Some providers break a woman’s bag of waters routinely to speed, strenghen and shorten labor.  However, Cochrane found no evidence to support routine use of AROM during labor.

We do not recommend that amniotomy, also known as breaking the waters, should be used routinely as part of standard labour management and care” says Cochrane Researcher Rebecca Smyth, after completing a systematic review of relevant research studies. “Women should be informed that it doesn’t shorten the first or second stage of labour, it doesn’t affect the woman’s satisfaction with her childbirth experience, and doesn’t result in the child being in better condition immediately after birth.”

This Cochrane Systematic Review found that breaking the waters may be associated with a slightly (non-significantly) higher rate of Caesarean section. Breaking the waters may cause changes in the baby’s heart rate.