All articles by Judy Cohain, CNM
Whether she is aware of it or not, the woman decides when, where and how to give birth. Our bodies are under our control whether we have accessed the keys to that control or not. Extreme control has been demonstrated by highly trained martial arts experts who can prevent themselves from ovulating. Mothers at term have put themselves into labor by simply walking up a steep hill for an hour to start contractions.
Doppler velocimetry is either useless or dangerous. If a woman is having growth retarded fetuses, eliminate smoking and recreational drugs and alcohol, eat a balanced, adequate diet before and during pregnancy, walk three miles per day, and eliminate extreme stress. That’s the only proven way to prevent unexplained stillbirth or prevent or treat IUGR. No one profits from it but the mother and the fetus.
In 2009, while 99.3% of US women delivered in hospital, 0.7% delivered at home. In response to this slight rise in homebirths, The American Journal of Obstetricians and Gynecologists issued a warning to all doctors and midwives to refuse to attend homebirth under all circumstances. In the absence of respected medical research showing planned homebirth to be unsafe, their recommendation is based on a single maternal death reported in the Daily Mail.
It's hard to compete with 20 billion years of evolutionary selection, but the current medical management of the birth of the fetus and the placenta attempts to do just that, albeit rather unsuccessfully. For eons, all animals including humans passed on genes and habits that ensured delivering a live healthy newborn without bleeding excessively or dying of postpartum hemorrhage at birth.
Caesarean sections, unless strictly indicated, may be harmful to the health of mothers and their newborn babies. Two questions remain. Why are rates still on the increase? What can be done to reverse current trends? As a head obstetrician recently said, "If highly-paid soccer goalies won't practice evidence-based diving for the ball when they are paid millions of dollars a year, what hope is there for obstetricians?"
Cord prolapse, a cause of permanent disability and death, can be caused by amniotomy at or near term. To achieve optimal neonatal outcomes, the amniotic sac should not be ruptured artificially to speed up labor or induce labor.
Today research wrongly considers hospital birth as the gold standard. Bias towards hospital births causes the majority of researchers to ignore the fact that women could achieve even better outcomes than hospital birth, at planned attended homebirth.
45% of births in the US are now induced, but evidence supporting this intervention is severely lacking. Case controlled studies show no benefit to inducing for postdates. Routinely inducing for postdates is based on 3 uncontrolled, retrospective studies showing 1/1000 less stillbirths while ignoring possible increases in brain damage to newborns as a result of induction.
Since the ability of ultrasound to both diagnose and improve outcomes of severe defects is close to non-existant in most locations, routine prenatal ultrasound screening is most often simply the best way to terrify a pregnant woman.
Garlic kills yeast. Those who bake bread know not to add garlic while the dough is rising or it will kill the yeast. Instead, garlic is added to the dough after it has risen, just before baking it in the oven.