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News & Research Round-up: In Transition Edition

October 27th, 2010 by avatar

It’s been a busy week or so. In addition to my mad flurry to finish several projects before I begin with Childbirth Connection next week, we’ve been busy reviewing the many great applications we got for Community Manager of this blog. I’m glad I’m not the one who has to choose, because I love so many of the applicants and get excited about the different ways this blog could evolve under any of them.  (Lamaze should be able to announce the new Community Manager by early November. Watch this space!)

Meanwhile, the world hasn’t stopped offering up fascinating things to blog about. So, here’s a round-up!

Speaking of round-up, the Lamaze Annual Conference returns to Texas in 2011. Abstracts are being accepted.

On the heels of my recent post about the limitations of standard evidence, the media and internet have been full of thought-provoking articles about the integrity and best use of scientific research. The Atlantic Monthly profiled one of the most outspoken skeptics of medical research in the feature-length article, “Lies, Damn Lies, and Medical Science” and e-Patients.net followed it up with a nice companion piece aptly titled, “Fixing Those Damn Lies.” Kent Bottles at the Health Care Blog weighs in on the politics of comparative effectiveness research, and Rachel Walden from Our Bodies, Our Blog offers a round-up of her own, with links and insights from the recent joint meeting of Consumers United for Evidence-Based Healthcare, the Cochrane Collaboration, and the Campbell Collaboration.

The Institute for Healthcare Improvement will offer several sessions on perinatal care at their upcoming National Forum, taking place December 5-8, 2010 in Orlando, FL: a learning lab entitled “Reducing Elective Near-Term Deliveries: When Doing Nothing Is the Right Thing” and a workshop “The Next Evolution of Neonatal Intensive Care,” among others.

The Effective Health Care Program of the Agency for Healthcare Research and Quality (AHRQ) is offering a free webcast, “Applying Existing Evidence to Obstetric Care on November 10 from 12:00 – 1:00 pm ET. The program will highlight AHRQ’s patient-centered outcomes research and review ways it can be used to support decision-making in clinical settings.

Several bloggers have written posts for the forthcoming blog carnival to raise awareness about Agnes Gereb, a Hungarian doctor and midwife who was jailed for attending an out-of-hospital birth. Rixa at Stand and Deliver has a nice summary of the issues. I have a post up at Giving Birth with Confidence about my two home births, one of which took place in a state where my midwives could have been arrested for attending me.

And in the maternity care journals:

Through November 15, the journal, Midwifery, is offering free access to a suite of articles on patient safety in maternity care. The issue includes contributions from former Science & Sensibility guest contributors Debra Bingham and Christine Morton.

If you’ve been around women laboring out of bed, you may have suspected that the purple vertical line on a woman’s low back late in labor signifies full dilation. Someone has finally studied this. (It correlates, but isn’t foolproof.)

Kathleen Fahy and Carolyn Hastie, subjects of one of my Consider the Source interviews, have, along with several additional co-authors, published a study comparing the outcomes of “holistic physiologic third stage care” with active management of the third stage. Their study, which looks only at low-risk women who had spontaneous vaginal births and no risk factors for hemorrhage, showed a markedly lower rate of postpartum blood loss in the women receiving physiologic care.

A woman’s brain grows after giving birth, and that growth happens in the areas of her brain that regulate how she responds to her infant.  The same research team that conducted this study published a 2008 study in which they reported differences in brain activity between women who had vaginal births and other women who gave birth by cesarean. Both studies were small and limited, but I’m interested in watching for more research from the Yale Child Study Center. It has potential implications for labor and birth care as well as how we approach postpartum care and support.

I know I’ve missed plenty of other goodies. Feel free to leave your favorite links in the comments! I’ll be blogging for Lamaze for several weeks longer, then when the new Community Manager is all up to speed, I’ll be posting less frequently and on behalf of Childbirth Connection.  Transition is hard, but in the end leads to great things…

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  1. avatar
    OBnurse
    October 27th, 2010 at 22:17 | #1

    Amy I am a Nurse and Lactation Consultant and would like to share with you my recent blog post http://birthmadesimple.com/Birth_Made_Simple/Blog/Entries/2010/10/15_Removing_Fear_in_the_Next_Generation.html . It talks about how birth and breastfeeding in our family has changed over the past 3-4 generations. I’m off to read your post at Birth With Confidence “My Two Homebirths”.

  2. October 27th, 2010 at 23:18 | #2

    I have always suspected that the research done on active management was not using a good comparison group ,but what does this research define as holistic physiologic care? I’m just curious as to what is done instead of active management.

  3. October 29th, 2010 at 20:19 | #3

    @OBNurse – what a beautiful and simple story. I really enjoyed it. @Rachel, the definition of holistic physiological third stage care is “immediate and sustained skin-to-skin contact between the woman and baby
    who are both kept warm; the midwife gently encourages the woman to focus on her baby whilst maintaining awareness that the placenta is yet to be born; the support people ensure all interactions remain focused on mother and baby; there is ‘self-attachment’ breastfeeding; the midwife unobtrusively observes for signs of separation of the placenta; there is no fundal meddling or massage; the placenta is birthed entirely
    by maternal effort and gravity. The midwife or the woman gently ‘checks the fundus’ frequently for 1 h postplacental birth to ensure contraction and haemostasis.” It was conducted in the context of a freestanding midwife-led maternity unit and all of the women were low-risk. You can read more about Fahy and Hastie’s model of third stage care in the interview I did with them, linked above.

  4. November 2nd, 2010 at 22:09 | #4

    Amy, I have enjoyed your blogging, and wish you every success in your new position, and I look forward to hearing from the new blog community manager.
    I would like to draw your readers’ attention to the WHO Global forum: optimising the effectiveness of Health Workers to achieve MDG’s 4 and 5, which is happening November 8-16. Go to http://my.ibpinitiative.org/ to join. The importance of our voices in forums like this includes the need to promote, protect and support the physiologically normal processes in birth wherever possible. Those of us who live and work in the developed world often have (mistaken) ideas about normality on the other side of the fence.

  5. avatar
    Lauren Orengo
    November 7th, 2010 at 01:33 | #5

    I am a L&D nurse who currently works in a hospital. I have worked in all settings with birth. I have attended a home birth and worked at a birth center in the past.
    I have also seen birth in Kenya. The article about the importance of having a safe environment and birth for mother and baby explains what is the goal for all births. After attending a birth in Kenya I do appreciate the way we make sure the baby is safe during the process.
    I don’t know if that comes from being conditioned to what is safe and unsafe in my mind or not.

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