Birth fun in the Greater Vancouver Area

This list will be updated and changed as new information comes into me. Check back frequently if you’re in this area. Gloria

DOULA TRAINING Dates

4 Saturdays, Oct. 16, 23, 30 and Nov 6, 2010.

Sunday, Sept. 26 Vancouver Family Roots Presents: “BABIES” Movie Event
Time: 12:30pm – 4:00pm (doors open at 12:30 p.m., film starts at 1:00 p.m.)
Location: Vancouver International Film Center, Davie and Seymour
Vancouver, BC Admission $10.
http://www.vancouverfamilyroots.com/

We are making arrangements to have Patti Ramos, Doula and Photographer, and Simone Valk, midwife from Holland, speak to our groups in November. Stay tuned.

• What was the starting baseline BP in this pregnancy? How many w.g.a is she now?
• What is the BP now?
• Who’s taking the BP reading, and is the mother in the same position (sitting, side lying, standing) each time?
• Does the mother have a fat arm and is the cuff long enough for her?
• Is she on any medication right now?
• Is she spilling any protein in the urine?
• Does the baby seem to be growing appropriately – i.e., is it the right fundal height for dates or close to it?
• Are the BP readings done at the same time of day?
• Is the mother active, sedentary?
• What kind of diet does she eat?

It’s important for student midwives to learn to ask lots of questions. If a midwife phoned a doctor and said “I have a client whose BP is dangerously high” the doctor would (hopefully) ask the midwife every one of those questions before jumping to any conclusions. The thing to remember about high blood pressure is that the body is trying to protect the baby and the mother by sending the BP up. Why it does this we don’t know, but even the doctors don’t want to bring it down to “normal” 110/70 levels. They are happy if they get it down to 140/90 and they stop medicating there. Many obstetricians around the world will not treat any hypertension which does not include proteinuria (protein in the urine).

The treatments have dangerous side effects, especially to the liver, which is the organ that is having difficulty in the first place. If the client had a diastolic reading that was more than 15 higher than her initial BP, protein in the urine, and swelling in the face, hands and feet, this would be of great concern. If increasing her protein, high quality natural salt, and rest did not turn it around very quickly, I would want her to seek medical advice. Dr Thomas Brewer recommends intravenous serum albumin therapy. http://www.drbrewerpregnancydiet.com/index.html

I helped one woman who got into this scenario, and her baby was removed from her body by cesarean at 32 weeks gestation. The baby was small for dates. The woman did a fantastic job of persevering with breastfeeding against all odds, and her daughter is a big healthy girl now. In her second pregnancy her blood pressure was normal and she had a VBAC at home. That is one case in more than 1000 women I have worked with, so it should be a very rare occurrence.

By Mitchel L. Zoler
Elsevier Global Medical News

http://www.imng.com

Breaking News

VIENNA (EGMN) – Circumcision rates for newborn boys in the United States
dropped steadily and markedly over the past 4 years, based on the largest
review of U.S. rates ever done.

Circumcision rates fell from 56% in 2006 to 33% in 2009.

The review, which included more than 6.5 million U.S. newborn boys during
the period, also showed that adverse event rates following newborn male
circumcision were “extremely low,” and that the most common adverse events
were “mild and easily corrected,” Charbel El Bcheraoui, Ph.D., said at the
18th International AIDS Conference.

“Severe male circumcision-related adverse events are extremely rare,” said
Dr. El Bcheraoui, an epidemic intelligence service officer in the division
of HIV/AIDS prevention at the Centers for Disease Control and Prevention.

The dramatic decline in circumcision rates during 2006-2009 continued a
trend that began in the United States earlier in the decade, although the
fall appeared to accelerate recently, he said. He attributed the drop to a
1999 statement by the American Academy of Pediatrics that said existing data
were not sufficient to recommend routine newborn male circumcision
(Pediatrics 1999;103:686-93).

Another factor may be that following the AAP statement, several states
withdrew Medicaid coverage of newborn male circumcision, Dr. El Bcheraoui
said. An earlier report by him and his CDC associates documented that during
1979-2006, the U.S. newborn male circumcision rate was relatively stable,
with an average rate of 61%.

The recent fall in U.S. circumcision rates coincided with reports from three
African-based randomized controlled trials in 2005-2007 that showed
circumcised men had a 50%-70% reduced risk for acquiring HIV infection,
compared with uncircumcised men. These findings led the World Health
Organization and the Joint United Nations Programme on HIV/AIDS to recommend
male circumcision as an important intervention to reduce the risk for
heterosexually acquired HIV infection in 2007. The CDC and AAP are now
independently interpreting the application of these recent findings on HIV
transmission to the United States based on U.S. prevalence rates of HIV and
circumcision, he said.

The new study also analyzed 90-day outcome data on 258,189 boys and men aged
1 or older who underwent circumcision during 2006-2009, and found that
adverse events occurred much more frequently in this age group, “an
important new finding,” Dr. El Bcheraoui said.

His study used data from the largest U.S. consolidator of electronic health
care reimbursement claims, which included data on 117 million unique U.S.
patients annually undergoing short hospital stays, and data from more than
800,000 unique U.S. health care providers. In this database, 6,571,500
newborn boys underwent circumcision during 2006-2009. To estimate the
incidence of circumcision-associated adverse events, the researchers tallied
the rate of any of 41 different ICD-9 and CPT codes that could be such
events during the 90 days following circumcision. They also compared these
rates in 18,330 infants circumcised within the first month of life with a
matched set of uncircumcised infants.

The data showed that the rates for a range of adverse events, such as
mishaps, correctional procedures, and infections were substantially lower in
boys less than 1 year old, compared with boys aged 1-9 years, and with boys
and men aged 10 years or older. For example, mishaps occurred in none of the
boys aged less than 1 year or aged 1-9 years, but in 158/100,000 boys and
men aged 10 years or older. The rate of correctional procedures was
58/100,000; 2,544/100,000; and 1,709/100,000 in the three age groups,
respectively. Infections occurred at a rate of 154/100,000; 5,664/100,000;
and 4,527/100,000 in the three age groups.

The case-control analysis identified only two types of adverse events that
were more common in circumcised newborn boys, compared with matched
uncircumcised infants: repair for incomplete circumcision, and lysis or
excision of penile adhesions. All other adverse events tallied either
similar rates among the cases and controls, or were significantly more
common among the controls.

“This is the largest study to examine the incidence of male circumcision
adverse events to date. It is highly representative [for the United States],
with a large data set” and with a large number of potential adverse events
tracked, Dr. El Bcheraoui said. One of the strengths of the study was its
longitudinal design, which followed subjects for 90 days following
circumcision.

Dr. El Bcheraoui and his associates said they had no disclosures.
http://www.mdconsult.com/das/news/body/213521005-2/mnfp/0/220621/1.html

This is the 3 min. trailer for a new film coming out called “Prescription Milk”. I think it will be an incredible wake up call about prematurity, donated milk and the heroic women who want to make a difference for families with fragile babies.

Three minute video narrated by Gloria Lemay on the cost of breast milk substitutes (better described as “crap in a can”). Background poster is a WIC publication by the California Dept of Health 2008.

http://www.cdph.ca.gov/programs/wicworks/Documents/WIC-EdMaterials-HowDoesFormulaCompareToBreastmilk.pdf

APGAR Scoring for Newborns
________________________________________
A score is given for each sign at one minute and five minutes after the birth. If there are problems with the baby an additional score is given at 10 minutes. A score of 7-10 is considered normal, while 4-7 might require some resuscitative measures, and a baby with Apgar scores of 3 and below requires immediate resuscitation.