If this is your first visit, be sure to check out the FAQ by clicking the link above. You may have to register before you can post: click the register link above to proceed. To start viewing messages, select the forum that you want to visit from the selection below. |
|
|
Thread Tools | Display Modes |
#1
|
|||
|
|||
Article on Hi Tech Interventions in Labor, etc.
I got this article from an online newsletter that I receive. Thought it was
appropriate to share with you ladies (and gentlemen)... - Jen Landmark Childbirth Interventions Survey Shows Mothers Hi-tech, but Happy By Barbra Williams Cosentino, RN, CSW Have you ever wondered if other women's experiences during childbirth and the postpartum period were similar to yours? Most likely you have, because the majority of women are fascinated by birth stories, including their own. If things about your birth experience upset or surprised you, if they were different from what you were led to believe might happen during labor and delivery, you've probably wondered why they occurred and what, if anything, could have been done to prevent it. The national Maternity Center Association recently issued the first comprehensive survey of American women's childbearing experiences, gathering data that had never been collected before at the national level. Called "Listening to Mothers," the landmark survey provides health care providers, pregnant and parenting women, and the general public with a more complete understanding of the childbearing experience as it is experienced in America today. For the study, which was conducted by Harris Interactive and the Maternity Center Association, a national not-for-profit health organization dedicated to the needs and interests of childbearing women and their families, nearly 1,600 women, who had given birth within the previous 24 months, were surveyed. The survey, which is one component of MCA's Maternity Wise program to promote evidence-based maternity care, was the first national tally of women's pregnancy, labor, and postpartum experiences, and, as such, has far-reaching implications. "Although more than four million women give birth in the United States every year, this is the first time that women from across the country have systematically described their childbearing experiences," explains Maureen Corry, MCA executive director. High Labor Intervention Rates The survey found that technology-intensive labor was the norm, with a majority of women reporting having had the following interventions while giving birth: electronic fetal monitoring (93 percent), intravenous drip (86 percent), epidural analgesia (63 percent), artificial rupture of membranes surrounding the baby (55 percent), bladder catheter for drainage of urine (52 percent), and stitching to repair an episiotomy or tear (52 percent). Almost half of the women reported that their caregiver had tried to induce labor, most commonly through the use of oxytocin. Dr. Eugene Declercq, chair of the National Advisory Council, lead author of the report, and professor of maternal and child health at the Boston University School of Public Health, says: "Given that childbearing women are, for the most part, a well and healthy population, these high rates of intervention are of great concern. Mothers and others responsible for the health and well-being of mothers and babies need to repeatedly ask: 'Is a decision to use a specific intervention supported by the best evidence?'" The survey did find high levels of satisfaction with care during the labor and birth process, however. Ninety-four percent of the mothers surveyed felt that they understood what was happening, 93 percent felt comfortable asking questions, and 89 percent felt they had an active voice in decision-making. Almost two-thirds of the women used epidural analgesia, including 59 percent who had a vaginal birth, and the majority rated it as "very effective" in relieving pain. Drug-free methods rated either "very" or "somewhat" helpful included: application of ice or heat (82 percent), hands-on techniques (81 percent), position changes (79 percent), and environmental changes (76 percent). The use of breathing techniques was used by 61 percent of women-with 70 percent finding them somewhat helpful, and the remainder finding them of little or no help. Immersion in a tub was rated "very helpful" by almost half of the women who used it; but both immersion and showering, which was also found helpful, were used by only 8 percent of the women surveyed. Once contractions were well established, 71 percent of women were not permitted to walk around. Twenty-four percent of women surveyed had a Cesarean delivery; about half of those had been planned. Survey participants expressed primarily negative views of the ideas of C-sections on demand without medical reason. Of women with a previous Cesarean, 26 percent were able to give birth to their next child vaginally. Almost three in ten women had never before met, or met only briefly, the person who delivered their baby. Seventy percent of first-time mothers took childbirth education classes, while only 19 percent of mothers who had given birth before did. Overall, the women surveyed felt generally positive about their care during the labor and delivery process, particularly praising the level of support and understanding given to them by the doctor/midwife and the nursing staff. Doulas (trained labor support companions) and midwives were the most highly rated providers of labor support, and were associated with lower levels of pain medications, yet were used by only small proportions of women (five percent and eleven percent, respectively). After the Baby is Born During the hospital stay, 56 percent of mothers had their babies with them all the time (rooming in). About three in five mothers (59 percent) were exclusively breastfeeding at one week, slightly fewer than the 67 percent who had intended to breastfeed exclusively when asked at the end of their pregnancy. Among all mothers, the most commonly cited postpartum physical problems were pain from Cesarean incision (83 percent of mothers who had a Caesarean), physical exhaustion (76 percent), sore nipples/breasts (74 percent), lack of sexual desire (59 percent), backache (51 percent), painful perineum (45 percent). Problems most likely to persist for at least six months included lack of sexual desire (16 percent), physical exhaustion (10 percent), and pain from Cesarean incision (7 percent among moms who had C-section). The majority of the women characterized their experiences in the weeks and months following their baby's birth as positive-they felt rewarded (85 percent), contented (74 percent) and confident (73 percent); but at least one-fourth of the women selected negative choices such as unsure (39 percent), isolated (35 percent) and confused (25 percent). Nineteen percent of the women surveyed using a standardized postpartum depression assessment tool were found to be experiencing some degree of depression in the week before the survey. The majority in this depressed group (57 percent) had not seen a professional for mental health concerns since giving birth. "Women's need for support does not end with their six-week postpartum checkup. Most important, we need to encourage women to get the help they need to address their physical and emotional concerns," Corry says. Survey Spawns New Childbirth Recommendations While the "Listening to Mothers" survey revealed good news for childbearing moms and maternity care at large, it also identified some troubling and widespread concerns for a smaller proportion. Because there are about four million births in the United States alone each year, even these few concerns add up to the potential to adversely impact a large population of women, babies, and families, according to key findings and recommendations from the Maternity Center Association. 1. Owing to the fact that so few women never, or only briefly, meet the person who deliver their baby, research should be undertaken to clarify whether American women desired greater continuity of caregiver, both throughout pregnancy and from pregnancy through birth, and, if this is found to be a concern, policymakers and clinicians should take steps to ensure the likelihood of this happening. 2. Because a number of labor and birth interventions and restrictions are experienced by a majority of mothers, professional organizations, researchers, and agencies should determine whether adequate research has been done (using an evidence-based maternity care approach) to determine the necessity and appropriateness of these interventions and restrictions. Addressing gaps in knowledge about appropriate use of these should be a high priority. 3. There is an urgent need to better understand the implications of labor management practices, including the benefits/risk ratio between vaginal delivery and Cesarean sections, for women's ongoing physical health. 4. Women and caregivers need access to research about pain medications and drug-free methods of labor pain relief, and women should be supported in selecting methods according to their preferences. 5. Rooming-in should be the standard of care whenever babies do not require special care and mothers are able to be primary caregivers. 6. Breastfeeding support should be consistent with the Baby-Friendly Hospital Initiative. 7. Women should have access for longer than six weeks postpartum to appropriate care to meet their ongoing physical and mental health concerns. 8. It is crucially important to understand postpartum and maternal depression (which may persist up to two years after birth), to screen for it, and to research ways to reduce its incidence. 9. Women should be provided with clear information about their childbearing rights and choices so they can become informed partners with their health care providers. 10. Feedback from childbearing women should be obtained and incorporated into all dimensions of the maternity care system |
#2
|
|||
|
|||
Article on Hi Tech Interventions in Labor, etc.
Jen, Interesting article. I am pretty sure I don't buy the implied connection between more hi-tech births, and more happier mothers. I think there is a snow job being done here. Please look at the Medscape article that I posted a link to elsewhere in this newsgroup. Their conclusion was that mother are better off with continuous care during labor. They theorized in this article that the higher rates of PPD in recent years is a direct result of the mechanization of labor as practiced in the hospital environment. This would seem to fly in the face of more happy hi-tech births! :-) Larry |
Thread Tools | |
Display Modes | |
|
|
Similar Threads | ||||
Thread | Thread Starter | Forum | Replies | Last Post |
Kids should work... | bobb | General | 108 | December 15th 03 03:23 PM |
Recalls (X-posted) | Ali's Daddie | General | 0 | November 20th 03 08:52 PM |
Recalls (X-posted) | Ali's Daddie | Pregnancy | 0 | November 20th 03 08:52 PM |
CyberNews article: THE NEW PHONICS methodology and its history | Tracy Sherwood | General | 2 | September 4th 03 03:39 AM |
Food Recalls (x-posted) | Ali's Daddie | General | 0 | August 28th 03 06:12 PM |