Monday, November 30, 2009

My Beautiful Boy, I Am Sorry




Please print my apologies.

My beautiful boy, Evan, I am so sorry I did not learn more about circumcision before you were born. I am sorry we made the quick and thoughtless decision to get you circumcised so you would not look different from your dad. It is ok to look different. I am so sorry I never changed your diaper at the hospital and I never saw what you looked like intact. I was ignorant. I am so sorry.

My beautiful boy, Colby, I am so sorry I was weak and caved when it came to the decision about your circumcision. I am sorry we made the decision to get you circumcised so you would not look different from your dad and your brother. It is ok to look different. You were born in a birth center and I changed your diapers for a week before you were circumcised. Every time I saw you intact, I felt sad for Evan. I cried and talked to your Dad and others around me. But hardly anyone wanted to talk about it, or if they did, they said it was better to do it as a baby when you would not remember having it done, it would be too painful to have it done as an adult, and your self-esteem would be damaged for looking different. When I saw that device attached to you at the pediatrician¹s office as he circumcised you, I couldn¹t believe the cruelty. I felt so small there, like I was a kid again with no say in the matter. But I'm an adult now and I should not have been so passive. I should have fought tooth and nail to keep you intact. I am so sorry.

My beautiful husband, I am so sorry that I was weak and passive and agreed to circumcise our boys. I am sorry someone circumcised you. None of you were allowed to decide for yourselves whether to remain intact or not. I could have given your sons that choice, but I did not. I am so sorry.

Jennifer V., OR
also published in The Compleat Mother



We cannot withhold facts for fear of offending
because the importance of the information
outweighs people's right to not be challenged in their beliefs.

~ Maddy Reid



Please.
Speak up on the issue of keeping babies whole.

You never know whose life you will change forever,
or what mother will thank you later.





To read more from others who will be keeping future sons and grandsons intact, visit sites, pages, and letter links at: I Circumcised My Son: Healing From Regret.

If your first son was circumcised, and you would like to keep future sons intact, or make a difference in the lives of your grandsons or boys born around you, please join with others at Keeping Future Sons Intact







"I did then what I knew how to do. 
Now that I know better, I do better." 
~Maya Angelou



For parents-to-be who have not yet witnessed the difference between an intact vs. circumcised newborn baby boy, below is one example. [View additional examples, and see the difference between an intact and non-intact adult here.]






Saturday, November 28, 2009

Jack Black & Circumcision in Antiquity


Circumcision 'humor' if you will: a movie scene from Year One:


While the above video clip is merely Hollywood humor, we would encourage anyone who believes they are circumcising their baby boy for religious reasons to dive into the subject further.

"Cutting the Blessing" among the Hebrews in antiquity was done in a MUCH different fashion than in modern U.S. culture where we amputate the entire prepuce organ. Hebrews and early Jews made a very tiny slit in the tip of the prepuce to allow for mere drops of blood to be shed as the blood sacrifice of the covenant.

The Hebrew words used for this practice in the Hebrew Bible (Old Testament) are "namal" and "muwl." Namal means 'to clip' - like one would clip the tips of your fingernails. Muwl means 'to curtail, to blunt.' Neither of these words mean "to cut," "to amputate," "to remove," "to cut off," etc. There were very different Hebrew words with clearly understood meanings representing 'the cutting off' or 'the removal of' something. The difference was plainly obviously to those practicing and writing about the practice at the time.

At this time in antiquity, we could not possibly amputate the prepuce organ (as circumcision is done today) and expect the child to live! Even in the 21st century we suffer from a 1-in-3 rate of complications due to prepuce amputation. At this early time in human history, babies would have hemorrhaged from the complete cutting off of the prepuce, and in rare cases when they lived through the blood loss, they would have died of surgical site infection and disease (something we commonly find today despite our sterile environments and understanding of wound infection).


Side Note: I have been working recently on a compilation of paintings from antiquity representing Jesus as a baby. Jesus (born to Jewish parents) would likely have been 'circumcised' on his 8th day of life. Again, this means a tiny slit would have been made in the end of his prepuce to allow for the shedding drops of blood as a part of the covenant his parents had with YHVH (Yahweh). When we (with our modern, Western eyes and presumptions about circumcision) pour over these paintings of a naked baby Jesus, it would appear that he was always painted as INTACT. Why? Because the prepuce was NOT removed. It was not amputated. It was never 'cut off'.


Ancient peoples never dreamed of doing away with a God-created organ that was so useful, so important. The prepuce was regarded with such honor that it was thee organ seen as being most GOD-LIKE. Hence the reason it was the organ 'slit' for the blood letting as a sign that "YHVH is the one I follow"...not my own 'god-like' member.

When Jews in antiquity wanted to exercise in the gymnasium (often done in the nude) they had to appear intact. Greeks only allowed intact men to participate in activities there and the rules were strictly adhered to. To do so, Jewish men regularly pulled the prepuce down over the glans (head) of the penis, before going in. There were even little devices made to cover the scar from the slit in the prepuce end so that no one would be the wiser as to their 'circumcision'. None of this would have been possible if the entire prepuce were removed.

There is a lot more to be said on this topic. Completing graduate studies in Human Sexuality, I found it necessary to also complete a corresponding degree in Religion because (as shocking as it may sound) the two subjects go together SO much of the time... We frequently must understand one in order to fully understand the other. When it comes to issues of circumcision in antiquity this is most certainly the case.

Much more recently in American history, we started the prepuce amputation practice in an effort to curtail masturbation among boys and cut down on men's sexual exploits (especially among soldiers overseas during war times). It was in our post-WWII drive to circumcise all boys and men that we first introduced 'circumcision' to the mass society as we now know it today. Even Americans at that time KNEW that removing the prepuce would take away a man's most sensitive and sexual organ.

It is empowering to find that many of the most outspoken intactivists today are Jewish men and women. At the same time, many Jews today are opting instead for a Brit Shalom in place of cutting their perfectly born sons.

Links to articles and information on Judaism and circumcision can be found here.
Books on the subject include:
Marked in Your Flesh: Circumcision from Ancient Judea to Modern America
Circumcision: A History of the World's Most Controversial Surgery
Questioning Circumcision: A Jewish Perspective
Covenant of Blood: Circumcision and Gender in Rabbinic Judaism



On a related note - if you are Christian, you will find that circumcision is fully against what early Christians taught. Jesus followers, the New Testament, and the early Christian Church were unquestionably opposed to genital cutting in any form. It is Jesus who is the 'New Covenant' between God and his people, and participation in the Old Covenant (by shedding the blood of your newborn, for example) is to deny Christ's existence, authority, and power by grace in salvation.

More links to articles and information on Christianity and Circumcision can be found here.

Eliyahu Ungar-Sargon is the Jewish filmmaker (with an Orthodox Rabbi father) of the highly informative documentary, "CUT: Slicing Through the Myths of Circumcision". (Watch/Buy Here). After researching this topic and studying with some of the ‘experts’ in the fields of human sexuality, health, religion, and history, Ungar-Sargon concluded, “Circumcision was always a cure in search of a disease. When you look through history, you see that whatever the scary disease of the generation was, that was the one that circumcision would help prevent. So in the early 20th century it was syphilis, a scary disease that there was no cure for then. Later, it was cancer. Then UTIs, and now HIV.” As a Jewish man, strong in his faith, Ungar-Sargon chose not to cut his son.

Male circumcision as we know it, and female circumcision in the United States actually share a very similar history. All the myths we now toss around concerning MGM (male genital mutilation), we once held about FGM (female genital mutilation).

I wholeheartedly agree with what others (including Ungar-Sargon) have stated — genital cutting and the amputation of a healthy, functioning body organ from a non-consenting human being is a severe violation of human rights. If we did such a thing to a dog, we would be charged with animal abuse. And what we do to babies due to our own ignorance is certainly more criminal than that. This is not a subject that can be taken lightly or ignored any longer.

As far as having the religious freedom and choice to genitally cut our sons - we (in the United States) have outlawed, through the 1996 FGM Bill, any mutilation of baby girls for religious or non-religious reasons. It would therefor follow that the MGM Bill would be a logical and ethical item to pass in order to grant boys equal protection under law as girls. No human being is less valuable, or less deserving of basic human rights, simply because they were born with a larger prepuce organ... (oh, did I mention that girls have one too?!)

Friday, November 27, 2009

Midwifery Tricks, Tips & Accessories

Gloria Lemay has posted some of her favorite midwifery tricks, tips, and accessories in her blog. She has suggestions for use with lotus birth, clearing for the birth, heat for a burning vulva, roping the membranes, extra tap adapters (for waterbirth), help for soft breast nipples, umbilical cord banders, and post-partum teas.

We'd encourage midwives, birth-attendants and doulas to check it out! :)


Circumcision Increases Breastfeeding Complications

Image by Nick Baade for DrMomma.org

Source: Journal of Human Lactation 19(1), 2003.
Mothering News Bulletin 2005.

Need another reason to skip infant circumcision? For over twenty years, studies conducted by medical doctors and researchers have documented a connection between circumcision and breastfeeding complications. According to findings, the newly circumcised infant expresses noticeably decreased responses to a mother's attempts at engaging their attention. This "subdued" behavior has been linked by several researchers in separate studies to a subsequent struggle in the achievement of successful breastfeeding. Research has also demonstrated that following circumcision, infants suffer from prolonged periods of non-REM sleep, a symptom that would further contribute to inactive and unreceptive tendencies.

Some of the infants observed in one study were supplemented with formula after circumcision due either to frustration on the part of the mother from failed breastfeeding attempts or because doctors felt the infant was incapable of postoperative breastfeeding. Because infants usually leave the hospital seven to ten hours after the operation (many leave as early as three to six hours post-op) the long-term negative effects of circumcision on breastfeeding is more difficult to determine; however, the observed deterioration in ability to breastfeed may potentially contribute to breastfeeding failure.

Despite the fact that "circumcision is a painful, stressful, exhausting, and traumatic experience for many infants," as many as 45% of doctors ignore the recommendation by medical authorities to use an anesthetic during the procedure. Because conclusive benefits of infant circumcision are not evident, there is no danger in refusing or delaying the procedure. The Work Group on Breastfeeding of the American Academy of Pediatrics officially discourages "stressful procedures" such as circumcision and promotes breastfeeding as "primary in achieving optimal infant and child health, growth, and development."


For more information on circumcision and breastfeeding see:


image available at the Intactivism Shop

Religious Reasons for Circumcision Could Breach Human Rights

COULD be a breach of Human Rights?!?!
Hmmm...

If we are entirely against genital cutting of infant girls for religious reasons, then genital cutting of infant boys for religious reasons certainly deserves equal scrutiny and immediate bans by legal measures. Favoring one religion's practice of genital mutilation over another's simply because one is more wide-spread, or more well known in Western nations, makes the barbaric practice no less unethical. Girls and boys deserve equal rights - all humans have the basic human right to genital integrity.


Photo by Danelle with Intact D.C., 2009

By Rebecca Smith
Medical Editor for The Telegraph, UK

Circumcising boys for religious reasons is akin to pulling out their fingernails and could be a breach of the Human Rights Act, an academic has warned.

Dr David Shaw, lecturer in ethics at Glasgow University, argues that circumcising boys for no medical reason is unethical.

He wrote in the journal Clinical Ethics that any doctor who does perform circumcision without a medical reason could be guilty of negligence and in breach of the Human Rights Act as the child cannot consent to the operation and it can be argued it is not in their best interests.

Dr. Shaw wrote: "Imagine a situation where two adherents of a minority religion ask their doctor to pull off their son’s thumbnails, as this is part of the religion in which they want to bring up their son. The pain will be transient, and the nails will grow back, but the parents claim that it is an important rite of passage. I think it is reasonable to say that the doctor would send them packing. In the case of non-therapeutic circumcision, the foreskin will not grow back; why should this procedure be treated differently simply because of the weight of religious tradition?"

The controversial view is likely to cause a storm among Jewish populations who routinely circumcise boys when infants.

He said guidance to the medical profession on the issue from the General Medical Council and the British Medical Association are flawed and should be revised.

He added that the only medical reason for circumcising adult men is that there is some evidence it may prevent HIV in countries where cases are very high but that will not be relevant for doctors working in Britain [or other Western nations].


[End Note: The 'studies' conducted on adult men in Africa in an attempt to show that circumcision reduces HIV transmission have been called into question and found to be grossly unreliable. In all the areas of Africa where men were mass-circumcised as a part of the study, both men and women are now showing HIGHER rates of HIV infection among the circumcised men. Dr. Edell discusses HIV, Africa and circumcision in this video clip.]

Photo by Danelle with Intact D.C., 2009



~~~~

Thursday, November 26, 2009

Breastfeeding & Circumcision

By Yuki
Edited by Danelle Frisbie

image available at the Intactivism Shop


Starting in the late 19th century many changes were made in the way childbirth was viewed. These changes took wide effect by the 1950s. The birthing procedure was taken over by male obstetricians and childbirth became a medical condition - one that women were in need of being saved from. During this time women were routinely pumped full of drugs to give birth, subjected to shaving, enemas, episiotomies, they were encouraged not to breastfeed, and if the baby was born male, chances are likely that he would be circumcised whether it was asked for or not.

Today, more and more women are going back to doing things in a more humane manner - the way nature intended. It can be great to use modern medicine to aid in childbirth, when truly needed, but that does not mean we must medicalise every aspect of birth and the post-partum period. Mother Nature usually knows best.

Even when it was frowned upon for some time, breastfeeding has now made a comeback. Today, it is largely embraced by the medical community, and women breastfeed regularly in public, even if special laws are required to protect them in doing so. Although it hasn't quite become ubiquitously accepted across the country, breastfeeding is becoming a mainstream practice.

In recent U.S. history, breastfeeding and circumcision were treated as opposites by some in the medical community. Circumcision [the complete amputation of the prepuce organ at birth] was claimed to be beneficial and encouraged, or even forced -- while breastfeeding was said to offer no benefits for the longest time!

Today the claimed "benefits" of circumcision have been found to be without merit, while new benefits of breastfeeding are found all the time. Circumcision is not recommended by any medical or health organization in the world, while breastfeeding is universally recommended by all medical and health organizations.

The American Academy of Pediatrics (AAP) now states that babies should receive exclusive breastmilk (nothing else at all) for a minimum of the first 6 months of life, and continue nursing for at least the first 2 years of life. The World Health Organization (WHO) states that breastfeeding should be done for the first 2 years of life at a bare minimum and most infants world-wide receive their mother's milk past the age of 2.

Unfortunately in some U.S. cities, circumcision is still more common than breastfeeding. According to 2008 CDC statistics, only 26% of babies in the U.S. are still breastfed at 6 months of age, and the figure drops to just 19% by 12 months of age. At the same time, approximately 50% of baby boys born in the United States continue to be circumcised at birth. Most startling is that lactation reports from several U.S. hospitals show that it is circumcised baby boys who are most at risk of "failure to thrive" and are least likely to have a 'successful' breastfeeding relationship with their mother. Intact boys tend to latch better, nurse more effectively, and breastfeed longer than their circumcised peers.

Medical benefits of breastfeeding

According to the AAP, "human milk feeding decreases the incidence and/or severity of diarrhea, lower respiratory infection, otitis media, bacteremia, bacterial meningitis, botulism, urinary tract infection, and necrotizing enterocolitis infant death syndrome, insulin-dependent diabetes mellitus, Crohn's disease, ulcerative colitis, lymphoma, allergic diseases."(1) It should be noted that urinary tract infections (UTIs) are also reduced by breastfeeding (2,3) even though some claim circumcision may reduce UTIs during the first 12 months of an infants life. Breastfeeding, which does not permanently alter a boy's body via amputation as does circumcision, is shown to be much more effective at reducing UTI risk throughout infancy and childhood (not just in the first 12 months).

Formula fed infants have higher rates of infections, allergies, and a greater intensity of problems from infections and allergies. Over the course of childhood and life they have higher rates of cancer (including increased childhood lymphomas and increased breast cancer in women who were not breastfed as infants), adult intestinal disorders. Infants denied human milk score lower on tests of neurological development. (4,5) Man made breastmilk substitutes clearly do not offer the same nutritional value of breastmilk, and formula fed infants suffer as a result. They experience higher rates of morbidity and mortality across the board, but we continue to ignore the severity of the issue while presenting formula as a safe alternative to breastfeeding. (5)

Effects of circumcision on breastfeeding

In their policy on breastfeeding, the AAP states, "Except under special circumstances, the newborn infant should remain with the mother throughout the recovery period. Procedures that may interfere with breastfeeding or traumatize the infant should be avoided or minimized." (1)

Circumcision is the most commonly performed traumatic and painful surgical procedure done on infants today and is usually conducted in the first 48 hours of life without anesthesia.

Even if we ignore commonsense and human observation on this issue, studies demonstrate without a doubt that circumcision interferes with breastfeeding. Dixon et al., conducted a study on circumcision pain and behavioral consequences with and without anesthesia. The Brazelton Neonatal Assessment Scale (BNAS), a series of stimuli designed to elicit measured response from infants, was used and researchers found that all neurological and behavioral aspects of an infant circumcised at birth were impacted - including breastfeeding. They state, "Behavioral differences were still evident on the day following the procedure. This report adds to the growing body of data that indicate that circumcision is a painful procedure that disrupts the course of behavioral recovery following birth" (7)

Marshall et al., performed a study on how circumcision effects mother-infant interaction. This study also used the BNAS and was double blind (neither the researchers nor the mothers breastfeeding their babies knew when boys were circumcised). One group of babies were circumcised at two days and the other at three weeks. They found that infant behavior changes after circumcision in 90% of cases and that it has a "brief and transitory effect on mother-infant interactions observed during hospital feeding sessions." It was also found that mothers attempted to feed their infants 62% of the time, when their baby's eyes were closed (71%), had negative or neutral facial expressions (91%), did little vocalizing (8%), were clinging (13%), or not feeding (40%)." (8)

Howard et al., did a randomized, double blind and placebo controlled study on acetaminophen analgesia for pain management with circumcision. Among their results they found, "Neonates in both groups showed significant increases in heart rate, respiratory rate, and crying during circumcision with no clinically significant differences between the groups. Postoperative comfort scores showed no significant differences between the groups until the 360-minute postoperative assessment, at which time the acetaminophen group had significantly improved scores. Feeding behavior deteriorated in breast- and bottle-fed infants in both groups, and acetaminophen did not seem to influence this deterioration."

Conclusions

Circumcision and breastfeeding both represent areas that too many parents are simply uninformed in. Many parents are not well educated on the advantages and purposes of the prepuce organ (foreskin), and are not aware that NO medical organization recommends circumcision for their baby. Equal numbers of parents do not realize that exclusive breastfeeding IS recommended for a minimum of 6+ months of their infants' life, with partial breastfeeding for 2+ years to follow. Just as parents are not aware of all the side effects that result from circumcision, they are not aware of the gigantic health problems that result from denying a human baby human milk.

Some people buy into the myths of circumcision benefits, but they are not aware of all the documented benefits of breastfeeding -- those that do not put a newborn baby through pain and trauma and the permanently loss of a body organ.

Only in modern U.S. history have we found breastfeeding to be discouraged, while the cutting of newborn baby's genitals was encouraged. Unfortunately, we continue to see the repercussions of this discord played out in the lives of many newborn babies still in 2009.

But times are changing. People are wising up to the myths and misconceptions that surround birth and babies. Parents are choosing to become educated on the realities of breastfeeding and the horrors of circumcision. Advocates of breastfeeding (lactivists) and keeping babies intact (intactivists) share common ground in their missions, and we can work together to help children receive the very best care that they deserve.




For more information on circumcision and breastfeeding see:







Related Articles:

Protect Your Intact Son
Only Clean What is Seen
Intact = Do Not Retract!
Forced Retraction
Take Your Whole Baby Home
Functions of the Foreskin
Babies Voice Objections
Circumcision & Women's Health
Foreskin Restoration
Oprah & Circumcision
Dr. Sears & Circumcision

For more on circumcision, pain and related side effects see:

ALL pain studies conducted on circumcision in the US and Canada have come to an early end as a result of infant trauma.

The Brain Altered by Circumcision

Infant Pain Impacts Adult Sensitivity


Boys cut at birth move their bodies differently

Circumcision: How Much Does it Hurt?

A plastibell circumcision (the type used in Patti Ramos' photo essay on circumcision) - the company likes to claim genital cutting does not hurt as much when plastic clamps are used rather than metal clamps

Reports from mothers who observed son's circumcision


Reports from a father who observed his son's circumcision: Stop MGM and Will You Make the Cut?

Men on this site tell their stories of how circumcision impacted them.

Babies "voice their opinion" [video clip of common newborn reactions]

A mother of 2 circumcised sons researches it before her 3rd is born

Another plastibell circumcision is video taped here

For statistics on side effects (including death) due to circumcision see:
Cirp.Org/Library/Death

Dangers of Circumcision Report (pdf) at DoctorsOpposingCircumcision.org

Circumstitions.com/Complications

NoHarmm.org/complicationsUS



References:
1. American Academy of Pediatrics - Breastfeeding and the Use of Human Milk (RE9729)

2. Pisacane A et al.
Breastfeeding and urinary tract infection. The Lancet, July 7, 1990, p50.

3. Marild S.
Breastfeeding and Urinary Tract Infections. The Lancet 1990;336:942.

4. A full list of medical benefits of breastfeeding with citations from medical journals to back them up can be found at
http://www.promom.org/why_bf.htm

5. James W. Prescott,
Breastfeeding: Brain Nutrients in Brain Development for Human Love and Peace. Touch The Future Newsletter, Spring 1997

6. Katie Allison Granju.
Infant Formula: What Every Parent Should Know. Minnesota Parent 1997

7. Dixon S, Snyder J, Holve R, Bromberger P.
Behavioral effects of circumcision with and without anesthesia. Journal of Developmental Behavioral Pediatrics 1984; 5(5): 246-50.

8. Marshall RE, Porter FL, Rogers AG, et al.
Circumcision: II effects upon mother-infant interaction. Early Human Development 1982; 7:367-374.

9. Howard CR, Howard FM, and Weitzman ML.
Acetominophen analgesia in neonatal circumcision: the effect on pain. Pediatrics 1994;93(4): 641-646.

Homebirth Caretakers: Doctors Who Come to You


by Wendy Correa

On a bright May morning, 17-year-old Matthew Smith and his 15-year-old sister Emily watched their mother, Elaine, give birth to their baby sister Katherine. Until the early 20th century, this would have been a very common family event in rural America. But this was 1993, in Chicago, and the setting was not a hospital but the Smiths' own home.

Matthew and Emily themselves were born in hospitals. Both births had been induced with pitocin; for Emily's birth, Elaine was flat on her back, feet in stirrups, attached to a myriad of catheters, IVs, and monitors. Because Matthew's pediatrician recommended artificial baby milk supplementation within three months of his birth, presumably due to slow weight gain, Elaine sought the advice of La Leche League, which recommended that she simply breastfeed more often. Matthew thrived, Elaine's interest was piqued, and she became a La Leche League leader.

Elaine's co-leader was a nursing student with Homefirst Health Services, a family practice group that also attends homebirths. Fifteen years after her last baby was born, with numerous miscarriages in between, Elaine gratefully learned that she was pregnant. Armed with the knowledge of Homefirst's success and reputation, Elaine and her husband, Donald, decided that their baby would be born at home. "I knew that a homebirth would be better than what I had experienced with both of my hospital births," Elaine explains. "I'm much more comfortable at home, and I did not want my baby taken away from me."

To prepare Matthew and Emily for the birth, the Smith family went to an informational evening at Homefirst, at which the homebirth process was explained by doctors and nurses with videos and testimonials. Matthew remembers that he felt queasy while watching footage of a birth and feared that he would have the same reaction at his sister's birth. But by the time Katherine arrived, he says, his experience was more about the joy, excitement, and wonder of watching a new life coming into the world.

That day Matthew was responsible for answering the door to let in the nurse, Jude Wrezesinski, and the doctor, Mayer Eisenstein, getting his mother cold washcloths and drinks, and helping his father hold his mother's legs as she pushed her daughter into the world. Finally, Matthew got to cut Katherine's umbilical cord. Two years later, Matthew and Emily attended their sister Rachel's homebirth. This time, Matthew photographed the birth, and Emily got to cut Rachel's umbilical cord.

Mayer Eisenstein is the medical director of Homefirst, now the largest physician- and midwife-attended homebirth practice in the nation. Eisenstein maintains that homebirth is many times safer than hospital birth for over 90 percent of low-risk women, especially if you can take the hospital to them. Since 1973 he and his practice have delivered 15,000 babies at home, including five of his six children and all six of his grandchildren; they are now delivering second-generation babies for women who themselves were born at home with Homefirst.

With six medical centers in the greater Chicago metropolitan area, Homefirst has ten doctors, four certified nurse-midwives, and 45 registered nurses and certified nurse assistants. They provide preconception counseling, prenatal and postpartum care, delivery, and breastfeeding instruction and support. Homefirst also offers a full range of pediatric services as well as women and men's health care.

Eisenstein's unusual career began while he was still in medical school at the University of Illinois. The birth of his own first child was a less than satisfactory hospital experience, so, for their second birth, he and his wife sought the help of Gregory White, a physician who had quietly been doing homebirths for a number of years. Eisenstein was so awed by the birth of his second child that he began attending homebirths with White. He saw that the pregnant women were walking around until it was time for the actual birth, that they were empowered by the presence of family and friends, and that there were no episiotomies, forceps, or drugs. "The birth was a joyful, spiritual experience for the mother, rather than the climax of many fearful and helpless hours spent on her back at the mercy of medical staff. Dr. White was the most patient person in the world and could make everyone feel comfortable. The simplicity of his techniques amazed me. He would watch and watch at a birth, just really watch what was happening, and soon the baby would come out," Eisenstein recalls.

At the same time, Eisenstein began working at Chicago's Cook County Hospital to learn all he could about forceps delivery, episiotomies, and other intervention techniques because, White assured him, "You won't learn about these things at homebirths; they just aren't necessary." At the hospital, he soon began to "accidentally" drop the episiotomy scissors on the floor so that they could not be used. Consequently, he was the doctor called whenever a laboring woman did not want drugs or an episiotomy.

In addition to working with White, Eisenstein was also trained by White's teacher, Herbert Ratner, a general practitioner and professor of philosophy at Loyola University who conducted monthly forums on family life. He also began assisting Beatrice Tucker, America's first woman obstetrician. Tucker was then 81 and had been director of the Chicago Maternity Center for 50 years, during which time she and her staff delivered over 100,000 babies at home with an unsurpassed safety record. Tucker told her doctors and nurses, "Your role at the birth is not to deliver the baby. Your role is to be the lifeguard, to employ a watchful expectancy." "The goal of Homefirst is to practice scientific medicine, follow scientific literature, and produce the healthiest possible mothers and babies by delivering the largest percentage of women at home," Eisenstein says. The medical profession in general, he believes, does not follow its own studies, which demonstrate that homebirth is as safe as, if not safer than, hospital birth. "Just look at the cesarean section rate of 22 to 27 percent and higher in US hospitals. That is not scientific medicine," he adds.

Indeed, according to the National Center for Health Statistics, after falling steadily from 1989 to 1996 the rate of cesarean delivery increased again in 1999 to a national average of 22 percent, up 4 percent from 1998.1 According to a 1999 Reuters report, in a study of more than 1,200 women, researchers at Brigham and Women's Hospital in Boston found that first-time mothers who develop a fever during labor are three times more likely to deliver by cesarean section than those who don't. Ninety percent of the 301 women in the study who developed a fever during childbirth had been given an epidural, suggesting a link between the two.2 Studies at the University of Houston Medical School showed two to three times more cesareans for dystocia in first labors in the epidural group than in the group of women without anesthesia.3

In spite of these and other related studies, the rate of epidural anesthesia use continues to rise. Comprehensive reports from many hospitals indicate that almost all (80 to 98 percent of birthing women, depending on the hospital) receive (oral) medication, anesthesia (epidural analgesia), or both. In contrast, 90 percent of Homefirst mothers succeed at having uncomplicated and nonmedicated homebirths, and of the 10 percent who are transferred to the hospital half still have a vaginal birth.

Eisenstein minces no words when he declares that homebirth is safer than hospital birth for those 90 percent of mothers who are low risk. The problem is that obstetricians treat all women as high risk. "Obstetrics, which is really a combined philosophy, business, and religion, does not have science as its base," Eisenstein says. "Obstetricians practice much more philosophy than science. Pregnant women are tested, medicated, and operated on to excess every day by this profession in an unethical and dangerous way. This unscientific medicine is dangerous to us as a nation. Our maternal and infant mortality rate is unacceptable for a society as sophisticated as ours. We produce more premature infants than any other country with our interventionist technology and then praise ourselves for saving some of their lives."

Support for the safety of out-of-hospital and nonintervention births is abundant. According to a 1994 study, after "reviewing the full spectrum of literature from the United States and abroad, the literature shows that low- to moderate-risk home births attended by direct-entry midwives are at least as safe as hospital births attended by either physicians or midwives."4

A study at Columbia University College of Physicians and Surgeons concluded, "Home birth can be accomplished with good outcomes under the care of qualified practitioners and within a system that facilitates transfer to hospital care when necessary."5 Despite such scientific reports, Eisenstein comments, "Modern obstetricians continue to intervene excessively at births, to maintain their system of large consultant hospitals, and to find homebirth unthinkable."

Both the American Medical Association (AMA) and the American College of Obstetrics and Gynecology (ACOG) have issued policy statements cautioning against homebirths, whether attended by midwives (as in the majority of cases in the US) or physicians. The AMA policy states, "Obstetrical deliveries should be performed in properly licensed accredited, equipped, and staffed obstetrical units." According to ACOG, "Labor and delivery, while a physiologic process, clearly presents hazards to both mother and fetus before and after birth. These hazards require standards of safety which are provided in the hospital setting and cannot be matched in the home situation."

Perhaps Henci Goer offers the best answer to the home or hospital safety question in her book Obstetric Myths versus Research Realities: "The real question about safety is not, 'Do you want a pleasant birth at home or a safe birth in the hospital?' It is, 'Do you want to give birth at home and run the miniscule risk of an emergency that might (but not necessarily would) be handled better in the hospital, or do you want to give birth in the hospital and run the considerably increased risk of infection, the certainty of additional stress, and the near certainty of unnecessary (and potentially risky) interventions?"6

The convictions of the Homefirst doctors certainly put them at odds with the AMA and ACOG; on the other hand, Homefirst might be perceived by some childbirth reform advocates and midwives as the "medical model at home." Eisenstein contends, "The model that is important to us is not midwife or doctor; the right obstetrical model is homebirth. If a midwife delivers babies in a hospital, that is no better to me than an obstetrician. Once midwives start working in the hospital, they fall into the same trench as the obstetrician. The care may be nicer and gentler, but they are still altering the experience."

Paul Schattauer, one of the doctors present at Rachel Smith's birth, has been with Homefirst since 1987 and tells prospective clients, "Our goal is to bring the hospital to you." And that they do. The "hospital" arrives in a van filled with more than a hundred pieces of medical equipment. In addition, as a physician organization Homefirst is hospital-supported in the event of an emergency-one of the main obstacles facing midwives working on their own.) The combination of doctors and midwives seems to be mutually advantageous. According to Jennifer Gagnon, a certified nurse- midwife with Homefirst, the benefits for midwives include the comfort of a well-established and respected practice; the opportunity for homebirth mentoring experience; and more established hours and less stress than being in a solo or small midwifery practice.

"Having recently come from working as a labor and delivery nurse in a hospital, my view is that childbirth in a hospital is bad," Gagnon says. "The last year of my education as a CNM was very difficult because I was still working as a labor and delivery nurse. I had a lot of internal conflict because I could not resolve what I was seeing happening to women with what I knew should be the correct way. And what was even worse was hearing women thank their doctors, who, in my opinion, had really done them wrong. There was a lot of subtle misogynistic language directed toward laboring women. I saw so many examples of women getting the cascade of interventions they didn't need."

A recent study published by the Robert Wood Johnson Foundation found that 95 percent of doctors and 89 percent of nurses reported witnessing a colleague commit "serious" medical error(s).7 Eisenstein laments, "It is frightening to realize that most hospital-trained obstetricians have never seen a truly normal labor and delivery. Intervention gives power, control, and credit to the doctors for birth itself. Many obstetricians have been known to say behind the scenes that they only feel they have delivered the baby when they perform a cesarean section. It is a powerful feeling to 'deliver' babies rather than leaving delivery to the mothers themselves."

Asked if hospitals could ever be as comfortable and safe as home, Eisenstein answers with a firm, "No." He adds, "There is something about just walking into a hospital that changes the dynamics of labor. Scientific studies have shown that the length of labor is significantly increased in the hospital versus the home."

Schattauer expounds on this theory, referring to what he calls the "safe and secure response" promoted by the safety and security of homebirth, which releases endorphins that create a sense of well-being and provide pain relief. In contrast to "safe and secure," is the "fight or flight" response created by the unfamiliar territory of the hospital and doctors' interventions, which promote the release of adrenaline, hence potentially stopping or stalling labor and creating tension and pain.

"The majority of problems that develop in a labor situation stem not from some inherent health problem in the woman but from the normal physiological response to an artificial, stressful situation," Schattauer says. "Our whole focus can change once we realize that the built-in mechanisms for labor are more intricate and sophisticated than anything we could possibly develop in the biomedical industry. The new paradigm requires an emphasis on withdrawing any stimuli that would trigger the fight or flight response. Through the course of evolution, the body has adapted beautifully to labor in a most efficient way. That's the kind of confidence and belief system we need to have as doctors and medical caregivers so that we understand that the environment we provide can make a difference in whether the laboring woman succeeds and the normal physiology of the 'safe and secure response' is turned on."

In September 1999, four years after attending his sister Rachel's birth, Matthew Smith and his wife, Lisa, gave birth at home to a daughter, Caroline, attended by Homefirst staff. Lisa and Matthew had taken weeks of Homefirst homebirth preparation classes. For every "What if?" Lisa could think of, the doctors of Homefirst had an answer. The emergency equipment that the doctors bring to every birth, and the knowledge that a hospital was nearby in case of any problem and that her Homefirst doctor would still be her doctor in the event of a hospital transfer, soothed Lisa's concerns. It is this empowering kind of response from Lisa Smith and the other Homefirst mothers that seems to drive and inspire the Homefirst staff.

At first glance there appear to be insurmountable obstacles to the childbirth reform movement, but the desire for change continues to grow on a grassroots level. Homefirst recognizes the need to educate not only the consumer and the public but also insurance companies and legislators. Wearing one or more of these educational hats in addition to being the clinician can be taxing, but Homefirst is doing its part.

Eisenstein has written two books, The Home Birth Advantage and Safer Medicine, and appears weekly on the Homefirst Family Health Forum radio call-in program. In addition, Homefirst offers free educational seminars and free one-hour private consultations with prospective homebirth families. It also offers educational programs for students in medical, nursing, and midwifery schools, one-year fellowships for physicians and certified nurse-midwives, and rotations for resident medical students and nurses. "There have been so many medical students on the brink of quitting when they come to us to do a rotation, and their mouths just drop to the floor," Schattauer says. "They catch the inspiration again. They don't care about the economics and the politics, because they have regained the whole essence of why they went into medicine."

Once insurance companies understand that they will save millions of dollars each year by covering homebirths and reducing the rate of cesarean sections, Eisenstein and Schattauer believe they will provide services. Certainly the help of influential state and federal legislators could help expedite that process. Florida, for example, is considered a "midwifery-friendly" state, in contrast to Illinois, where lay midwives are prosecuted. According to Florida statute 641.31, "Health maintenance contracts that provide coverage, benefits, or services for maternity care must provide, as an option to the subscriber, the services of nurse-midwives (licensed midwives) and the services of birth centers." The statute goes on to say that this "does not require a mother who is a participant to give birth in a hospital or stay in a hospital."

Considering that the US now ranks a low 24th among industrialized nations in infant and maternal mortality,8 perhaps our legislators will finally look at the many European countries whose standard for childbirth is the midwifery model. In the Netherlands, for example, midwives have always maintained full autonomy, providing all primary maternity care, while obstetricians are reserved for medical necessity. Dutch insurance reimburses only for midwifery care; if a woman chooses to use an obstetrician, she must pay for the services herself, unless it is medically warranted. In addition, women may choose home or hospital, and about one-third choose to have their babies at home.

Eisenstein firmly believes that the demise of the American family is rooted in the displacement of birth from home to hospital, saying, "The family starts with birth, and homebirth traditionally was a cornerstone of strength in a family's life. Hospital birth deprives the new family of this most primal and strengthening experience."

NOTES
1. National Center for Health Sciences, press release, April 17, 2001.
2. Suzanne D. Dixon, editorial based on study in American Journal of Public Health, April 6, 1999. Editorial published by Pampers.com, July 1, 1999.
3. Diana Korte and Roberta M. Scaer, A Good Birth, a Safe Birth (Cambridge, MA: Harvard Common Press, 1992), 145.
4. C. Hafner-Eaton and L. K. Pearce, "Birth Choices, the Law, and Medicine: Balancing Individual Freedoms and Protection of the Public's Health," Journal of Health Politics, Policy and Law 19, no. 4 (Winter 1994): 813-835.
5. P. A. Murphy and J. Fullerton, "Outcomes of Intended Home Births in Nurse-Midwifery Practice: A Prospective Descriptive Study," Obstetrics & Gynecology 92, no. 3 (1998): 461-470.
6. Henci Goer, Obstetric Myths versus Research Realities: A Guide to the Medical Literature (Westport, CT: Bergin & Garvey, 1995), 334.
7. Robert Wood Johnson Foundation, press release, May 8, 2001. Regarding a nationwide survey of healthcare professionals and the multimillion-dollar initiative launched by RWJF to help providers and administrators pursue healthcare perfection.
8. Mayer Eisenstein, The Home Birth Advantage (Chicago, IL: CMI Press, 2000), 18.

For more information, contact Dr. Mayer Eisenstein or Dr. Paul Schattauer:

Homefirst Health Services

6400 North Keating, Lincolnwood, IL 60712

847.679.8336


Wendy Correa is a freelance writer, doula, childbirth educator, and pre/postnatal yoga instructor. She lives in Tampa, Florida, with her husband, Ignacio, and their son, Mateo.

No Episiotomy: Getting Through Birth in One Piece

By Elizabeth Bruce
posted with author's permission

Surgical scissors tied with ribbon

Episiotomy--the cutting of perineal tissues during delivery--is not something that most women give a second thought to, at least not until they've given birth for the first time. The perineum is the delicate area between the vagina and the anus. After an episiotomy, even sitting can be painful, and sex can be unbearable.

Episiotomy is the most common surgical procedure performed in the US, and, according to Sheila Kitzinger, "It is the only surgery likely to be performed without her consent on the body of a healthy woman in Western society."1 During a typical hospital birth, it's the rare woman who is not cut either "above" (in a C-section) or "below" (an episiotomy). Currently, at least 80 percent of first-time mothers delivering vaginally in the US undergo this painful procedure.2 A research review by the World Health Organization, however, indicates that evidence only supports a 5 to 20 percent episiotomy rate.3

Medical textbooks teach that episiotomies are necessary to prevent tearing and to protect the baby's head. Actually, tears are usually less severe without episiotomy, and the procedure itself can cause further tearing. Furthermore, unless the baby is premature, its head is made to withstand the pressures of delivery. For years, it was believed that an episiotomy protected a woman against future uterine prolapse, although this has since been disproved. As Penny Simkin points out, "The advantages of episiotomy have long been assumed, but never proven."4

One doctor told me that he preferred doing episiotomies because he found a straight edge easier to repair than a "jagged" tear. Christiane Northrup, MD, maintains, however, that vaginal lacerations "are trivial and very easy to repair in comparison to the damage done by episiotomies. They are also far less painful."5 In any event, should the doctor's convenience really take precedence over a woman's comfort? Another contributing factor in the hospital is the general rush to get the baby out once full cervical dilation has been reached, even though there is no evidence to suggest that faster is better. Since an OB is hired to "do something," he or she may feel pressured to do an episiotomy when things naturally slow down during transition.

Complications of Episiotomy


Although episiotomy seems like a simple operation, it carries the risk of complications, including "excessive blood loss, hematoma formation (a form of swelling or bruising), infection, or abscessing. Sometimes trauma from an episiotomy of the anal sphincter and rectal mucosa leads to a loss of rectal tone and, in severe cases, a fistula, or hole, between the vagina and rectum."6 It can also kill your sex life, at least temporarily.

Sheila Kitzinger found that episiotomy harmed women both physically and psychologically. Fifteen percent of postpartum women who had torn described their perineum as "painful or very painful" at the end of the first week, compared to 37 percent of the episiotomy group.7 Moreover, a woman "who has had an episiotomy, especially if her permission was not asked beforehand, may also feel violated. That is a word many women use when talking about their reaction to episiotomy."8 Certainly extreme pain and the feeling of being violated may help explain why some women have no interest in sex after an episiotomy.

Why Do Women Tear?


The myths that purport to explain why women tear during delivery include a)the mother is too small; b)the baby is too large; and c)pushing happened too fast. One of the most important considerations is the mother's position during second stage (pushing). The popularly used lithotomy position (flat on your back with your feet in stirrups--the standard hospital position) is the worst possible position for delivery. Putting a woman's feet into stirrups stretches her vaginal tissues in an abnormal way. The further back her legs are pushed, the more strain is involved. When a midwife notices your tissues looking "white," she will likely tell you to stop pushing, or she will apply counterpressure to the area. In contrast, a physician may figure he can repair the damage later and may continue telling you to push. In her book Gentle Birth Choices, Barbara Harper writes, "The combination of birthing in the lithotomy position and strained pushing will cause the perineum to tear."9

Success Stories


In 1993, I experienced the joy of my first vaginal birth (my first child had been delivered by cesarean section). My 7-pound, 11-ounce baby, born in the hospital, resulted in tears that required stitching. I now believe that the tearing occurred because I was encouraged to push before I was ready. Fortunately, I educated myself before the next birth. During the homebirths of my last two babies, I delivered in a hands-and-knees position. Although I am petite (105 pounds), both babies were birthed without any tears or cutting. My son weighed 9 pounds, 8 ounces. Total pushing time? Nine minutes and three minutes, respectively. The fact that the midwife said, "Push when you feel like it" helped immensely. I'm thankful that she urged me to slow down to allow the perineum time to stretch.

A few years ago, a woman named Gail came to me with a serious concern. During the birth of her first baby, she had received an episiotomy that resulted in a fourth-degree tear into the anus. Now pregnant again, Gail was worried that the resulting scar tissue might not stretch and that she would be cut again. Since the original incision had caused her considerable discomfort, she was anxious to do anything possible to avoid repeating the experience.

We discussed upright positions and the importance of expressing her wishes in a birth plan, and she and her husband used perineal massage at home. Gail birthed a 10-pound baby girl in the side-lying position and was elated at the fact that her perineum remained intact. She was also thrilled with her relatively easy recovery.

How to Avoid Episiotomy


If possible, have a midwife deliver your baby instead of a physician. Although midwives are skilled at performing episiotomies, they rarely find them necessary. Typically, midwives "place warm compresses on the perineum to relax the tissue and make it more flexible, or massage and stretch it out with warm oil."10

Hiring a doula is another way to keep your perineum intact. A doula stays with the mother during her labor and helps the mother and her partner to be comfortable. She helps make sure that the parents' birth plan is followed, and provides physical and emotional support during labor. In one study, the presence of a doula resulted in a 60 percent reduction in epidural requests and a 40 percent reduction in forceps deliveries;11 both procedures are major contributors to high episiotomy rates.

There are situations when an episiotomy may be necessary, but these are rare. A breech birth is the classic example, when time is of the essence to birth the baby's head. Other unusual fetal positions, such as face first or a compound presentation, may necessitate an episiotomy. Premature births sometimes also require an episiotomy to take pressure off the baby's delicate skull.

Women's bodies are designed to give birth without surgical intervention. Episiotomy was invented to facilitate forceps deliveries and has continued mainly out of habit not necessity. If you eat well during pregnancy, move around during labor and delivery, and deliver in a supportive environment, chances are that you won't require an episiotomy or even tear. If you do tear, recovery is almost always easier than with an episiotomy. As with most concerns about labor, often the best advice is to trust the process and to follow your instincts.

Notes


1. Sheila Kitzinger, Episiotomy and the Second Stage of Labor (Seattle, WA: Pennypress, 1990).

2. Watson Bowes, "Should Routine Episiotomy Be Performed Routinely in Primiparous Women?" Ob/Gyn Forum 5, no. 4 (1991): 1-4.

3. Marsden Wagner, Pursuing the Birth Machine: The Search for Appropriate Birth Technology (Camperdown, New South Wales, Australia: ACE Graphics, 1994), 165-174.

4. See Note 1, p.13.

5. Christiane Northrup, Women's Bodies, Women's Wisdom (New York: Bantam, 1998), 469.

6. Barbara Harper, RN, Gentle Birth Choices (Rochester, VT: Healing Arts Press, 1994), 75.

7. See Note 1, p.104.

8. See Note 1, p.103.

9. See Note 5, p.75.

10. Sandra Jacobs, with American College of Nurse-Midwives, Having Your Baby with a Nurse-Midwife (New York: Hyperion, 1993).

11. Marshall H. Klaus, MD, John Kennell, MD, and Phyllis H. Klaus, MEd, Mothering the Mother: How a Doula Can Help You Have a Shorter, Easier and Healthier Birth (Old Tappan, NJ: Addison Wesley Longman, 1993).

Elizabeth Bruce, MA, CCE, lives in the Washington, DC. She teaches Birth Works classes and has written for Midwifery Today and Compleat Mother.

Wednesday, November 25, 2009

The Uterus Vase


Wow! So what do you think?! :)

Although my husband laughed when I showed him this picture and told him I'd like one in a slightly reddish-clear shade of blown glass -- I do believe it would fit in perfectly with our Birth & Babies Library [which is quickly becoming a museum of sorts for all things pregnancy-birth-breastfeeding-babies].

I love anything and everything that celebrates the awesome power that is a woman's body. And the uterus is second to none in this category. As the strongest muscle in the human body, the uterus has the ability to grow from the size of a small pear to the size of watermelon. During labor, it contracts powerfully at 100lbs of pressure per square inch! The uterus does 80% of the work in pushing out a newborn baby from within. And even if it is cut open to 'deliver' a baby via cesarean, the uterus heals miraculously fast and is capable to grow, support, and protect a future baby within its' walls just months later.

The uterus is quit the amazing organ! So I kind of dig this vase designed by The Plug & Stephanie Rollin... even if it would be quite the unique conversation starter to have on our dinner table tomorrow for Thanksgiving.

But really, I AM thankful for the uterus!
And you should be too - you wouldn't be here without it. ;)

Tuesday, November 24, 2009

Baby On Board Men's T-Shirt


"Real Men Wear Babies" ~ and if you aren't a pappa yourself, and want to be like all the cool dads, you can still sling a baby with this funny tee from Paul Frank Industries. ;)

Paul says, "This tee is one of our most popular around! Men can enjoy the gift of fatherhood [when they don't have] the actual fatherhood part. This is a short sleeve jersey tee with the screenprint of a baby. Great gift for men at any age!"

I thought it was humorous. After all, who doesn't want to be babywearin'?!

For much more on babywearing, see any of these great links.

Sunday, November 22, 2009

C-Section NOT Best for Breech Birth

By Carla Wintersgill
for The Globe and Mail 
posted with permission


Physicians should no longer automatically opt to perform a cesarean section in the case of a breech birth, according to new guidelines by the Society of Obstetricians and Gynecologists of Canada.
Released yesterday, the guidelines are a response to new evidence that shows many women are safely able to vaginally deliver babies who enter the birth canal with the buttocks or feet first. Normally, the infant descends head first.

“Our primary purpose is to offer choice to women,” said AndrĂ© Lalonde, executive vice-president of the SOGC.

“More women are feeling disappointed when there is no one who is trained to assist in breech vaginal delivery,” he adds.

Since 2000, C-sections have been the preferred method of delivery in breech births. Studies suggested that breached births were associated with an increased rate of complication when performed vaginally.
As a result, many medical schools have stopped training their physicians in breech vaginal delivery.
The problem now, according to Dr. Lalonde, is that there is a serious shortage of doctors to teach and perform these deliveries.

With the release of the new guidelines, the SOGC will launch a nationwide training program to ensure that doctors will be adequately prepared to offer vaginal breech births.

The new approach was prompted by a reassessment of earlier trials. It now appears that there is no difference in complication rates between vaginal and cesarean section deliveries in the case of breech births.

News of the change is a boon for the Ottawa-based Coalition for Breech Birth.

“We're really, really pleased,” said Robin Guy, co-founder of the coalition.

Ms. Guy started the group after the birth of her second child in the fall of 2006. Although she had given birth to her first child at home with a midwife, Ms. Guy delivered her daughter in the hospital because of the baby's breech position.

“I was cornered into an unneeded and unwanted C-section because the obstetrician that I had didn't have the experience to catch her,” said Ms. Guy.

The aim of the coalition is to ensure that women know what their options are when it comes to breech birth. Ms. Guy believes that many women don't realize that vaginal breech births are even possible.
“Educating women is our primary goal because it takes more than just a guideline change,” she said.
The SOGC stresses that because of complications that may arise, many breech deliveries will still require a cesarean section.

Breech presentations occur in 3-4 per cent of pregnant women who reach term. That translates to approximately 11,000 to 14,500 breech deliveries a year in Canada.

The new decision to offer vaginal breech birth aligns with the SOGC promotion of normal childbirth – spontaneous labour, followed by a delivery that is not assisted by forceps, vacuum or cesarean section. In December of 2008, the society release a policy statement that included its recommendation for a development of national practice guidelines on normal childbirth.

“The safest way to deliver has always been the natural way,” said Dr. Lalonde.

“Vaginal birth is the preferred method of having a baby because a C-section in itself has complications.”
Cesarean sections, in which incisions are made through a mother's abdomen and uterus to deliver the baby, can lead to increased chance of bleeding and infections and can cause further complications for pregnancies later on.

“There's the idea out there in the public sometimes that having a C-section today with modern anesthesia and modern hospitals is as safe as having a normal childbirth, but we don't think so,” said Dr. Lalonde.
“It is the general principle in medicine to not make having a cesarean section trivial.”

The SOGC believes that if a woman is well-prepared during pregnancy, she has the innate ability to deliver vaginally.

The national average for babies delivered via cesarean section in Canada is 25%. [The national average in the United States is 33%.] 

Stem Cells: 3 Types Found in Breastmilk

posted with permission
Scientists say mother's milk may play vital role in helping children 'fulfill their genetic destiny.'

magnified photo of stem cells


mother's milk

Breast milk, long revered for the nutritional advantages it gives a newborn, could be just as vital in terms of infant development, a leading scientist will claim this week. Up to three different types of stem cells have been discovered in breast milk, according to revolutionary new research. 

Dr Mark Cregan, medical director at the Swiss healthcare and baby equipment company Medela, believes the existence of stem cells means breast milk could help a child "fulfil its genetic destiny", with a mother's mammary glands taking over from her placenta to guide infant development once her child is born. 

"Breast milk is the only adult tissue where more than one type of stem cell has been discovered. That is very unique and implies a lot about the impressive bioactivity of breast milk and the consequential benefits to the breastfed infant," said Dr Cregan, who is speaking at Unicef's Baby Friendly Initiative conference this week. His research has isolated adult stem cells of epithelial (mammary) and immune origin, with "very preliminary evidence" that breast milk also contains stem cells that promotes the growth of muscle and bone tissue. 

Scientists will use his discovery, made at the University of Western Australia, in Perth, Australia, to attempt to harvest stem cells from breast milk for research on a range of issues – from why some mothers struggle to produce milk to testing out new drugs that could aid milk production. "There is a plentiful resource of tissue-specific stem cells in breast milk, which are readily available and from a non-invasive and completely ethical source," Dr Cregan said. 

Advocates hope the discovery will help to lift the UK's breastfeeding rates: only one-third of babies are exclusively breastfed at one week, the number dropping to one-fifth at six weeks. At five months, only 3 per cent of mothers still exclusively nurse their babies – although the World Health Organisation recommends that babies should consume only breast milk until they are at least six months old.
Rosie Dodd, campaigns director at the National Childbirth Trust, said: "This finding highlights the many factors that are in breast milk that we know so little about and that all have different advantages, such as helping a baby's immune system to develop."

Dr Cregan said the discovery of immune stem cells was the "most exciting development", adding, "It's quite possible that immune cells in breast milk can survive digestion and end up in the infant's circulation. This has been shown to be occurring in animals, and so it would be unsurprising if this was also occurring in human infants." 

British scientists gave a cautious welcome to Dr Cregan's discovery, warning that just because stem cells exist in breast milk did not mean that they could be used to develop a therapy – the ultimate goal of stem cell research. Chris Mason, professor of regenerative medicine at University College London, said: "It may give us some insight into specific breast diseases and is potentially valuable when it comes to drug discovery and drug development but it is fanciful to think it could provide routine therapies."


Saturday, November 21, 2009

Babies Remember Circumcision Pain


This data is old, but for some reason we are still forgetting that it is nonetheless very TRUE for our babies born today.


Shared at: Doctor's Guide Publishing


TORONTO, Feb. 28, 1997 - Male infants feel pain during circumcision and they remember that pain six months later when they receive their routine vaccination, according to a study led by Hospital for Sick Children (HSC) researchers.

The results of this study, led by Dr. Gideon Koren, head of Clinical Pharmacology & Toxicology at HSC and a Professor of Pediatrics, Pharmacology, and Medicine at the University of Toronto, are reported in the March 1 issue of the British medical journal Lancet.

Earlier research led by Dr. Koren had indicated that male infants demonstrate a greater pain response to vaccination than female infants. The current study sought to determine whether there was a difference between circumcised and uncircumcised male infants in their pain response to vaccination, and whether pretreatment of circumcision pain with a topical anesthetic affected the pain response to vaccination.

The study involved 87 male infants in three groups: 32 uncircumcised infants; 29 infants receiving a topical anesthetic prior to circumcision; and 26 who were circumcised without pain relief. The infants were recruited to the study through Women's College Hospital. Between ages four and six months, the infants received routine diptheria-pertussis-tetanus (DPT) vaccinations from their primary care physician and their pain response to the vaccination was measured.

"What we discovered was that the infants who were uncircumcised demonstrated the least pain during vaccination," Dr. Koren explains. "The infants who were circumcised showed substantially more pain."

Pain response was measured by monitoring facial expression, duration of crying, blood pressure, and heart rate. In addition, parents and the primary care physician completed a questionnaire regarding their perception of the severity of pain the infant was experiencing.

"This study demonstrates two important findings," says Dr. Koren. "It shows that infants do in fact feel pain, and that their pain is not short-lived, as previously thought. Consequently, adequate pain relief should be routinely used during circumcision and any other medical and surgical procedures where pain is possible."


For more on circumcision, pain and related side effects see:

ALL pain studies conducted on circumcision in the US and Canada have come to an early end as a result of infant trauma.

The Brain Altered by Circumcision

Infant Pain Impacts Adult Sensitivity


Boys cut at birth move their bodies differently

Circumcision: How Much Does it Hurt?

A plastibell circumcision (the type used in Patti Ramos' photo essay on circumcision) - the company likes to claim genital cutting does not hurt as much when plastic clamps are used rather than metal clamps

Reports from mothers who observed son's circumcision


Reports from a father who observed his son's circumcision: Stop MGM and Will You Make the Cut?

Men on this site tell their stories of how circumcision impacted them.

Babies "voice their opinion" [video clip of common newborn reactions]

A mother of 2 circumcised sons researches it before her 3rd is born

Another plastibell circumcision is video taped here

For statistics on side effects (including death) due to circumcision see:

Cirp.Org/Library/Death

Increased Dangers of Circumcision Report (pdf) at DoctorsOpposingCircumcision.org

Circumstitions.com/Complications

NoHarmm.org/complicationsUS

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