“Except When Medically Necessary” : Making informed choices about induction of labor

by Amy Romano, CNMThis post was originally published on Science and Sensibility for Lamaze International.It’s not hard for women to find advice and recommendations to avoid induction of labor “except when medically necessary.” But what do those words mean and who decides when an induction is medically necessary? Lamaze’s Healthy Birth Practice Paper cites ACOG Guidelines that define medical

Midwifery Care from the Client’s Perspective

by Melissa Garvey, ACNM Writer and EditorOur friends at Science and Sensibility have an interesting post that should be generating more discussion. The post explores certified nurse-midwife Mary Ellen Doherty’s study in the Journal of Perinatal Education called “Midwifery Care: Reflections of Midwifery Clients.”Doherty conducted her study to describe the experiences of women who chose midwives as

The Truth About Omega-3s During Pregnancy

by Robin Jordan, CNM, PhDWhat pregnant woman wouldn’t want to grow a smart baby, one that has every last genetically programmed fully functioning brain cell, is ahead of the preschool pack, becomes the straight-A class president, and attends an Ivy League university?That might be a stretch. But research indicates that women who eat adequate amounts of omega-3 fatty acids—specifically DHA and EPA

ACNM Responds to Lancet Home Birth Editorial

by Holly Powell Kennedy, CNM, PhD, FACNM, FAAN,President, American College of Nurse-MidwivesOn the heels of a disturbing AJOG study on home birth, an editorial released today in The Lancet is fanning the flames of the home birth controversy that has been playing out in the media this summer. This morning I talked with an NPR reporter about ACNM’s take on the editorial. View her blog here, and

Evidence in Action at Midwife Connection

by Melissa Garvey, ACNM Writer and EditorWe’ve been pretty silent at Midwife Connection lately, but this week we’re getting back to normal. Yolanda Landon, our communications manager, is back from maternity leave with baby Kennedy in tow (yes, ACNM has the best mother-friendly, baby-friendly work policies I’ve ever encountered!), and we’re gearing up for the ACNM 55th Annual Meeting scheduled for

Becoming a Critical Reader: Bias, Bias Everywhere!

by Andrea Lythgoe, LCCE (Originally published on Science and Sensibility for Lamaze International)Pretty much everyone would agree that there is bias in research. Most people would say that bias is inherently bad. While it absolutely can be a bad thing, it can’t be completely eliminated. So what can be done about bias in research? There are many kinds of bias: Researcher bias: researcher sets out

Restricting food and drink in labor is not justified

by Amy Romano, CNM (Originally published on Science and Sensibility for Lamaze International)Listen to this great podcast about the new Cochrane review showing that the policy of restricting food and drink in labor is not justified. It’s a nice summary of how and why the research was conducted. In addition, I particularly liked these tidbits: 1. Rather than asking “is eating and drinking in

Are consumers at the bottom of the evidence pyramid?

by Amy Romano, CNM (Originally published on Science and Sensibility for Lamaze International)I have argued (here, here, and here) that strategies that involve increased participation by women and families in maternity care hold major potential for improving our rather dismal maternal and infant health outcomes.A study reported in the current issue of The International Journal of Gynecology &

The “Patient Push” for Early Birth: A Dangerous Concept or Valid Point?

by Melissa Garvey, ACNM Writer and Editor Last summer, ACOG officially revised its recommendations on elective labor induction, raising the “safe” gestational age to induce from 37 to 39 weeks. Now a study in the December 2009 issue of Obstetrics & Gynecology examines women’s perceptions of the definition of full term and the safety of birth at various gestational ages. Long study short, nearly

Cherrypicking stats: bad form and not helpful

by Amy Romano, CNM (Originally published on Science and Sensibility for Lamaze International)Science & Sensibility contributor, Andrea Lythgoe, has a great post up at her own blog. In The Doula Numbers Game, Andrea shows that many of us may be overestimating – and overstating – the beneficial effects of continuous support from doulas. She argues and I agree that using outdated statistics that

The Real Risk of Late Prematurity

A study in the August 2009 issue of Obstetrics and Gynecology shows that late prematurity is an independent risk factor for neonatal morbidity. For those of us who aren’t women’s health experts, that means babies born between 34 and 37 weeks of pregnancy are at greater risk for health problems than babies born on or after week 37. Midwives already know that late prematurity puts babies at risk

Denis Walsh, mommy wars, and coming together On Common Ground

Originally published on Science and Sensibility by Amy Romano, CNM, for Lamaze InternationalLast week, I was thrilled and humbled to be asked to contribute to the On Common Ground collection at RH Reality Check. My assignment was to write a piece from the maternity care perspective that represents common ground for people on opposing sides of the abortion debate. I was asked to help readers who

Mothers of Multiples at Greater Risk for Postpartum Depression

A study in the April 2009 issue of Pediatrics found that mothers of multiples are at a 43% greater risk of having moderate/severe depressive symptoms compared to mothers of singletons. These results were found even after adjusting for demographic and household socioeconomic characteristics and maternal history of mental health problems. Researchers conclude that greater care must be taken to