Re: OB: Home births - keeping it normal - low section rates
From: Anna Meenan, MD (annam@uic.edu)
Thu Nov 17 23:15:03 2005
Can I come practice with you, Gail?
--
Anna Meenan, MD
At Thu, 17 Nov 2005, GA12L@aol.com wrote:
>
>In a message dated 17/11/2005 18:29:26 GMT Standard Time,
>ajfields@pine-net.com writes:
>
>It's next to
>impossible to give birth in a hospital without continuous EFM, which
>makes labor absolutely miserable for a lot of women.
>
>That's why section rates are high. We stopped doing routine admission
>traces over here and our section rate dropped without compromising the mum or her
>baby.
>
>These are some of the things I have learned that have contributed to low c/s
>rates.
>
>1. The safest place to give birth is where there is least intervention, i.e.
>home or birth centre.
>
>2. Keep the woman upright and mobile.
>
>3. Do NOT encourage a woman to push until she has an urge to push. It will
>exhaust her.
>
>4. Do NOT ask her to breath hold during second stage it is dangerous. It
>cuts off oxygen to the fetus and to the uterus. No oxygen to the uterus and it
>stops contracting as it is muscle and all muscles need oxygen to work properly.
>
>5. No arbitrary time limits on second stage. Research done in the US shows
>there is no deleterious outcomes whether 2nd stage is 1, 2 or 3 hours long.
>
>6. Recognise the latent phase of second stage. It is a phenomenon that
>occurs in a lot of labours. The contractions will come back.
>
>7. Encourage the woman to eat and drink what she wants when she wants. An
>engine won't work without fuel!
>
>8. Do NOT do continuous EFM on low risk women, it will lead to intervention.
>
>9. Do not rupture membranes unless clinically indicated. Amniotic fluid is
>there for a reason. Most of the woman I care for rupture their membranes just
>before they give birth and many babies are born with them still intact (looks
>very strange).
>
>10. Empower the woman, give her the confidence and support to labour without
>an epidural. Recent work over here shows that epidurals lead to
>instrumentals and sections.
>
>11. Use birthing balls, birthing pools, massage and aromatherapy to help her
>cope.
>
>Of course I practise in a culture of no blame and therefore feel confident
>practising in this way. Because I know the normal inside out I know
>immediately that something is not going as it should and am glad of a good OB to refer
>to.
>
>Gail
