With a Side of Fava Beans

November 27, 2010

I hope you’ve had a great Thanksgiving and that the following will not entirely ruin your appetite for leftovers.

Yes, I know moms who have eaten their placentas, and recommendations about doing this have been flying around my mom support board lately.  For a few hundred bucks, Sara Pereira, a licensed massage therapist who has been featured in Time Magazine, will come over to your house, cut up, dry out, and encapsulate your placenta, so you can ingest it.

Read the rest of this entry »


FAQ: Episode 29 – Dr. Amy Tuteur

September 29, 2010

These were facts in The Business of Being Born press release. I asked Dr. Amy Tuteur in our interview for Podcast Beyond Belief to address these claims…

Is it true that the United States has the second worst newborn death rate in the world?

It’s not true, and this is one of the things that has been used to confuse people and things have been said in a very misleading way. First of all, typically what people refer to when they talk about the US’s poor position is “infant mortality rate”.  Now, infant mortality rate refers to deaths that are birth to one year. That’s a measure of pediatric care. It’s not a measure of obstetric care. According to the World Health Organization, the best measure of obstetric care is perinatal mortality, which is stillbirth plus deaths during labor, and up to 28 days of life. In fact, the Unites States has one of the best perinatal mortality rates in the world. The World Health Organization in their 2006 report shows that it has a lower perinatal mortality rate than Denmark, the United Kingdom, and even The Netherlands, which is the place where they have more home births than anywhere. So, it’s an incredibly misleading statement, and when it comes to obstetric care, the Unites States does very very well.

Is it true that obstetricians rarely see natural births?

Ha! That’s a bunch of baloney too. You know, not everybody is a white American middle class woman. This is the way these people imagine all the people in the hospital are.  The fact is that if you work in any large hospital you see women from other cultures who have different ideas of how birth should be conducted. You see many women who come in late in labor, way too late to get an epidural. I’ve delivered women in the emergency room. Many of my colleagues have delivered in the parking lot. We see plenty of unmedicated births, and some of us, myself included, have had unmedicated births. So, it’s just a bunch of baloney that obstetricians don’t know what an unmedicated birth looks like.

Why is it that the five countries with the lowest rates of infant mortality also have very high rates of midwifery?

First of all, infant mortality is the wrong statistic, but there’s another thing too that they don’t point out. Unfortunately, race is a risk factor for perinatal mortality. Women of African descent have higher rates of premature labor, higher rates of pregnancy complications, and higher rates of perinatal mortality, and that occurs regardless of what country they give birth in. And it actually persists even in women of African descent who are of higher education and higher income levels; they have a much higher rate of problems compared to their economic cohort of other races. The fact of the matter is the countries with the best perinatal morality rates are the whitest countries. If you correct for race, you get a very different picture. The Unites States is the first world country with the largest population of women of African descent, and that has a big impact on our statistics.

Is it true that the WHO reported that the leading cause of maternal death in developed countries is c-section surgery?

No, that is completely not true. There have been a number of studies that have claimed that c-sections increases the rate of maternal deaths. Maternal deaths are very rare. The average person is not at risk for that, and women who die in pregnancy or in childbirth tend to have lots of risk factors. They usually have a serious pregnancy complications, they have eclampsia or preeclampsia, they have preexisting medical problems, they’re very sick to begin with. Generally, as part of treating them, they have a c-section either because the delivery needs to be expedited or they have a heart condition because they can’t withstand the strain of labor. Those are women who are more likely to die, not because they  had the c-section, but because they were at high risk to begin with.


in which I muse on babies, birth, and chocolate

November 7, 2009

We’re having a bit of a kerfuffle in the comments right now, concerning the question of home birth v. hospital birth. And I have to tell you, it’s another time in my life when I realize how amazingly lucky I am to be married to Grrl, and not to any number of previous wives or girlfriends who lack her basic good sense.

When we were preparing to have our first child, there was no debate about a hospital birth. There was no agonizing about the joys and wonders of childbirth. Grrl–rightly in my mind–saw childbirth as a job she had to do, the focus of the job being a healthy, safe baby. Nothing else was particularly interesting to her.

In direct contrast to the picture being painted by the pro-home birth advocates on this site and others, the establishment actually tried to persuade her the other way. The dangers of an epidural were duly explained. The joys of a “natural” childbirth were extolled in our preparatory classes. To all of this, the Grrl simply raised her chin and stuck with her birth plan, as worked out between her and her OB.

The birthing room was quite nice, the bed extremely comfortable, the nurses very pleasant and affable. I had a wifi connection and a bench to sleep on, she was constantly monitored for any signs of danger, helped up if she needed or wanted to walk. We were never treated in any way that was not pleasant and accommodating and respectful.

In other words, the nightmare scenario that some home-birth advocates project, where women are–apparently–strapped down to beds and force fed drugs before being C-sectioned for no reason, is not an accurate portrayal of modern medicine at a decent hospital.

It helps that Grrl works in the NICU (Neonatal Intensive Care Unit). She knows the kinds of things that can go wrong in a birth. She knows what can happen to a baby during a trip to a hospital, how a baby that should be fine can end up on life support, fighting lung infections in it’s first week of life. She swims in that sea.

So there was never any question of where we would be having the baby. Home birth, birthing center… these options were simply ignored. She stayed a focused, dedicated, and fierce advocate for her children.

Grrl worries, now, whether she should have gone natural. She has occasionally admitted to a tinge of regret that she was so businesslike about the whole matter. But we only have the opportunity to have that conversation, and worry about that sort of trivial detail, because we have two beautiful, healthy children. It is a luxury to be able to worry our heads about “fulfillment” or whatever, because the job of bringing the babies into the world is done.

It’s not like we could possibly love them more than we already do!


Flu Vaccine and Pregnancy – Have no fear

October 31, 2009

http://www.losthatch.com/images%5Cscreen_captures%5CS2E15_Ethan_Doctors_Claire.jpg

Four new studies are confirming what I’ve already said. The flu vaccine is safe for pregnant women (who account for 6% of all H1N1 flu deaths) and the little fetuses living within them.

Not only are pregnant women safe from harm, but there’s even been some noted benefits for their babies. Three of the studies show that pregnant women who vaccinated were 80% less likely to have premature babies, 70% less likely to have small babies for their gestational age during flu season, and 80% less likely to have babies who were hospitalized with flu. The fourth study shows that the flu vaccine is even safe during the third trimester.

There has not been one study that has shown any maternal or fetal complications from the inactivated flu vaccine.

The news was announced during a news conference for the annual meeting for the International Disease Society of America.

 


This Week in Parenting Science 4/17/09

April 17, 2009

It’s been a few good months since I posted updates on scientific studies relevant to parents.  I’ve been pretty busy with my new play that I’ve been directing.  It opens this weekend.

Exercising While Pregnant – My wife refused to give up her running routine when she was pregnant.  She studied up to determine how much she could run without harming the baby, and she made the appropriate adjustments.  Imagine the looks she got when she showed up to a 5K at seven months pregnant.  Well, according to a new study by the Kansas City University of Medicine and Biosciences, pregnant moms might have healthier babies if they hop on a treadmill every now and then.  Researchers detected more mature nervous systems and better fetal breathing in the babies of mothers who exercised compared to those of mothers who didn’t.

Home Birth Better? - It’s been debated before, most recently on an episode of The Doctors, but another study has shown that a low risk home birth is just as safe as those that are done in a hospital.  The dutch study looked at data from half a million low risk births to compare the relative safety between births at home and births at the hospital.  On the merits of the data, it seems that both choices are equally valid.

Of course, hospitals should be the default choice whenever there are high risks such as a breached baby, a need for induction, or known abnormalities.  I also condemn the choice of home birth based on an irrational fear of modern medicine.

Bright Bilingual Babies? – Good grief.  How does a bilingual household have any effect on 7 month old babies.  They can’t even talk yet.  You have to determine their intelligence with movements of the eye.  Despite my incredulity, one study claims that they’ve discovered eye-tracking difference in babies who are raised in bilingual households.

Why not choose children who are talking?  What sort of logic inspires a scientist to even hypothesize that any information gathered from non-verbal babies can be linked to the languages spoken by their families?  It doesn’t make sense, but if you want to use Spanish and French flash cards on your baby, then be my guest.


Pregnancy News

November 14, 2008

If you are trying to get pregnantstay away from acupuncture.  Once again, quality placebo-controlled science disproves another claim of acupuncture.  This time the study, published in the journal Human Reproduction, showed that IVF was more successful under placebo acupuncture than actual acupuncture.  Sound familiar?  That’s because this study confirms another meta-analysis study that demonstrated the same thing.  Unbelievably, Dr. Ng, who conducted this new study, is actually saying that placebo acupuncture is better because it’s using acupressure (turning acupuncture into something that is now unfalsifiable), and he still clings to his belief that needling works for IVF, despite his own observations.  Why is it that every time an acupuncture study successfully proves acupuncture, the experiment was not blind or controlled, but when an acupuncture study disproves acupuncture, it is a well conducted double-blind placebo-controlled study?  And why is it that acupuncturists will still claim to help IVF when it has been proven wrong twice now?

If you are pregnantdon’t be afraid to have an occasional beer or glass of wine.  In fact, careful imbibing may make your kids smarter, or so says a London study that noticed better behavior and better vocabulary scores among children with mothers who admitted to having the occasional drink during pregnancy.  I’m sure that this was not the result the scientists expected to find, but if anything, it corrects a long-standing myth that alcohol is off-limits for pregnant moms.  The only time that pregnant women should completely abstain from the wet bar is during the first trimester, but after that, it is fine to have a glass of champagne at a cocktail party without being chastised.

If you are giving birthtry listening to some classic music or lullabies.   Recent studies show that relaxing music actually significantly reduces stress levels.  This one seems like a no-brainer to me, but maybe some moms will need that extra reassurance that Enya is the best choice for their labor & delivery mixtape.  And pregger moms, while you are at it, another study shows that you may want to listen to joyful music to increase your blood flow.  So, may I recommend Vivaldi or something equally joyful?


Dr. Phil & ‘The Doctors’ Vs. Home Birth

September 18, 2008

Dr. Phil must have an agenda against mothers who choose to do home birth.  First, he solicits submissions from mothers who regret their home birth, and then his spin-off program ‘The Doctors‘ presents an unfair, inaccurate, and biased pro-hospital argument to a couple considering home birth.

Regular readers will know that my wife chose to do a drug-free “natural” birth.  I specifically requested that the birth be done at a hospital because I didn’t want to take any chances.  I think everyone can agree that the instinctual concern about the health and safety of mother and child is normal, but just because I had worries about birthing at home doesn’t mean I had all the facts.  Licensed midwives are trained to take care of serious situations, they know when a birth requires medical attention, and they are professionals.  But, you wouldn’t know that it if you relied on the bad facts from the CBS hit piece “The Doctors”.

Read a midwife’s detailed response to the “home birth” episode of “The Doctors” here.  She does a great job disputing their bad information and obvious biased propaganda.  If anyone would like to challenge the corrections provided by this midwife, I will happy to host the debate.  I’m not an expert or scholar on home vs. hospital birth, but I can see that CBS did not present a balanced view on the subject.  I understand that sticking up for home birth is not the skeptical thing to do, but I also think that skeptics should defend truthful arguments, whether they fit modern traditions or not.  I welcome true balance on this divisive issue; if any doctors or scientists have an informed opinion, please let us know in the comments section.


Vaginal Birth Vs. C-Section: The Interview!

September 13, 2008

As promised, I sent James E. Swain some questions about his study comparing the MRI scans of mothers who delivered vaginally to mothers who delivered by c-section.  The results of the study seemed to show that only the mothers who delivered vaginally had bonding signals light up when hearing a recording of their baby cry.

Dr. Swain’s unedited answers to my questions are below:

Was it documented which mothers breast fed, and did such a factor make a difference in the statistics?

For this study, we chose mothers who all were breastfeeding. However, we have looked at breast- vs. formula-feeding mothers as a way to get at altered oxytocin levels and there are differences in brain responses to baby stimuli. We have a manuscript in preparation.

Did any of the mother’s have postpartum depression?  How did that effect the data?

The mothers in our study were all well with no personal or family history of mental health diagnoses and none of them developed postpartum depression. We are beginning to study mothers at risk for postpartum depression or actually suffering peripartum mental health problems toward developing tests for early detection and optimal treatment of peripartum health problems.

Did all the mothers who delivered a vaginal birth use an epidural?  Did any of them go through labor and delivery without drugs?

For this first study we took all subjects, so some of our subjects took pain medications and others did not. We hope to control this variable in future studies.

What specific areas of the brain were being looked at in the MRI scans?

We looked at the entire brain. Specific areas of relatively higher responsiveness to baby cry in vaginal compared to cesarean delivering mothers are listed in the paper and broadly described in the press release.

How can any we attach any significance to data from such a small sample size?  Why did you choose to make it so small?  Will you be planning on expanding the study?

The number of subjects was not by choice. Of course we would rather have larger sample sizes, but this is limited by time and money. When the request for papers in this area from the journal was posted, we responded with the numbers that we had. However, the number did satisfy statistical testing and many studies in cognitive neuroscience with brain imaging are currently being published with simlar numbers. This is partly possible because we measure brain activity in each subject many times (rather than just asking a question for example). We are working on larger sample sizes, and populations at risk for depression. These experiments are expensive and it is challenging to recruit subjects willing to participate in the early postpartum. Hopefully the attention that this paper is receiving will help us raise funds to replicate our results with better controls and hopefully develop intervention trials to improve the postpartum for all.

Do you think that women who show bonding signals in their brain have an advantage over those who don’t?

It’s hard to say at this point. It may be that our statistically significant results are not clinically significant – especially for healthy mothers. I suspect that some mothers are at risk for peripartum mental health problems and that brain imaging may be able to detect such risks and that some interventions – perhaps some straightforward support and cognitive psychotherapy may be abe to head off many problems

How do you explain the disparity between the self-reported feelings of the c-section mothers and the lack of corresponding areas of brain stimulation?

The brain has many different areas and I would not expect all areas of response to vary with delivery mode. For instance, brain areas related to attention may not be affected.

Reports of this study often bring up oxytocin as a possible bonding chemical missing in the c-section group of mothers.  Do you have any other alternate theories that don’t involve oxytocin?

The difference in mode of delivery are multifaceted from family, culture, personal factors as well as the biological mechanisms that may involve oxytocin. All are worthy of study and may be means of understanding as well as targets of therapy.

Thanks to Dr. Swain for taking the time out of his busy schedule to discuss this issue.  Best of luck to him on continuing this area of research!  Attached below is the press release that he added to the bottom of his message.  I reprint it here to clear up any confusion that any readers may have about the way the mainstream media and I have interpreted the study.

Natural Childbirth Makes Mothers More Responsive to Own Baby-Cry

Research news from The Journal of Child Psychology and Psychiatry

A new study has found that mothers who delivered vaginally compared to caesarean section delivery (CSD) were significantly more responsive to the cry of their own baby, identified through MRI brain scans two to four weeks after delivery.

The results of the study, to be published today in The Journal of Child Psychology and Psychiatry, suggest that vaginal delivery (VD) mothers are more sensitive to own baby-cry in the regions of the brain that are believed to regulate emotions, motivation and habitual behaviours.

CSD is a surgical procedure, in which delivery occurs via incisions in the abdominal and uterine wall. It is considered necessary under some conditions to protect the health or survival of infant or mother, but it is controversially linked with postpartum depression.  In the US the occurrence of CSD has increased steeply from 4.5% of all deliveries in 1965 to a recent high in 2006 of 29.1%.

The critical capacity of adults to develop the thoughts and behaviours needed for parents to care successfully for their newborn infants is supported by specific brain circuits and a range of hormones.  The experience of childbirth by VD compared with CSD uniquely involves the pulsatile release of oxytocin from the posterior pituitary, uterine contractions and vagino-cervical stimulation.  Oxytocin is a key mediator of maternal behaviour in animals.

“We wondered which brain areas would be less active in parents who delivered by caesarean section, given that this mode of delivery has been associated with decreased maternal behaviours in animal models, and a trend for increased postpartum depression in humans,” said lead author Dr. James Swain, Child Study Centre, Yale University. “Our results support the theory that variations in delivery conditions such as with caesarean section, which alters the neurohormonal experiences of childbirth, might decrease the responsiveness of the human maternal brain in the early postpartum.”

The researchers also looked into the brain areas affected by delivery conditions and found relationships between brain activity and measures of mood suggesting that some of the same brain regions may help regulate postpartum mood.

“As more women opt to wait until they are older to have children, and by association be more likely to have a caesarean section delivery, these results are important because they could provide better understanding of the basic neurophysiology and psychology of parent-infant attachment,” said Swain.  “This work could lead to early detection of families at risk for postpartum depression and attachment problems and form a model for testing interventions.”

________________________________________________________________

This study is published in the October 2008 issue of The Journal of Child Psychology and Psychiatry. Media wishing to receive a PDF of this article may contact wbnewseurope@wiley.com

Full citation: Swain JE, Tasgin E, Mayes LC, Feldman R, Constable RT, Leckman JF; Maternal Brain Response to Own Baby Cry is Affected by Cesarean Section Delivery; The Journal of Child Psychology and Psychiatry; 49(10); DOI: 10.1111/j.1469-7610.2008.01963.x

About the author: Dr. James Swain MD, PhD is based at the Child Study Centre at Yale University.  Dr. Swain has been working in this field for 5 years and is among the first to do brain imaging of parents using baby-stimuli. His background includes a basic neuroscience PhD, MD training and subsequent psychiatry and child psychiatry specialty training before beginning this work.  To arrange an interview, please contact the Office of Public Affairs at Yale University on 001-203-432-1345 / oropa[at]yale.ac.edu or contact Dr. Swain directly on 001-203-785-6973 / james.swain[at]yale.edu.

About the journal: The Journal of Child Psychology and Psychiatry, published by Wiley-Blackwell on behalf of the Association for Child and Adolescent Mental Health, is internationally recognised to be the leading journal covering both child and adolescent psychology and psychiatry.  Articles published include experimental and developmental studies, especially those relating to developmental psychopathology and the developmental disorders.  An important function of the Journal is to bring together empirical research, clinical studies and reviews of high quality arising from different points of view. The Journal of Child Psychology and Psychiatry can be accessed online at: www.blackwellpublishing.com/jcpp

About The Association for Child and Adolescent Mental Health: The Association is a learned Society managed by an elected Council within a Constitution accepted by the membership. The Objects of the Association are the scientific study of all matters concerning the mental health and development of children through the medium of meetings and the establishment of The Journal of Child Psychology and Psychiatry, Child and Adolescent Mental Health, and the ACAMH Occasional Papers series, in which scientific matters can be discussed, and clinical findings, research projects and results can be published. The Association is multi-disciplinary in nature, and exists to further child psychology and psychiatry. Membership of the Association does not confer professional status on any individual. For further information, please visit www.acamh.org.uk/


Vaginal Births: A True Bonding Experience?

September 5, 2008

The verdict is in – mothers who elect to do c-sections don’t love their children.

Hooray for vaginal births!!!

OK, now that I’ve completely ruined my reputation as a respectable blogger, let me get to the actual science (and the truth).  A recent study of 12 new mothers indicates that women who give birth vaginally react to a crying baby with more concern and empathy; or at the least, the emotional areas of their brains light up on an MRI scanner when they hear a recording of their baby crying.

This is an extremely small study with six moms who gave birth naturally and six who had c-sections for “convenience” reasons.  There are a lot of possible reasons for the results, including random chance.  There’s also the possibility that mothers who opt to schedule abdominal surgery out of convenience have a strong-willed personality and a good grip on their emotions.

Also, it has been generously pointed out by several scientists that an MRI scan is not something that can be translated perfectly.  Nobody doubts that these women who chose their c-section actually love and care for their children.  Researchers hypothesize that the reason for the disparity in the two groups of new moms may come down to a lack of oxytocin.  It’s well known that the pushing of vaginal birth, as well as breastfeeding, releases oxytocin and floods new mothers with strong emotional and protective feelings.  That’s why new Moms can power through sleepless nights and still love their kids in the morning, and probably why Dads like myself can sleep through the night without waking once.  Not that I did that!!!

This is one study that deserves follow up.  I’ll try to contact the original researchers for an interview.  You can check out some of my previous interviews in the category links to the right.


Palin Admits to Bristol’s Pregnancy… not to Rumors

September 1, 2008

In a stunning twist of events, Sarah Palin has come forward to announce that her 17 year old daughter Bristol is actually five months pregnant.

What a huge coincidence!

The gossip hit full steam yesterday that Bristol was the actual Mom of Sarah Palin’s four month old child Trig Paxton Van Palin.  When in actuality, it appears that Bristol IS pregnant with her own child.  Damn.  That would have made for an excellent scandal if the rumors had been proven true.  It turns out that today’s news is not nearly as scandalous as the potential news of a VP candidate faking a pregnancy while she was a sitting governor.

How fortunate!

The McCain campaign made sure to trash liberal blogs for dredging up the story, though Daily Kos, to whom I linked in my last post, never supported the anonymous diary entry and never linked to it on their main page.  The scandal of having to address liberal mud slinging and slander has allowed the Republicans some wiggle room to evade the potential scandals that would have come from family values voters.  By pointing to the anonymous “smears”, they are escaping the embarrassment that comes from a conservative VP Mom having an underage teen pregnant and ready for a shotgun wedding.

Whew!  Lucky them!

With all this attention on the weekend’s rumors, I’m wondering whether the press will focus on the one unsettling fact from Pregnancy-Gate that might disturb any voter.  How is it that Sarah Palin felt comfortable giving a speech, flying home eight hours (or more) to Alaska, and driving to a rural hospital when she was eight months pregnant with a special needs child and leaking amniotic fluid the entire time?  Do you think that the Mainstream Media will pick up on that aspect of the gossip?

What are the odds?


Follow

Get every new post delivered to your Inbox.

Join 36 other followers