Monday, March 20, 2017

Big Steps to Limit Interventions for Low-Risk Pregnancy


RYANJLANE VIA GETTY IMAGES
The American College of Obstetricians & Gynecologists (ACOG) recently issued Committee Opinion: Approaches to Limit Intervention During Labor and Birth. The opinion addresses many "hands off" practices that doulas have long promoted in pursuit of satisfying labors and healthy birth outcomes for mothers and babies.  While publication of these guidelines doesn't mean every health provider will automatically adopt them, it does offer pregnant persons a frame of reference when talking to their obstetrician or midwife.

The opinion affirms the benefit of continuous support (doulas!) and reasonable alternatives to common "intervention" practices like:

-Automatic hospital admission for prelabor rupture of membranes
-Management of early labor
-Continuous fetal monitoring
-Routine amniotomy (breaking bag of waters)
-Eating and drinking in labor
And more......

Check out this DONA summary for easy reading and be informed!   

Monday, January 16, 2017

"Looks like your baby might be big"

This comment, so often heard by mothers approaching their due date, is NOT itself a sufficient reason to plan a surgical birth. And the message it sends can often undermine a mother's confidence. Be prepared, be informed. "When a Big Baby Isn't So Big"



Tuesday, November 15, 2016


So this is something we need to talk about more - our mental health and well-being after our births. We've all heard of the baby blues, but sometimes those feelings can be a bit more. And it's much more common than you may think! Did you know that up 1-7 women will experience some mental health disturbance in her childbirthing year? And that symptoms can occur in any period for up to a year after birth? Depression, anxiety, intrusive thoughts, obsessive compulsive disorder (OCD) are all some of the common mood disorders that many new mothers suffer in silence, fear and shame, afraid to reach out for help. But there is help!! The good news is that these conditions are so very treatable. 
There is no reason to suffer. And you are not alone. 

For more information, please visit

Friday, September 23, 2016

Even ACOG Says....

I'm not a huge fan of ACOG (American Congress of Obstetricians and Gynecologists). My personal ambivalence has to do with the potential conflicts of interest in their own vision statement: to serve women's health (advocacy, practice & research) and to serve their own members. Unfortunately,  these intentions sometimes travel in opposite directions!  Nonetheless, it's interesting to review ACOG recommendations. It seems to take a long time for ACOG recommendations to reflect the evidence, and then even longer to put them into practice. How about your provider? Is she or he trying to keep up with evidence based practices? Click HERE for some better-late-then-never recommendations regarding inductions, ultrasounds and more. Be informed.

If you appreciate and value this sort of information and would like to evaluate the evidence for yourself, please visit Rebecca Dekker's excellent site, Evidence Based Birth!!

Sunday, July 10, 2016

Cesarean Rates in Erie, PA continue to be excessive.

A review of CesareanRates.com* for data from our local hospitals shows the following for 2012:

Millcreek Community Hospital 34.35%
Saint Vincent Medical Center  31.34%
UPMC Hamot Women's Hospital  38.68%

23.9% or less is the target rate for PA, USA, Healthy People 2020

The PA State Department of Health has published a report of preliminary data for 2013. There is very little change in the local rates. Lag time for reporting is about 1.5 yrs, so data for 2014 should be made public in early fall of 2016. I called each hospital listed above to inquire if they would voluntarily share their most recent rates. Only Saint Vincent shared information - by phone, undocumented - and stated that their 2015 cearean rate was 30%. This is the best of all our local hospitals and is moving in the right direction, but there is still a long, long way to go. Be informed, be prepared. - Michelle

*About the site:
CesareanRates.com launched February 9, 2012, as a snapshot of online cesarean rate reporting in the United States. Most recently updated in January 2015, the site compiles the most current hospital-level data accessible to the public online, whether reported directly by a state’s department of health or gathered from state hospital association web sites via pull-down menus.
The initial goals of the site were to a) show the quality and inaccessibility of information available to the public, b) to assess whether there is public demand for this information and c) to work toward establishing a precedent for hospital data transparency.