Tuesday, April 27, 2010

Celebrating VBACs

Can you imagine a Cesarean Section rate of OVER 32%? That's nearly 1/3 of all births!! Now that's just NOT RIGHT!! Yet, that is the most recent rate from preliminary 2008 data from the CDC. Many of those cesareans are because the mother had a cesarean with her first and she was unable to find support to have a VBAC with her second. The VBAC movement (Vaginal Birth After Cesarean) began in earnest in the late 80's-mid 90's. However, recently many hospitals have made it difficult if not impossible for a woman to make that choice. As a result, the CDC has recently convened a conference to address this topic. The summit was convened with expectation that the very best research-based EVIDENCE would be presented to address this "controversial" issue. Data shows about 75% of women who attempt a VBAC will have a vaginal birth and VBACs overall are a reasonable choice for most mothers and babies. ALSO, the experts found that repeat cesareans exposed women to greater risk of death than VBAC and added further risk for future pregnancies including placenta previa and placenta acreta. The conference urged restrictive policies be lifted to support women in their pursuit of a TOL and VBAC. As a practice we welcome this evidence and support for the work we do with VBAC women and their families. We have supported women and their families wanting to attempt a TOL and are heartened with recognition regarding the advisability and researched evidenced from "experts". We have started a VBAC class on the second Monday night of each month, beginning on May 10 from 7 to 9PM. If you are considering or have already chosen a VBAC for your pregnancy, please come join us for this informative and fun class! We will help you outline strategies that will optimize your success!

Friday, April 16, 2010

March for Babies - Time is Running out to donate!!!!!

As March fast approaches, the time for walking to fight prematurity is here again. Every year, in an attempt to raise funds to fight prematurity and birth defects, the March of Dimes hosts March for Babies. The Phoenix, AZ walk is actually April 17th. Bethany Womens Healthcare has a team and we are inviting everyone....and I do mean everyone...to walk, donate, or both with us! Our goal is to raise $1000 for the march of Dimes....will you help?

Click here to go to my homepage to donate or join our team.

My son was born prematurely at 34 weeks after spending a couple weeks in the hospital on magnesium sulfate on and off. While most babies will do fine in the long run at this gestational age, he did not. He experienced bleeding in his brain, which caused permanent brain damage. He is now mildy mentally retarded.

Do you have a story to tell about a child born premature or with birth defects? We would love to share your story on our blog. Email your story to me by clicking on my name then Email and I will post it up.

Wednesday, April 14, 2010

Consistent lactation lowers maternal vascular risk

I recently read that women who have more than 3 children are at increased risk for cardiovascular events such as heart attack and strokes later in life. The research study postulates that this may be related to the changes in the circulatory system brought on by repeated pregnancies. If there ends up being some founding to this then breastfeeding may be a counteractive measure that moms can take...

March 1, 2010

Contemporary OB/GYN

Consistent lactation lowers maternal vascular risk

Breastfeeding may protect mothers against the development of vascular disease, according to a recent study. The new data add to existing data for the long-term health benefits of lactation.

The new finding comes from 297 women, 45 to 58 years old, who were enrolled in an ancillary study to the Study of Women Across the Nation (SWAN), called SWAN-Heart. SWAN is a community-based cohort study of racially diverse women conducted at 7 sites across the United States; SWAN-Heart participants were enrolled only at the Pittsburgh and Chicago sites. Women in SWAN reported at least 1 live birth at enrollment and were free of cardiovascular disease at entry.

Lactation history was assessed at enrollment and was self-reported. It was classified as no lactation, inconsistent lactation (breastfeeding at least 1 child for less than 3 months), and consistent lactation (breastfeeding each child for 3 months or more).

SWAN-Heart participants had subclinical cardiovascular disease measured at baseline by 2 screening tools: electron beam tomography with an ultrafast computed tomography (CT) scanner and B-mode ultrasonography (carotid duplex scanning).

Ultrafast CT provides a measure of calcification; in SWAN-Heart, calcification of the aorta and coronary arteries was assessed. B-mode ultrasonography was used to assess carotid adventitial diameter, carotid intima-media thickness, and carotid plaque.

After adjusting for age, parity, measures of socioeconomic status, and lifestyle and family history, a significant association was observed between aortic and coronary calcification and consistent lactation for 3 months postpartum, reported Eleanor Bimla Schwarz, MD, MS, assistant professor, medicine, and obstetrics, gynecology, and reproductive sciences, University of Pittsburgh, and colleagues.

The odds of aortic calcification was increased by a factor of 3.85, and the odds of coronary artery calcification by 2.78 in the mothers who did not breastfeed compared to the mothers who consistently breastfed. The association between lactation and less aortic calcification persisted after adjusting for body mass index and traditional cardiovascular risk factors. In fact, after adjusting for all potential confounders, the risk of aortic calcification increased by more than 5-fold in the mothers who did not breastfeed compared to those who consistently breastfed.

The authors wrote: "These findings build on previous work that has shown that women who do not breastfeed are at greater risk of clinical cardiovascular disease, by providing insight in to the early effects of lactation on a mother's body."

They speculate that the effects of lactation on prolactin and oxytocin may have positive long-term effects on cardiovascular risk profiles because these hormones have been shown to be associated with blood pressure, preclinical atherosclerosis, and vascular resistance.

Schwarz EB, McClure CK, Tepper PG, et al. Lactation and maternal measures of subclinical cardiovascular disease. Obstet Gynecol. 2010;115(1):41-48.

Bitter Melon Extract May prevent Breast Cancer

Thought this was interesting and wanted to share...

Bitter Melon Extract May Help Prevent Breast Cancer

Study finds extract inhibits signal transduction pathways linked to breast cancer cell growth

Mar 2, 2010

TUESDAY, March 2 (HealthDay News) -- Extract of bitter melon, which is used in folk remedies in Asia and Central America, inhibits the signal transduction pathways associated with breast cancer cell growth and could be used in preventing the disease, according to research published in the March 1 issue of Cancer Research.

Ratna B. Ray, Ph.D., of Saint Louis University, and colleagues discuss their work with bitter melon extract, prepared from raw green Momordica charantia melons, and two breast-cancer cell lines.

The researchers noted greater than 80 percent cell death in both types after treatment with the extract. Treatment also led to a decrease in cell proliferation. Cell apoptosis was associated with greater poly(ADP-ribose) polymerase cleavage and caspase activation. In both types of cells, bitter melon treatment was associated with inhibition of survivin and claspin, which are involved in cell-cycle regulation. Their experiments also showed that treated MCF-7 cells accumulated during the G2-M cell cycle phase.

"Together, these results suggest that bitter melon extract modulates several signal transduction pathways that additively or synergistically induce breast cancer cell death and can be used as a dietary supplement for prevention of breast cancer," the authors conclude.

Tuesday, April 13, 2010

Violence Unsilenced


Push It!

I am sitting here at my husband's bedside and am so thankful, among other things, for a laptop and free WiFi! Phoenix Baptist is a wonderful hospital but I have been told there is no WiFi available. I would really be insane by now (we've been here for 6 days now) with no internet! I am taking advantage of this time (and believe me, I have a LOT of time on my hands at the moment) to do some blogging and catch up on my regular blogs I like to read.

I was over on At Your Cervix when I found a link to this wonderful blog carnival on pushing....a a baby out that is. Amy Romano is hosting this carnival on Science and Sensibility blog. I very much enjoyed the post and think you will too.

The Fifth Healthy Birth Blog Carnival: Push it real good!

Herbal Use in Pregnancy Part II

Continuation of herbal remedies (listed by problem)

  • Perineal Care - postpartum use, calendula or comfrey - make a tea, strain and add to a sitz bath. Vitamin E oil or calndula, comfrey, pilewort, St John's wort, symphytum, hydrastis, and achillea creams or ointments can be topically applied to the perineum. Make comfrey tea and soak sanitary pads in the teat, then freeze and use on perineum.
  • Postpartum Depression - teas of chasteberry, motherwort, nettle, or raspberry leaf. (Encapsulated placenta is supposed to be wonderful in preventing depression - will get an article up at some point about that!)
  • Sleep Problems - take a small bed pillow, open one end, add cloves, mint, and rosemary, and sew up open end.
  • Sore Nipples - wash the nipples with infusions of marigold or comfrey and expose to the air or sunlight. Ointments from calendula, comfrey, plantain, St. John's wort, or yarrow are particulary effective in healing cracked nipples and relieving pain. Wipe breasts prior to feeding baby.
  • Threatened miscarriage - crampbark or black haw bark taken in the form of a cup of the decoction or drops, or a tincture of chasteberry, or raspberry leaf tea
  • Varicose veins and hemorrhoids - tea, capsule, or tonic of blessed thistle. Lotions, compresses, or creams made from comfrey, marshmallow, marigold, plantin, yarow, or hawthorn berries. For hemorrhoids, try pilewort cream combined with an equal quantity of comfrey cream or try echinacea an comfrey teas put into a sitz bath, soak 15-30 minutes.
  • Water retention - dandelion leaf, corn silk, or both used in tea form.

I can't stress enough that seeing a well trained herbalist is the best option for trying herbal remedies. There is an extensive list of herbs that are to be avoided during pregnancy and childbirth so be sure to check with your provider or a skilled herbalist prior to trying ANY herbal remedy.

There are numerous books and websites on herbal medicine, which can be found doing a search on the internet.

Information on herbs in this post and Part I are from Childbirth Education: Practice, Research, and Theory 2nd Edition by Nichols and Humenick.

Sunday, April 11, 2010

Dark Chocolate Is Good For You?!?!

I was sent a suggestion for a blog topic - a yummy one at that - dark chocolate and the health benefits associated. I am a huge chocolate lover - I'm all about anything in support of it being healthy :) So here are some resources I checked out and think you will find helpful and interesting!

This first one is actually from WebMD - it has a lovely slideslow with yummy pictures and some interesting history as well. It discusses chocolate's history as an aphrodisiac and more recently the health benefits.

This article, also from WebMD, discusses how dark chocolate seems to help prevent heart disease. It works by keeping c-reactive protein (CRP) at lower levels. This chemical marker is associated with inflammation which contributes to heart problems.

This article, Health By Chocolate, actually delves more into the type of chocolate you need to get to reap the health benefits.

This article, on chocolate during pregnancy, discusses how dark chocolate used sparingly may help avoid pre-eclampsia!

This is only the beginning of research on dark chocolate. So feel free to head out and grab some chocolate BUT you gotta buy the right kind and it has to be in moderation. No chocolate for every meal of the day ok! Cuz then you will be hearing us lecturing about weight gain!

Sunday, April 4, 2010

Group B Strep Testing in Pregnancy

I was browsing around on the computer, accumulating a little energy prior to starting the Easter dinner, and found this blog post on Group B Strep (GBS) testing at the Arizona Birth Network blog.

I felt like the info offered was very accurate and appropriate. Check it out and feel free to ask any questions you might have! I have on occasion had women decline testing or treatment in the event of a positive result. That's really ok as long as a woman understands the benefits AND the risks of her decision. We each have to determine what our own acceptable risk is for every decision you make in life. This is no different!

Thursday, April 1, 2010

April Support Group Topics and a New Class

Nursing Mothers Group Discussion Topics
April 2010
Wednesday Mornings: 10 AM – Noon

Join us in the Breastfeeding Support Center. Babies and toddlers always welcome. Bring your questions and concerns –
In addition to the discussion topic, we’ll explore answers that work for YOU. This is informal and fun!

April 7 He Can’t Be Hungry – He Just Ate!
Babies nurse for many reasons in addition to food. We’ll discuss normal feeding behaviors in breastfed babies AND how mommies can prepare to cope with the demands this can represent.

April 14 What About Dad?
A Dad’s role in the breastfeeding relationship might seem, well . . . invisible. Surprise! What Dads do for babies is also important, though very different from nursing mothers.

April 21 Ah Choo! Allergies and the Breastfed Baby
Breastfed babies have a reduced incidence of allergies. We’ll discuss the protective effective of breastfeeding.

April 28 Taking Fun Vacations with Breastfed Babies
Traveling with a breastfed baby? Join us for a fun discussion and learn some tips from the experienced travelers in the room. Plan ahead for your own get-a-way!

New Class from the BWHC Breastfeeding Support Center

In response to the NEEDS of nursing mothers who are returning to work, we are offering a new class beginning in April: Employed and Breastfeeding Seminar.

First, the basics:

Breastfeeding Works! is the class that ALL expectant parents should attend to learn about the basics of breastfeeding. This puts new moms ahead of the inevitable learning curve
when their babies are born. It includes information about comfortable positioning and latch, how to know that your baby is getting enough to eat, and basic information for trouble-shooting common breastfeeding challenges. You don't have to go it alone!

If you are returning to work, the Employed and Breastfeeding Seminar, is designed for you:

· from 7 to 8 PM, usually on the 3rd Monday of the month
· Call 602-973-3200 to register
· Dads/one support person are welcome and encouraged to attend
· The fee includes attendance for you and your husband, partner or a support person
· Babies and toddlers are welcome – you DON’T need a babysitter
· All class materials are provided, and space is limited.

After reviewing the critical importance of breastfeeding and how the breast makes milk, the evening will focus on:

· how to prioritize so that you can build an ample milk supply early on
· how to add a pumping routine to your life so that you have some milk stored before your return to work or school
· tips to make the transition back to work a little bit easier
· how to negotiate with your employer for a time and place to express your milk
· options to consider if reality is not ideal
· what to do if breastfeeding challenges arise
· information about pumps -- including how breast pumps work and what type of pump is appropriate for your situation
· how to manage the adjustments as you balance your return to work or school

Payment is made when you arrive at 6:45 p.m. the day of your class
· Fee: $10.00
· We accept cash, MasterCard, Visa, and checks payable to Bethany Womens Healthcare

I'm so proud of the many remarkable mothers in our practice who have overcome common challenges when they began breastfeeding. And, then they have adjusted to the return to work AND continued breastfeeding. It just proves that with a good plan, there is NOTHING a woman cannot do!

Sharon Olson, BS, IBCLC


Our blog was listed on a couple sites and wanted to say 'thanks'!

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