Consumer First, Patient Second

One of our BBN members passed along this article, which talks about why it's important to find the right doctor for your birth. My experience in urban India is that women and couples have to do a great amount of self-advocacy in order to get accurate information, assert their birth preferences (assuming there are some!), and have some amount of control over their delivery. This is a crucial exercise for having a satisfying birth experience.

Here's an excerpt from the article, which speaks to what we in the Bangalore Birth Network have been discussing for awhile now:

If [physicians'] parameters of care include routine epidurals, episiotomies for all their patients, routines IVs, etc. then that is their place of comfort in giving care. If you don’t want any of those things, you’d be much better off finding a different physician than trying to convert this one to your way of thinking, because you’re asking them to take themselves out of their comfort zone to care for you. It’s important that as consumers of healthcare, women understand the pressures that come to bear upon care providers.

Click here to read the entire article.

Exercise During Pregnancy Benefits Babies

If anyone - your doctor, your mother-in-law, etc - tells you that it's not good to exercise while pregnant, think again! A new study found that moderate exercise - that is, moderate intensity aerobic exercise for 30 minutes, at least three times a week - has cardiovascular benefits for the baby as well as for the mother. Read more about it here.

Delayed Cord Cutting Benefits Babies

In most hospital settings, doctors routinely clamp the umbilical cord as soon as the baby is born, cutting off blood and oxygen flow from the placenta to the baby. However, waiting until the cord has stopped pulsating (just a few minutes) allows the baby to get his or her maximum blood flow and iron stores, and makes the placenta less bulky and thus easier to detach from the uterine wall.

A new study out of Canada, recently published in the Journal of the American Medical Association, challenges the common practice of immediate cord cutting. Read more about it here.

Dais in India, and I'd guess other Traditional Birth Attendants around the world, are quite puzzled and sometimes even appalled at immediate cord cutting. Here's an excerpt from Hearing Dais' Voices, a publication by Matrika:

"The practice of not cutting the cord until the placenta is delivered is common in all the areas we have studied. Doctors, health workers and anthropological literature report the custom throughout the country. Dais have the utmost respect for these parts of the female body usually considered as waste products by the bio-medical system or highly polluting by the Brahmanic religious texts. Dais consider the infant-cord-placenta as a package. They have been together for nine months with cord and placenta functioning to nurture the fetus -- why should they be severed too quickly? The placenta is considered 'another mother' to the baby. Sometimes this afterbirth is buried with rituals and prayers for the well being of the infant. It is believed that how the placenta-cord-sac is handled influences the child's health in later life."

IMBCI

The International MotherBaby Childbirth Organization (IMBCO) has just come out with their International MotherBaby Childbirth Initiatve (IMBCI): 10 Steps to Optimal Maternity Services Worldwide. It's based on the results of a survey of birth and breastfeeding organizations in 163 countries and on input from IMBCO's Technical Advisory Group, international representatives, and from birth experts all over the world who participated in its construction.

It would be great if the Bangalore Birth Network could use this in our advocacy work and to help hospitals improve their maternity care.

Step 1: Treat every woman with respect and dignity.

Step 2: Possess and routinely apply midwifery knowledge and skills that optimize the normal physiology of birth and breastfeeding.

Step 3: Inform the mother of the benefits of continuous support during labour and birth, and affirm her right to receive such support from companions of her choice.

Step 4: Provide drug-free comfort and pain relief methods during labour, explaining their benefits for facilitating normal birth and avoiding unnecessary harm.

Step 5: Provide evidence-based practices proven to be beneficial.

Step 6: Avoid potentially harmful procedures and practices that have no scientific support for routine or frequent use in normal labour and birth.

Step 7: Implement measures that enhance wellness and prevent illness and emergencies.

Step 8: Provide access to evidence-based skilled emergency treatment.

Step 9: Provide a continuum of collaborative care with all relevant health care providers, institutions and organizations.

Step 10: Strive to achieve the BFHI 10 Steps to Successful Breastfeeding.