Friday, November 15th, 2013
An Argentine car mechanic has developed a device to help deliver babies who are trapped inside the birth canal–and the World Health Organization has taken notice and endorsed the product, and an American medical technology company has licensed it for production. More from The New York Times:
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Mr. [Jorge] Odón, 59, an Argentine car mechanic, built his first prototype in his kitchen, using a glass jar for a womb, his daughter’s doll for the trapped baby, and a fabric bag and sleeve sewn by his wife as his lifesaving device.
Unlikely as it seems, the idea that took shape on his counter has won the enthusiastic endorsement of the World Health Organization and major donors, and an American medical technology company has just licensed it for production.
With the Odón Device, an attendant slips a plastic bag inside a lubricated plastic sleeve around the head, inflates it to grip the head and pulls the bag until the baby emerges.
Doctors say it has enormous potential to save babies in poor countries, and perhaps to reduce cesarean section births in rich ones.
“This is very exciting,” said Dr. Mario Merialdi, the W.H.O.’s chief coordinator for improving maternal and perinatal health and an early champion of the Odón Device. “This critical moment of life is one in which there’s been very little advancement for years.”
Friday, October 4th, 2013
A large new study of twin births in the U.S. has concluded that most are safe without requiring mothers to have Cesarean sections. More on the study from NBC News:
Studies increasingly are challenging long-held beliefs about Caesareans, such as that women who had one need to deliver future babies the same way.
Now doctors are looking hard at C-sections for twin births, which are on the rise because of infertility treatments. Twins have more risk for birth complications and some studies suggest C-sections lower that risk, but this had not been put to a rigorous test.
Dr. Jon Barrett of Sunnybrook Health Sciences Center in Toronto, led a study in 25 countries of 2,800 women pregnant with twins. All of the first of the twins to be delivered were in good position for birth (most doctors still recommend a C-section if the first twin is in feet-first or breech position).
Half of the moms were scheduled to have C-sections and the rest, vaginal births. About 40 percent of the latter group wound up having C-sections, and 10 percent of those scheduled to have Caesareans ended up giving birth vaginally.
About 2 percent of newborns died or had a serious problem, but the manner of birth made no difference. Nor did it affect the rate of complications in moms.
The Canadian Institutes of Health Research paid for the study. Results are in Thursday’s New England Journal of Medicine.
Image: Twin babies, via Shutterstock
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Tuesday, September 24th, 2013
Over the past 15 years, the cost of delivering a baby vaginally in a hospital has more than doubled, and the cost of Cesarean sections–which have also increased in frequency–have skyrocketed by 70 percent during that period. More from NBC.com:
Over the last 15 years, the cost of vaginal deliveries has practically doubled in the United States, shooting up from $4,918 to $9,294, while the cost of C-sections has increased 70 percent from an average of $8,268 to $14,055, according to Truven Health Analytics.
By contrast, the average cost for an uncomplicated vaginal delivery last year in Switzerland was $4,039 and the average cost in France was $3,541, according to the International Federation of Health Plans (IFHP). That’s nearly half to a third of what it cost in the U.S.
In fact, the United States is the most expensive place in the world to give birth, according to the IFHP. The reason, experts say, has to do with the way hospitals calculate our bills.
“Every time you walk into the hospital, they look at everything that happens to you and say, ‘Can I bill for that?’” explained Gerard Anderson, director of the Johns Hopkins Center for Hospital Finance and Management.
“So, if you get an aspirin, they’re going to bill for that. If you get seen by a specialist, they’re going to bill for that.”
Even when families do have insurance, their portion of the bill can be staggering.
Image: Pregnant woman in the hospital, via Shutterstock
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Thursday, September 19th, 2013
A new study published in the American Journal of Obstetrics and Gynecology has found that women who give birth at home are 10 times more likely to have stillbirths; first-born children who are delivered at home are 14 times more likely to be stillborn. More from ABC News:
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In the largest study of its kind, investigators at New York-Presbyterian/Weill Cornell Medical Center in New York City reviewed data from a sampling of 13 million of the nearly 17 million singleton full-term births in the United States between 2004-2007. These included births to parents of all races, ethnic groups and income levels.
Among their findings: Babies born at home were nearly 10 times more likely to be stillborn, and the risk of stillbirth increased to 14 times for firstborns. Babies born at home were also almost four times more likely to experience neonatal seizures or serious neurologic dysfunction compared with babies born in hospitals.
The study’s results were confirmed by analyzing birth certificate files from the National Center for Health Statistics to evaluate deliveries by physicians and midwives in the hospital and at home from 2007 to 2010. The researchers looked at Apgars, scores that assess the health of an infant one minute and five minutes after birth. A five-minute Apgar score of zero is considered a stillbirth. About 10 percent of these babies survive, though often with major health problems.
“Childbirth is one of the most wonderful moments in humanity, and people deserve the best of all circumstances, including enhancing the experience and reducing unnecessary interventions,” said Dr. Amos Grunebaum, chief of labor and delivery at New York-Presbyterian/Weill Cornell Medical Center, and the study’s lead author. “Having said that, it’s not only about experience. It’s also about making sure the baby is born safely.”
Grunebaum said that the study associated risk with the location of a planned birth, rather than the credentials of the person delivering the baby. When a child is born at home, typically there is only the midwife or doctor to address any unpredictable circumstances that arise, but in the hospital, a team of specialists can be mobilized in seconds if needed, he said.
Thursday, August 22nd, 2013
A new research review finds that women who receive consistent care from midwives during pregnancy have better outcomes than those who see family doctors or obstetricians. This review, conducted by the Cochrane Library, found that moms who saw midwives were less likely to need medical interventions or to give birth prematurely.
More from The Huffington Post:
The reviewers looked at 13 trials of more than 16,000 women who saw a small team of midwives throughout their pregnancy, or one primary midwife. Eight of the trials included women who were at low-risk for complications during pregnancy and birth, while five included higher-risk women. All of the midwives were licensed in their respective countries, and none of the trials looked at home births.
On the whole, women who saw midwives throughout their pregnancy were less likely to have an epidural painkiller, an episiotomy (an incision made from the vagina to anus during delivery), or a delivery using instruments, such as a vacuum or forceps. There were no differences in Cesarean birth rates.
Women who received continuous care from midwives also were less likely to have a baby before 37 weeks of gestation, or to lose their babies before 24 weeks.
Notably, higher-risk women who saw a midwife as their point-person did not have worse outcomes than low-risk women — a discovery the researchers interpreted with cautious optimism.
“This is an important finding, because it means that midwives have something to offer women who are not low-risk, when they are coordinating care with a primary care physician or an OBGYN,” argued review author Jane Sandall, with the division of women’s health at Kings College, London.
For now, the researchers can only guess why continuous midwife care seems to confer important benefits.
“Having someone who is there for you, who you know is going to be there at your birth is important to women,” said Sandall. “Because women know their midwives, and they’re often easier to get in touch with them, the midwives are picking up any problems sooner and helping women get the right specialist input as early as possible.”
Image: Newborn baby and mom, via Shutterstock
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