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Robin Elise Weiss, LCCE

Pregnancy / Birth Blog

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Cesarean Rate Edges Slightly Downward Again

Thursday May 29, 2014
Newborn baby in hat

In the just released 2013 Preliminary birth data, the cesarean rate fell slightly from 32.8% of all birth to 32.7% of all births. There was also a drop in the rate of preterm birth for the seventh straight year. The number of births to older mothers increased, but there was a decline in births to women in their 20s. About 44% of births are to unmarried women, also slightly down.

So what does this mean for the average pregnant woman? Not much in terms of everyday life. I think it's important to look at the statistics to get an idea of the trends in pregnancy and birth. It helps you guide your questions and educate yourself. What do you do with the data?

If you want to see the rates broken down by state - head on over to the The Unnecesarean.

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Take a Hospital Tour Early in Pregnancy

Tuesday May 27, 2014

Hospital Tour

Many moms choose a hospital based on what is close to their house, or what they see on television, or even what a neighbor says about her birth. Giving birth isn't like buying a camera. You may have needs that you don't even know about, particularly early in pregnancy. You can't leave this important decision up to polished bits of information in the media or from people who may have different needs then you have. You actually have to go and look yourself.

I highly encourage everyone to take a tour of the hospitals that they are thinking about. You should tour more than one if you can, because you don't have anything to compare it to if you haven't see what everyone else has to offer. You may even find that you are surprised when you get there and get more information than you previously had. Many hospitals run official tours at the end of pregnancy in conjunction with hospital classes. That is fine for a refresher, but you may want to decide earlier on in the process where you will give birth.

Be prepared for your tour with these questions.

Photo Digital Vision/Getty Images

Memorial Day Advice in Pregnancy

Friday May 23, 2014

Pregnant Woman Floatingin the Pool

This weekend is a huge travel weekend. It is also a big weekend for pools opening, trips to the beach, and yes, tons of picnics. That said, there are special considerations that you will want to think about if you are pregnant.

 

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Increase in Second Trimester Car Wrecks

Friday May 16, 2014

pregnant woman in car

I will never forget being 39 weeks pregnant and being involved in a car wreck. There is all the far and panic of being in a wreck, added to the complete concern for your baby. While I was fine, the EMTs just basically sent me away. I remember calling my OB in a panic. He was kind and told me all the reasons not to worry, asking me to just come on in to get checked out. His kindness and soothing voice were really wonderful in a terrible situation.

A new study out looks at the risk to women who are pregnant and driving. They found a 42% increase over baseline in accidents in the second trimester when the woman was the driver. This means that about 1 in 50 pregnant women will be involved in a wreck. Dr. Donald A. Redelmeier says that pregnant women spend a lot of times worried about things like hot tubs, when this can be a very serious complication of pregnancy. Partially because of the rise in the number of accidents, but also because of the added risk to the woman and her baby. Emergency care is complicated in pregnancy.

Redelmeier says that the takeaway from the study is not to skip driving, but to pay attention and drive cautiously. I would add that you should also remember to wear your seat belt correctly.

Have you been in an accident in pregnancy?

Source:
Donald A. Redelmeier, Sharon C. May, Deva Thiruchelvam, Jon F. Barrett. Pregnancy and the risk of a traffic crash. Canadian Medical Association Journal, 2014 DOI: 10.1503/cmaj.131650

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Hyperemesis Gravidarum

Wednesday May 14, 2014
Morning Sickness

Morning sickness is thought to be nearly a rite of passage in pregnancy. While many women have morning sickness, and even more complain about it, there is a subset of women who experience truly horrific morning sickness called Hyperemesis Gravidarum (HG). This is characterized by constant vomiting and weight loss. Treatment can be long and painful and includes hospitalization and/or home IV therapy and other medications.

This is not pleasant for anyone involved. The sad fact is that many women don't know that this is a problem. They may assume that it sucks, but that it's "normal." When in doubt, don't hesitate to talk to your doctor or midwife. In the meantime, you can learn more at HelpHER. Their goal is to educate, research, and support those living with HG. You can also follow them with the following hashtag: #HGaware

Photo iStockPhoto

Don't Panic Over Most Common Baby Names

Sunday May 11, 2014

Boy and Girl Babies Eating Cake

Every year the Social Security Administration (SSA) releases the top baby names. This causes panic in some parents who realize that the name that they picked for their baby is very popular. I would like to point out the difference between popular and common. If you look at the top names on the website, they will let you break those numbers down by the actual number of babies who were given that name or you can choose the percentage of babies born with that name.

So if you take the top two names this year: Noah and Sophia, you will find that they are each about 1% of the total names in each category (girl/boy). While you can have multiple spellings, for example, Sofia, also ranks up there at number 13, adding another half of a percent. This is really extremely low. About 18,090 baby boys were named Noah, out of just over 3,900,000 births, assuming about half are baby boys.

By the time that you reach the end of the list of the top 1,000 baby names, you have the names Darien and Collins (female). Both of these names represent about 0.01% of the babies born. That is really a very small fraction of the babies.

So if these numbers hold up - why might you run into several kids in play group all that have the same name or something very similar? Well, there are a couple of reasons. The first one is that there are regional variations. Depending on the population make up near you, you might have baby names that are heavily influences with some ethnicities. You might also have pockets of areas where there was a movie star located there or some other specific significance that makes people want to name their baby after a person that make not happen in a nearby city or state.

Do you take the name popularity into consideration as you name your kids?

 

 

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Are pregnant women included in Mother's Day?

Thursday May 8, 2014
Couple snuggling in bed

I don't mean anything by this title, but it's something that I wondered when I was about 20 weeks pregnant on Mother's Day. Was it my first Mother's Day? Was it a pre-mother Mother's Day? Should I be allowed to celebrate as a mother? We had a low key "celebration" that consisted of dinner, talking about the baby, and I think ice cream. But I wondered...

Certainly the next year, there was no question. I was about six months into this journey of motherhood. But I often thought back to that weird feeling about the year before.

Many moms that I talk to today seem to fall into three camps: 1) Absolutely celebrate! 2) Absolutely do not celebrate! 3) Who the heck really knows? So why is it such a big deal? I think for me it was about me having trouble seeing myself as a mother. I had planned for the baby, and yet began having the very normal doubts of whether or not I'd be a good mother. I didn't want to risk getting called out by the "real" mothers.

Where do you fall in this debate? Will you be celebrating this weekend? If so, how?

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Consumer Reports Adds Cesarean Rates

Thursday May 8, 2014

Mom Holding Baby in the OR After a Cesarean

If you have ever taken one of my childbirth classes, been my doula client, or heck, spent more than about five minutes with me, you know that I am often encouraging people to find out what the cesarean rates are at their hospitals and those of their providers. Believe it or not, this is not simple data to gather for the average person. Most states don't aggregate the data in one easy to find spot. If you do find the data, it might not be intelligible. So what's a consumer of maternity care to do?

Until recently, not much... But Consumer Reports has jumped into the game. They have taken data for 22 states and made very handy charts, divided by state, for you to search for data. The best part - this information is free. If you are a member of Consumer Reports, there is expanded information available, including their handy, well-known ratings to make it quickly obvious the better versus worse on their five point scale. (This also includes information like surgical infection rates, readmission rates, etc., which is handy information if you are looking at surgery.)

One thing that is important to understand about the information on what the ratings are based on is that these numbers will look very different than numbers you may have heard before. This is because this data is reporting the number of low-risk women who had a cesarean. This means, no preterm births, no multiples, etc. These births were all taken out of the data to try to create an even playing field. This is particularly true when you hear about high risk pregnancy centers defending their cesarean rates by saying it's the patient population. It is more likely that a high risk mother may have a cesarean, but more importantly, how are these facilities treating the low risk women. We know it can be harmful to treat low risk women as if they were high risk.

This goes a long way to helping a consumer figure out where their best options are for giving birth. Not sure what to do with the data once you have it? Ask your childbirth educator, doula, midwife, or doctor to help explain it to you. Basically, this gives you the ability to look at all the hospitals in your area that do a fair number of births and quickly and easily tell which one has a lower rate of unnecessary cesareans, higher infections, etc. I think that a lot of women are truly surprised at the wide gap you can experience in rates in one city. (My city doesn't have any hospitals in any ranking other than second from the bottom.) You might also want to read the article on What to Reject When You're Expecting.

So are you surprised at what the data shows?

You might also be interested in:

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Keeping Baby Well Positioned for Birth

Sunday May 4, 2014

Daily Essentials Video

You've heard me talk about Spinning Babies before here. Gail Tully, the midwife who runs this website, has spent years studying how the positions that moms assume during pregnancy an labor alter their baby's position. Basically, when you assume some of the positions in modern chairs, cars, and couches, you can create a less than ideal situation for your baby to be in the optimal position.

Tully has spent a lot of time working on these concepts. She has a whole section on her website dedicated to moving babies in less common, and potentially difficult positions. Well, Tully has teamed up with Sarah Longacre from Blooma Yoga. Together they have created a beautiful video to help moms figure out the best ways to move in pregnancy to work towards having less pain in pregnancy and a baby who is in the best position possible. (See a review of Daily Essentials: Activities for pregnancy comfort and easier birth.)

Using the techniques she's studied for so long, with the known benefits of yoga in pregnancy, and the knowledge of Longacre, you're in for a real treat! You can rent the video, download the full length, or (coming soon) purchase the DVD.

In the meantime, you can watch a few free prenatal yoga pose videos.

Photo Tully/Longacre


Home Birth and Birth Center Transfer Guidelines

Tuesday April 22, 2014

Doula helping mom push

Home births and birth center births are rising in popularity in the United States as medical groups differ on opinions about it, rising by 59% from 2004-2012. While 90% of mothers who choose home birth and birth center births will be able to have a safe birth in those locations, not everyone can stay at home or in a birth center safely. This is when a transfer to a hospital is needed.

Currently these transfers happen, but there are varying provisions in place for this possibility. There is not a system in place to help guide providers because everything is currently individually defined by the providers. This means that each provider has to make their own arrangements for hospital support, which can sometimes leave huge gaps in the quality of care or in patient satisfaction.

So the Home Birth Consensus Summitt's Collaboration Task Force gathered together to design a set of guidelines for the care of the families who require a transfer of care either prior to labor, during labor or afterwards.

Just as you should know about the call schedule, you should also ask about the transfer plans. Do you know the transfer plans in your practice?

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