March 29, 2007

Jen's pelvis info

February 25, 2007

Who attends births in the US?

This is a report of the most recent data from the National Center for Health Statistics. It gives info on % c-sections, % inductions, % births attended by midwives, % births attended by physicians, % births in hosptial/out of hosptial ... Rebecca, this is where I got that 8% of births attended by midwives figure. Midwife-attended births tend to be under-reported and vary by region, but the numbers are still pretty low. What else? 99 percent of births take place in hospitals and that percentage has been consistent for DECADES! Ugh!

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February 24, 2007

National Women's Studies Association Journal

This is a journal we might consider for publishing a short article about our study group ...

Article from spinning babies website

It is on op babies and epidurals and subsequently on c-sections.

February 22, 2007

Pregnancy and Prenatal

Some topics from Ina May’s Guide to Childbirth (2003, pp. 183-203) that we might want to use to organize our discussion:

• Nutrition

• Ultrasound

• Chorionic Villus Sampling (CVS)

• Amniocentesis

• Maternal Serum Alpha-fetoprotein Screening

• Gestational Diabetes

• Screening for Beta Strep (Group B Streptococcus)

• Prenatal Rhogam

• Informed Consent

Some topics from Elizabeth Davis’ Heart and Hands (2004, pp. 11-64) – another way to organize our discussion ...

Initial Interview
• What does this look like?
• What are the goals of this meeting?

Medical History
Can we find some medical history forms to look at?
• Obstetrical history
• Abortion history
• Gynecological history
• Contraceptive history
• Family history – cancer, hypertension, diabetes, cancer ...
• Other – bleeding, spotting, flu-like symptoms, chicken pox, herpes, vomiting, fatigue, urinary tract problems, vaginal discharge, meds (prescription and OTC), household or workplace chemicals

Physical Exam
Other resources – Varney’s Midwifery or Holistic Midwifery (Vol.1)
• Estimated Date of Birth
* Ways to calculate this?
*Bimanual exam

• Weight

• BP

• Pulse

• Temp

• Reflexes

• Breast Exam

• Pelvic Assessment
* consider rape/sexual abuse history – see Simkin’s When Survivors Give Birth

• Pelvimetry (pp. 23-28)
*becoming a lost art (p. 28)
*see also Frye’s Holistic Midwifery (Vol. II)

• Fundal height

• Assessing gestational age

• Fetal stuff - uterine/fetal palpation, Leopold’s maneuvers, fetal lie, fetal position, presentation, attitude, fetal heart tones
* lost midwifery arts of pelvic assessment, fetal and uterine palpation, fetal heart auscultation, fundal height assessment – almost all replaced by ultrasound (p. 30)

Nutrition and Exercise

Screening Out

Lab Work and much more ...

Historical Look at Childbirth in the US, 1750-1975

This figure show all sorts of things in the history of US childbirth - % midwife attended births over time, % hospital births over time, % of births using anesthesia ... Figure from:

Leavitt, Judith Walzer. 1986. Brought to Bed: Childbearing in America 1750 to 1950. New York: Oxford University Press.

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Midwife-Attended Birth in the U.S. and Netherlands, 1940-2000

This figure shows % of births that were midwife-attended in US and NL between 1940 and 2000. Figure from:

De Vries, Raymond. 2004. A Pleasing Birth: Midwives and Maternity Care in the Netherlands. Philadelphia, PA: Temple University Press.

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Home Births in the U.S. and the Netherlands, 1955-2000

This is a figure shows % home births in the US and NL from 1955-2000. Figure from:

De Vries, Raymond. 2004. A Pleasing Birth: Midwives and Maternity Care in the Netherlands. Philadelphia, PA: Temple University Press.
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British Medical Journal Article

This is the best article of its kind looking at home birth outcomes in the U.S. and Canada.

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Maternity Care in the Netherlands in 2002: Place of Birth and Attendant

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Explanation of figure

At the beginning of pregnancy
79.2% of women in the Netherlands under the care of a midwife (generally on track for a home birth)
6.5% under the care of a general practitioner (generally on track for a home birth)
14.3% under the care of a OB/gyn (on track for a hospital birth)

During pregnancy
26.1% transfer from midwife to OB/gyn care
2.2% transfer from GP to OB.gyn care
now a total of:
• 53.1% under midwifery care
• 4.3% under GP care
• 42.6% under OB/gyn care

During labor
15.7% transfer from midwife to OB/gyn care
1.1% transfer from GP to OB/gyn care
now a total of:
• 37.4% under midwifery care
• 3.2% under GP care
• 59.4% under OB/gyn care

Place of birth and attendant
Total home births: 29.4%
• 26.6% at home with a midwife
• 2.8% at home with a GP

Total hospital births: 70.6%
• 10.8% with a midwife
• 0.4% with a GP
• 59.4% with an OB/gyn

Data from:
Wiegers, Trees and B. M. Janssen. 2006. Monitor Verloskundige Zorgverlening: Eindrapport [Monitoring Midwifery Care: End Report]. Utrecht, Netherlands: NIVEL.

Dutch List of Obstetrical Indications

This is the (very long) list that the national midwifery and ob/gyn organizations in the Netherlands came up with to determine when and under what conditions a woman should be transfered from midwifery to OB care and visa versa .

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