Midwifery Study Group

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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Posted by Rachael at 4:33 PM | Permalink | Comments (0) | TrackBacks (0)

This is a journal we might consider for publishing a short article about our study group ...
http://www.nwsaj.engl.iastate.edu/

Posted by Rachael at 6:35 PM | Permalink | Comments (0) | TrackBacks (0)

http://www.greenjournal.org/cgi/reprint/105/5/974

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

Posted by Rachael at 2:51 AM | Permalink | Comments (0) | TrackBacks (0)

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 ...

Posted by Rachael at 11:59 PM | Permalink | Comments (1) | TrackBacks (0)

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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Posted by Rachael at 9:11 PM | Permalink | Comments (1) | TrackBacks (0)

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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Posted by Rachael at 9:09 PM | Permalink | Comments (2) | TrackBacks (0)

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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Posted by Rachael at 9:06 PM | Permalink | Comments (1) | TrackBacks (0)

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

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Posted by Rachael at 9:00 PM | Permalink | Comments (1) | TrackBacks (0)

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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.

Posted by Rachael at 8:48 PM | Permalink | Comments (0) | TrackBacks (0)

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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Posted by Rachael at 8:15 PM | Permalink | Comments (1) | TrackBacks (0)