Good things a brewin

I haven’t had time to post recently. But, good things have been brewing, so I wanted to throw up some links.

First, a study finds homebirth as safe as hospital birth. Of course, this occurred in the Netherlands. I would love to practice there one day. An American DO needs to pave the way, since our licensing is ambiguous in that country. Note the complication rate was 7 per 1000. That includes NICU admission or any neonatal mortality.

Note that in the United States, our infant mortality rate alone is 7 in 1000.

Hillary Clinton gave a rousing defense of comprehensive international reproductive medicine. I still get misty when I hear our administration advocating for evidence based, women centered medicine that will save more lives of women and children.

Also good stuff, the FDA is going to be extending over the counter, non prescription status for plan B to 17 yr olds. It is safer than a pregnancy for all ages, children who can’t talk to their parents about it are high risk and should have more access. Unfortunately, proving your age requires ID. I think the requirement should be lifted because privacy outweighs the negligible risk. If a young woman is in a small town, she will be forced to show her license in order to get Plan B. We need mroe progress on this issue. Plan B needs to be available without a prescription, end of story.

The New England Journal of Medicine published a study on using PCR, a cheap DNA analysis is better than a pap smear when screening for cervical cancer. Very interesting. I may be doing some research on PCR testing for HPV during my research fellowship.

And, finally, Shakesville has been cracking me the hell up.

4 Comments

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4 responses to “Good things a brewin

  1. I was very excited to see that huge homebirth study. Of course, American woman have rapidly evolved into a new species (one that can’t birth without pharmaceuticals and tools) compared to our Dutch sisters, so I’m sure it will be written off as irrelevant here by the powers that be.

    One comment on the 7 in 1000 figure. All the women in this study were low risk, so I don’t think you can really compare the study’s 7 in 1000 complication rate with the overall US population’s 7 in 1000 mortality rate, since the latter includes multiples, diabetics, etc. Right?

    • MomTFH

      Yes, the statistics are not directly comparable. But, keep these factors in mind:

      First, something like 95% of women deliver in hospitals in the United States. The vast majority of these births are not in women with heart disease or diabetes, or other preexisting risk profiles. Younger, healthier women are the ones who give birth. Most do not have preexisting conditions that would predispose them to complications. Unlike in the Netherlands, where healthier women have a decent chance of opting to deliver at home, out of hospital birth has dropped recently in the United States to 1 to 2%. So, hospital births in the United States are not inherently high risk births. They are, by and large, normal women giving birth.

      Secondly, the 7 in 1000 number in the Netherlands home (and hospital) birth populations was the number of neonatal deaths AND NICU admissions combined. The 7 in 1000 number for the United States was neonatal deaths ALONE. There are many more NICU admissions that deaths.

  2. Here is my thought. 8 years ago if a baby was having a difficult time transitioning, we deep suctioned him/her and placed her in a warmer to watch very carefully. We did not do a bunch of test on them. Maybe if it persisted, we would get a chest X-ray. But nowadays if a baby so much as grunts or flairs, we run them right to the nicu. I think we are jumping the gun. BAbies need time to transition. In order to do tht safely, we need more nurses who can watch the baby and mother. Where I work as soon as you deliver on woman, you are at risk to get another hit or you may also have another patient who someone else is watching. So it is busy. Too busy really. I would love to see a law passed where each nurse could only have 3 patients to care for. One mother baby unit would be called on patient. But I wonder how things would come out if nurses only had 3 patients instead of the 5-8 patients. Nobody can keep up with all that work. It is stupid to assume someone can. Something is being missed.

    • MomTFH

      I am all for one to one care of nurse to mom at delivery, but I’ll settle for 3. What does a mother baby unit consist of? The LDN and the nurse for the baby?

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