My Story: The Transforming Power of Birth.

In this column Henci Goer shares the stories of her two births and how those births shaped her life's work. With her first birth she believed that her caregivers knew better than she what was right for her. During the birth she was ignored. She was left feeling distressed and diminished. Her second birth was dramatically different. She was an active participant, listened to, respected and part of decision-making. She highlights that no matter how difficult the birth, whether things go as planned or not, the joy, the pride, the satisfaction with birth comes with being listened to, respected, and part of decision-making. This birth story is an excerpt from Henci Goer's recent publication, Labor Pain: What's Your Best Strategy? (2022).

Dueling Statistics: Is Out-of-Hospital Birth Safe?

In this article, two recent studies comparing out-of-hospital birth and hospital birth are discussed. The author critiques the studies highlighting the possible reasons for differences in the findings related to home birth. In addition, the findings of both studies add to the body of knowledge that suggests there are risks associated with hospital birth.

Epidurals: Do They or Don't They Increase Cesareans?

The controversy over whether epidurals increase the risk of cesarean has raged since the 1970s. This article provides a history of of the early observational research designed to answer this question and an in-depth analysis of the most recent randomized control trials. Based on the research, the author concludes that we cannot assure women that epidurals do not increase the risk of cesarean.

They said so on the news: parsing media reports about birth.

In this column, the authors reprise recent selections from the Lamaze International research blog, Science & Sensibility. Each selection discusses shortcomings in the news media coverage of childbirth issues. The authors demonstrate how to identify misleading claims in the media and highlight how childbirth educators can apply a common-sense approach and careful fact checking to help women understand the whole story.

Cruelty in maternity wards: fifty years later.

Fifty years have passed since a scandal broke over inhumane treatment of laboring women in U.S. hospitals, yet first-person and eyewitness reports document that medical care providers continue to subject childbearing women to verbal and physical abuse and even to what would constitute sexual assault in any other context. Women frequently are denied their right to make informed decisions about care and may be punished for attempting to assert their right to refusal. Mistreatment is not uncommon and persists because of factors inherent to hospital social culture. Concerted action on the part of all stakeholders will be required to bring about systemic reform.

Research summaries for normal birth.

In this column, the authors summarize four research studies relevant to normal birth. Topics of the studies summarized include the harms of screening for macrosomia late in pregnancy, the risk factors for and impact of postpartum pain in childbearing women, the effects of a breastfeeding approach called "biological nurturing" on reflexive behavior in newborns, and the effects of prenatal yoga on labor and birth outcomes.

Research summaries for normal birth.

In this column, the authors summarize four research studies that further support the benefits of normal birth. The topics of the studies include the association of cesarean birth with an increased risk of neonatal death; the use of acupuncture and self-hypnosis as effective pain-management strategies; factors associated with amniotic-fluid embolism; and the positive influence of continuous support by lay doulas on obstetric outcomes for low-income women.

Methods: the coalition for improving maternity services:.

In this article, the details of the methods used to determine the evidence basis of the Ten Steps of Mother-Friendly Care are presented and discussed.

Step 6: does not routinely employ practices, procedures unsupported by scientific evidence: the coalition for improving maternity services:.

Step 6 of the Ten Steps of Mother-Friendly Care addresses two issues: 1) the routine use of interventions (shaving, enemas, intravenous drips, withholding food and fluids, early rupture of membranes, and continuous electronic fetal monitoring; and 2) the optimal rates of induction, episiotomy, cesareans, and vaginal births after cesarean. Rationales for compliance and systematic reviews are presented.

Humanizing birth: a global grassroots movement.

A survey of a convenience sample of 24 grassroots birth activist groups based in several countries revealed remarkable similarities despite differences in culture and maternity care systems. With few exceptions, they began with a few individuals, generally women, who were dissatisfied or angry with an obstetric management system that failed to provide safe, effective, humane maternity care, that suppressed alternative models of care and nonconforming practitioners, or both. Responses indicated that organizational structures tend to fall into a limited number of categories, and strategies intended to accomplish reform overlap considerably. All groups have experienced difficulties resulting from the hegemony of conventional obstetric management and active opposition of practitioners within that model. Most groups are volunteer based, and all struggle under the handicap of limited resources compared with the forces arrayed against them and the scope of what they hope to accomplish.

#4: no routine interventions.

In this position paper-one of six care practice papers published by Lamaze International and reprinted here with permission-the benefit of no routine interventions during birth is discussed and presented as an evidence-based practice that helps promote, protect, and support normal birth. The paper is written for childbearing women and their families. It presents evidence related to restrictions on eating and drinking, use of intravenous fluids, continuous electronic fetal monitoring, artificial rupture of the membranes, augmentation of labor, and epidural analgesia. The accompanying commentary-written by an award-winning medical writer-supports and expands on the benefits of no routine interventions during birth. Lamaze International recommends that laboring women avoid restrictions on eating and drinking. The organization also recommends avoidance of IVs, continuous electronic fetal monitoring, epidurals, and efforts to speed up labor, unless a clear indication for their use is evident.