Friday, November 30, 2007
The notable difference between these outcomes is the extent to which other developing countries provide access to midwifery care for their citizens. In those nations where midwives attend a significant portion of births, their intervention rates are lower and maternal outcomes prove
1. TIME, October 29, 2007, p18
2. Marsden Wagner, MD, MSPH; Fish Can't See Water: The Need to Humanize Birth;
International Journal of Gynecology and Obstetrics, 75, supplement s25-37, 2001
Monday, November 12, 2007
The March of Dimes has done a wonderful job of convincing people that prematurity is a tragedy and must be stopped. In the twenty-first century, it’s so vogue to be fighting prematurity. Who wouldn’t want to be listed as a donor to such a noble cause?
It is a noble cause.
I have friends, actually quite a lot of them, who have suffered from the modern day plague of babies born far too early and far too small. I have friends whose babies only lived a few days as a little struggling bit of humanity, enclosed in glass, full of wires and tubes. As their frail little bodies failed and slowly gave up, their mothers were left only with memories of barely touching their baby’s fragile skin, wishing that for one moment their baby could have nursed at their breast.
I have never been the mother or sister of one of these babies, and I’m sure that being such would make me far more sensitive to the grief that accompanies loosing such a baby. Or even watching the baby survive, but with many struggles to overcome – loss of eyesight, brain function, emotional disorders… and the list could go on.
Babies, even those with remarkable stories of survival, always pay the price for the weeks and months that they had to spend growing in the harsh world outside the womb, before they were ready.
The March of Dimes continues to shout “Find the causes of prematurity! Stop it! No more premature babies!” With such a noble and heart-stirring mission, millions of dollars are donated to the cause. Many of the donations probably come from fathers and mothers who have personally been affected by the bitter memories of their own premature baby, struggling to survive.
And yet, where are the answers?
Our prematurity problem is only growing.
March of Dimes has not found the answer… The world’s most noted obstetricians, perinatologists, and neonatologists don’t know how to end the plague. They sadly tell grieving mothers who wonder if it was their fault that their baby was born at 26 weeks gestation instead of 40 that “nobody knows why. Sometimes these things just happen.”
But some interesting and very promising research is under way.
I spent the weekend with some international scientists and researchers who have spent over a decade focusing on various kinds of maternity care and the resulting outcomes to mothers and babies.
They are not ready to go public with their discoveries yet, as there is still more research to be done, and statistics to looked at, but so far they are finding a correlation between greatly lowered rates of prematurity when a pregnant woman sees a midwife as her primary maternity care provider.
In looking at large populations of low-risk, healthy white women, they noted that:
Of those who received typical obstetrical care, approximately 11.2 % gave birth to babies at less than 37 weeks gestational age.
Of those who received care from a Certified Professional Midwife (planning for a birth in an out-of-hospital setting), approximately only 4 % gave birth to babies under 37 weeks gestational age!
The research is still being done, but the preliminary results are showing a drastic difference in the care of a midwife vs. the care of a physician when it comes to preventing prematurity.
Maybe the March of Dimes should start to look outside the box. Instead of looking to high-tech, high-cost care, maybe they should take a glance at what happens when people use high-touch, personalized care.