Muslimah Doula Service





Home

FAQ

Islamic Information

Breastfeeding/Know your body

Uterine abnormalities

Interventions

Interventions

Here are some links to various interventions that can take place during childbirth.

 Please read and use at your own discretion.

How can epidural analgesia affect my pelvic floor?

http://maternitywise.org/mw/topics/pelvic-floor/options-epidural.html

 

Setting the Record Straight:
Best Current Research on "Walking" or "Light" Epidurals

http://maternitywise.org/epidurals.html

 

Cesarean Section booklet

 ( you can download this, it is a pdf file)

http://www.maternitywise.org/mw/topics/cesarean/booklet.html

A Guide to Effective Care in Pregnancy and Childbirth

http://www.maternitywise.org/guide/

 

Technology in Birth: First Do No Harm

http://www.midwiferytoday.com/articles/technologyinbirth.asp?a=1&r=1&e=1&q=epidural

 

Cyotec Induction

Misoprostol Caution

The opinion of the best perinatal scientists is that misoprostol (cytotec) induction is still experimental and should only be done in a controlled research setting with the usual protection of research subjects including fully informed consent. This is because to date our scientific data are inadequate to tell us whether or not misoprostol induction is safe.

How to hold back the rapid spread of misoprostol induction, which heralds the return of all the convenience of daylight obstetrics? That the drug is not approved by the FDA for this purpose, not approved for this use by the drug manufacturer, not endorsed for this use by the American College of Obstetricians and Gynecologists or midwifery organizations and not recommended for routine use by scientists (who tell us we do not know if it is safe) has had no apparent effect on the enthusiasm with which clinicians, both doctors and midwives, are starting to use it . . . . Midwives need to make every effort to achieve evidence based practice, particularly when using drugs and invasive technologies, and the clear lack of data on serious risks of misoprostol induction should be sufficient to deter all midwives from this procedure, whether in hospital or out of hospital.

The issue here is consumer protection and quality assurance in maternity care. We need a system of rational pharmaceutical management which guarantees adequate evaluation of every use of a drug prior to its use for that purpose and drug protocols developed by an officially recognized group of scientists, clinicians (including midwives), policy makers and consumers and based on the best scientific evidence. Present consumer protection systems in some countries, for example in Scandinavia, include mandatory prior evaluation and officially endorsed consensus protocols, and there is no evidence that progress in maternity care is held back. -Marsden Wagner, MD, "Misoprostol (Cytotec) for Labor Induction: A Cautionary Tale," Midwifery Today Issue No. 49, Spring 1999

Cyotec Induction and Off-Label Use

http://www.midwiferytoday.com/articles/cytotec.asp?a=1&r=1&e=1&q=induction

 

Effects of Labor Drugs

The risks of epidurals convert normal labor to a high-tech event. An IV must be started to help counteract the tendency of epidurals to cause hypotension. Electronic fetal monitoring is necessary because epidurals can cause fetal distress, and the mother's vital signs must be closely monitored to warn of maternal adverse reactions. If the needle or catheter pierces a blood vessel, which is easy to do in pregnancy because blood vessels are enlarged, or the needle goes deeper than the epidural space, convulsions, respiratory paralysis, and/or cardiac arrest can occur. Tests are done to confirm proper placement before giving the full dosage, but these are not completely preventative. Trained personnel, resuscitation equipment, and medication must be immediately available.

In labor, epidurals increase the need for oxytocin, instrumental delivery, episiotomy, and bladder catheterization. The first-time mother is more likely to have a cesarean. Temporary postpartum complications include urinary incontinence, nerve injury causing muscle weakness or abnormal sensation, and headache that can last for days and is excruciatingly painful. Instrumental delivery and episiotomy increase the probability of deep perineal tears. Backache and headache may become chronic. In the newborn, epidurals may cause jaundice, and there may be adverse behavioral effects.
- Henci Goer, Obtetric Myths Versus Research Realities, Bergin & Garvey 1995
====

Induction with Cytotec should never be attempted anywhere, most especially in out-of-hospital settings. Incredibly, the American College of Obstetricians and Gynecologists (ACOG) recently approved Cytotec induction in spite of lack of FDA approval; in spite of a letter to doctors from Searle, the manufacturer of Cytotec, imploring doctors not to use it for induction; in spite of lack of approval from the Cochrane Library (the best scientific opinion); and in spite of the fact that it is not approved or used for induction in any country in Western Europe.

ACOG quotes studies of Cytotec induction, none of which have a sufficient number of research subjects, and consequently none of the studies quoted have sufficient statistical power to detect small but potentially important risks such as uterine hyperstimulation and uterine rupture. Furthermore, because published studies of Cytotec induction have such wide methodological variability, meta-analysis is impossible and the published attempts at such meta-analysis are seriously flawed.... Midwives should stay as far away as possible from such vigilante obstetrics--obstetricians taking matters into their own hands while ignoring the recommendations of the real judges.
- excerpted from "Midwives and Cytotec: A True Story, by Marsden Wagner, MD,
Midwifery Today Issue 57

A Butcher's Dozen

article about VBAC

http://www.midwiferytoday.com/articles/dozen.asp



Ultrasounds

 

Ultrasound scans can affect brain development

'Souvenir' scans discouraged, but medical value outweighs risks

WASHINGTON (AP) -- Keepsake sonograms have become a popular item with many young parents -- from Tom Cruise to the couple next door. It's a practice many physicians would like to discourage.

The latest concern comes from a study that suggests, in mice at least, that ultrasound can affect the development of the fetal brain.

Even so, researchers say the findings should not keep pregnant women from having ultrasound scans when needed for medical reasons.

When pregnant mice were exposed to ultrasound, a small number of nerve cells in the developing brains of their fetuses failed to extend correctly in the cerebral cortex.

"Our study in mice does not mean that use of ultrasound on human fetuses for appropriate diagnostic and medical purposes should be abandoned," said Dr. Pasko Rakic, lead researcher and chairman of the neurobiology department at Yale University School of Medicine.

However, he added in a telephone interview, women should avoid unnecessary ultrasound scans until more research has been done.

Dr. Joshua Copel, president-elect of the American Institute of Ultrasound Medicine, said his organization tries to discourage "entertainment" ultrasound, but considers sonograms important when there is a medical benefit.

"Anytime we're doing an ultrasound we have to think of risk versus benefit. What clinical question are we trying to answer," Copel said in a telephone interview. "It may be very important to know the exact dating of pregnancy, it's certainly helpful to know the anatomy of the fetus, but we shouldn't be holding a transducer on mom's abdomen for hours and hours and hours."

Rakic's paper said that while the effects of ultrasound in human brain development are not yet known, there are disorders thought to be the result of misplacement of brain cells during their development.

"These disorders range from mental retardation and childhood epilepsy to developmental dyslexia, autism spectrum disorders and schizophrenia," the researchers said.

Their report is in Tuesday's edition of Proceedings of the National Academy of Sciences.

Early ultrasound scans are done to determine the exact week of the pregnancy and they are also done later to check for anatomical defects and other problems.

However, some expectant parents have sought scans to save as keepsakes even when they were not medically necessary, a practice the Food and Drug Administration discourages.

The Institute of Ultrasound Medicine was particularly concerned last year when it was announced that actor Cruise had purchased an ultrasound machine so he and his pregnant fiancee, Katie Holmes, could do their own sonograms.

"Purchase of an ultrasound machine for private, at home use entails inappropriate operation of a prescription medical device designed for diagnostic use by a trained medical professional," the group said in a statement issued at the time.

Copel, a professor of obstetrics and gynecology at Yale University School of Medicine, did point out that there are large differences between scanning mice and scanning people.

For example, because of their size, the distance between the scanner and the fetus is larger in people than mice, which reduces the intensity of the ultrasound. In addition, he said, the cranial bones in a human baby are denser than those of a tiny mouse, which further reduces exposure to the scan.

The paper noted that the developmental period of these brain cells is much longer in humans than in mice, so exposure would be a smaller percentage of their developmental period.

However, it also pointed out that brain cell development in people is more complex and there are more cells developing, which could increase the chances of some going astray.

In Rakic's study, pregnant mice were exposed to ultrasound for various amounts of time ranging from a total exposure of 5 minutes to 420 minutes. After the baby mice were born, their brains were studied and compared with those of mice whose mothers had not been exposed to ultrasound.

The study of 335 mice concluded that in those whose mothers were exposed to a total of 30 minutes or more, "a small but statistically significant number" of brain cells failed to grow into their proper position and remained scattered in incorrect parts of the brain. The number of affected cells increased with longer exposures.

The research was funded by the National Institute of Neurological Disorders and Stroke.

Copyright 2006 The Associated Press. All rights reserved

 

Find this article at:
http://www.cnn.com/2006/HEALTH/08/07/ultrasound.brains.ap/index.html









© 2005 All Rights Reserved.  

Create a free website at Webs.com