Birth Controversies

n    Cesarean Section

n    Is used in approximately 20% of U.S. births a rate that is much higher than in most countries

n    What accounts for this high rate?

 

 

Birth Controversies

n    Fetal Monitoring

n    Is it related to birth risk?

Birth Controversies

n    Birth Position

n    Is the supine position best?

n    Birth Chair

 

 

Birth Controversies

n    Use of Analgesics and Anesthetics

n    General anesthetics

n    Epidurals

n    Natural births 

Birth Controversies

n     Episiotomy

n    Rate in U.S. between 65-95% depending on hospital and parity

n    Claimed benefits:

n   Speed up birth

n   Prevent tearing

n   Protect against incontinence

n   Heals easier than tears

n    Reported Side effects

n   Infection

n   Increased Pain

n   Longer healing times

n   Increased discomfort when intercourse is resumed

Birth Controversies

n    Bonding

n   1970’s Klaus and Kennel two pediatricians claimed there was a “critical” period after birth for attachment

n   Later research tended not to support claims

n   However, the ideas changed birthing procedures at almost all hospitals

Birth Controversies

n    Alternative and Home Births

 

n    Accounts for very few birth in the U.S., this contrasts with other countries where most infants are born at home

n    Is it safe?

n    Why use an alternative center?

Premature Birth

n    Typical term is 40 weeks, however

n   In U.S. about 11% are born early

n   7% are born too small (SGA)

n    Premature birthrates have increase 17% in last decade as a result of advances in neonatology

n    High Risk Infants: Serious problems and developmental delays tend to occur when

n   Babies are less then 32 weeks and

n   Less than 1500 grams (3.3 lbs) at birth

High Risk Infants

n    Average hospital stay is 45 to 50 days

n    30% to 50% experience rehospitalizations in first 3 years

 

Causes for Prematurity

n    Mother’s reproductive system such as with young teens or insufficient recovery time from previous birth

n    Multiple births (e.g., twins, fertility drugs)

n    Previously discussed prenatal impacts

Effects of Prematurity

n    Respiratory Distress Syndrome (RDS)

n    Generally occurs in babies less than 32 weeks

n    Due to lack of surfactin

n    Are given higher amounts of Oxygen which can cause retinopathy (damage to the retina)

n    Very premature and low birth weight can lead to brain complications

n    Intraventricular Hemorrhage (IVH): bleeding into the vetricals

n    Periventricular Leukomalacia: death of brain tissue around ventricles