Tuesday, January 18, 2011

Trivial Pursuit

I thought it might be fun to mix things a little. So instead of me writing about something specific, let's play a game.

True or False

Eating and/or drinking during labor is dangerous.
A Cochrane study reports that there is no benefit to withholding food or drink during labor. From a personal viewpoint, I wouldn't go hiking without food, so why labor without food?

Any pregnancy over 40 weeks is "overdue".
"Term" is actually considered to be 38-42 weeks. 40 weeks is just the middle value. Overdue doesn't happen until you pass the 42 week mark.

VBAC is more dangerous than a repeat c-section.
On the contrary a cesarean is major surgery and carries all risk associated with major surgery in addition to special risks to the baby, and the addition of possible fertility problems later.

There is a risk of catching on fire during a c-section.
In fact it happens more often than you might think. Operating rooms are full of flammable materials like oxygen and alcohol solutions, combine those with lasers and possible electrical sparks and you have a foxnews.com story. In 2008 the American Society of Anesthesiologists flash surgical fires occur approximately 50-200 times a year.

Laying on your back is the best way to birth.
This is called the supine or lithotomy position. It restricts your pelvis, and forces the baby to fight against gravity to exit the mother. Dr. Roberto Caldeyro-Barcia and his researchers found that this position is the worst one for laboring women because it adversely affects every facet of birth: makes labor more painful, reduces uterine activity, and can dangerously lower blood pressure. He says, "Except for being hanged by the feet, the supine position is the worst conceivable position for labor and delivery."

(Roberto Caldeyro-Barcia, past president of the International Federation of Obstetricians and Gynecologists, leading researcher in perintology)

Homebirth is always risky.
It seems that only in America is homebirth considered dangerous. A list of links concerning U.S homebirth safety.

Labor hurts.
Let's face it, the definition of "labor" is hard work. And yes it can be painful, but it's an entirely different type of pain than breaking your leg. On the other hand, women have been know to orgasm during birth. An orgasm comes from a release of hormones and contracting muscles. Labor and birth involves the same release of hormones and contracting muscles.

There's no real benefit to laboring.
Natural labor helps get the baby's lungs get ready for breathing. It stimulates the release of oxytocin, the "love hormone", that helps establish bonding and breastfeeding after the birth. Benefits of natural labor

An epidural is risk free.
False. Even if you ignore the fact that epidurals slow down labor, there is still a long list of side effects that should be taken into consideration. Including septic meningitis, neurological disorders and fetal distress.

Electronic fetal monitoring improves outcomes for the baby and mother.
No, it doesn't. In fact it's associated with HIGHER chances of cesareans because of inaccurate readings. EFM began being routinely used in 1970. In 1976 the FDA received authority to regulate medical devices. EFM was grandfathered in.


Tuesday, January 11, 2011

Misoprostol and pregnancy don't mix

Cytotec (misoprostol) is a drug commonly used to induce labor. But what mothers aren't told is that Cytotec (misoprostol) is a drug used to prevent stomach ulcers, and the manufactures warn against using during pregnancy and labor. Some of the known side effects include birth defects, premature labor, uterine rupture, maternal and perinatal mortality, and in the infant, hypoxic ischemic encephalopathy. Hypoxic-ischemic encephalopathy occurs when oxygen is cut off to the brain. This can cause long term damage like cerebral palsy, delayed developement, seizures and of course, death.

That's not the whole story behind Cytotec (misoprostol). When RU-486 (aka the abortion drug) was approved by the FDA, they also approved Cytotec (Misoprostol) as a companion drug to complete the termination of the pregnancy.

The Tatia Oden French Memorial Foundation was started by the family of a young mother. She was in perfect health during her pregnancy, and induced just under 42 weeks. She was given Cytotec without being told the risks, she suffered hyperstimulation of the uterus and an emergency c-section was performed. Both Tatia and her newborn daughter died.

While there are risks associated with any drug you take, it's important to point out that the FDA has not approved the use of Cytotec (misoprostol) during labor. And that the manufacture has publicly asked that doctors stop using it to induce labor.

If Cytotec isn't approved for labor and pregnancy, why is it commonly used? Unfortunately the answer is "because it's cheap". Hospitals are businesses. And like all businesses they try to keep their overhead expenses low. Does that make it okay to use Cytotec for a purpose not only it isn't made for, but that the manufacture has not approved? Absolutely not. I'm honestly not sure with is more appalling, the fact that this drug is so commonly used in the U.S despite known complications and warnings, or that health professionals don't feel the need to inform their clients about the possible dangerous side effects.

Cytotec induction and off-label use by Marsden Wagner, MD, MS