HW 41 - Independent Research

NATURAL LABOR  INDUCTION ALTERNATIVES


Annotated Bibliography-
1. Kelly AJ, Kavanagh J, Thomas J. Castor oil, bath and/or enema for cervical priming and induction of labour. Cochrane Database of Systematic Reviews 2001, Issue 2. Art. No.: CD003099. DOI: 10.1002/14651858.CD003099

This is an investigation of the effectiveness of Castor oil for inducing labor and/or ripening the cervix during labor. Castor oil is a natural labor catalyst that has been used for many years and is considered "traditional". It is commonly used by practicing midwives although there has never been a clear grasp on its effectiveness. This study compares this method of induction to other commonly used practices. The group of women included in this study was too small to have a determinable outcome but based on the results, Castor oil had very little effect.

2. McFarlin BL, Gibson MH, O'Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. J Nurse Midwifery 1999;44:205-16.

This study was conducted to show the effectiveness of herbal preparations for cervical ripening, induction, and augmentation of labor.  Also, this study investigates whether or not midwives are teaching these practices with accurate information of the effectiveness of herbal methods. Herbal methods for labor induction are somewhat popular in the midwifery field and those who use them do because they are "natural", while those who do not claim they don't have enough information about them to practice them on woman. Based on this study, majority (92%) of the midwives who use or teach these practices are using and teaching them informally.


3. TENORE, JOSIE L. "Methods for Cervical Ripening and Induction." Precious Passage Birth Services- Homebirth Midwifery Akron Ohio. American Academy of Family Physicians, 15 May 2003. Web. 01 Apr. 2011. <http://www.preciouspassage.com/Methods for Cervical Ripening and induction.htm>.

This article provides information about the most commonly used alternatives for labor induction.

The most prescribed agents are evening primrose oil, black haw, black and blue cohosh, and red raspberry leaves. Evening primrose oil is the most used out of all listed above but they have not been proven to have any effect on the softness of the cervix or the speed of the labor. This article states that the risks and benefits of these listed herbal alternatives are still indeterminable. Also, sexual intercourse and stimulation has been suggested in this paper as an alternative for induction. Although there are many logical reasons why it makes sense for sexual intercourse to speed up the laboring process, its effectiveness is still indeterminable.

4.  Smith CA, Collins CT, Cyna AM, Crowther CA. Complementary and alternative therapies for pain management in labour. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD003521. DOI: 10.1002/14651858.CD003521.pub2.

It is important to be relaxed during labor for it to proceed quicker and less painfully. Tension and anxiety make labor pains worse and stress can also slow down labor.  There is some evidence that acupuncture may be a good alternative for relaxation methods but more research needs to be done for it to be proven. Some other alternative methods for relieving labor pain are massage, reflexology, herbal medicines or homoeopathy, hypnosis and music.

5.  "Foods That Induce Labor?" Empowering Each Woman Giving Birth Naturally. GivingBirthNaturally.com, 2007. Web. 01 Apr. 2011. <http://www.givingbirthnaturally.com/foods-that-induce-labor.html>.

Many women believe in and turn to food for inducing labor. Based on gathered information, the most beneficial and effective foods for the labor process are Pineapple, spicy foods, Chinese food, eggplant Parmesan, and licorice. There is only anecdotal evidence proving that these foods work for inducing labor but more evidence needs to be gathered to solidify this claim.



Based on the information gathered, I see there is a common theme that a lot of natural alternatives to labor induction and cervix ripening have not been fully explored. I believe that this is a real problem because there is plenty of information about the benefits and pitfalls or medical a mechanical interventions. I think that it is important to turn to nature for the answers before artificial chemicals, and where nature doesn't prevail, medicine should then be used. Maybe I could take this information (or lack there of) to create a campaign for doctors to do more research on natural alternatives because if they are effective enough, they could become common practices replacing the drugs Cytotec or Pitocin (which have their own cons).

HW 40 - Insights from Book - Part 3

Letter to Marsden Wagner, M.D., M.S.:

Dear Doctor Marsden,

Your book completely changed my view of the practices of obstetricians( not that I knew much about their practices to begin with.) You did an amazing job executing your main objective which was that majority of obstetricians in America have convoluted mindsets and objectives but if they learn to work with midwives, the U.S. maternity care system would be much improved and therefore match the success of many other advanced nations. Also, this reiterated the importance of women being educated about what potentially happens to their body. Honestly, I might have underwent the "normal" procedure of birth in this country if I had not been provided the information you offered me, but gaining an actual obstetricians perspective helped me realize how that might not be something I would want to partake in. Their motives lead to unnecessary interventions that make their lives easier (but from the looks of the risk factors, not necessarily the lives of women or babies), they also lead to misinformation about their practices and the practices of their so called "competitors" (midwives) To be fair, your book does shine a very negative light on these practicing doctors as a whole but I realize the importance of this because it seems that doctors stand on their self-built pedestals that we the people help support.

I like how specifically in the last third of the book, you discuss how the medias portrayal of birth adds to the misinformation of the birth process and the added trust in doctors to make everything better. I believe this beefs up your initial argument that if women were informed about what they are experiencing, then they (we) would want better for themselves (ourselves). We have a very negative outlook on such a beautiful process which makes us afraid of our own bodies and what we are going through. From all the television shows and movies I've seen, women turn into irrational beasts screaming in the most severe pain begging out for an epidural. Based on this image, birth does seem like something that need to be controlled and restricted.

3 QUOTES THAT RELATE TO THIS POINT:
"Thanks to soap operas and sitcoms, most of the American public currently thinks birth is a surgical procedure carried out not by a woman but by a doctor (the hero)" (pg. 220)

"Any group that wants to maintain a monopoly and is worth its salt knows that controlling the media must be a key part of its strategy. Organized obstetrics in the United States puts enormous energy into what is often called "public relations". (pg 221)

"If the book or article says, 'ask your doctor,' 'trust your doctor,' or 'listen to your doctor', it has failed the trust test and should probably go back on the shelf. If it says, "trust your body," or "trust the scientific evidence,' then it is probably worth reading.(pg. 223)

You did an amazing job proving your ideas and providing an alternative perspective on our countries normal practices, but I believe to take this book further you could have provided more positive birth stories from alternative births rather than statistics that they are just "better for low-risk women".  Positive stories are more encouraging and help women really grasp what having a natural birth is like. Because it is not a necessity it is nice to know what the natural option provides. Also it would have been great if more information about what qualifies as a high risk birth is very important. Not every woman is suitable for natural home births so it is important to distinguish those women apart from the majority. obstetricians do have a purpose so it is necessary to know when they are needed.

But I don't want you to feel like I'm criticizing. I appreciate the immense amount of labor you dedicated to this important issue and particularly for making me think about what an obstetricians true intentions may be before I put all my trust in them  and also how regular practices and the maternity field could greatly damage me and my (theoretical) child. In fact, I'm likely to seek the help of a midwife and experience a completely natural birth thanks to the information provided by this book.

Thank you for writing!

From, Amhara Rein

HW 39 - Insights from Book - Part 2

Wagner, Marsden. Born in the USA How a Broken Maternity System Must Be Fixed to Put Women and Children First. Berekely and Los Angeles, California: University of Berkely, 2006. 1-189. Print.

1. So far, the movie "Business of Being Born" has a good balance of factual evidence and personal experiences while the book has a clear thesis that is constantly proved by numerical and anecdotal evidence. It seems as if the movie is a reference of experience and information about the birthing process for women, and the book is greatly encouraging natural childbirth while demonizing those in the obstetrician field and their common practices. The movie, at one point, brought up the rates of medical interventions in the country and how they are connected to the high maternity rates in this country but the book repeatedly references these rates and also explains the reason behind why they are so high although all this information has been proven.Having practiced with many obstetricians , the author of the book has a lot of insight about their perspective and their true motives behind their actions. The movie offers a much more objective view where midwifery is encouraged, but not advised. The movie also did not go into as much depth about the decrease in midwifery in the United States and the reason behind it. Midwives and home-births are very vilified in this country and it is important to address why they are even though many other highly developed countries use their practices and have a lower maternal and infant mortality rates. Marsden Wagner explains how doctors use the power of their authority to "knock out the competition".
2. I believe that the biggest insight the author is trying to communicate in the second hundred pages of the book is that most obstetricians work in fear: fear of competition and losing their jobs to equally competent midwives, fear of being sued for litigation, fear of losing control and monopoly over the births in the U.S., and mostly of making a mistake and having to admit that they are wrong. I feel as if these obstetricians are fighting for a position that they do not necessarily want to handle. They go to extremes to vilify (through the law and inaccurate statistics from biased studies) midwifery and alternate birthing options yet they aren't willing to handle the pitfalls of their own mistakes.

HW 38 - Insights from pregnancy & birth book - part 1

Response to: Born in the USA by Marsden Wagner. M.D., M.S.

Based on what I have read so far in the book, and the chapters titles in table of contents, this book has a clear tendency to argue right vs. wrong. Each chapter reveals a new nightmarish aspect of the medical maternity system and argues how much better it would be if midwifery and natural births were more common. The book starts off stating the atrocities of the common practice of birth in the medical field, then it eventually leads up to his perfect vision of birth. The general question the author is trying to answer is "what is the most optimal way to birth a child?" I personally agree with his angle of valuing this process as a pivotal moment in life that woman should experience fully. I do believe that every woman deserves the right to choose how she delivers, but more woman should be informed about their options to make the perfect decision to answer this essential question. The major insight given in this section of the book communicates that most obstetricians are more concerned with themselves and their convenience that they do the women they treat and they ultimately take the power of the birthing process in their own hands. The author illustrated his points very well by using mass amounts of evidence regarding statistics of the times of birth and also personal experiences with other obstetricians.  I see how doctors would ultimately want to make the process easier on themselves, seeing as their work hrs are (or should be) indeterminable, but in many cases the convenience of the doctors take away a lot of the convenience of the women in labor. It is a big issue how much doctors take this significant process for granted, but I wouldn't want to vilify them because I can understand their desire for time and convenience, which is a right every human being should be able to possess (which is unfortunately not the case). I believe that the authors use of evidence is very strong and reliable but it is also very bias. The author casually introduces anecdotes which mostly relate to the emotions of himself, other obstetricians, woman, interviewers etc. They help build his points with a poignant connotation. Usually after he makes a major argument,  he backs himself up with statistical and scientific evidence because, as he argues, all the facts should be available to women before they are told what to do.

5 interesting aspects:
1. Doctor's commit insurance fraud by giving elective C-Sections( which aren't beneficial unless in extreme/ rare cases).
2. Interventions during pregnancy usually lead to more interventions that all have their individual risks to the woman and her child.
3. The natural method of giving birth is almost outdated in this country even though it would seem to be the better option for the majority of women.
4.Doctors rarely admit their mistakes or inform women the risks of their procedures. Doctors want full control of the birth process and want it to be as convenient as possible for themselves.
5.  A lot of medical methods used during the birth process not only prove to be unnesicary in most cases, but also increase a lot of risks for the woman and child. They also cost a lot more money to perform than any natural model of birth. (what's the pro in this situation? who is benefiting?)

HW 36 comments

Comments received:

Chris(group member):
WELL,
Before I say your best line and how you can improve, Ill say something I liked about the entire assignment, you started to build off ideas and you basically answered the last part of the blog that you did in blog three times. After every story you talked about how it changed your mind and how it made you realize some things. You started to mention some things about how you had some questions and wanted to look into things after the story. Personally I think your best story was your first one but i think you could have analyzed this more. Because you probably know this story I think you analyzed it less and this shows because in your story about the inducing of birth, you say you didn't know a lot about it and you analyzed that the best in my mind. I think thats how you can improve, you started out alright and ended great so if you could start off as great as you ended you would have a even better post. Heres the line I liked the most "Before this, I had no clue that doctor's inducing birth was something standard. I began to wonder how the drugs and gels given by doctors affected the children, and if they were more affective than any natural alternatives" it shows curiosity and willingness to grow.

Sophia(group member):

First off, this was my favorite line from the interviews:

A- "Did you receive any pain relievers?"
F- "No, this wasn't America" {Laughs}

I really liked the whole first interview, because it was interesting, as you said, to hear about how birth happens in other countries (like how there are maternity homes instead of hospitals).

You also built off your previous ideas after each interview, and you brought up many different topics: natural vs. induced labor, whether the father should be there for the birth, and why birth makes people uncomfortable.

I also didn't know until recently how common it is now for labor to be induced by a doctor; I've heard this isn't very good for the mother or the baby.

All in all, I thought your post was well done and organized. I also liked this line of yours: "It was also interesting to see how these two different parts of the birth process were connected to one another. It makes me imagine the process as a game board where your path is altered depending on where you move."

Brianna (protege):

I think that you did a very good job of analyzing the interviews. You seemed to build off ideas mentioned in the first interview. You also sound really interested in what you are writing. My favorite line was "This interview geared me in a new direction in thought that I hadn't really considered before, which was the difference in birth experience depending on the country your in". I thought that it showed how you were learning new things during the interview. I thikn that you could analyze the first interview a little more thouroughly. It seems the be the most informative so if you analyzed it some more there would be more comparisions to make, points to argue , etc. 

Marcus (mentor):

its interesting to hear your thoughts on the differences in the birth experience depending on the country you're in. your grandmothers experience in a third world country does sound interesting and unlike most of the stories we are used to hearing. that being said i also think that within each country there are also many different experiences. i am not sure if maternity homes are used as widely by women in the u.s. but people also give birth in hospitals in Jamaica. i think that something to consider is not only seeing the differences but also the fact that in any culture there will always be alternative ways of going about things.
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Comments Given:


to Chirs:
I liked how you started this assignment with an idea/ theme in mind because it shows how much thought you put into your objectives before you actually perform them. Plus it was a pretty cool idea to compare birth stories from different time periods. I thought the most interesting part of this post was comparing the male counterparts participation of the sisters birth process. I could see you were on the brink of asking a very insightful question which is " how involved is too much and how involved is not enough?". Another question you could have asked yourself to take your thought process further is: why did the woman in the first interview think it was strange that her male counterpart was so involved?- those questions would have led you to a lot of good points and thoughts.


to Sophia:


I thought it was smart of you to explain the physical and mental effects DURING a pregnancy, which is something I didn't really have in mind going into this assignment. Its important to explain those specific things because in our culture there are many assumptions and stereotypes of women while pregnant. It was also interesting for you to talk about how other people treated her during the pregnancy because that is also definitely a factor.

I believe that your best thought was:
"
I thought it was interesting how her friend's death made her want to have another child. "

because you were touching on the big idea of what motivates people to have children! and this is a very unique and beautiful example of that.