Article: Continuous care

[christy]

Better Births Feature Continuous Care for Moms, “Kangaroo” Care for Kids
Released: Thu 12-Jul-2007

When it comes to giving birth, some traditional approaches could result in happier and healthier moms and newborns, according to two research reviews.

Newswise — When it comes to giving birth, some traditional approaches could result in happier and healthier moms and newborns, according to two research reviews.

Women who have a midwife, doula or a supportive family member with them throughout labor are more likely to have a shorter labor, less likely to use painkillers during labor and more likely to be satisfied with their childbirth experience, compared to those who receive regular hospital care.

In addition, women who practice “kangaroo care” — skin-to-skin snuggling with their newborns — directly after birth are more successful early on at breastfeeding, compared to births where the newborns are taken away to be swaddled or washed.

The reviews appear in The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Skin-to-skin contact and supportive labor care were the norm for centuries, before hospital births became the accepted practice in Western culture. However, “concerns about the consequent dehumanization of women’s birth experiences have led to calls for a return” to some of these practices, said Ellen Hodnett of the University of Toronto.

Hodnett and colleagues reviewed 16 studies of 13,391 women that compared supportive one-on-one care with routine hospital care during labor. In the studies, supportive care included a variety of elements, from encouragement and massage to relaying a woman’s wishes to the attending medical staff.

In general, the researchers found that supportive care worked best when it began in early labor and someone other than hospital staff provided it. The authors conclude, “Continuous support during labor should be the norm, rather than the exception.”

Early skin-to-skin contact between mother and newborn is another practice that has fallen by the wayside in hospital births. In skin-to-skin contact, the naked baby rests on the mother’s bare chest immediately after birth, taking advantage of what Elizabeth Moore, Ph.D., calls “a sensitive period for programming future behavior.”

In 30 studies of 1,925 mother-infant pairs analyzed by Moore and colleagues, pairs who had early skin-to-skin contact were more likely to breastfeed and to breastfeed for longer than those who did not. The review also showed that babies who had kangaroo care immediately after birth “interacted more with their mothers, stayed warmer and cried less,” said Moore.

Hodnett ED, et al. Continuous support for women during childbirth. The Cochrane Database of Systematic Reviews 2007, Issue 3.

LOVE IT

[Inanna]

Thanks for this Christy - it confirms all that my instincts tell me and more...

[christy]

I think thats it, it just brings home what a lot of women want. I think if I was pregnant again I would add this article to my birth plan back up. When I had my birth plan I put it in a folder & put articles and information in a pocket to "back up" what I wanted That way if anyone wanted to argue with me, I had the info right there.

[Inanna]

That's a brilliant idea Christy! Brilliant! I had never thought of that I think it's something that a lot of women could do that would help...

[babygiggles]

Great Artical!!!!

[Smoke Jaguar]

Christy, good work! Could you please PM me the link? I'm doing an assignment on breastfeeding (commencing bfing and retention of it beyond 3 months) and I would like to use it
Similarly, whilst I'm researching articles, I'll post some more of the stand-out ones on BB!

[Carrie]

Great article, and good idea about putting articles etc with your birth plan!

[Julie Doula]

Awesome Christy. I totally concur with this article. I think that continuity of care and skin-to-skin bonding are two vital elements for a satisfying birth.

In countries where women have continuity of care with a known midwife, (who of course promote the skin-to-skin) they really do have excellent outcomes.

This needs to happen with maternity reform in Australia. At present, doulas are filling that gap. I'm looking forward to the day when continuity of care from a doula complements continuity of care received from a chosen midwife. That would be excellent birth support. (You can achieve that in Australia at present if you plan a homebirth.)

I've heard several midwives express how much they would like to have a model of care in Australia that provides for case load care so they can have continuity with women. It's much safer. It's why What Women Want and Maternity Coalition are pushing for medicare numbers for midwives. (That's how it is in New Zealand).

Imagine if you chose your midwife, she looked after you from early pregnancy and through birth and post-natal, and a few years later you chose her again? By baby number 3 or 4, she would really know your style and how to work together. She would know all about your history, if you had any risk factors, what worked best for you emotionally, your social situation - everything. (And if you weren't impressed you could shop around for a midwife you had a better 'click' with). That's what happens in New Zealand. To add a doula to the birth support team where this is the case would mean that you really had fantastic continuous support right through the birthing journey - that's got to help with breast-feeding and post-natal issues including fatigue, stress, depression etc. I wait with hope for the day this is the norm for Aussie women.

The Cochrane Database is a great place to go to find research to back up your birth plan! Great idea, Christy!

[christy]

Yes Julie I agree, I had the same midwife with both girls at the hospital but it wasn't because of "choice" it was luck only. One came on shift 2 hours before my emergency c/s with Matilda and still followed my choices in theatre (breastfeeding before leaving theatre, skin to skin ASAP, Matilda never leaving my sight etc etc) and she was the same one who was on duty when I came into the hospital in labour with Jovie & stayed an extra hour to see the birth. I also had a private midwife (friend) the second time around.

[Julie Doula]

It just makes such a difference, doesn't it? It is much preferred by midwives, too. It is costly to have to hire one's own private midwife (but still worth it! IMO) I think the govenment would save millions and have a much healthier, happier birthing population if they funded case-load midwifery options for women.