New Evidence: Give Women More Time in Labor.

This one is so simple, so straight forward. Give women a bit more time to labor and we can reduce the cesarean rate. This is of course assuming that everything points to the mother and the baby being in good health. As long as everyone is doing find, and the mother is game, let's create the space and be encouraging and supporting to women who want to labor just a bit longer and potentially avoid a c-section. This recent study showed that giving mothers just one more hour of time can cut the Cesarean rate in half. That's big. Here's the article you can read to learn more:

http://www.huffingtonpost.com/entry/new-evidence-that-we-just-need-to-give-women-more-time-to-labor_us_56ec4f66e4b084c672203418

US C-Sections Rate: Too High

If you've been or are pregnant in NYC,  probably one of the first things you did was to figure out who your doctor would be and where you would give birth. You may have spent hours googling something like "NYC OB low cesarean rate," or "NYC hospital low c-section rate." And you may or may not have found the answers you were looking for. Consumer Reports just released an article reviewing the current state of cesarean births and rates by hospitals around the country. Many of the hospitals in NYC that my clients have given birth in do not release their statistics. Considering that your biggest Cesarean risk might be the hospital that you give birth in, withholding c-section rates by hospital (and even by practice or doctor) just doesn't seem ethical.

You can read the full article here: http://www.consumerreports.org/doctors-hospitals/your-biggest-c-section-risk-may-be-your-hospital/

Using a Mother’s Microbes to Protect Cesarean Babies

"The first germs to colonize a newborn delivered vaginally come almost exclusively from its mother. But the first to reach an infant born by cesarean section come mostly from the environment — particularly bacteria from inaccessible or less-scrubbed areas like lamps and walls, and skin cells from everyone else in the delivery room.

That difference, some experts believe, could influence a child’s lifelong health. Now, in the first study of its kind, researchers on Monday confirmed that a mother’s beneficial microbes can be transferred, at least partially, from her vagina to her baby after a C-section."

Read the full article from the NYT Well Blog here.

The Big Baby Card

Below is an excerpt from When A Big Baby Isn't So Big

"The new study, called Listening to Mothers III, was based on Childbirth Connection’s nationally representative survey of some 1,960 new mothers. It found that four out of five of the mothers who were warned they might have large babies gave birth to infants who were not large, and weighed less than 8 pounds 13 ounces.

Yet these mothers were almost twice as likely to have medical interventions such as having doctors medically induce their labor or attempting to self-induce labor, presumably out of concern the baby would continue growing otherwise. They were also nearly twice as likely as other mothers to have a planned cesarean, though the increase fell just short of being statistically meaningful."

Avoiding the costs and risks of Cesareans

One of the big reasons I get hired by my clients is because they want to avoid a c-section. In the U.S., our national c-section rate is about 33%, just over more than twice that of the rate recommended by the World Health Organization, which is 15%. Why are they performed so often then? Many people believe it's motivated financially, which it may be in some cases, but for most, it may be more motivated by the risk tolerance of a woman's OB. 

Read more here: http://www.latimes.com/business/la-fi-healthcare-watch-20151113-story.html?utm_content=24577747&utm_medium=social&utm_source=facebook

The Big Baby Myth

I often hear care providers telling women that they recommend and induction or a C-section or other intervention if it's suspected that they have a "big baby." Here are two great articles that take a researched and balanced approach to the Big Baby phenomena.

Evidence-based Care for Suspected Big Babies

Babies Declared "Too Big" In Utero Are Often Smaller Than Doctors Predict, Any Why That's A Problem

How Doulas Impact C-Section Rates

"The presence of a doula at birth was linked to an almost 60 percent reduction in women's odds of having a C-section, and 80 percent lower odds of having a nonmedically indicated C-section compared with women who had no doula. (Overall, 10 percent of the women in the survey said they had no clear medical need for a cesarean delivery, yet delivered via C-section anyway.) 

Women with doulas also had significantly lower odds of having a C-section -- both for clear medical reasons and otherwise -- than those who wanted a doula but did not have one.

"What our study showed is that [lower odds of a C-section] don't come with wanting a doula; it's having a doula that is actually associated with important and substantial risk reductions," Kozhimannil said."

Read the full text of the article here.

Mothers facing C-sections look to vaginal 'seeding' to boost their babies' health

"Dominguez-Bello, a microbiologist from NYU, has been studying the microbiome for several years. For the past three she’s been trying to determine if C-section babies can reap the benefits of a vaginal birth through the process of seeding with gauze that’s been incubated in its mother’s vagina. So far, the results are very promising."