From NYTimes: Artificially breaking water does not speed up labor

The practice of artificially rupturing a woman’s membrane, or bag of waters, during labor has become quite common. I have seen it myself a few times, and have heard about it A LOT. Well, now there is research proving that it has no affect on shortening the length of labor or improving the health of the baby.

From the report:

Evidence does not support the routine breaking the waters for women in spontaneous labour
The aim of breaking the waters (also known as artificial rupture of the membranes, ARM, or amniotomy), is to speed up and strengthen contractions, and thus shorten the length of labour. The membranes are punctured with a crochet-like long-handled hook during a vaginal examination, and the amniotic fluid floods out. Rupturing the membranes is thought to release chemicals and hormones that stimulate contractions. Amniotomy has been standard practice in recent years in many countries around the world. In some centres it is advocated and performed routinely in all women, and in many centres it is used for women whose labours have become prolonged. However, there is little evidence that a shorter labour has benefits for the mother or the baby. There are a number of potential important but rare risks associated with amniotomy, including problems with the umbilical cord or the baby’s heart rate.

The question is whether or not the research recommendations will get implemented in practice. The trickle-down effect is slow–research comes out, and has to slowly trickle down the medical system to providers. Medical students are probably the most likely to hear these things first, as they are studying the practices, although medical textbooks don’t always have the most up-to-date research. This just reinforces the idea that doctors are routinely performing procedures that have no benefit to the laboring woman.

Thanks to Doulicia for the link.

“In simpler times, we were all gay.”

At least according to Salon.com’s John Aravosis. His article, entitled How did the T get in LGBT, tackles the question of the Employment Non-Discrimination Act (ENDA) and the current political battle going on in Congress about including transgender people in the protections afforded by the bill.

This discussion, about whether it’s right to leave transgendered people out of the bill if it helps to pass the legislation (which protects LGB people from workplace discrimination based on sexual preference) isn’t a new debate for the progressive community. In an attempt to advance what Aravosis calls “practical politics,” minority groups have been sold down the river. Examples? Women under 18 and the Emergency Contraception over the counter debate (they still need a prescription). State Children’s Health Insurance Program (SCHIP) and immigrants.

I understand the idea that some victories need to happen piecemeal–but these kind of compromises always leave me with a bad taste in my mouth. “Practical politics” work well for the people who don’t get cut out of the deal, but they don’t really help us move forward a broader vision for social justice.

Aravosis brings up the example of civil rights in his article as well, and the history there connects to another interesting example of compromise. When the civil rights movement was first developing, a political decision was made by the leaders to use the civil rights framework rather than the human rights framework (of which civil rights in one of eight rights afforded to human beings within this framework).

This broader vision of human rights has allowed other countries (who in many ways seem less “developed” than ours) make headway into some of the areas where we have not, because the human rights framework lays it all out in clear and indisputable ways. Mexico City for example, just legalized first trimester abortion, an argument that made headway in a heavily Catholic country because of this framework. Spain and South Africa have both legalized gay marriage.

Where would we be if we had pushed for a broader vision of human rights back in the day? Aravosis would argue that African-American’s would be without any rights at all. I have trouble believing that.

So I just read Cara’s reponse to Aravosis’ piece. She says it all, in an angry and justified tone. Check it out. My favorite part might be the title: You don’t have to be straight to be an ass.

In case you needed another reason not to want a c-section

This one is scary, and unfortunately not from an episode of ER or Grey’s Anatomy.

A Florida woman is being awarded over 2 million dollars in damages after a doctor left a one foot by one foot surgical sponge in her uterus after a c-section. According to the woman, it was severe pain in the days following her c-section that brought her back to the hospital.

“I couldn’t walk,” she said. “I had to double over because the pain was horrendous.” When antibiotics did nothing to alleviate what doctors said was an infection, Dr. Joseph Becerra took an X-ray. The radiologist noticed a foreign object lodged in the 37-year-old’s abdomen, but it took days before Becerra removed the 1-foot by 1-foot surgical sponge that eventually damaged her uterus.

Here’s the even scarier part:

According to Florida’s Agency for Healthcare Administration, there were 88 surgeries in 2005 in hospitals statewide to remove objects left in patients from a previous operation.

And that’s just in Florida.

More on the C-section crisis

Jennifer Block, the author of Pushed, a look at the crisis in maternity care for a mainstream audience has a piece at the LA Times about the cesarean crisis.

Via Feministe.

Police Brutality Strikes Fifth Anniversary of Sylvia Rivera Law Project

This is just sad.

Police Brutality Strikes Fifth Anniversary of Sylvia Rivera Law Project

Contacts:
Jack Aponte (jack@slrp.org)
Naomi Clark  (naomi@slrp.org)

NEW YORK – On the night of Wednesday, September 26, officers from the 9th Precinct of the New York Police Department attacked without provocation members of the Sylvia Rivera Law Project and of its community. Two of our community members were violently arrested, and others were pepper sprayed in the face without warning or cause.

The Sylvia Rivera Law Project is an organization that works on behalf of low-income people of color who are transgender, gender non-conforming, or intersex, providing free legal services and advocacy among many other initiatives. On Wednesday night, the Sylvia Rivera Law Project was celebrating its fifth anniversary with a celebration and fundraising event at a bar in the East Village.

A group of our community members, consisting largely of queer and transgender people of color, witnessed two officers attempting to detain a young Black man outside of the bar. Several of our community members asked the officers why they were making the arrest and using excessive force. Despite the fact that our community was on the sidewalk, gathered peacefully and not obstructing foot traffic, the NYPD chose to forcefully grab two people and arrested them. Without warning, an officer then sprayed pepper spray across the group in a wide arc, temporarily blinding many and causing vomiting and intense pain.

“This is the sort of all-too-common police violence and overreaction towards people of color that happens all the time,” said Dean Spade, founder of the Sylvia Rivera Law Project. “It’s ironic that we were celebrating the work of an organization that specifically opposes state violence against marginalized communities, and we experienced a police attack at our celebration.”

“We are outraged, and demand that our community members be released and the police be held accountable for unnecessary use of excessive force and falsely arresting people,” Spade continued.

Damaris Reyes is executive director of GOLES, an organization working to preserve the Lower East Side. She commented, “I’m extremely concerned and disappointed by the 9th Precinct’s response to the situation and how it escalated into violence. This kind of aggressive behavior doesn’t do them any good in community-police relations.”

Supporters will be gathering at 100 Centre Street tomorrow, where the two community members will be arraigned. The community calls for charges to be dropped and to demand the immediate release of those arrested.

– END –

For more information visit, www.srlp.org

Brittain looks to allow midwives and nurses to perform early abortions

This article from the Independent today announces that some politicians in the UK are looking to expand women’s access to early abortions by allowing nurses and midwives to perform them.

MPs from all parties are to launch a campaign to modernise abortion law. They want to allow women to have early abortions on an “informed consent” basis and to allow trained nurses and midwives to carry out early abortions for the first time. They also want to expand the number of clinics offering early abortions so that women are no longer restricted to using centres officially licensed to carry out terminations.

A first trimester abortion is a very simple medical procedure (as well as one of the safest ones out there) and this isn’t the first time I’ve heard the idea to expand the definitions of who can perform these procedures. I’m not as familiar with the UK abortion climate, but here in the US, many of the laws regulating abortion providers are really meant to limit women’s access to abortion, rather than for their safety and protection. In the US, we are looking at a serious abortion provider shortage in the near future, with medical schools and students not being taught how to do the procedure.

The more authority midwives can gain to do medical procedures, particularly ones that have historically fallen under doctors domain, but are relatively simple. Plus, it will be a huge step forward toward increasing access to this important (and one of the most common) medical procedure for women.

Parting words for Attorney General Alberto Gonzalez

To mark the resignation of Attorney General Alberto Gonzalez on Monday, Page Rockwell has a great piece up at Salon about what kind of legacy he is leaving behind.

Let’s recap:

  • Torture
  • Suspicous and unexplainable firing of US Attorney’s
  • The first Supreme Court cases banning an abortion procedure
  • Overall shadyness and misconduct

Thanks a lot Alberto. We won’t miss you.

What is so broken that they don’t want to use it?

Yesterday’s Washington Post article about “do it yourself” birth has some interesting things to say about this practice (that they imply is on the rise) of women giving birth alone at home, without help from any providers at all–no doctors or midwives.

This idea, of a woman giving birth alone, cutting the umbilical cord herself, is definitely not a new one. Despite the fact that it is a huge departure from our “modern” idea of childbirth (where huge amounts of technology and expertise are seen as indispensable), there is a long history of isolationist birth practices. Indigenous cultures have (and continue to) employ these practices–a group of indigenous midwives in the Ecuadorian Amazon told me about women from certain groups who would walk into the jungle when ready to give birth, and come back hours later with the newborn child.

I definitely wouldn’t advocate for a return to these times, or an adoption of these practices from other cultures. I don’t think most women in the US are ready to take on childbirth solo, but these extreme cases to prove a few things to the rest of us:

-It is possible to be completely in control of ones birth, without high-level medical expertise

-Some number of people are giving birth this way, disrupting the birth-as-emergency paradigm

The midwife interviewed for the article points out the most crucial question:

“To me the really interesting question is, Why would someone go outside the system?” Rothman said. “What is so broken that they don’t want to use it?”

Menstruation Optional

After all the recent buzz about the new birth control pill Lybrel, which gets rid of the traditional “sugar pill” week and allows women to skip menstruating all together–the pill is finally on the shelves this month.

Karen Houppert has an Op-Ed about it at the NYTimes today, and she points out the interesting ways the menstruation as proof of inferiority has been used to certain groups advantage. She points out that when women were needed in the factories during the World Wars, they were told that having their period didn’t matter, and they should “buck up.” But when it comes to having a woman in the White House, its not uncommon to hear PMS and emotional instability thrown around like character flaws.

So we’ll see how Wyeth Pharmaceuticals, the makers of Lybrel, decide to try and market their new pill. But in my own, non-biologist opinion, I have some immediate concerns about these new technologies:

  • All those synthetic hormones? I personally am wary of all hormonal birth control, I’m not sure if I believe that there are no negative side effects to them. I’ve also been told that when you introduce synthetic hormones into your body, your body doesn’t make any of its own hormones–so you might be subsisting at a level that is too high or too low for you, which can have side effects like bone loss. Also let’s remember the Hormone Replacement Therapy fiasco.
  • What about the good effects of the sloughing of the uterine lining each month? I think of it as rejuvenatory, allowing new and healthier cells to grow in its place. Could this have an impact on risk for uterine cancers?
  • Lastly, when I think of missing periods, or amenorrhea, I think of it being an indicator of something else wrong with the body–bad nutrition, stress, (or pregnancy). How can something that indicates a bodily imbalance be a good thing?

There could be a lot of other arguments about how great menstruating is, and how it connects us with mother earth, la pacha mama or the lunar calender. I’ll spare you all of those, and leave it at my concerns above.

All of this controversy reminded me of a great piece written by Gloria Steinem, called If Men Could Menstruate. Read it. While published in 1978, I think it has particular resonance today.

I’d love to hear what other doulas and midwives think about this new pill.

Woman gives birth in jail cell

This story from the Times-Tribune today, is a chilling reminder of the horrible criminal justice system (ironic that they use the word justice) which regularly abuses the people caught up in it. The Tribune reports that a Pennsylvania woman being held at a county jail for minor drug charges was refused transfer to a hospital during labor, and was forced to give birth to her child in her cell. According to the woman’s grandmother, a female warden cut the umbilical cord with her fingernails.

One of the most repulsive things about this story is the reaction of prison officials, who refuse to confirm or deny this story based on the woman’s supposed rights to privacy. So all of a sudden when it helps protect prison image they are all about defending her rights? What about her right to medical care and equal treatment? This is an obvious human rights violation, and it scares me to think about what other violations are being carried out in our growing prison system.

For more information about prisoner’s rights work, check out the ACLU or Critical Resistance, a campaign to end the Prison Industrial Complex. Also check out my post about the Prison Doula Project.