Midwifery: August 2003 Archives


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I have welcomed three babies into this world in the last 24 hours and I am exhausted. I am going to sleep in a few minutes, so I can be awake to pick up my box of veges this afternoon. But right now I am just happy for the three new babies. Two boys, one girl, and all cute as can be!

Midwife Crisis

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$QUEEZED OUT: The Elizabeth Seton Childbearing Center, a midwife facility popular with celebrities like Ricki Lake, is being forced to close because of skyrocketing malpractice costs.

Jeff Miller was kind enough to send me a link to this sad news story.
I do have one issue with the wording of this (and similar stories). The cost that is skyrocketing is not that of actual malpractice, it is for insurance to protect against claims of malpractice.
In the mid-1980s, there was a similar crisis with malpractice insurance costs. The one company then providing malpractice insurance to privately insured CNMs (certified nurse-midwives) decided, for reasons that were never explained, to simply non-renew all policies held by midwives. This resulted in the loss of hospital privileges for several dozens of CNMs across the country and the closure of several thriving private nurse-midwifery practices. Practices in public hospitals serving mostly the uninsured and the poor were not affected, as their coverage was generally through a large pool.
A more cynical soul than I might have thought that this was one salvo in an economic war - as long as midwives restrict their practice to the poor and uninsured they could be tolerated or even encouraged (as long as they leave enough poor women to be available for resident training purposes). However, we all know that there isn't really economic competition to care for childbearing women - it is all about providing the highest quality of service at the lowest cost. The insurance companies just don't understand that CNMs (and other midwifes) cost less, have comparable or better outcomes than other OB care providers, and are less likely to be sued. They only see that they are liable for potential suit for 18 years plus the statute of limitations, and lump them in with OB doctors who also do surgeries, and with family practice docs who also deliver babies.
A premium that a doc can roll into their overhead and absorb (albeit with a lot of pain) can kill a midwifery practice.
Something needs to be done. I just don't know what.

A miracle birth

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Boy survives after growing in abdomen
Healthy baby delivered at sacré coeur. Fewer than one in a million of such cases carried successfully to term, doctors say (more)

A friend of my sisters was one of these miracle babies. Technically, the surgery should not be called a cesarean, as the uterus is not entered. The surgery is a laparotomy. But whatever one calls it, it truly is a miracle.

Dinka's Birth


dinka's birth story is posted.

On the ECUSA Vote


Many bloggers have posted or commented on the ECUSA vote on the (Epsicopal) bishop of New Hampshire. Sparki (fonticules fides) has an interesting set of comments, but for issues involving same sex attraction (SSA) I defer to Sed Contra. David Morrison has some excellent commentary posted recently, and I can say is that I second his thoughts.
It is really interesting to me that the feminist movement spent decades proclaiming "Biology is not destiny", and yet the homosexual libertine movement has spent the same decades proclaiming basically that 1) homosexual attraction and acting out is hard-wired into the brains and bodies of some men and women and 2) in this case, biology is destiny.
Kind of reminds me of Pilate's famous line, "What is truth?".
We have an assurance that Christ is the way, the truth, and the life. No matter how many votes would deny that truth, it still remains true.

U.S. Births


The preliminary data presented in this report are based on records of births occurring in 2002 that were received and that underwent quality control by the Centers for Disease Control and Prevention's National Center for Health
Statistics as of March 7, 2003. These records represent nearly 98% of the births that occurred in the United States in 2002. The records were weighted to independent control counts of all births received in state vital statistics offices in 2002, and comparisons were made with final data from previous years.

The report presents the following trends in birth numbers and rates:

* The fertility rate for women ages 15-44 years dropped by 1% in 2002, a 9% decline since 1990.
* The birth rate for adolescents ages 15-19 dropped by 5% in 2002, a 28% decline since 1990.
* The birth rate for women ages 20-24 dropped by 3% in 2002 compared with 2001, whereas the birth rates for women ages 35-39 and 40-44 rose by 2%.
* The number of births to unmarried women ages 15-44 rose by 1% in 2002; however, births to unmarried adolescents ages 15-19 dropped by 4%.
* Prenatal care utilization continued to slowly but steadily improve; 83.8% of women began prenatal care in the first trimester of pregnancy in 2002, compared with 83.4% in 2001.
* More than one-fourth of all births in 2002 were cesarean deliveries, the highest rate ever reported in the United States. The primary cesarean rate jumped 7% from the previous year to 18%, also the highest level ever reported for the country. The rate of vaginal births after previous cesarean delivery plummeted by 23% between 2001-2002 to 12.7%.
* Preterm and low-birthweight rates (7.8%) rose slightly in 2002. The low-birthweight rate is the highest reported in more than three decades.

See the report for a list of references and detailed tables, as well as technical notes.

National Center for Health Statistics. 2003. Births: Preliminary data for 2002. National Vital Statistics Report 51(11). Atlanta, GA: Centers for Disease Control and Prevention.

Oral Contraceptive


An interesting article on post-fertilization effects of oral contraceptives. It is pretty technical, but the bottom line is pretty clear - breakthrough ovulation is fairly common with commonly used oral contraceptive medications.

Baby Blues


Baby Blues on 'new improved' infant formula.

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About this Archive

This page is a archive of entries in the Midwifery category from August 2003.

Midwifery: July 2003 is the previous archive.

Midwifery: September 2003 is the next archive.

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