As Nature Intended
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2010 VBAC Summit 02/19/2010
 
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Nancy Wainer, CPM and Author of
Silent Knife:
Cesarean Prevention and VBAC

Below you will find one of the Power Point presentations used by one of the speakers, which talk about the effects of cesarean birth on the newborn. It is one of the topics that concerns our organization as we try to help mothers and fathers to make educated decisions about methods of birth and how they impact the well-being of our babies.

2010 VBAC Summit Topic: Conversations about the reality of maternity care in the United States:  Skyrocketing cesarean rates and the decline in vaginal births after cesareans.

Make sure to click with your mouse on each slide to go to the next.

http://www.vbacsummit.org
Speakers:
Nancy Wainer, CPM
Dr. Magloire, OB-GYN
R. Zachary Pearson-Martinez, MD FAAP
Tamara Taitt, MS
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Genital Autonomy 2010
29-31 July 2010
University of California, Berkeley

REGISTRATION Register early, space is limited.
Campus Accommodations
(dormitory rooms)
Check in after 3pm Wednesday, 28 July, check out by
noon Sunday. Prices include accommodations & breakfast
(Thursday-Sunday and lunch Thursday-Saturday)

Early Registration (postmarked to NOCIRC by June 10):
Single room – $550 full symposium; $239 per day
Double room – $450 full symposium; $199 per day

Late Registration (postmarked to NOCIRC after June 10)
Single room – $599 full symposium; $249 per day
Double room – $499 full symposium; $219 per day
Additional accommodation nights available upon request

Registration Without Accommodations
(includes all meals as mentioned above)

$250 full symposium; $129 per day

Student Rates:
$190 full symposium; $96 per day

Parking Permits Required at Symposium Site
Rates: $14 per day. Must be ordered in advance.

Off Campus Accommodations:
Hotel Shattuck; http://www.hotelshattuckplaza.com
866-466-9199 or 510-845-7300

Banquet Dinner
Friday night, Faculty Club
Preferences: Chicken, Salmon, or Healthy Wok Vegetarian

Flight Arrangements & Door-to-Door Ground Transportation
Oakland Airport
(closest to UC Berkeley)
Bay Porter $25 + tip; http://www.BayPorter.com

San Francisco Airport
Bay Porter $32 + tip; http://www.BayPorter.com

Continuing Education
CE credits provided upon request

Registration Forms
Available at http://www.nocirc.org (bottom right, home page)

ONLINE RSVP http://www.facebook.com/event.php?eid=315907489615
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Please join us in Boston to voice your
support for the Massachusetts MGM Bill! [link]
Tuesday, March 2, 2010
1:00 pm
Hearing Room A-1
The Massachusetts State House24 [link]
Beacon Street  [link]
Boston, MA 02108
Directions
[link]
Parking
[link]
Massachusetts MGM Bill Status [link]
Massachusetts MGM Bill History [link]
Committee Hearing Tips [link]

Please also email your written testimony and/or a link to your video testimony [link] in support of the bill before March 2nd by writing to:  

Michael Avitzur, Legislative Counsel (Michael.Avitzur@state.ma.us)
 and
Rep. Eugene O’ Flaherty, House Judiciary Chair (Rep.GeneOFlaherty@hou.state.ma.us)

with a copy to these other Judiciary Committee members:

Senator Cynthia Creem, Senate Judiciary Chair (Cynthia.Creem@state.ma.us)
Senator Steven Baddour, Senate Judiciary Vice-Chair (Steven.Baddour@state.ma.us)
Senator Gale Candaras (Gale.Candaras@State.MA.US)
Senator Jack Hart (John.Hart@state.ma.us)
Senator Thomas McGee (Thomas.McGee@state.ma.us)
Senator Bruce Tarr (Bruce.Tarr@state.ma.us)

Rep. Christopher Speranzo, House Judiciary Vice-Chair (Rep.ChristopherSperanzo@Hou.State.MA.US)
Rep. James Fagan (Rep.JamesFagan@hou.state.ma.us)
Rep. Colleen Garry (Rep.ColleenGarry@hou.state.ma.us)
Rep. Marie St. Fleur (Rep.MarieSt.Fleur@hou.state.ma.us)
Rep. John Fernandes (Rep.JohnFernandes@Hou.State.MA.US)
Rep. Katherine Clark (Rep.KatherineClark@HOU.State.MA.US)
Rep. James Dwyer (Rep.JamesJDwyer@hou.state.ma.us)
Rep. Danielle Gregoire (Rep.DanielleGregoire@hou.state.ma.us)
Rep. Lewis Evangelidis (Rep.LewisEvangelidis@hou.state.ma.us)
Rep. Daniel Webster (Rep.DanielWebster@hou.state.ma.us)

You can also contact the Boston news media and ask them to report on this history making event:

Print
Boston Globe: 617-929-2000
Boston Herald: 617-619-6789
Metro Boston: 617-210-7905
Boston Phoenix: 617-536-5390
New York Times, Boston: 617-227-6188
Associated Press, Boston: 617-357-8101
Wall Street Journal, Boston: 617-654-6714

Radio
NPR WBUR Boston: 617-353-0770

Television
CBS WBZ TV 38: 877-WBZ-TIPS
ABC WCVB TV 5: 781-449-0400
NBC WHDH 7: 800-280-TIPS
FOX WFXT TV 25: 781-467-1300
PBS WGBH TV 2: 617-300-5400

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Renante Taris breastfeeds her son, Erikson
are at a hospital in Port-au-Prince, Haiti.
As nature intended.
UNICEF, WHO and WFP call for support for appropriate infant and young child feeding in the current emergency, and caution about unnecessary and potentially harmful donations and use of breast-milk substitutes.

UNICEF, WHO and WFP call for support for appropriate infant and young child feeding in the current emergency, and caution about unnecessary and potentially harmful donations and use of breast-milk substitutes

During emergency situations, disease and death rates among under-five children are higher than for any other age group; the younger the infant the higher the risk. Mortality risk is particularly high because of the combined impact of a greatly increased prevalence of communicable diseases and diarrhoea and soaring rates of under-nutrition. Appropriate feeding and care of infants and young children is essential to preventing malnutrition, morbidity and mortality.

Major health problems among Haitian children, which have been exacerbated by this crisis, are acute and chronic malnutrition and communicable diseases. Given the structural damage caused by the earthquake to water supply systems, there is an additional risk of water borne diseases affecting large numbers of the urban, rural and displaced populations. Many infants and young children have been orphaned or separated from their mothers. Risks to children in Haiti are exacerbated by pre-earthquake poor infant and young child feeding practices and malnutrition. In this emergency situation, the lifeline offered by exclusive breastfeeding to children for the first six months of life and continued breastfeeding with complementary feeding for two years or more is of utmost importance and must be protected, promoted and supported as much as possible.

Most mothers initiate breastfeeding in Haiti, and the majority of infants less than six months of age were at least partially breastfed prior to the earthquake. At this stage it is critical to encourage and support mothers to initiate breastfeeding immediately after the delivery, exclusively breastfeed up to six months and for those with infants below six months who ‘mix feed’ to revert to exclusive breastfeeding. Nonbreastfed infants are at especially high risk and need early identification and targeted skilled support, including re-establishing breastfeeding (relactation).

Protection and support for breastfeeding women
No food or liquid other than breast milk, not even water, is needed to meet an infant’s nutritional and fluid requirements during the first six months of life. The valuable protection from infection that breastfeeding confers is all the more important in environments without safe water supply and sanitation. Therefore, creation of a protective environment and provision of skilled support to breastfeeding women are essential interventions. There is a common misconception that in emergencies, many mothers can no longer breastfeed adequately because of stress or inadequate nutrition. Concern for these mothers and their infants can fuel donations of breastmilk substitutes (BMS) such as infant formula. Although stress can temporarily interfere with the flow of breastmilk, it is not likely to inhibit breastmilk production, provided mothers and infants remain together and are supported to initiate and continue breastfeeding. Mothers who lack food or who are malnourished can still breastfeed. Provision of adequate fluids and food for mothers must be a priority as it will help to protect their health and well-being as well as that of their young children.

Basic interventions to facilitate breastfeeding include prioritising mothers with young children for shelter, food, security, and water and sanitation, enabling mother-to-mother support, providing specific space for skilled breastfeeding counselling and support to maintain or re-establish lactation. Traumatised and depressed mothers may have difficulty responding to their infants and require particular mental and emotional support. UNICEF, WHO and other organizations involved in infant feeding in emergencies will support training of staff on individual assessment of the best options for feeding infants, as well as education and support of caregivers on optimal infant feeding in these emergency circumstances.
 
 
There is so much misinformation regarding how to care for an intact penis of a boy. Many parents complain that their doctors are telling them to retract the foreskin to clean underneath when this is not true. We are not supposed to retract the foreskin of our sons, ONLY the owner of the penis should do it. The foreskin is naturally fused to the glans from birth until after puberty (see graph in video), all boys are different and they develop differently. Forcibly retraction of the foreskin will cause pain, scarring and damage, and can become a problem later in life - which is the commonest cause of true phimosis. Please watch the video and educate others about proper intact care. You can also print out some information for your doctor, nurses or birth care providers by clicking here.
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Note separation happens naturally and
gradually and it varies boy to boy
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This eye-opening documentary reveals how the marketing of powdered milk has caused fewer mothers to breastfeed in the Philippines - including those who can ill afford artificial milk and suffer its harmful consequences. The milk companies' formula for profits is a formula for disaster. 

(set of 5 clips)

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Our children are constantly growing, they need a balanced diet for their brains and bones from the start, for healthy growth and mind. Some of us assume that because these foods are sold in our supermarkets, they are safe for our family. When I started reading labels I noticed that most of our (processed) foods are full of dangerous additives and preservatives that are essential for cheap production and preserve shelf life. If we take each of these ingredients individually, I bet you would hesitate to eat them because these are NOT food. Most of these ingredients are linked with many known diseases like Diabetes, behavioral problems (ie. ADD or ADHD), Cancer, Heart Disease, Digestive problems, Allergies, the list goes on...
Lunchables pre-packaged meals are unhealthy for both children and adults.
These include sodium nitrite, artificial flavor, refined flour, partially
hydrogenated cottonseed oil (trans fat) and high fructose corn syrup.
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12 Dangerous Food Additives: The Dirty Dozen Food Additives You Really Need to be Aware Of by www.SixWise.com

In the United States, more than 3,000 substances can be added to foods for the purpose of preservation, coloring, texture, increasing flavor and more. While each of these substances is legal to use (at least here in the States), whether or not they are all something you want to be consuming is another story all together.

The food colorings that make candy pretty colors have been linked to cancer and tumors of the brain, thyroid, adrenal gland and kidney in animal studies.

With any processed food you run the risk of coming across additives, and reading through ingredient labels can be like trying to decode a puzzle.

Of course, eating largely fresh, whole foods is the best way to stay away from unsavory additives, but, assuming you do include some processed foods in your diet, the following additives are ones you surely want to stay away from. Look for them on ingredient labels and if one turns up, take a pass.


Propyl Gallate

This preservative, used to prevent fats and oils from spoiling, might cause cancer. It's used in vegetable oil, meat products, potato sticks, chicken soup base and chewing gum, and is often used with BHA and BHT (see below).

BHA and BHT

Butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT) are used similarly to propyl gallate -- to keep fats and oils from going rancid. Used commonly in cereals, chewing gum, vegetable oil and potato chips (and also in some food packaging to preserve freshness), these additives have been found by some studies to cause cancer in rats. If a brand you commonly buy uses these additives, look for a different variety, as not all manufacturers use these preservatives.

Food Additives and Your Brain:Free e-Book

If you want to know more about the effects of food additives on your brain, check out this FREE 300+-page e-book "Neurotoxicity: Identifying and Controlling Poisons of the Nervous System."

Some food additives are neurotoxic, which means they're capable of altering the normal activity of the nervous system -- and even killing neurons. Symptoms include:

  • Limb weakness or numbness
  • Loss of memory, vision, and intellect
  • Headache
  • Cognitive and behavioral problems
  • Sexual dysfunction

See and Download "Neurotoxicity: Identifying and Controlling Poisons of the Nervous System." Now

Potassium Bromate

This additive is used in breads and rolls to increase the volume and produce a fine crumb structure. Although most bromate breaks down into bromide, which is harmless, the bromate that does remain causes cancer in animals. Bromate has been banned throughout the world, except for in the United States and Japan. In California, a cancer warning would likely be required if it were used, which is why it is rarely used in that state.

Monosodium glutamate (MSG)

MSG is used as a flavor enhancer in many packaged foods, including soups, salad dressings, sausages, hot dogs, canned tuna, potato chips and many more. According to Dr. Russell Blaylock, an author and neurosurgeon, there is a link between sudden cardiac death, particularly in athletes, and excitotoxic damage caused by food additives like MSG and artificial sweeteners. Excitotoxins are, according to Dr. Blaylock, "A group of excitatory amino acids that can cause sensitive neurons to die."

Many consumers have also personally experienced the ill effects of MSG, which leave them with a headache, nausea or vomiting after eating MSG-containing foods. To find out more about the side effects associated with MSG, as well as a complete list of which foods contain it, see our past article MSG: If it's Safe: Why do They Disguise it on the Labels?

Aspartame (Equal, NutraSweet)

This artificial sweetener is found in Equal and NutraSweet, along with products that contain them (diet sodas and other low-cal and diet foods). This sweetener has been found to cause brain tumors in rats as far back as the 1970s, however a more recent study in 2005 found that even small doses increase the incidence of lymphomas and leukemia in rats, along with brain tumors.

People who are sensitive to aspartame may also suffer from headaches, dizziness and hallucinations after consuming it.

Acesulfame-K

Acesulfame-K is an artificial sweetener that's about 200 times sweeter than sugar. It's used in baked goods, chewing gum, gelatin desserts and soft drinks. Two rat studies have found that this substance may cause cancer, and other studies to reliably prove this additive's safety have not been conducted. Acesulfame-K also breaks down into acetoacetamide, which has been found to affect the thyroid in rats, rabbits and dogs.

Olestra

Olestra is a fat substitute used in crackers and potato chips, marketed under the brand name Olean. This synthetic fat is not absorbed by the body (instead it goes right through it), so it can cause diarrhea, loose stools, abdominal cramps and flatulence, along with other effects. Further, olestra reduces the body's ability to absorb beneficial fat-soluble nutrients, including lycopene, lutein and beta-carotene.

Sodium Nitrite (Sodium Nitrate)

Like diet soda? The aspartame that's used to sweeten it increases lymphomas, leukemia and brain tumors in rats -- even in small doses.

Sodium nitrite (or sodium nitrate) is used as a preservative, coloring and flavoring in bacon, ham, hot dogs, luncheon meats, corned beef, smoked fish and other processed meats. These additives can lead to the formation of cancer-causing chemicals called nitrosamines.

Some studies have found a link between consuming cured meats and nitrite and cancer in humans.

Hydrogenated Vegetable Oil

The process used to make hydrogenated vegetable oil (or partially hydrogenated vegetable oil) creates trans fats, which promote heart disease and diabetes. The Institute of Medicine has advised that consumers should eat as little trans fat as possible. You should avoid anything with these ingredients on the label, which includes some margarine, vegetable shortening, crackers, cookies, baked goods, salad dressings, bread and more. It's used because it reduces cost and increases the shelf life and flavor stability of foods.

Blue 1 and Blue 2

Blue 1, used to color candy, beverages and baked goods, may cause cancer. Blue 2, found in pet food, candy and beverages, has caused brain tumors in mice.

Red 3

This food coloring is used in cherries (in fruit cocktails), baked goods and candy. It causes thyroid tumors in rats, and may cause them in humans as well.

Yellow 6

As the third most often used food coloring, yellow 6 is found in many products, including baked goods, candy, gelatin and sausages. It has been found to cause adrenal gland and kidney tumors, and contains small amounts of many carcinogens.

Here is a list of a few products that may contain one to five or more of these ingredients above:

sodas

http://www.cretafarms.com/retail/images/r-index_01.jpg

http://gothamist.com/attachments/food_laren/2007_07_food_hotdogs.jpg

http://www.thatsoftwareguy.com/candy.jpg

http://lh4.ggpht.com/_XudcSUFiIuQ/RpMjwpkC4pI/AAAAAAAAAF4/D2-4VPgYa6E/DSC00579.JPG

http://www.giantrobot.com/blogs/eric/uploaded_images/R0016987-795651.JPG

http://www.ethicurean.com/wp-content/uploads/2007/image/gogurt.jpg

http://farm4.static.flickr.com/3364/3409077709_c7e8e666b3.jpg?v=0

http://lifehackery.com/qimages/5/potato%20chips.jpg

http://www.smcsd.us/Community/Stores/picts/bakinggoodsisle_yt.jpg

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But what should we do? Should we just stop eating? How about making a change? It's our responsibility to raise a healthy family by eating as organic and/or whole as possible.

Read, Read, Read Labels

First, you need to become familiar with the unwanted additives or preservatives and start reading labels. Food manufacturers are known to use "clean labels," in which they hide ingredients they know consumers would rather not have in their foods under names they won't recognize.For instance, if you're trying to avoid MSG, you need to look for all of the following terms, as they all contain MSG:
  • Autolyzed yeast
  • Calcium caseinate
  • Gelatin
  • Glutamate
  • Glutamic acid
  • Hydrolyzed protein
  • Monopotassium glutamate
  • Monosodium glutamate
  • Sodium caseinate
  • Textured protein
  • Yeast extract
  • Yeast food
  • Yeast Nutrient
Sometimes, foods that claim to include healthy ingredients actually don't contain them, or only contain them in miniscule amounts. Common offenders are blueberry waffles with no blueberries and strawberry yogurt with no strawberries. The Center for Science in the Public Interest (CSPI) recently asked the FDA to "immediately stop misleading food labels," including:
  • Kellogg's Eggo Nutri-Grain Pancakes: The label says they're made with whole wheat and whole grain, but they're made primarily of white flour and contain more high-fructose corn syrup than whole wheat or whole grain.

  • Betty Crocker Super Moist Carrot Cake Mix: Contains only carrot powder as the 19th ingredient on the label.

  • Gerber Graduates for Toddlers Fruit Juice Snacks: The primary ingredients are corn syrup and sugar.
"Food manufacturers are shamelessly tricking consumers who are trying to eat more fruits, vegetables, and whole grains," said CSPI director of legal affairs Bruce Silverglade. "Too many processed foods contain only token amounts of the healthful ingredients highlighted on labels and are typically loaded with fats, refined sugars, refined flour, and salt, in various combinations."

It's funny because I've heard many moms telling me they have no time to cook a homemade meal, they work or they go to school, or they just don't know how to cook. Well, let me tell you that I didn't know how to cook until I started cooking. If you know how to follow instructions you can easily find free healthy recipes throughout the internet, some websites even have ratings in it just to give you an idea how good the dish was. Keep it simple. Whole Foods came out with a great iPhone app for healthy recipes, it's one of my favorite apps so far, get it!

Leftovers are GREAT! Get a Crock Pot

Before I got pregnant with my boy, I worked. I worked hard and my two girls always took their own lunchboxes with homemade meals everyday to school. It is so easy to make extra batches to pack these for their lunchboxes, VERY EASY. Another great idea is to utilize a Crock Pot. You can leave your Crock Pot on before leaving to work in the mornings, so you can have a nice hot homemade meal when you get back for dinner time.

I will have to admit, there is only one day of the week that I let my kids eat from the school menu which is Pizza day. The rest of the week, they have a nice variety of meals in their lunchboxes, like cold sandwiches, cold or warm pasta lunches, boiled eggs, cheese sticks, organic yogurts, whole wheat bread, raw veggies like baby carrots or grape tomatoes, a fruit (everyday they get a piece of fruit of any kind, whatever we have available) with every meal, most of the meals are left overs from the night before and we only do Spring water. Juices are very rare in our household, they only add sugar to their diets which leads to hyperactivity and lack of attention in class.

Don't pack too much food

If you are packing healthy foods and snacks, your children won't need to be fed so much since they are getting enough nutrients from those food you are giving them. The less food you pack the more chances their lunchbox will come back empty. You can also apply this at home. We eat to live not live to eat.

Set an example

YOU need to make a change in your diet as well, the more likely your kids will want to do the same. It works for us, and they always want to make us proud by eating the same things we eat. Eat salads for dinner, they are very cheap and easy to make. Learn how to make your own dressings, and one of my favorite dressings is a homemade vinaigrette I make every night we have leafy salads:

Thin sliced sweet onions (half onion)

Lemon juice (one lemon)

1/2 teaspoon dried oregano

1/2 sea salt

1 oz cold pressed olive oil

1 oz white distilled vinegar (optional)

Mix all in a crystal bowl and let it sit until dinner is served.  You can also squirt some Bragg for added flavor, the kids LOVE this stuff! We use it on everything: Potatoes, rice, soups, beans, pasta, salads, anything you can imagine!

Go organic! (when possible)

When I mean to go organic, doesn't mean that you are going to buy every single bottled/canned item labeled organic. The idea is to buy (probably join an organic co-op) organic produce and make everything from scratch! Learn how to make your own tomato sauce, dressings with herbs, buy dry beans instead of canned, make your own soups from scratch with simple water and fresh produce. The ideas are endless! If you skip the junk isle, including all the processed stuff, you can save a ton of money this way. Find coupons online for your dairy items, shop at your Farmers Market instead and bring with you the top 15 non-organic foods to eat and avoid list! This way, you won't feel the need to buy everything organic and save money.

Eat less

When we eat organic (or from scratch), we tend to eat less everyday. This is because our bodies are receiving the nutrients the body needs for survival. Remember, quality is better than quantity. Recent studies indicate cutting your diet by 30 percent of what you're supposed to eat can extend your life, but you need to make sure that what you are eating is high in quality.

Don't stop at Breastfeeding

It seems that a lot of people know how beneficial Breastfeeding is for our children and mothers, but if we don't practice healthy habits in general; these benefits will be thrown out the window. Why are we taking any chances? In the old days, both parents worked hard to support their families, they were still able to make homecooking for the whole family each day when convenience-foods was pretty much non-existent! We take the time to find the best car seats for our children to protect them from car accidents, or child-proofing our homes or making sure they don't get sunburned by applying sun block right before a nice day at the beach yet we forget about the food that it is feeding our family, going inside our bodies and it is making us sick or providing little to non nutrition to our bodies.

Great resources:

Great Advice on how to read Ingredients Labels <--click to watch video

Eating Well for Optimum Health - DVD
(You can watch online through Netflix) Watch Clip


King Corn - DVD
(You can watch online through Netflix) Watch Trailer


Super Size Me - DVD
(You can watch online through Netflix) Watch Trailer


Food, Inc. - DVD
(coming soon to stores) Watch Trailer
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Modern scientific research indicates that early childhood trauma, especially during the first two years of life when the brain is still rapidly developing, produces permanent adverse physical changes in brain development.

Although we know of no research specific to circumcision trauma causing brain damage, we include some of the related research that is applicable. Genital trauma cannot be different from trauma to other parts of the body in its potential to cause brain damage.

This page brings together articles that relate in some way to the risk of possible brain damage due to traumatic non-therapeutic circumcision. Articles are arranged in approximate chronological order of publication.

References:

  1. Anders T, Sachar E, Kream J et al. Behavioral state and plasma cortisol response in the human neonate. Pediatrics 1970; 46(4):532-537.
  2. Talbert LM, Kraybill EN, and Potter HM. Adrenal cortical response to circumcision in the neonate. Obstet Gynecol 1976;46(2):208-210.
  3. Richards MPM, Bernal, JF, Brackbill Y. Early behavioral differences: gender or circumcision? Dev Psychobiol 1976;9(1):89-95.
  4. Rawlings DJ, Miller PA, Engel RR. The effect of circumcision on transcutaneous PO2 in term infants.Am J Dis Child 1980 Jul;134(7):676-8.
  5. Gunnar MR, Fisch RO, Korsvik S, Donhowe JM. The effects of circumcision on serum cortisol and behavior. Psychoneuroendocrinology 1981; 6(3)269-275.
  6. Anand KJS, Hickey PR. Pain and its effects in the human neonate and fetus. New Engl J Med 1987; 317 (21):1321-1329.
  7. Jacobson B, Eklund G, Hamberger L, et al. Perinatal origin of adult self-destructive behavior. Acta Psychiatr Scand 1987 Oct;76(4):364-71
  8. American Psychiatric Association. 309.81 Posttraumatic Stress Disorder. In: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. American Psychiatric Association, Washington 1994:424-429.
  9. Walco GA, Cassidy RC, Schechter NL. The ethics of pain control in infants and children. N Engl J Med 1994; 331 (8): 541-544.
  10. van der Kolk, B.A. The body keeps the score: Memory and the emerging psychobiology of post traumatic stress. Harvard Review of Psychiatry 1994; 1: 253-265.
  11. Daniel Goleman. Early violence leaves its mark on the brain. The New York Times, Tuesday, October 3, 1995: C1.
  12. Bower B. Exploring trauma's cerebral side. Science News 1996; 149:315
  13. Lloyd-Thomas AR. Fitzgerald M. Reflex responses do not necessarily signify pain. BMJ 1996;313:797-798.
  14. Taddio A, Katz J, Ilersich AL, et al. Effect of neonatal circumcision on pain response during subsequent routine vaccination. The Lancet 1997;349:599-603.
  15. Van Howe RS. Neonatal circumcision. Lancet 1997; 349:1257-1258.
  16. Fitzgerald M. The birth of pain. MRC News (London) Summer 1998:20-23.
  17. Jacobson B, Bygdeman M. Obstetric care and proneness of offspring to suicide. BMJ 1998; 317:1346-49.
  18. Stang HJ, Snellman LW. Circumcision practice patterns in the United States. Pediatrics 1998; 101: e5.
  19. Immerman RS, Mackey WC. A biocultural analysis of circumcision: a kinder gentler tumescence Social Biology 1998; 44:265-275.
  20. Immerman RS, Mackey WC. A proposed relationship between circumcision and neural reorganization. Journal of Genetic Psychology 1998; 159(3):367-378.
  21. Goldman R. The psychological impact of circumcision. BJU International 1999;83 Suppl. 1:93-103.
  22. Rhinehart J. Neonatal circumcision reconsidered. Transactional Analysis Journal 1999; 29(3):215-221.
  23. Anand KJ, Scalzo FM. Can adverse neonatal experiences alter brain development and subsequent behavior? Biol Neonate 2000 Feb;77(2):69-82.
  24. American Academy of Pediatrics. Committee on Fetus and Newborn, Committee on Drugs, Section on Anesthesiology, Section on Surgery. Prevention and Management of Pain and Stress in the Neonate. Pediatrics 2000;105(2):454-461.
  25. Hill G. Kraemer's review contraindicates newborn male non-therapeutic circumcision. BMJ 2000 Rapid Responses. 22 December 2000.
  26. Teicher M. Cerebrum 2000;2:50-67.
  27. Georgia State University - published by ScienceDailyInfant Pain, Adult Repercussions: How Infant Pain Changes Sensitivity In Adults [NEW!]

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The Coalition for Improving Maternity Services (CIMS) is concerned about the dramatic increase and ongoing overuse of cesarean section. Since 1983, one in five women or more has given birth by this major abdominal surgery. Today, one in four or 25% of women have a cesarean for the birth of their baby. The rate for first-time mothers may approach one in three. Studies show that the cesarean rate could safely be halved. The World Health Organization recommends no more than a 15% cesarean rate. With a million women having cesarean sections every year, this means that 400,000 to 500,000 of them were unnecessary.

No evidence supports the idea that cesareans are as safe as vaginal birth for mother or baby. In fact, the increase in cesarean births risks the health and well being of childbearing women and their babies.

For elective repeat cesarean, the consensus of dozens of studies totaling tens of thousands of women is that elective repeat cesarean section is riskier for the mother and not any safer for the baby. Recent studies used to conclude otherwise are both seriously flawed and have been misrepresented in the media.

In addition to the hazards of cesarean section per se, the risks of certain complications increase with accumulating surgeries. Studies also show that seven out of ten women or more who are allowed to labor without undue restrictions will give birth vaginally, thus ending their exposure to the dangers of cesarean section.

Hazards of Cesarean Section to the Mother
  • Women run 5 to 7 times the risk of death with cesarean section. ·Complications during and after the surgery include surgical injury to the bladder, uterus and blood vessels (2 per 100), hemorrhage (1 to 6 women per 100 require a blood transfusion), anesthesia accidents, blood clots in the legs (6 to 20 per 1000), pulmonary embolism (1 to 2 per 1000), paralyzed bowel (10 to 20 per 100 mild cases, 1 in 100 severe), and infection (up to 50 times more common).
  • One in ten women report difficulties with normal activities two months after the birth, and one in four report pain at the incision site as a major problem. One in fourteen still report incisional pain six months or more after delivery.
  • Twice as many women require rehospitalization as women having normal vaginal birth. 
  • Especially with unplanned cesarean section, women are more likely to experience negative emotions, including lower self-esteem, a sense of failure, loss of control, and disappointment. They may develop postpartum depression or post-traumatic stress syndrome. Some mothers express dominant feelings of fear and anxiety about their cesarean as long as five years later.
  • Women having cesarean sections are less likely to decide to become pregnant again. 
  • Long-term risks of cesarean section include pelvic pain, pain during sexual intercourse, and bowel problems. 
  • Reproductive consequences compared with vaginal birth include increased infertility, miscarriage,placenta previa (placenta overlays the cervix), placental abruption (the placenta detaches partially or completely before the birth),and premature birth. Even in women planning repeat cesarean, uterine rupture occurs at a rate of 1 in 500 versus 1 in 10,000 in women with no uterine scar.
Hazards of Cesarean Section to the Baby
  • Studies comparing elective cesarean section with vaginal birth or cesarean section for reasons unrelated to the baby find that babies are 50% more likely to have low Apgar scores, 5 times more likely to require assistance with breathing, and 4 times more likely to be admitted to intensive care for breathing difficulties.
  • One to two babies per 100 will be cut during the surgery. 
  • Some babies will inadvertently be delivered prematurely. Babies born even slightly before they are ready may experience breathing and breastfeeding problems. 
  • Babies born after elective cesarean section are more than four times as likely to develop persistent pulmonary hypertension compared with babies born vaginally. Persistent pulmonary hypertension is life threatening.
  • Mothers who have cesareans are more likely to have difficulties forming an attachment with the infant. This may be because women are less likely to hold and breastfeed their infants after birth and have rooming-in, and because of the difficulties of caring for an infant while recovering from major surgery.
  • Cesarean born babies are less likely to be breastfed. The adverse health consequences of formula feeding are numerous and can be severe.
 Hazards of Elective Repeat Cesarean Section
  • Elective cesarean section carries twice the risk of maternal death compared with vaginal birth. 
  • Old scar tissue increases the likelihood of surgical injury. 
  • One more woman in every 100 with a history of more than one cesarean will have an ectopic pregnancy (embryo implants outside the womb); hemorrhage associated with ectopic pregnancy is one of the leading causes of maternal death in the US.
  • Compared with women with no uterine scar, women have more than 4 times the risk of placenta previa with one prior cesarean, 7 times the risk with two to three prior cesareans, and 45 times the risk with four or more prior cesareans.
  • Compared with women with prior births and no previous cesareans, women with one prior cesarean or more have greater than 4 times the risk of placental abruption. About half of maternal deaths due to hemorrhage involve placenta previa or placental abruption.
  • The odds of placenta accreta (placenta grows into or even through the uterus) jump from 1 in 1,000 with one prior cesarean to 1 in 100 with more than one prior cesarean. Nearly all women with this complication will require a hysterectomy, nearly half will have a massive hemorrhage, and 1 in 11 babies and 1 in 14 mothers will die. The incidence of placenta accreta has increased 10-fold in the last 50 years and now occurs in 1 in 2,500 births.
  • Women having elective repeat cesareans are more likely to experience hemorrhage requiring transfusion, blood clots, and infection compared with women planning vaginal birth.
  • Postpartum recovery after repeat cesarean section is even more difficult when there is another child or children to care for.
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The Coalition for Improving Maternity Services (CIMS) is concerned about the dramatic increase and ongoing overuse of induction of labor. The U.S. induction rate has more than doubled since 1989, rising from one woman in ten to one woman in five in 2001.  This may, however, grossly undercount the true incidence of labor induction. Nearly half of women in a 2002 survey reported that some effort had been made to start labor artificially.  The World Health Organization recommends no more than a 10 percent induction rate.  Despite modern techniques, induction of labor still introduces considerable risk compared with natural onset of labor, and many, if not most, inductions are done for reasons that are not supported by sound medical research.

HAZARDS OF LABOR INDUCTION
  • First-time mothers have approximately twice the likelihood of cesarean section with induction compared with natural onset of labor. This risk is due to the procedure itself, not any reason that might have led to inducing labor.  Inducing labor at 41 weeks in a hypothetical population of 100,000 first- time mothers will result in somewhere between 3,700 and 8,200 excess cesareans and cost an extra $29 to $39 million. 
  • Women who have had prior vaginal births may increase their chances of cesarean section five-fold if the cervix is not ready for labor, and they are given cervical ripening agents.  Inducing 100,000 hypothetical women with prior births at 41 weeks will result in between 100 and 2,300 excess cesareans and cost an extra $25 to $26 million. 
  • All induction agents can cause uterine hyperstimulation (contractions too long, too strong, and too close together and higher baseline muscle tension).  Uterine hyperstimulation can cause fetal distress This means that, paradoxically, inducing labor because of concern over the baby’s condition may cause the very problem the induction was intended to forestall while the baby might have tolerated natural labor.
  • Induction of labor involves the need for other interventions—IV drip, continuous electronic fetal monitoring, usually confinement to bed—that also can have adverse effects.
  • Rupturing fetal membranes, a routine component of labor induction, can cause fetal distress and increases the likelihood of cesarean section It may also precipitate umbilical cord prolapse (a life-threatening emergency for the baby in which the umbilical cord slips down into the vagina).  Forty percent of all full term births involving cord prolapse were induced labors, rising to nearly 50% of births involving prolapse at 42 weeks or more. 
  • Induced labors are usually more painful, which can increase the need for epidural analgesia. Epidurals introduce a higher probability of a host of adverse effects on the labor, the baby, and the mother.
  • Women with prior cesarean sections have a slightly increased probability of the scar giving way with Pitocin (oxytocin) induction (8 per 1,000 vs 5 per 1,000 with spontaneous labor onset) and greatly increased risk when prostaglandins (24 per 1,000) are used for cervical ripening or induction. Prostaglandins include Cytotec (misoprostol), Prepidil (prostaglandin E2), and Cervidil (prostaglandin E2).
HAZARDS AND PROBLEMS OF INDUCTION AGENTS

Cytotec (Misoprostol)

  • Cytotec, although widely used as an induction agent, is neither formulated nor intended for use in labor. Cytotec’s manufacturer, Searle, has repudiated its off-label use as an induction/cervical ripening agent because of Cytotec’s attendant risks. 
  • The FDA states that Cytotec’s major adverse effects include uterine hyperstimulation, which can become severe and result in profound fetal distress; uterine rupture; amniotic fluid embolism, which has a high maternal and infant mortality rate; severe genital bleeding; shock; fetal death; and maternal death. Other adverse effects include retained placenta, cesarean section, and passage of meconium (the baby’s first stool) into the amniotic fluid, which can cause a type of newborn pneumonia if inhaled.
  • Cytotec is commonly believed to pose a life-threatening risk only in women with a uterine scar or with high doses. However, cases of maternal and infant death and hemorrhage requiring hysterectomy have been reported in women with no uterine scar, some of whom were given a minimal dose.
  • Cytotec dosage cannot be controlled because the drug is a small pill that must be cut in pieces.
  • Once given, the drug cannot be rescinded or the dosage reduced in case of adverse effects.
  • Cytotec does not decrease cesarean rates compared with prostaglandin E2, which is FDA-approved for use in labor.
  • Cytotec’s only advantages compared with prostaglandin E2 are much reduced cost and faster labors.  Both benefit only hospitals and doctors as short labors are usually intense, tumultuous, and difficult.
Prostaglandin E2 (Prepidil, Cervidil)
  • Prostaglandin E2 can cause uterine hyperstimulation and fetal distress.  Fetal distress can require cesarean section.
  • Prostaglandin E2 does not reduce excess cesareans associated with labor induction.
  • Unless the drug is formulated in a tampon (Cervidil), the drug cannot be rescinded or the dosage reduced in case of adverse effects.
Oxytocin (Pitocin)

  • Complications of oxytocin (Pitocin) include uterine hyperstimulation,  which can lead to fetal distress; twice the chance of the baby being born in poor condition;  postpartum hemorrhage;  and greater probability of newborn jaundice.  Rare, severe, maternal complications include uterine rupture and water intoxication leading to coma and death. Oxytocin may also cause brain damage or death in the baby.
MEDICAL RESEARCH FAILS TO SUPPORT COMMON INDUCTION RATIONALES
  • Elective induction of labor, that is, induction for nonmedical reasons such as convenience, exposes babies and mothers to the hazards of induction with no counterbalancing benefit.
  • Inducing labor for suspected big baby produces no benefits but increases the likelihood of cesarean section.
  • No credible evidence supports inducing labor in women with gestational—as opposed to pre- existing —diabetes.
  • Routinely inducing labor for prelabor rupture of membranes does not reduce the incidence of newborn infection with the exception of women testing positive for Group B strep who do not receive IV antibiotics during labor.
  • Inducing labor in women with Group B strep has not been shown to improve outcomes when antibiotics are given regardless of membrane status and is not part of the Centers for Disease Control recommended guidelines.
  • Studies claiming to support routine induction of labor at 41 weeks of pregnancy have serious flaws.  No research supports routine induction at any earlier point in pregnancy; no sound research supports routine induction at any point in pregnancy.
  • Proponents of inducing labor at full-term argue that the stillbirth rate and the rates of other newborn complications increase markedly after that date, but, in fact, these rates show no such increase.  Induction at 41 weeks in a hypothetical population of 100,000 first-time mothers would theoretically prevent 120 fetal deaths that would statistically occur in the ensuing week, but:
  1. We don’t know how many of those deaths would actually be prevented by routine induction in that they were unpredictable events in healthy mothers carrying healthy, normally formed babies.  
  2. That number would be offset by some babies dying as a result of the hazards of induction.
  3. Any decrease in fetal deaths would be outweighed by the infertility, miscarriage, and fetal and newborn losses consequent to the excess cesareans.
  • Forty-one weeks is the median length of pregnancy in healthy first-time mothers.  This means that one- half of such pregnancies will last longer than 41 weeks.
  • If there is no reason to curtail the natural length of pregnancy, then there is no reason for measures such as stripping or sweeping membranes, which themselves introduce the possibility of risk.
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