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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Human milk is the perfect food for our human babies, learn a few of the many reasons why:

Stem Cells found in Breastmilk
By Catherine Madden - ScienceNetwork WA

The Perth scientist who made the world-first discovery that human breast milk contains stem cells is confident that within five years scientists will be harvesting them to research treatment for conditions as far-reaching as spinal injuries, diabetes and Parkinson’s disease. Read More...


Breastmilk component kills cancer cells
http://www.infactcanada.ca/milkkillscancer.htm

A few years ago immunology student, Anders Hakansson1, of Lund University, Sweden, was experimenting by mixing human milk, cancer cells and bacteria. To his surprise the cancer cells were "acting up". Their volume was decreasing and their nuclei shrinking. Hakansson's supervisor, Catharina Svanborg, quickly recognized that the cancer cells were committing suicide. The phenomenon of apoptosis, whereby the body rids itself of old and unnecessary cells was well known, however for this to occur with cancer cells was unknown as their usual pattern is to reproduce in an uncontrolled fashion. Something in the breastmilk caused the cancer cells to self-destruct. Svanborg and her team had already done extensive investigation in the ability of breastmilk to protect the gut lining from invasive bacteria such as pneumococcus that causes the increased rates of upper respiratory tract infections and otitis media in children not breastfed. And so they began to track down the cancer-killing component in breastmilk. Then in 1995 they reported2 that the protein alpha-lactalbumin, or alpha-lac for short, was capable of targeting not only cancer cells but also other immature and rapidly growing cells, leaving stable, mature cells for growth and development. Alpha-lac's amazing capabilities may explain in part why formula fed infants suffer from increased rates of infectious diseases as well as childhood cancers.

References:
1. Discover Magazine, June 30, 1999
2. Hakahsson, A. et al. Apoptosis induced by a human milk protein. Proc Natl Acad Sci. 92:8064-8068, 1995

Breastmilk prevents childhood diabetes
http://www.drmirkin.com/diabetes/D216.htm

At the scientific session of the American Diabetic Association meeting in San Diego, Finnish researchers presented evidence that juvenile diabetes may be caused by genetically susceptible children taking cow's milk in the first 6 months of life.

When a germ gets into your bloodstream, your immune system makes proteins called antibodies that attach to and kill that germ. Unfortunately, your immune system makes antibodies against almost all proteins that get into your bloodstream. Adults are protected from making antibodies against proteins in food because they have intact intestines that do not allow whole proteins to pass into their blood streams, but in the first few months of life, infants have holes in their intestines that allow proteins to pass into their bloodstream.

The Finnish researchers showed that cow's milk contains cow insulin that is similar, but not exactly the same as, human insulin. So when cow's milk is taken by infants in the first three months of life, the cow insulin can pass into their blood streams and those genetically susceptible to diabetes develop antibodies that attach to and kill the beta cells of the pancreas that make insulin, causing permanent loss of insulin and diabetes. Other studies show that almost all mothers in Puerto Rico feed cow's milk to their infants. In Cuba, almost all mothers feed from their breasts. Type I diabetes is ten times more common in Puerto Rico than in Cuba. On the basis of this and much other research, those of you who have a family history of diabetes should try to feed your infant from your breast.

*Among infants with family history of juvenile diabetes, those on cow's milk have a much higher incidence of diabetes than those on breast milk.

*Among animals bred to develop diabetes, infant animals given cow's milk have a much higher incidence of diabetes.

*Human babies with antibodies against cow's insulin have a much higher incidence of diabetes.(this study)

*In Puerto Rico, almost all babies get cow's milk. In Cuba, almost all babies are breast fed. Puerto Rican babies are more than 10 times more likely to suffer juvenile diabetes.

1)Burke JP et al. Rapid rise in the incidence of Type 2 diabetes from 1987 to 1996. Archives of Internal Medicine. 1999(July 12);159:1450-1456.
2)Vaarala, M Knip, J Paronen, AM Hamalainen, P Muona, M Vaatainen, J Ilonen, O Simell, HK Akerblom. Cow's milk formula feeding induces primary immunization to insulin in infants at genetic risk for type 1 diabetes. Diabetes, 1999, Vol 48, Iss 7, pp 1389-13947884.
3)LC Harrison, MC Honeyman. Cow's milk and type 1 diabetes - The real debate is about mucosal immune function.Diabetes, 1999, Vol 48, Iss 8, pp 1501-1507.

Some of the molecules and cells in human milk
actively help infants stave off infection
By Jack Newman, MD, FRCPC

Doctors have long known that infants who are breast-fed contract fewer infections than do those who are given formula. Until fairly recently, most physicians presumed that breast-fed children fared better simply because milk supplied directly from the breast is free of bacteria. Formula, which must often be mixed with water and placed in bottles, can become contaminated easily. Yet even infants who receive sterilized formula suffer from more meningitis and infection of the gut, ear, respiratory tract and urinary tract than do breast-fed youngsters. Read More...

We are receiving more and more reports from mothers of a decrease in milk production associated with the Mirena IUD. Today I received two such reports. Given the constant chronological relationship between the placement of the IUD and the mother’s decrease in milk production (1 to 2 weeks), it is quite possible that the decrease in milk production is a result of the IUD.

Of course, it is also likely that not all women will have a significant decrease; nobody contacts me when they don’t have a decreased production. But it is also likely that only a tiny percentage of women who do have a decrease actually contact me.

I think we need to be prudent and warn women about this possible side effect of the Mirena. All hormonal contraceptive methods should be avoided by breastfeeding mothers if possible.

Please forward to all your contacts.

Jack Newman, MD
http://www.drjacknewman.com/

THE BENEFITS OF BABYWEARING
by William Sears, MD and Martha Sears, RN.
http://www.askdrsears.com

1. Sling babies cry less. Parents in my practice commonly report, "As long as I wear her, she's content!" Parents of fussy babies who try babywearing relate that their babies seem to forget to fuss. This is more than just my own impression. In 1986, a team of pediatricians in Montreal reported on a study of ninety-nine mother-infant pairs. The first group of parents were provided with a baby carrier and assigned to carry their babies for at least three extra hours a day. They were encouraged to carry their infants throughout the day, regardless of the state of the infant, not just in response to crying or fussing. In the control, or noncarried group, parents were not given any specific instructions about carrying. After six weeks, the infants who received supplemental carrying cried and fussed 43 percent less than the noncarried group.

Anthropologists who travel throughout the world studying infant-care practices in other cultures agree that infants in babywearing cultures cry much less. In Western culture we measure a baby's crying in hours, but in other cultures, crying is measured in minutes. We have been led to believe that it is "normal" for babies to cry a lot, but in other cultures this is not accepted as the norm. In these cultures, babies are normally "up" in arms and are put down only to sleep – next to the mother. When the parent must attend to her own needs, the baby is in someone else's arms.

2. Sling babies learn more. If infants spend less time crying and fussing, what do they do with the free time? They learn! Sling babies spend more time in the state of quiet alertness . This is the behavioral state in which an infant is most content and best able to interact with his environment. It may be called the optimal state of learning for a baby. Researchers have also reported that carried babies show enhanced visual and auditory alertness.

The behavioral state of quiet alertness also gives parents a better opportunity to interact with their baby. Notice how mother and baby position their faces in order to achieve this optimal visually interactive plane. The human face, especially in this position, is a potent stimulator for interpersonal bonding. In the kangaroo carry, baby has a 180-degree view of her environment and is able to scan her world. She learns to choose, picking out what she wishes to look at and shutting out what she doesn't. This ability to make choices enhances learning. A sling baby learns a lot in the arms of a busy caregiver.

3. Sling babies are more organized. It's easier to understand babywearing when you think of a baby's gestation as lasting eighteen months – nine months inside the womb and at least nine more months outside. The womb environment automatically regulates baby's systems. Birth temporarily disrupts this organization. The more quickly, however, baby gets outside help with organizing these systems, the more easily he adapts to the puzzle of life outside the womb. By extending the womb experience, the babywearing mother (and father) provides an external regulating system that balances the irregular and disorganized tendencies of the baby. Picture how these regulating systems work. Mother's rhythmic walk, for example, (which baby has been feeling for nine months) reminds baby of the womb experience. This familiar rhythm, imprinted on baby's mind in the womb, now reappears in the "outside womb" and calms baby. As baby places her ear against her mother's chest, mother's heartbeat, beautifully regular and familiar, reminds baby of the sounds of the womb. As another biological regulator, baby senses mother's rhythmic breathing while worn tummy- to-tummy, chest-to-chest. Simply stated, regular parental rhythms have a balancing effect on the infant's irregular rhythms. Babywearing "reminds" the baby of and continues the motion and balance he enjoyed in the womb.

What may happen if the baby spends most of his time lying horizontally in a crib, attended to only for feeding and comforting, and then again separated from mother? A newborn has an inherent urge to become organized, to fit into his or her new environment. If left to his own resources, without the regulating presence of the mother, the infant may develop disorganized patterns of behavior: colicky cries, jerky movements, disorganized self-rocking behaviors, anxious thumb sucking, irregular breathing, and disturbed sleep. The infant, who is forced to self-calm, wastes valuable energy he could have used to grow and develop.

While there is a variety of child-rearing theories, attachment researchers all agree on one thing: In order for a baby's emotional, intellectual, and physiological systems to function optimally, the continued presence of the mother, as during babywearing, is a necessary regulatory influence.

4. Sling babies get "humanized" earlier. Another reason that babywearing enhances learning is that baby is intimately involved in the caregiver's world. Baby sees what mother or father sees, hears what they hear, and in some ways feels what they feel. Carried babies become more aware of their parents' faces, walking rhythms, and scents. Baby becomes aware of, and learns from, all the subtle facial expressions, body language, voice inflections and tones, breathing patterns, and emotions of the caregiver. A parent will relate to the baby a lot more often, because baby is sitting right under her nose. Proximity increases interaction, and baby can constantly be learning how to be human. Carried babies are intimately involved in their parents' world because they participate in what mother and father are doing. A baby worn while a parent washes dishes, for example, hears, smells, sees, and experiences in depth the adult world. He is more exposed to and involved in what is going on around him. Baby learns much in the arms of a busy person.

5. Sling babies are smarter. Environmental experiences stimulate nerves to branch out and connect with other nerves, which helps the brain grow and develop. Babywearing helps the infant's developing brain make the right connections. Because baby is intimately involved in the mother and father's world, she is exposed to, and participates in, the environmental stimuli that mother selects and is protected from those stimuli that bombard or overload her developing nervous system. She so intimately participates in what mother is doing that her developing brain stores a myriad of experiences, called patterns of behavior. These experiences can be thought of as thousands of tiny short-run movies that are filed in the infant's neurological library to be rerun when baby is exposed to a similar situation that reminds her of the making of the original "movie." For example, mothers often tell me, "As soon as I pick up the sling and put it on, my baby lights up and raises his arms as if in anticipation that he will soon be in my arms and in my world."

I have noticed that sling babies seem more attentive, clicking into adult conversations as if they were part of it. Babywearing enhances speech development. Because baby is up at voice and eye level, he is more involved in conversations. He learns a valuable speech lesson – the ability to listen.

Normal ambient sounds, such as the noises of daily activities, may either have learning value for the infant or disturb him. If baby is alone, sounds may frighten him. If baby is worn, these sounds have learning value. The mother filters out what she perceives as unsuitable for the baby and gives the infant an "It's okay" feeling when he is exposed to unfamiliar sounds and experiences.