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Sep 27, 2009

A Contemporary Children's Book for Todays Homebirthing Families...

Children will love this colorful, contemporary book about
their family's special upcoming homebirth event. A great
tool for discussion about what to expect when the baby
arrives, this affordable book covers important issues like
the role of a midwife, being good labor support, noises to
expect mom to make, cord cutting, placenta delivery and
breastfeeding. Combined with healthy conversation about
pregnancy and homebirth, this book will help teach children
that birth is a natural occurence, not a medical emergency.

To learn more or make a purchase

Sep 18, 2009

Have something to say? Question to ask? Something to submit? I'd love to hear from you.

Welcome to Mama Sayana Doula support. I started this blog as a way to provide real, unedited information about pregnancy and birth to pregnant mothers and couples.

The true heart of this blog lies in the stories and pictures submitted by you.
Please feel free to visit often and post your comments.

Happy blogging.

Sep 16, 2009

Yemeni Girl, 12, Dies in Painful Childbirth.

CNN reports that a 12-year-old Yemeni girl, who was forced into marriage, died during a painful childbirth that also killed her baby, a children's rights group said Monday.

Fawziya Ammodi struggled for three days in labor, before dying of severe bleeding at a hospital on Friday, said the Seyaj Organization for the Protection of Children.

"Although the cause of her death was lack of medical care, the real case was the lack of education in Yemen and the fact that child marriages keep happening," said Seyaj President Ahmed al-Qureshi.

Born into an impoverished family in Hodeidah, Fawziya was forced to drop out of school and married off to a 24-year-old man last year, al-Qureshi said.

Child brides are commonplace in Yemen, especially in the Red Sea Coast where tribal customs hold sway. Hodeidah is the fourth largest city in Yemen and an important port.

More than half of all young Yemeni girls are married off before the age of 18 -- many times to older men, some with more than one wife, a study by Sanaa University found.

While it was not immediately known why Fawziya's parents married her off, the reasons vary. Sometimes, financially-strapped parents offer up their daughters for hefty dowries.

Marriage means the girls are no longer a financial or moral burden to their parents. And often, parents will extract a promise from the husband to wait until the girl is older to consummate the marriage.

The issue of Yemeni child brides came to the forefront in 2008 with 10-year-old Nujood Ali.

She was pulled out of school and married to a man who beat and raped her within weeks of the ceremony.

To escape, Nujood hailed a taxi -- the first time in her life -- to get across town to the central courthouse where she sat on a bench and demanded to see a judge.

After a well-publicized trial, she was granted a divorce.

Mother’s Milk

Students in an advanced Biology class were taking their mid-term exam. The last question was, 'Name seven advantages of mother's milk; worth 70 points or none at all.

One student in particular was having a hard time to think of seven advantages. He wrote:

1. It is perfect formula for the child.

2. It provides immunity against several diseases..

3. It is always the right temperature.

4. It is inexpensive.

5. It bonds the child to mother, and vice versa..

6. It is always available as needed.

And then, the student's mind went blank. Finally, in desperation, just before the bell rang indicating the end of the test, he wrote....

7. It comes in awesome containers.

He got an A.

Sep 2, 2009

Moms-to-be warned over use of fetal heart rate monitors

Moms-to-be are being advised not to use personal monitors (Doppler devices) to listen to their baby's heartbeat at home over fears that they may lead to delays in seeking help for reduced fetal movements.

In this week's BMJ, Dr Thomas Aust and colleagues from the Department of Obstetrics and Gynaecology at Arrowe Park Hospital, Wirral describe the case of a 27 year old woman who presented to their labour ward 32 weeks into her first pregnancy with reduced fetal movements.

She had first noted a reduction in her baby's activity two days earlier but had used her own Doppler device to listen to the heartbeat and reassured herself that everything was normal.
Further monitoring by the antenatal care team was not reassuring and the baby was delivered by caesarean section later that evening. The baby remained on the special care baby unit for eight weeks and is making steady progress.

A hand-held Doppler device assesses the presence of fetal heart pulsations only at that moment, and it is used by midwives and obstetricians to check for viability or for intermittent monitoring during labour, explain the authors. In untrained hands it is more likely that blood flow through the placenta or the mother's main blood vessels will be heard.
Following this case, they searched the internet and found that a fetal Doppler device could be hired for £10 a month or bought for £25-50 ( Although the companies offering sales state that the device is not intended to replace recommended antenatal care, they also make claims such as "you will be able to locate and hear the heartbeat with excellent clarity" (

It is difficult to say whether self monitoring altered the outcome in this case, say the authors. But they now have posters in their antenatal areas recommending that patients do not use these devices.

Home birth with midwife safe as hospital

Giving birth at home with a registered midwife can be as safe as a hospital birth for the infant and the mom, according to a Canadian study released Monday.

Midwives provide round-the-clock care for women during pregnancy, childbirth and postpartum in hospitals, birthing centres and at the homes of women.

The rate of deaths was about two per 1,000 for planned home births involving midwives as well as deliveries in hospitals involving either midwives or doctors, the researchers found.

"Women planning birth at home experienced reduced risk for all obstetric interventions measured, and similar or reduced risk for adverse maternal outcomes," such as electronic fetal monitoring and postpartum hemorrhage, Dr. Patricia Janssen from the University of British Columbia and her co-authors wrote in the Canadian Medical Association Journal.

The Society of Obstetricians and Gynecologists of Canada does not take a specific stand on the safety of home births, and has called for more research on it. The society said it should be up to each woman to decide where to give birth.

The American, Australian and New Zealand Colleges of Obstetricians and Gynecologists oppose home births while the United Kingdom's Royal College of Obstetrics and Gynecology and the Royal College of Midwives are supportive, as are midwife organizations in Canada, Australia and New Zealand.

In the study, researchers looked at 2,889 home births attended by regulated midwives in British Columbia and 4,752 planned hospital births attended by the same group of midwives, compared with 5,331 births in hospital attended by a physician.

The rate of deaths per 1,000 births in the first month of life was 0.35 for the planned home births, 0.57 for the hospital births with a midwife, and 0.64 with a physician, the researchers found.

Women in the planned home-birth group were much less likely than those who gave birth in hospital to have obstetric interventions including:

0.32 times less likely to receive electronic fetal monitoring.
0.41 times less likely to have an assisted vaginal delivery.
0.41 times less likely to suffer third- or fourth-degree perineal tears.
0.62 times less likely to have postpartum hemorrhage.
Women who planned to give birth at home needed less medical intervention, even among those who ended up in the hospital. Janssen doesn't know why, but it may be because women who choose home birth are determined not to have those procedures.

"So our study is not to say that home birth causes you to have fewer interventions," said Janssen. "It's really to say for women choosing this option, do they put themselves at increased risk for bad outcomes? And the answer to that is no."

Newborns who were born at home were also 0.23 times less likely to require resuscitation or oxygen therapy after 24 hours compared with those who were born in hospital with a midwife.

Infants born at home were also 0.45 times less likely to have aspirate meconium (inhaling a mixture of their feces and amniotic fluid).

Babies born to mothers who planned a home birth were 1.39 times more likely to be admitted to hospital after the birth, but Janssen believes the hospitalizations were related to jaundice, an easily treatable and relatively common condition.

Women self-selecting home births

It's not well understood what factors may help decrease the risks while giving birth at home, but researchers cautioned that those who choose to do so are self-selecting and may be healthier, which would be an important way to manage the risk.

The study also excluded women with medical conditions either before or during pregnancy. The results also don't cover deliveries by midwives who lacked extensive academic and clinical training.

"Given the current lack of evidence from randomized controlled trials, the study by Janssen and colleagues makes an important contribution to our knowledge about the safety of home birth," midwife Helen McLachlan from La Trobe University in Bundoora, Australia, and Della Forster of Royal Women's Hospital in Parville, Australia, wrote in a journal commentary.

Despite ethical hurdles for conducting randomized controlled trials on home births, the pair called for such research to provide better evidence.

"The available evidence suggests that planned home birth is safe for women who are at low risk of complications and are cared for by appropriately qualified and licensed midwives with access to timely transfer to hospital if required," they wrote.

Option to consider

McLachlan and Forster also noted that while policymakers often support choice in childbirth, home-birthing options may be limited, particularly in rural and remote areas.

Acceptance of home births is generally low. For example, six per cent of all births in B.C. involve a midwife.

"Obviously a research study such as this provides more information for women to carefully consider their options," said Kris Robinson, who chairs the Canadian Midwife Regulators Consortium. "You know, one of them might be more attractive to women if they see results of this research that are so favourable."

In Canada, midwives are registered in British Columbia, Alberta, Manitoba, Ontario and Quebec and the Northwest Territories, according to the Society of Obstetricians and Gynecologists of Canada.

B.C.'s regulations for home births are stricter than in most provinces, said Dr. André Lalonde, executive vice-president of the society.

The study may not offer a fair comparison between between home and hospital births, Lalonde said.

"What I would like to see is that we have a hospital setting where every woman that comes into a hospital setting has a full-time nurse with her from the beginning to the end of delivery," Lalonde said. "Then we can compare."

In 2007, Statistics Canada reported that the majority of Canadian mothers who gave birth during a three-month period in 2006 were happy with their labour and the birth of their child.

Among those who had a midwife delivery, 71 per cent rated it as "very positive" compared with 53 per cent of women who had their babies delivered by obstetricians/gynecologists, family doctors or nurses and nurse practitioners.

The B.C. researchers are planning to compare the costs involved for home births, and to track the health of each of the babies up to one year of age.

CBC News