Research

I have collected research on areas of perinatal well being: breastfeeding, tongue tie, co-sleeping, doulas, midwives, water birth, home birth, pregnancy, birth, labour, birth trauma, human rights, formula feeding, attachment etc.

There are areas of perinatal research that I am particularly interested in, or that I think are not well represented in current UK NHS antenatal classes (in my experience!). Of course this is not a collection of research without bias, it is not exhaustive.

Kent doula Mother Mother

Reduced risk of Caesarean birth

There is evidence to show that having a doula can mean:

Reduced risk of Caesarean birth † *.

* Brigstocke S. MIDIRS Midwifery Digest, vol 24, no 2, 2014, pp 157-160
† Hodnett ED, Gates S, Hofmeyr G, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub5

Reduced risk of instrumental birth

There is evidence to show that having a doula can mean:

Reduced risk of instrumental birth † *.

Reduced need for painkillers or epidural during birth

There is evidence to show that having a doula can mean:

Reduced need for painkillers or epidural during birth † *.

Reduced rate of induction of labour

Reduced rate of induction of labour † *.

Shorter labour †.

There is evidence to show that having a doula can mean:

Shorter labour †.

Increased parental satisfaction with the birth experience. †

There is evidence to show that having a doula can mean:

Increased parental satisfaction with the birth experience. †

Electronic Fetal Monitoring

What is the issue?

Is continuous cardiotocography (CTG) to electronically monitor babies' heartbeats and wellbeing during labour better at identifying problems than listening intermittently?

Breastfeeding and the relationship with reducing breast cancer

Abstract

In this review, we describe the patterns of known immunological components in breast milk and examine the relationship between breastfeeding and reduced risk of breast cancer. The top risk factors for breast cancer are a woman's age and family history, specifically having a first-degree relative with breast cancer. Women that have a history of breastfeeding have been shown to have reduced rates of breast cancer.

Health implications of advertising formula

WHO statement on how advertising formula could be affecting the world’s health.

The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis.

Background and Objective: A 2001 study revealed that $3.6 billion could be saved if breastfeeding rates were increased to levels of the Healthy People objectives. It studied 3 diseases and totaled direct and indirect costs and cost of premature death. The 2001 study can be updated by using current breastfeeding rates and adding additional diseases analyzed in the 2007 breastfeeding report from the Agency for Healthcare Research and Quality.

Microbiome Seeding

Abstract

Cesarean section (CS) delivery is a common surgical procedure intended to increase the chances of successful delivery and to protect the health of the mother and baby. Yet this intervention is overused and has been associated with higher risk of immune and metabolic disorders in the offspring. It is hypothesized that these associations are due to CS‐delivered newborns not receiving the full inoculum of maternal microbes at birth.

NICE Induction recommendations

This guideline covers circumstances, methods and monitoring for inducing labour in pregnant women to avoid a pregnancy lasting longer than 42 weeks (known as a prolonged pregnancy) or if a woman’s waters break but labour does not start. It aims to improve the advice and care provided to women considering and undergoing induction of labour in hospital-based maternity units, midwifery led units and at home .

WHO Intrapartum guidelines

WHO recommendations Intrapartum care for a positive childbirth experience “It has been more than two decades since the World Health Organization (WHO) issued technical guidance dedicated to the care of healthy pregnant women and their babies – Care in normal birth: a practical guide. The global landscape for maternity services has changed considerably since that guidance was issued. More women are now giving birth in health care facilities in many parts of the world, and yet suboptimal quality of care continues to impede attainment of the desired health outcomes. While in some settings too few interventions are being provided too late to women, in other settings women are receiving too many interventions that they do not need too soon. “

NICE Antenatal

This quality standard covers care for healthy women and their babies during pregnancy (up to 42 weeks). It covers routine antenatal care in primary, community and hospital settings. It describes high-quality care in priority areas for improvement.

It includes checking for complications, but does not cover additional care for women with complications of pregnancy (for example, gestational diabetes, pre-eclampsia and venous thromboembolism).

Royal College of Obstetricians & Gynaecologists

“This area of the website provides guidance for healthcare professionals on obtaining consent from women within obstetrics and gynaecology services. It provides easy access to all of our procedure-specific consent documentation, and gives advice on how best to support women’s decision-making about their care. “

If you find yourself asking Am I allowed?

Belly Belly -

Macrosomia – 5 Myths About Big Babies and Birth. Information about gestational diabetes and “big babies”

Pre-labour Rupture of Membranes: impatience and risk

Amniotic sac and fluid play an important role in the labour process and usually remain intact until the end of labour. However, around 10% of women will experience their waters breaking before labour begins.

The Lancet - reduced fetal movements

2·6 million pregnancies were estimated to have ended in stillbirth in 2015. The aim of the AFFIRM study was to test the hypothesis that introduction of a reduced fetal movement (RFM), care package for pregnant women and clinicians that increased women's awareness of the need for prompt reporting of RFM and that standardised management, including timely delivery, would alter the incidence of stillbirth.

Homebirth Micobiome differences

Infants born at home have more diverse bacteria in their guts and feces, which may affect their developing immunity and metabolism, according to a study in Scientific Reports.

BMJ - Aging of the placenta

It is widely believed that during the relatively short duration of a normal pregnancy the placenta progressively ages and is, at term, on the verge of a decline into morphological and physiological senescence.1-3 This belief is based on the apparent convergence of clinical, structural, and functional data, all of which have been taken, rather uncritically, as supporting this concept of the placenta as an aging organ with, all too often, no distinction being made between time related changes and true aging changes. I will review some of these concepts and consider whether the placenta truly undergoes an aging process. For the purposes of this review an aging change is considered to be one which is intrinsic, detrimental, and progressive and which results in an irreversible loss of functional capacity, an impaired ability to maintain homeostasis, and decreased ability to repair damage.

Sara Whickham - Routine early induction in healthy women not supported by evidence

A systematic review has looked at the effects of induction of labour prior to post-term on the mother and baby and concluded that induction prior to post-term is associated with few beneficial outcomes and several adverse outcomes.

Maternity Experience

#matexp

#MATEXP IS A POWERFUL SOCIAL CAMPAIGN INVOLVING PEOPLE FROM ALL WALKS OF LIFE FROM ALL ACROSS THE COUNTRY

RCM - Interventions in Normal Labour and Birth

Rising rates of intervention during labour and birth have caused national and international concern. A number of initiatives to combat this trend have been introduced in recent years including the promotion of normal birth.

Optimal Cord Clamping

Information on delayed cord clamping

SPD - belly belly article

Pain in the front of the pelvis is a common cause of mild to extreme discomfort for approximately 1 in 300 pregnant women. Most mothers-to-be accept this pain as general pregnancy discomfort and, instead of seeking support, simply put up with it. - See more at: https://www.bellybelly.com.au/pregnancy/symphysis-pubic-dysfunction-spd/

Babies feeling Pain - Oxford University study

The brains of babies 'light up' in a very similar way to adults when exposed to the same painful stimulus, a pioneering Oxford University brain scanning study has discovered. It suggests that babies experience pain much like adults.

NICE - Preeclampsia pathway guidelines

helpful workflow of steps advised for women with preeclampsia

NHS Maternity Statistics, England 2017-18

This is a publication on maternity activity in English NHS hospitals. This report examines data relating to delivery and birth episodes in 2017-18, and the booking appointments for these deliveries.

Midwifery continuity of carer in an area of high socio-economic disadvantage in London

The Albany Midwifery Practice was established within King's College Hospital NHS Trust in South East London and provided care to 2568 women from 1997 until 2009.

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The caseload included high proportions (57%) of women from Black, Asian and Minority Ethnic communities from an area of high social disadvantage.

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Midwifery continuity of carer was high with almost all women (95.5%) being attended in labour by their primary or secondary midwife.

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Spontaneous birth rates were high (79.8%) with a low caesarean section rate (16%). Overall, 43.5% of women gave birth at home.

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Neonatal outcomes were positive with 95% of babies having Apgar scores of >8 at 5 minutes. There were 15 perinatal deaths and no intrapartum intrauterine deaths.

Cochrane Review of debrief after birth trauma

Having a baby is a complex life event. While many women view their experiences of giving birth as very positive, childbirth can sometimes be experienced as a traumatic event. If a birth is experienced as traumatic, it could have a negative impact on a woman's long-term emotional well-being. Relationships between mother and child may be affected, as can the women's relationships with other family members. One intervention that is commonly used with the aim of reducing psychological trauma (that is anxiety, trauma or depressive symptoms) and preventing the development of post-traumatic stress disorder following birth is debriefing.

Anti D - Sara Whickham

Various papers and evidence based research on the effectiveness of anti-D to help you choose if it what you want

Emotional Load - You Should've Asked.

a comment on balancing the load in the home between men and women by Emma Clit

Doula - Kent & London

Research