Health and Medical News and Resources

General interest items edited by Janice Flahiff

Birth is no reason to go to hospital

Accouchement à domicile en piscine à Tahiti

Accouchement à domicile en piscine à Tahiti (Photo credit: Wikipedia)

From the 19 September 2012 article at EurekAlert

A new Cochrane Review concludes that all countries should consider establishing proper home birth services. They should also provide low-risk pregnant women with information enabling them to make an informed choice. The review has been prepared by senior researcher, statistician Ole Olsen, the Research Unit for General Practice, University of Copenhagen, and midwifery lecturer PhD Jette Aaroe Clausen.

In many countries it is believed that the safest option for all women is to give birth in hospital. However, observational studies of increasingly better quality and in different settings suggest that planned home birth in many places can be as safe as planned hospital birth and with less intervention and fewer complications.

“If home birth is going be an attractive and safe option for most pregnant women, it has to be an integrated part of the health care system,” Ole Olsen says and adds, “In several Danish regions the home birth service has been very well organised for several years. This is not the case everywhere in the world.”

The updated Cochrane Review concludes that there is no strong evidence from experimental studies (randomised trials) to favour either planned hospital birth or planned home birth for low-risk pregnant women. At least not as long as the planned home birth is assisted by an experienced midwife with collaborative medical back up in case transfer should be necessary.

Fewer interventions in home birth

Routines and easy access to medical interventions may increase the risk of unnecessary interventions in birth explaining why women who give birth at home have a higher likelihood for a spontaneous labour. There are 20-60 per cent fewer interventions, for example fewer cesarean sections, epidurals and augmentation among those women who plan a homebirth; and 10-30 per cent fewer complications, for example post partum bleeding and severe perineal tears.

“Patience is important if women want to avoid interference and give birth spontaneously,” says Jette Aaroe Clausen. “At home the temptation to make unnecessary interventions is reduced. The woman avoids for example routine electronic monitoring that may easily lead to further interventions in birth.”

Jette Aaroe Clausen adds that interventions in childbirth are common in many countries, but also that there is a growing concern internationally because interventions may lead to iatrogenic effects; iatrogenic effects meaning unintended consequences of the intervention. Routine electronic monitoring may for example lead to more women having artificial rupture of membranes which in turn can lead to more interventions.

Evidence and human rights

While the scientific evidence from observational studies has been growing, the European Court of Human Rights in Strasbourg in the case Ternovszky versus Hungary has handed down a judgment stating that “the right to respect for private life includes the right to choose the circumstances of birth”. This is quoted in the review.

Thus the conclusions of the review are based on human rights and ethics as well as on results from the best available scientific studies.

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Further information

Ref.: Olsen O, Clausen JA. Planned hospital birth versus planned home birth. The Cochrane Library, Issue 9, 2012.

The full review may be available here (depends on country): http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000352.pub2/abstract

[Check your local medical, academic, and public libraries for access to this article.
Many medical and academic libraries are open to the public. Ask a reference librarian for assistance]

 

Related Resource

  • Cocharane Reviews
    Cochrane Reviews are systematic reviews of primary research in human health care and health policy, and are internationally recognised as the highest standard in evidence-based health care. They investigate the effects of interventions for prevention, treatment and rehabilitation. They also assess the accuracy of a diagnostic test for a given condition in a specific patient group and setting. They are published online in The Cochrane Library.

September 19, 2012 Posted by | Consumer Health | , , , , , | Leave a comment

One in Three Victims of Teen Dating Violence Has Had More Than One Abuser

After reading this article a few questions come to mind.
Has this kind of violence always occurred, and is only now being studied more closely in the past?
Are more people becoming increasingly desensitized to violence through depiction in the media? and being violent (including verbally) without realizing the consequences?
Should dating be discouraged in people under 16 ? Should they be encouraged to socialize with others in the younger teen years rather than date in order to learn how to communicate, respect one another, and develop as individuals?
Do people (especially girls, young women) have too high expectations of dating? Do they expect a boy or young man to fill needs best met by families/parents?

On a related note, about a year ago I was on our courthouse grounds for a few hours. I was participating in a local peace group’s display of the cost of the Iraq war. A couple walked by, and the young man (late teens/early 20’s) was pushing the young woman he was walking with and calling her names.  Although both were smiling, it seemed like it was escalating. I stepped in, not boldly, and tried to get him to stop through words. Forgot what I said. He didn’t really stop, but at least it did not get any worse.
On reflection, the relationship seemed to be based more on ownership than mutual love. So sad.

 

Excerpts From the 18 September 2012 article at Science Daily

Overall, nearly two-thirds of both men and women reported some type of abuse during their teenage years, which falls in line with other studies.

But it was surprising how many teen victims had two or more abusive partners, said Amy Bonomi, lead author of the study and associate professor of human development and family science at Ohio State University.

“For about one in three teens who were abused, it wasn’t just one bad boyfriend or girlfriend. It may have been at least the start of a trend,” Bonomi said.

The same patterns were not seen in similar population-based studies of adults, who tend to report abuse by a single partner, she said….

One argument that violence researchers often hear is that behaviors like name-calling and insults aren’t serious enough to be called abuse. But that’s not true, Bonomi said.

“Studies in adults have shown that psychological abuse alone can be damaging to health,” she said. She is currently studying whether the same is true for adolescents….

Some types of dating violence tended to occur at earlier ages than others, the study found. For females reporting dating violence, controlling behavior tended to occur early, with 44 percent reporting it between the ages of 13 and 15. For males, 13 to 15 was the most common age range for the first occurrence of put-downs and name-calling (60 percent).

Pressure to have sex was more likely to start at later ages, from 16 to 17 for women.

Bonomi said it was significant that college students were reporting this level of abuse as teens.

“There’s a common belief in our society that dating violence only affects low-income and disadvantaged teens. But these results show that even relatively privileged kids, who are on their way to college, can be victims.”

The results also call for better education in our elementary schools.

“Many of these kids are getting in relationships early, by the age of 13,” Bonomi said. “We need to help them learn about healthy relationships and how to set sexual boundaries. It shouldn’t just be one class session — it needs to be a routine discussion in school.”

  • Teen Dating Violence (politicalsocialworker.wordpress.com)
  • What’s Behind All The Violence In America Today? (fromthetrenchesworldreport.com)
    “The reality untaught in American schools and textbooks is that war — whether on a large or small scale — and domestic violence have been pervasive in American life and culture from this country’s earliest days almost 400 years ago. Violence, in varying forms,according to the leading historian of the subject, Richard Maxwell Brown, “has accompanied virtually every stage and aspect of our national experience,” and is “part of our unacknowledged (underground) value structure.” Indeed, “repeated episodes of violence going far back into our colonial past, have imprinted upon our citizens a propensity to violence.”Thus, America demonstrated a national predilection for war and domestic violence long before the 9/11 attacks, but its leaders and intellectuals through most of the last century cultivated the national self-image, a myth, of America as a moral, “peace-loving” nation which the American population seems unquestioningly to have embraced. But the Reality tells different story.”

Take dating violence, for example. Emily Rothman, associate professor at Boston University School of Public Health recently, published a study on dating violence among teenagers in December of 2010 in Archives of Pediatrics and Adolescent Medicine. She surveyed around 1,500 students from the Boston area. Rothman found that:

… Nearly 19% of students reported physically abusing a romantic partner in the past month, including pushing, shoving, hitting, punching, kicking or choking. Nearly 43% reported verbally abusing their partner, cursing at them or calling them fat, ugly, stupid or some other insult.”

September 19, 2012 Posted by | Consumer Safety, Psychology | , , , , | Leave a comment

Lack of Sleep Affects Bone Health and Bone Marrow Activity

 

English: Human bone marrow.

English: Human bone marrow. (Photo credit: Wikipedia)

 

From the 18th September 2012 article at Science News Daily

 

Scientists at the Medical College of Wisconsin, in a team led by Carol Everson, Ph.D., professor of neurology, cell biology, neurobiology and anatomy, have discovered abnormalities in bone and bone marrow in rats undergoing chronic lack of sleep. They discovered abnormalities in serum markers of bone metabolism in sleep-deprived rats, which led them to conduct direct measurements of bone parameters; this time in rats experiencing recurrent sleep restriction during a large portion of their young adulthood….

 

 

 

September 19, 2012 Posted by | Consumer Health | , , , , | Leave a comment

   

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