normal birth
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Author(s):  
Doan Thi Thuy Duong ◽  
Colin Binns ◽  
Andy Lee ◽  
Yun Zhao ◽  
Ngoc Minh Pham ◽  
...  

Background: Breastfeeding brings benefits to both mothers and children in the short term and long term. Unnecessary cesarean sections can bring risks to both parties. This study was undertaken to examine the relationship between exclusive breastfeeding intention and cesarean delivery. Methods: We analyzed data collected from 554 single mothers who delivered in Dong Anh General District Hospital or Hanoi Obstetrics and Gynecology Hospital, Vietnam, in 2020–2021. The relationship between exclusive breastfeeding intention and cesarean delivery for nonmedical reasons was adjusted for maternal education, maternal age, parity, history of fetal loss, having at least eight antenatal contacts, hospital of delivery, child sex, and birth weight. Results: Antenatally, 34.8% (184/529) of mothers intended to breastfeed exclusively until 6 months and 30.8% (84/274) underwent cesarean section for a nonmedical reason. After adjusting for other factors, mothers who intended to breastfeed exclusively until 6 months were less likely to undergo cesarean delivery for nonmedical reasons (OR = 0.55, 95% CI: 0.31–0.96, p = 0.034). Conclusions: This study adds to the growing evidence related to unnecessary cesarean sections and routine over-medicalization of normal birth in the urban areas of Vietnam. The association between breastfeeding intentions and a lower rate of cesarean section suggests that education on breastfeeding could be a useful intervention for reducing the rate of cesarean sections and improving maternal and child health.


Author(s):  
Lucy C. Irvine

AbstractMaternal health care continues to be excessively medicalised in many national health systems. Global, national, and local level policy initiatives seek to normalise low-risk birth and optimise the use of clinical interventions, informed by strong evidence supporting care that is centred on women’s preferences and needs. Challenges remain in translating evidence into practice in settings where care is primarily clinician-led and hospital-based, such as in Brazil.I conducted an ethnography of the movement for humanised care in childbirth in São Paulo between 2015 and 2018. I draw on interviews and focus groups with movement members (including mothers, doulas, midwives, obstetricians, politicians, programme leads, and researchers), and observations in health facilities implementing humanised protocols, state health council meetings, and key policy fora (including conferences, campaigning events, and social media). Key actors in this movement have been involved in the development and implementation of evidence-based policy programmes to “humanise” childbirth. Scientific evidence is used strategically alongside rights-based language, such as “obstetric violence”, to legitimise moral and ideological aims. When faced with resistance from pro-c-section doctors, movement members make use of other strategies to improve access to quality care, such as stimulating demand for humanised birth in the private health sector. In Brazil, this has led to a greater public awareness of the risks of the excessive medicalisation of birth but can reinforce existing inequalities in access to high-quality maternity care. Lessons might be drawn that have wider relevance in settings where policymakers are trying to reduce iatrogenic harm from unnecessary interventions in childbirth and for supporters of normal birth working to reduce barriers to access to midwifery-led, woman-centred care.


Populasi ◽  
2021 ◽  
Vol 29 (2) ◽  
pp. 16
Author(s):  
Sri Rum Giyarsih ◽  
Ratih Fitria Putri ◽  
Maulana Malik Sebdo Aji ◽  
Yuyun Arining Jayanti ◽  
Fauzi Darmawan ◽  
...  

This study is set out to examine the socioeconomic and demographic characteristics of stunted children under five years of age in Magelang Regency, Central Java Province. Indonesia. It used questionnaire surveys (structured interviews) to collect data on 266 heads of households with stunted children under-five that had been selected using a tiered sampling method, then analyzed the data in the SPPS program. Also, in-depth interviews were conducted with informants from these households and staff of community health center, Health Office, Social Office, and Regional Development Planning Agency (BAPPEDA), and the resulting data were processed and analyzed through the stages of data reduction, data presentation, conclusion withdrawal, and verification. The quantitative data were tested for validity using the statistical procedures provided in the SPSS program, while the qualitative data were examined for their reliability by the triangulation method. The results showed that the majority of stunted children under-five in the regency had normal birth weight and length, received a complete series of immunization, and were breastfed. Furthermore, about one-third of the mothers were employed, showing that many of the families observed are less stable economically. This study also found that parents still lacked the knowledge to recognize stunting in their children, about 80 percent of which did not realize that their children experienced impaired growth and development. Another finding is that government programs have reached 50 percent of families with stunted children under-five.


2021 ◽  
Author(s):  
Chunyun Qi ◽  
Daxin Pang ◽  
Kang Yang ◽  
Shuyu Jiao ◽  
Heyong Wu ◽  
...  

Classical swine fever virus (CSFV), pathogen of classic swine fever, has caused severe economic losses worldwide. Poly (rC)-binding protein 1 (PCBP1), interacting with Npro of CSFV, plays a vital role in CSFV growth. Here, our research is the first report to generate PCBP1 knockout pigs via gene editing technology. The PCBP1 knockout pigs exhibited normal birth weight, reproductive-performance traits, and developed normally. Viral challenge results indicated that primary cells isolated from F0 and F1 generation pigs could significantly reduce CSFV infection. Additional mechanism exploration further confirmed that PCBP1 KO mediated antiviral effect is related with the activation of type I interferon. Beyond showing that gene editing strategy can be used to generate PCBP1 KO pigs, our study introduces a valuable animal model for further investigating infection mechanisms of CSFV that help to develop better antiviral solution.


2021 ◽  
pp. 147-176
Author(s):  
Nicky Leap ◽  
Billie Hunter
Keyword(s):  

Antioxidants ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1995
Author(s):  
Hao Zhang ◽  
Ping Zheng ◽  
Daiwen Chen ◽  
Bing Yu ◽  
Jun He ◽  
...  

Our previous studies revealed that L-arginine supplementation had beneficial effects on intestinal barrier functions of low-birth-weight (LBW) piglets, which were associated with the enhanced antioxidant capacity. Moreover, mitochondrial functions are closely related to the redox state. This study was to explore potential mechanisms of L-arginine-induced beneficial effects against intestinal dysfunction by regulating mitochondrial function of LBW piglets. Twenty 4-day-old normal birth weight (NBW) piglets (BW: 2.08 ± 0.09 kg) and 20 LBW siblings (BW: 1.16 ± 0.07 kg) were artificially fed either a basal diet or a basal diet supplemented with 1.0% L-arginine for 21 d, respectively. Growth performance, intestinal morphology, redox status, mitochondrial morphology, and mitochondrial functions were examined. Data were subjected to two-way analysis of variance. LBW piglets presented lower (p < 0.05) ADG, shorter (p < 0.05) intestinal villus height, lower (p < 0.05) jejunal adenosine triphosphate (ATP) content and higher (p < 0.05) concentrations of Ca2+ and 8-OH-dG in jejunal mitochondria, compared with NBW piglets. Supplementation with 1.0% L-arginine significantly increased (p < 0.05) ADG, the activities of CAT, SOD, and GPx, intestinal villus height and mRNA abundances of ZO-1 (2-fold) in the jejunum of LBW piglets, but not in NBW piglets. Furthermore, the concentrations of ATP and the transcription of COX IV, COX V genes were up-regulated (p < 0.05) and the concentration of Ca2+ and 8-OH-dG were decreased (p < 0.05) in arginine-treated LBW piglets. The results suggest that mitochondrial morphology is affected, and mitochondrial functions are impaired in the jejunum of LBW piglets. While supplementation with 1.0% L-arginine relieved intestinal dysfunction through enhancing antioxidant capacity and improving mitochondrial functions via repairing mitochondrial morphology, normalizing mitochondrial calcium, and increasing ATP concentration in the jejunum of LBW piglets. However, supplementation with L-arginine has no significant beneficial effects on intestinal health in NBW piglets.


2021 ◽  
Author(s):  
◽  
Suzanne Miller

<p>In Aotearoa New Zealand, healthy women giving birth for the first time may plan to give birth in range of settings - from home to a tertiary hospital where surgical and anaesthetic services are available. Each birth location has its own culture, and the extent to which this culture influences the birth experience lies at the heart of this research. Just twenty-three percent of first-time mothers experience a normal birth with no obstetric interventions, and the chosen place of birth is implicated in this statistical outcome. Tertiary maternity settings report the highest rates of birth interventions, even for healthy women who can anticipate straightforward labour experiences. Among the most frequently used birth interventions are labour augmentation procedures - artificial rupture of membranes and administration of synthetic oxytocin infusions.   My critical realist ethnography aims to explore the cultural landscape within one tertiary birthing suite and in doing so to identify the generative mechanisms that influence the likelihood of labour augmentation for well first-time mothers. I begin with a retrospective chart review to uncover the magnitude of the use of augmentation procedures for a sample of healthy women presenting in labour to the birthing suite over one calendar year. Interviews with women who experienced long labours yield insights about their decision-making with respect to augmentation. Focus groups and interviews with midwives and obstetric doctors contribute an understanding of factors associated with their use of augmentation, and a period of non-participant observation in the birthing suite illuminates the nuanced ways the unit culture contributes to the permissive use of augmentation procedures in this birthing environment.  Findings reveal that sixty percent of women experienced labour augmentation procedures and for one third of them, the augmentation was not indicated according to the clinical guideline in use at the time. Pressure to be “moving things forward” characterises the birthing suite culture. The identified generative mechanisms that combine to influence the likelihood of augmentation include a lack of belief in birth, not valuing midwives, the education and socialisation of midwives and doctors, and the industrialisation of birth - all underpinned by available social discourses about being a good mother, a good midwife or a good doctor.  Ironically, the very attributes that make the tertiary hospital the ideal place to be when birth is complex or the unexpected happens (‘poised-ness’ for action, being a ‘well-oiled machine’ for emergency care, surveillance and control) are the same attributes that create a dis-abling environment for physiological first birth to unfold at its own pace. The ‘perfect system’ is in place; a well-embedded midwifery-led continuity of care model incorporating seamless and integrated secondary referral processes. But despite this potentially enabling model of maternity care, once ‘nested’ within the tertiary hospital setting the impact of social, professional and industrial discourses overwhelms the salutogenic factors that should protect normal birth.  A re-focussed commitment to providing continuity of care across the labour continuum, home visiting in early labour, enhancing physiological birth support in both the relational and environmental realms, averting the obstetric gaze and prioritising women’s needs over institutional needs represent the best way forward as strategies to resist the inexorable rise of obstetric intervention. Midwives are well-positioned to respond to this call. Reclaiming their expertise in support of physiological first birth by driving the practice and research agenda presents the optimal way to “move things forward” for women.</p>


2021 ◽  
Author(s):  
◽  
Suzanne Miller

<p>In Aotearoa New Zealand, healthy women giving birth for the first time may plan to give birth in range of settings - from home to a tertiary hospital where surgical and anaesthetic services are available. Each birth location has its own culture, and the extent to which this culture influences the birth experience lies at the heart of this research. Just twenty-three percent of first-time mothers experience a normal birth with no obstetric interventions, and the chosen place of birth is implicated in this statistical outcome. Tertiary maternity settings report the highest rates of birth interventions, even for healthy women who can anticipate straightforward labour experiences. Among the most frequently used birth interventions are labour augmentation procedures - artificial rupture of membranes and administration of synthetic oxytocin infusions.   My critical realist ethnography aims to explore the cultural landscape within one tertiary birthing suite and in doing so to identify the generative mechanisms that influence the likelihood of labour augmentation for well first-time mothers. I begin with a retrospective chart review to uncover the magnitude of the use of augmentation procedures for a sample of healthy women presenting in labour to the birthing suite over one calendar year. Interviews with women who experienced long labours yield insights about their decision-making with respect to augmentation. Focus groups and interviews with midwives and obstetric doctors contribute an understanding of factors associated with their use of augmentation, and a period of non-participant observation in the birthing suite illuminates the nuanced ways the unit culture contributes to the permissive use of augmentation procedures in this birthing environment.  Findings reveal that sixty percent of women experienced labour augmentation procedures and for one third of them, the augmentation was not indicated according to the clinical guideline in use at the time. Pressure to be “moving things forward” characterises the birthing suite culture. The identified generative mechanisms that combine to influence the likelihood of augmentation include a lack of belief in birth, not valuing midwives, the education and socialisation of midwives and doctors, and the industrialisation of birth - all underpinned by available social discourses about being a good mother, a good midwife or a good doctor.  Ironically, the very attributes that make the tertiary hospital the ideal place to be when birth is complex or the unexpected happens (‘poised-ness’ for action, being a ‘well-oiled machine’ for emergency care, surveillance and control) are the same attributes that create a dis-abling environment for physiological first birth to unfold at its own pace. The ‘perfect system’ is in place; a well-embedded midwifery-led continuity of care model incorporating seamless and integrated secondary referral processes. But despite this potentially enabling model of maternity care, once ‘nested’ within the tertiary hospital setting the impact of social, professional and industrial discourses overwhelms the salutogenic factors that should protect normal birth.  A re-focussed commitment to providing continuity of care across the labour continuum, home visiting in early labour, enhancing physiological birth support in both the relational and environmental realms, averting the obstetric gaze and prioritising women’s needs over institutional needs represent the best way forward as strategies to resist the inexorable rise of obstetric intervention. Midwives are well-positioned to respond to this call. Reclaiming their expertise in support of physiological first birth by driving the practice and research agenda presents the optimal way to “move things forward” for women.</p>


2021 ◽  
Author(s):  
◽  
Bronwyn Torrance

<p>In New Zealand women choose their place of birth in partnership with their Lead Maternity Care (case loading) midwife, with most choosing a hospital regardless of their lack of risk factors. The reasons why most women in western countries choose to birth in hospital have been widely investigated. Risk aversity is most commonly implicated. For both women and health professionals this powerful discourse persists despite consistent research findings indicating higher rates of normal birth, and lower rates of maternal morbidity associated with interventions for healthy women who birth in out-of-hospital (primary) maternity units, with no difference in neonatal outcomes. There is however a gap in the literature regarding what is known about how midwives might positively influence the choice to birth in a primary unit.   A qualitative descriptive design through an appreciative inquiry lens enabled insight from 12 midwives who have a higher ratio of women within their caseload who choose to birth in a primary unit. Four focus groups were formed with these midwives to explore their perspectives and approaches as they assist women to make their place of birth decisions. From thematically analysed data, five themes emerged, Ways of knowing: woman, art, science and research; Trusting in you, me, and the process of childbirth; Setting boundaries as a ‘primary birth midwife’; and Delaying and diverting, a malleable approach, centered around the theme When it matters what we say: reframing safety and risk.   Alongside supporting current research, this study adds to the body of knowledge about birthplace choice by bringing to the fore the notion of paradox in practice, setting boundaries whilst remaining malleable for example. In a contemporary maternity context, these midwives dance between two worlds fundamentally at odds with one another, effectively managing contradiction, complexity and uncertainty to achieve a high primary unit caseload. The experience of what works to promote the primary unit for a cohort of New Zealand midwives is uncovered in this research.   The social recalibrations needed to adjust the hospital birth norm are much broader issues than midwives alone can change, but in this study, we see they are staying the course in order to protect and promote normal birth. How midwives might inform decision-making for place of birth choice is described.</p>


2021 ◽  
Author(s):  
◽  
Bronwyn Torrance

<p>In New Zealand women choose their place of birth in partnership with their Lead Maternity Care (case loading) midwife, with most choosing a hospital regardless of their lack of risk factors. The reasons why most women in western countries choose to birth in hospital have been widely investigated. Risk aversity is most commonly implicated. For both women and health professionals this powerful discourse persists despite consistent research findings indicating higher rates of normal birth, and lower rates of maternal morbidity associated with interventions for healthy women who birth in out-of-hospital (primary) maternity units, with no difference in neonatal outcomes. There is however a gap in the literature regarding what is known about how midwives might positively influence the choice to birth in a primary unit.   A qualitative descriptive design through an appreciative inquiry lens enabled insight from 12 midwives who have a higher ratio of women within their caseload who choose to birth in a primary unit. Four focus groups were formed with these midwives to explore their perspectives and approaches as they assist women to make their place of birth decisions. From thematically analysed data, five themes emerged, Ways of knowing: woman, art, science and research; Trusting in you, me, and the process of childbirth; Setting boundaries as a ‘primary birth midwife’; and Delaying and diverting, a malleable approach, centered around the theme When it matters what we say: reframing safety and risk.   Alongside supporting current research, this study adds to the body of knowledge about birthplace choice by bringing to the fore the notion of paradox in practice, setting boundaries whilst remaining malleable for example. In a contemporary maternity context, these midwives dance between two worlds fundamentally at odds with one another, effectively managing contradiction, complexity and uncertainty to achieve a high primary unit caseload. The experience of what works to promote the primary unit for a cohort of New Zealand midwives is uncovered in this research.   The social recalibrations needed to adjust the hospital birth norm are much broader issues than midwives alone can change, but in this study, we see they are staying the course in order to protect and promote normal birth. How midwives might inform decision-making for place of birth choice is described.</p>


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