Research Evidence

NICE Guidelines on Intrapartum care Sept 2007
Birth Statistics for England

Waterbirth Collaboration
Caesaereans linked to risk of infertility
Why Mothers Die?
Breastfeeding past 4 months and arterial stiffness?
Consumers should be involved in decisions about research
Media representation of breast and bottle feeding
Waterbirths: A Comparative Study
Motherhood is good for the brain, US scientists conclude
Episiotomy Research
Aromatherapy in Childbirth
Midirs Informed Choice Leaflets

 

  September 2007

NICE Guidelines on Intrapartum care

http://guidance.nice.org.uk/CG55

CG55 Intrapartum care: Quick reference guide

 

 

June 2007

Birth statistics published for England

NHS Maternity Statistics, England: 2005-06
NHS Maternity Statistics, England: 2004-05
NHS maternity statistics, England: 2003-04
NHS maternity statistics, England: 2002-03
NHS maternity statistics, England: 2001-02
Caesarean rate up from 21.5% to 22.3%, Over 21% of deliveries induced, A third of women had an epidural, general or spinal anaesthetic.

 

  April 2002

Caesareans linked to risk of infertility

The Observer: One in three women cannot have a second baby after emergency operation, study claims by Amelia Hill

 

  December 2001

Why Mothers Die?

This was a Confidential Enquiry into Maternal Deaths for the United Kingdom. It found that the poorest women are 20 times more likely to die in childbirth. Women from non white ethnic groups were twice as likely to die, and women were still dying of potentially treatable conditions. The leading cause of death in women in the first year of the baby's life is suicide.

 

  April 2001

Waterbirth Collaboration

For the first time, an opportunity for midwives and doctors world-wide to collaborate to collect consistent data, and contribute to the evidence concerning water immersion during labour and birth.

Click here to find out about the Waterbirth Collaboration

 

  March 2001

Breastfeeding past 4 months and arterial stiffness?

Misleading reports in the press implied that it is risky to breastfeed for longer than 4 months because it may lay the foundations of heart disease in later life. This follows a paper published in the British Medical Journal about which there has been lively debate on its website. Read the discussion - and keep breastfeeding!

 

  2000

Consumers should be involved in decisions about research

Sir Iain Chalmers, Director of the Cochrane Institute, believes that consumers should be involved in decisions about what research to do, how to do it, and dissemination of the results. In a letter to the Lancet Vol 356 Page 774 he writes:

Patients are likely to have the most unconflicted vested interests in promoting important trials. Now that an international meta-register of controlled trials has been established the framework exists for creating a consumer-led, electronic good controlled trials guide, to help people who are considering participating in trials to make well-informed choices. Consumer commentaries on trials in the register could convey, for example, the importance of the questions being addressed, whether these had already been answered satisfactorily by previous research, whether the design of the study was scientifically and ethically robust, whether the primary outcomes chosen mattered to patients, and whether arrangements were in place for communicating the results of the research to those who had participated in it. Mobilisation of consumer influence...might help to reorientate the clinical research agenda to serves the interests of patients better, just as Sheila Kitzinger's Good Birth Guide, for example, helped to make British maternity hospitals more aware of the public image of the care each of them was providing.

Researchers and research sponsors will need to realise that one of the preconditions for consumer endorsement of and partnership in their trials is likely to be that protocols and other trial document should be made public. Researchers – commercial or non-commercial – who wish to compete successfully for the attention of potential partners must therefore be prepared to be far more open about their activities than they have been in the past'

 

 

10th November 2000

Media representation of breast and bottle feeding

Research on media representation of breast and bottle feeding was published in the British Medical Journal
Representing infant feeding: content analysis of British media portrayals of bottle feeding and breast feeding

Lesley Henderson, Jenny Kitzinger, and Josephine Green
BMJ, 2000, 321(7270): pp. 1196-1198

Breastfeeding photo by Nancy Durrel McKennaMedia representations of breastfeeding often portray it as unusual, embarrassing, difficult or funny. By contrast, bottle feeding is presented as the normal and socially acceptable way to feed a baby. Analysis of one month of television output located just one TV program, Channel 4's soap opera Brookside , that showed a woman breastfeeding. The researchers found another 9 scenes in which breast pumps appeared (not in use). By contrast there were 170 scenes of bottle feeding (including formula preparation) across all kinds of programmes. Problems with bottle feeding were suggested only once in the TV sample while there were 27 references to problems with breastfeeding, including sleepless nights, 'droopy' breasts, sore nipples and being tied to the baby. Similar findings were echoed in the analysis of newspaper reporting. The conclusion: the media rarely present positive or just routine representations of breastfeeding and this may have profound implications for how women decide to feed their babies and thus for the health of the next generation.

 

  November 2000

Waterbirths: A Comparative Study

Fetal Diagnosis and Therapy 15:5:2000, 291-300.
Waterbirths: A Comparative Study.
A Prospective Study on More than 2,000 Waterbirths
Verena Geissbühler, Jakob Eberhard
Clinic for Obstetrics and Gynecology, Thurgauisches Kantonsspital, Frauenfeld, Switzerland

This new research from Switzerland shows that:

"waterbirths demonstrate fewer episiotomies, higher rates of intact perineum, lower blood loss and lower use of painkillers. Moreover, neonatal infections do not occur more frequently"

 

 

November 1999

Motherhood is good for the brain, US scientists conclude

The journal Nature reported that a psychologist research team found mother rats to be significantly cleverer than virgin females. They were three times faster as extricating themselves from a maze. This was not due to genetic differences and so was likely to be due to motherhood.

 

 

June 2000

Episiotomy Research

An editorial on episiotomy by Stephen Thacker in The British Medical Journal [ BMJ 2000;320:1615-1616, 17 June] in which he urged research to compare medio-lateral with mid-line episiotomies, was followed by a lively discussion on the BMJ web site. Sheila wrote:

"Stephen Thacker’s editorial is welcome. But it is rather like saying that there should be research into the benefits and risks of two kinds of female circumcision. Both constitute genital mutilation.
He reminds readers that the first research into episiotomy followed the systematic review by Thacker and Banta in 1983, examining what was then treated as a routine minor procedure. Yet it was also women’s concern about brutal episiotomies and botched repair jobs that stimulated research. When I first asked for episiotomy rates in hospitals around the U.K. in 1978, as part of the research for my first Good Birth Guide, I was told that statistics were not kept. It was considered a normal and necessary intervention in childbirth. It was only after this that hospitals started recording episiotomy rates.
Episiotomy also needs to be evaluated in terms of the conduct of the second stage: comparing commanded pushing and voluntary breath-holding with spontaneous breathing and pushing, as well as comparing relative immobility with freedom of movement .
"The relationship between a woman and her physician should be based on trust." What does that mean? The woman trusts the doctor? The doctor trusts the woman? It might be better to say that she and her doctor, or midwife, should together explore the evidence available concerning different alternatives so that the woman can come to her own truly informed decision . This may be one of informed refusal.

 

 

October 1999

Aromatherapy in Childbirth

"Aromatherapy is easier to administer and costs very little. It changes the whole atmosphere of the birth room. It is not just the mother who can be more relaxed, but the staff caring for her feel calmer and happier too.

`Aromatherapy is not a magic charm. But it is one way in which a midwife can communicate warmth, sensitivity and friendship in an institutional and medical environment" .

by Sheila Kitzinger
The Independent, Health Page 21 Oct 1999

Research published 1999 through Oxford Brookes University

 

 

Midirs Informed Choice Leaflets

The best evidence-based research into birth options and interventions is described in the Midirs Informed Choice leaflets. Even if you are not a midwife Sheila thinks you should get the leaflets for health professionals because they have all the references.

Series 1

1 Support in Labour
2 Fetal heart rate monitoring in labour
3 Ultrasound screening in the fist half of pregnancy: is it useful for everyone?
4 Alcohol and pregnancy
5 Positions in labour and delivery

Series 2

6 Epidurals for pain relief in labour
7 Breastfeeding or bottlefeeding - helping women to choose
8 Antenatal screening for congenital abnormalities: helping women to choose
9 Breech presentation - options for care
10 Place of Birth

Each pack contains: a sample of the womens and professionals leaflets, a durable plastic leaflet, wallets for protection and to ensure longevity, background information to the initiative, the essential Informed Choice references, useful information sheets covering key issues, free posters.

Series 1
Item code IPSER1

UK £4.95, Overseas £5.95
Series 2
Item code IPSER2
UK £4.95, Overseas £5.95
Series 1&2
Item code IPSERB
UK £8.35, Overseas £9.35
To order UK freephone 0800 58100
from overseas 44 117 925 1791
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