bluuebunny/crossref_metadata_2025 huggingface dataset:
Mitochondrial dysfunction early after traumatic brain injury in immature rats
Authors: Robertson Courtney L. , Saraswati Manda , Fiskum Gary
Published: April 2007

Mitochondria play central roles in acute brain injury; however, little is known about mitochondrial function following traumatic brain injury (TBI) to the immature brain. We hypothesized that TBI would cause mitochondrial dysfunction early (<4 h) after injury. Immature rats underwent controlled cortical impact (CCI) or sham injury to the left cortex, and mitochondria were isolated from both hemispheres at 1 and 4 h after TBI. Rates of phosphorylating (State 3) and resting (State 4) respiration were measured with and without bovine serum albumin. The respiratory control ratio was calculated (State 3/State 4). Rates of mitochondrial H2O2 production, pyruvate dehydrogenase complex enzyme activity, and cytochrome c content were measured. Mitochondrial State 4 rates (ipsilateral/contralateral ratios) were higher after TBI at 1 h, which was reversed with bovine serum albumin. Four hours after TBI, pyruvate dehydrogenase complex activity and cytochrome c content (ipsilateral/contralateral ratios) were lower in TBI mitochondria. These data demonstrate abnormal mitochondrial function early (≤4 h) after TBI in the developing brain. Future studies directed at reversing mitochondrial abnormalities could guide neuroprotective interventions after pediatric TBI.
Breast Feeding the Adopted Baby
Authors: Hermann Elizabeth
Published: April 2007

ABSTRACT: Sixty‐five women nursed adopted babies. Eighteen of the women had never been pregnant, seven had been pregnant but had not lactated, and forty had been pregnant and lactated before. The physiology of this lactation is discussed, along with the factors leading to production of enough breast milk under these circumstances to sustain an infant.
A Study of Fathers and Infant Caretaking
Authors: Manion Jo
Published: April 2007

ABSTRACT: Forty‐five first time fathers’involvement with their newborn infants was studied. These fathers were found to provide infant care activities, which depended upon the complexity of the tasks, the sex of the infant, past parental relationships, and the father's participation in the birth.
Exploratory Study of Women's Reactions to Having a Cesarean Birth
Authors: Affonso Dyanne D. , Stichler Jaynelle F.
Published: April 2007

ABSTRACT: One hundred and five women who had cesarean sections were interviewed to assess their feelings about their births. Forty‐one percent of the women were told they had to have a cesarean fewer than two hours before, and 35% were repeat cesareans. Statistical data are presented on women's reasons for feeling cesareans were harder, easier, or not different, including the finding that 30% felt relief at having a cesarean. Sources of stress and negative feelings after cesareans are discussed.
A Study of the Effects of Extended Mother‐Infant Contact on Maternal Behavior at One and Three Months
Authors: Kontos Donna
Published: April 2007

ABSTRACT: This study is concerned with the effects of early separation of human mothers and their full term infants on later maternal attachment behaviour. Four groups of twelve mother‐infant dyads experienced differing amounts of separation from their newborns. Data from two observation periods, at one month and three months postpartum, revealed that separating mother and infant in the early postpartum period does affect maternal attachment behaviour for at least three months. Mothers who received extended contact displayed more attachment behaviour towards their infants than did mothers who were separated and mothers who roomed‐in displayed more attachment behaviour than mothers who did not. This study lends further evidence for a sensitive period within the first two hours after birth in the human mother.
Lamaze Childbirth Training and Changes in Belief about Personal Control
Authors: Felton Gary S. , Segelman Florrie B.
Published: April 2007

ABSTRACT: This study explored changes in parents’beliefs about the origin of control for behavior and its consequences after completion of Lamaze classes, Red Cross classes, and no classes. Results indicate that Lamaze training for women, led to a significant increase in new mothers seeing themselves as origins of control (as against seeing others or chance as agents of control). Other modes showed no significant change for women. No significant postpartum findings emerged for men under any condition. These findings are discussed and suggestions are made for modification of Lamaze training to improve it and to better meet the immediate needs of expectant and new parents.
The Influence of Maternal Bearing‐down Efforts during Second Stage on Fetal Well‐being
Authors: Caldeyro‐Barcia Roberto
Published: April 2007

ABSTRACT: Fetal heart rate patterns, and intrauterine and maternal blood pressures were recorded during various types of maternal bearing‐down efforts. Bearing‐down efforts which lasted more than 5 seconds resulted in late decelerations of the fetal heart rate, marked falls in the maternal systolic and diastolic blood pressures and resultant delayed recovery of the fetal heart rate, with fetal hypoxia and acidosis in some cases. When women are not urged to bear down long and hard, their spontaneous efforts are usually within physiologic limits‐5–6 seconds long‐and fetal acidosis is thereby avoided.
Childbirth Education Evaluation: The Indianapolis Experience
Authors: Zwirn Enid Errante , Fry Linda Reddington , Reed Diane Bartram , Martin Richard E.
Published: April 2007

ABSTRACT: A rapidly growing volunteer childbirth education organization developed a data collection system useful in evaluating its present performance and planning its future growth. The design of data outputs, costs, data sources and data results are described.
Electronic Fetal Monitoring: Is It of Benefit?
Authors: Banta David , Thacker Stephen
Published: April 2007

ABSTRACT: Electronic fetal monitoring (EFM) of the fetal heart rate during labor and delivery has become a cornerstone of the new technology of obstetrics. Its routine use has been advocated, and the majority of labors in the U.S. are now monitored electronically. Recently, questions have been raised about the benefits of EFM. Review of the literature shows that only 4 randomized controlled clinical trials (RCTs) of EFM have been carried out. These show little if any benefit from the use of EFM in comparison to monitoring by stethoscope (fetoscope).

The lack of diagnostic precision of EFM is reflected in high false positive and false negative rates of identification of fetuses in distress. Although many retrospective studies of EFM attempt to correlate use of EFM with declines in perinatal mortality in specific hospitals, the 4 RCTs showed no difference in mortality between babies monitored by auscultation and those who were electronically monitored. No differences have been found in morbidity, including neurologic status, between infants in the two groups. Electronic fetal monitoring has been associated with a significant increase in the cesarean section rate in most retrospective studies and all the RCTs.
Electronic Fetal Monitoring and The Law
Authors: Katz Barbara F.
Published: April 2007

ABSTRACT: This paper concerns whether electronic fetal monitoring (EFM) has become a standard of care, such that physicians who do not use it can be held liable for injury to the offspring which would have been avoided by the use of EFM. Several defenses against potential liability are described. These include the “respectable minority rule” whereby physicians are protected when they choose between competing regimens of treatment; the “best judgement rule” by which it is the duty of a physician not to follow standards of care which show evidence of being erroneous; and the questioning of a standard of care as negligent in and of itself. These defenses, and the potential liability of a physician for over‐utilizing a technology, or taking a course of action which unnecessarily causes surgery, hospitalization or increased cost, are illustrated with court decisions. Hospitals may be liable for loss or injury which results from failing to inform prospective patients that necessary staff and/or facilities are unavailable to complete an offered treatment and handle its complications. The potential impact of the new FDA medical device regulation, and of any future state or local regulations on EFM are discussed.
The Courts, the Government and the Obstetric Care Consumer: An Inventory
Authors: Gray Ann
Published: April 2007

ABSTRACT: A review of recent court cases challenging midwifery is presented, along with a description of the role of the Federal Trade Commission in this area. Activities of the Senate, HEW, the General Accounting Office, the National Institutes of Health consensus meetings, and the FDA, as they relate to obstetric care, are described.
Observing the Childbirth Environment: A Research Model
Authors: Standley Kay , Nicholson Joanne
Published: April 2007

ABSTRACT: An instrument for recording naturalistic observations of labor is described. This instrument provides detailed data on the physical state of the laboring woman, and social and medical events which involve her. Uses of the instrument in research and model‐building are discussed.
Pain or Pleasure: The Dilemma of Early Breastfeeding
Authors: L'Esperance Carol Mikusa
Published: April 2007

ABSTRACT: For many women breastfeeding in the early days after childbirth is a painful rather than a pleasureable experience. Sixteen factors which have been reported to have an association with nipple discomfort were studied in 102 women in the first 96 hours after delivery. Only three of these 16 factors were found to be significantly associated with nipple pain. Both flat and inverted nipples and frequency of breastfeeding had significant negative associations with nipple discomfort. Engorgement of the breasts was found to have a significant positive correlation with nipple pain during breastfeeding. Breast preparation in the prenatal period was among the 13 factors which was not related to soreness in the early nursing period.
Malnutrition in Middle‐class Pregnant Women
Authors: Shearer Madeleine H.
Published: April 2007

ABSTRACT: Using three case histories, a review of malnutrition caused by calorie and salt restriction and diuretics is made, with special note of the relationship between these factors and toxemia, low birth weight and other obstetric complications. A survey of women entering prenatal classes in four geographic areas of the US is reported. We found that between 24 percent and 79 percent of women entering prenatal classes are actually dieting to hold the line at their seventh month weight gains. Up to 66 percent of women were told nothing as to an ideal weight gain by their doctors, and as many as 10% thought the weight gain given was too high. We found that about half of all women surveyed reached whatever they thought was the maximum weight gain by the seventh month of pregnancy, and then dieted to hold the line; up to 7 percent were trying to lose weight. Sodium restriction is still being prescribed for between 12 and 49 percent of women in the communities surveyed. Diuretics for late pregnancy edema are seldom prescribed. The physiology of protein‐calorie restriction and salt depletion are reviewed, with recommendations for action on the part of childbirth educators.
NIH Consensus Development Task Force on Cesarean Childbirth: The Process and the Result
Authors: Shearer Elizabeth
Published: April 2007

ABSTRACT: Ways to lower the incidence of the two most frequent indications for cesarean, repeat cesarean and dystocia, were recommended by the NIH Consensus Development Task Force in September, 1980. This paper describes the recommendations and criticisms of the work of the Task Force.
Teaching Prenatal Exercise: Part I ‐ Posture
Authors: Shearer Madeleine H.
Published: April 2007

ABSTRACT: Even if they are well‐motivated, most people will not remember or practice more than 3 exercises. Thus, it is necessary to tailor the exercise to the needs of each woman. Analysis of the pelvic tilt reveals that, during pregnancy, the maneuver is maintained mostly by the external obliques, with the cooperative synergy of the muscles of the torso and thighs. Common abdominal leg‐ and head‐raising exercises do not use these muscles as they are used during the pelvic tilt. Rather, maintaining the pelvic tilt for longer and longer periods is the best exercise for promoting good postural alignment during pregnancy.
Breastfeeding and Reproduction in Women in Western Australia — A Review
Authors: Hartmann P. E. , Kulski J. K. , Rattigan S. , Prosser C. G. , Saint L.
Published: April 2007

ABSTRACT: Beginning with a historical account of advice to breastfeeding mothers, the authors review recent changes in the incidence of breastfeeding in Perth, and studies of milk production, constituents of various milks, management of breastfeeding and weaning, and circadian and menstrual cycle variation in breastmilk. The effects of contaminants, the seasons, and pregnancy are also discussed.
Dancing in the Dark I. Romanticized Motherhood and the Breastfeeding Venture
Authors: Blachman Linda
Published: April 2007

ABSTRACT: Women who breastfeed today are burdened cruelly by romanticized fantasies and idealized images of selfless motherhood which are purveyed not only by books and periodicals, but by other mothers. Yet there is a dark side to breastfeeding, one part of which is simply the wish to have one's body back to oneself. The denial of the doubts, insecurities, and fears that often accompany early motherhood can lead to difficulties for the new mother and the nursing experience.
An Answer to Childbirth Educator Burn‐Out
Authors: Hecht Carolyn
Published: April 2007

ABSTRACT: A childbirth educator describes burn‐out as having been due to boredom, frustration and exhaustion. She overcame burn‐out by changing focus in her classes, and by introducing skills learned in courses in teaching the adult learner, group dynamics, and assertiveness training. Many new books were added to her lending library, and she joined two new organizations in the childbirth field. She drew up a Prepared Childbirth Preferences form to help couples talk to their doctors during pregnancy. Finally, she devised an evaluation system for her classes, and helped begin a teacher enrichment series within her local chapter.
The Importance of Maternal Nutrition in the Weeks Before and After Conception
Authors: Wynn Margaret , Wynn Arthur
Published: April 2007

ABSTRACT: The New York trial of prenatal protein supplements by Rush et al., together with the study by Stein et al. of the Dutch Hunger Winter, are reviewed to show the importance of maternal nutrition around the time of conception. Both studies reinforce the view that embryonic hypoplasia and dysplasia early in pregnancy cannot be reversed by good nutrition, or protein supplements, during the last half of pregnancy. The high perinatal casualties in both studies were among populations of women with body weights around the Harvard infertility threshold at the time of conception. The population studied in New York was not short of protein and the supplements caused nutritional imbalance for some patients
Nutrition, Family Planning, and Health Promotion: The Guatemalan Program of Primary Health Care
Authors: Lechtig Aarón , Townsend John W. , Pineda Francisco , Arroyo Juan Jose , Klein Robert E. , de Leon Romeo
Published: April 2007

ABSTRACT: This paper describes SINAPS, a program of primary health care in Guatemala, planned by the Ministry of Public Health (MOH), Pan American Health Organization (PAHO), and the Institute of Nutrition of Central America and Panama (INCAP). The objective was to design, implement, and evaluate a program of primary health care in Guatemala based on service delivery by non‐professional personnel. These personnel consist of Auxiliary Nurses (AN), Rural Health Technicians (RHT), Rural Health Promoters (RHP), and Traditional Birth Attendants (TBA).

SINAPS activities are focused on immunizations, food supplementation, oral rehydration of children suffering from dehydration, family planning, perinatal surveillance, and promotion of health and environmental sanitation, with the participation of the community. This limited set of interventions is aimed at controlling the most important causes of death and disability in mothers and children in a cost‐effective way.
II. Organogenesis, Fetal Growth, and Food
Authors: Wharton Brian , Viegas Osborne
Published: April 2007

ABSTRACT: In the third commentary in our Roundtable evidence is presented that malnutrition around the time of conception can cause fetal malformation. However, disagreeing with the analysis of the Wynns in the last Roundtable, the authors present evidence that in mothers who have an inadequate increase in triceps skin fold thickness a balanced protein energy supplement resulted in increased fetal growth. Supplementation ofother mothers was ineffective, or, as in Rush et al., it had harmful effects.
Southeast Asian Refugees and Maternity Care: The Oakland Experience
Authors: Ellis Judith
Published: April 2007

ABSTRACT: A county hospital obstetric and nurse‐midwifery service to Southeast Asian refugee families is described, including outreach to bring women into care, translators, and cultural and social adaptations of families and care‐givers. The major concerns are diseases coexistent with pregnancy, diet, and financing care. Families often prefer the birth room.
Outcomes of Father Involvement in Pregnancy and Birth
Authors: Nicholson Joanne , Gist Nancy Fohrell , Klein Robert P. , Standley Kay
Published: April 2007

: To test the assumption that father involvement in pregnancy and childbirth results in more positive birth and fathering experiences, 40 primiparous couples recruited from childbirth education classes and obstetricians were studied. About two weeks before their due dates each mother was asked to rate her marital closeness and her husband's interest in children. These couples were observed for one hour in mid‐labor. Then mothers and fathers were interviewed about one week after the birth.

Fathers who were more involved in terms of their wives’ reports of prenatal marital closeness gave generally more positive reports of the delivery and the new baby. Fathers who were involved in terms of their wives’ estimates of their interest in children were rated by observers as interacting with their wives less during labor. (BIRTH 10:1, Spring 1983)
Perinatal Death: Grief Support for Families
Authors: Estok Patricia , Lehman Ann
Published: April 2007

:Adequate support for parents whose baby dies requires close listening to the parents themselves, and familiarity with other successful programs of helping parents with grief. Interviews with 24 parents who lost their babies revealed what they found to be supportive or damaging behavior on the part of caregivers. Parents wanted doctors and nurses to acknowledge their feelings of shock, guilt, and grief, to recognize the importance of parents’ memories of the birth and the baby, and to help parents sharpen the reality of the death. Parents’ and hospital staff views of several types of grief support through the postpartum period, during and after hospital discharge, and throughout a subsequent pregnancy and birth, are discussed. (BIRTH 10:1, Spring 1983)
A Survey of Parents’ Attitudes Toward Their Cesarean Births In Manitoba Hospitals
Authors: Erb Lois , Hill Gail , Houston Doreen
Published: April 2007

: After announcements were made in the public media, 316 couples who had had cesarean births asked to be sent questionnaires about their births. Of these, 228 couples (72%) returned completed questionnaires. The questionnaire covered the reasons for the cesarean, obstetric history, educational level, prenatal and cesarean education, attendance by partner at surgery, anesthesia used, postpartum contact with the baby, and many specific postpartum feelings on the part of father and mother about the birth, baby, themselves, and their care.

Six per cent of the women who had had a first cesarean reported that in‐depth information had been provided by physicians, 12 per cent in prenatal classes, 13 per cent by friends and relatives, and 27 per cent by books and magazines. Sixty per cent of women said they got no cesarean information from their doctors and 22 per cent reported getting no cesarean information in their prenatal classes. Disappointment in the birth was felt by 68 per cent and joy by 93 per cent. The majority of respondents found their birth experiences satisfying, but would have liked more information, earlier and more prolonged contact with their infants, and more family‐centered births. (BIR TH10:2, Summer 1983)
Social Consequences of Obstetric Technology: the Importance of Measuring “Soft” Outcomes
Authors: Oakley Ann
Published: April 2007

The impact of obstetric technology on the outcome of pregnancy has been evaluated by three main categories of outcome measures‐those to do with mortality, physical morbidity, and “psychosocial” morbidity. There has been a marked preference among obstetricians and epidemiologists for mortality as a measure of outcome. The reasons for this situation are examined. The importance is argued of taking into account the other groups of outcomes, especially the psychosocial or so‐called “soft” outcomes. Some relevant studies which have included the assessment of mothers’ attitudes to obstetric technology are cited, and the limitations of present methods of evaluating “soft” outcomes are discussed. The social evaluation and consequences of obstetric technology are placed in the broad context of the problems generated by the role of technology in modern industrialized society. (BIRTH 10:2, Summer 1983)
The Politics of Co‐optation: Strategies for Childbirth Educators
Authors: Declercq Eugene Ft.
Published: April 2007

Co‐optation is the process of absorbing new elements into the leadership of an organization in order to diffuse the threat of challenging groups or individuals and to protect the status quo. Childbirth educators and other representatives of parents are targets for attempted co‐optation by, among others, advertisers seeking to use the influence of childbirth educators on the buying habits of new parents; by hospitals that incorporate the form of childbirth classes without their substance; and by members of associations that invite “consumer advocates” to participate in order to create the impression of willingness to change. Some ways to advance the interests of parents in these situations, without being co‐opted, are discussed. (BIRTH 10:3, Fall 1983)
Influence of Maternal Weight, Smoking, and Socioeconomic Status on Infant Triceps Skinfold Thickness and Growth During the First Year
Authors: Taper L. Janette , Hayes Mary , Rogers Cosby S. , Frary Robert B.
Published: April 2007

ABSTRACT: The effect of pregravid weight‐for‐height status, pregnancy weight gain, demographic factors, and smoking on several infant growth parameters from birth to eleven months of age was investigated in 120 mother/infant pairs. Pregravid weight‐for‐height status and total weight gain during pregnancy were positively related to infant birth weight but were not predictive of triceps skinfold measurements or changes in weight/length ratios from one to eleven months of age measured at bimonthly intervals. Although maternal smoking habits were related to lower infant birthweight, they did account for some increase in triceps measurements and changes in weight/length ratios at nine to eleven months of age. In light of the fact that maternal factors were not highly predictive of infant growth, except at birth, other factors in the early infant environment may play a more significant role in determining infant growth patterns.
Effects of In Utero Ultrasound Exposure In Humans
Authors: Petitti Diana B.
Published: April 2007

ABSTRACT: A review and analysis of studies of the effects of ultrasound exposure on human fetuses leads to a conclusion that there is no association of exposure with birthweight, hearing loss, or major congenital anomalies. Conflicting data from studies on birthweight is probably due to methodologic problems with the studies that have found positive associations. There have been few sound studies of the effects of in utero ultrasound exposure in humans. Limited studies to date are mostly reassuring, but it is premature to say that ultrasound has been proven safe for the human fetus. Further research on the question of biological effects of ultrasound in humans is needed, particularly the question of a possible association of ultrasound with dyslexia.
Mothers' Views of Continuous Electronic Fetal Heart Monitoring and Intermittent Auscultation in a Randomized Controlled Trial
Authors: Garcia Jo , Corry Martina , MacDonald Dermot , Elbourne Diana , Grant Adrian
Published: April 2007

ABSTRACT: We report the views of 200 women interviewed as part of a large randomized controlled trial in a Dublin hospital to compare a policy of continuous intrapartum fetal heart rate monitoring (EFM) with an alternative policy of intermittent auscultation using a Pinard stethoscope (IA). More women allocated to EFM reported that they felt restricted in their movements than did those allocated to IA. On the other hand, we found no evidence that the method of monitoring either influenced the support that they said they experienced or provided significant reassurance or made them feel more or less in control. There is a suggestion that women monitored with EFM were more likely to be left alone for short periods.

This study suggests that the method of monitoring was less important to women in this hospital than the support and reassurance they received from staff and companions. Personal and continuous care from a midwife for all women in labor is a key feature of the hospital's policy and our study suggests that, in general, this policy was successfully translated into both IA and EFM practice, although the association between the use of EFM and an increase in women being left alone for short periods indicates a need for caution.
Controlled Trials of Routine Ultrasound in Pregnancy
Authors: Grant Adrian
Published: April 2007

ABSTRACT: It is uncertain whether the evidence of randomized controlled trials justifies extending diagnostic ultrasonography for specific indication to routine screening in early and late pregnancy. The five such trials analyzed here show different inclusion criteria, outcome variables, trial reporting, and use of ultrasound, which makes them difficult to aggregate. They do not collectively form an adequate basis for deciding whether to recommend early or late ultrasound pregnancy screening on a routine basis.
Compliance with Childbirth Education Classes in Second Stage Labor
Authors: Lindell Sandra G. , Rossi Mary A.
Published: April 2007

ABSTRACT: Studies have compared the outcomes of those who attend childbirth education classes with those who do not. In this study, 28 women were asked to recount the instructions they had been given for breathing techniques and body positioning and to consider what positions and breathing techniques they might like to try during second stage when given the freedom and support to choose. The study found that many women did not comply with instructions given in childbirth classes when they delivered in an environment which supported their responding to their own instincts for birthing. Ten (59%) of 17 taught traditional pushing did not maintain the position they were taught, and 16 (94%) did not hold their breath and push as taught. However, if their childbirth educator instructed them to use a variety of positions or to do what was most comfortable in second stage, women did comply.
OXYTOCIN, NEONATAL SEIZURES, AND OTHER INSIGHTS DERIVED FROM THE DUBLIN TRIAL
Authors: Haverkamp Albert D.
Published: April 2007

Nearly 23 percent of the 13,000 labors randomized to electronic fetal monitoring (EFM) or to auscultation in the 1985 Dublin Trial were high risk by U.S. criteria due to the use of oxytocin. EFM was associated with increased cesarean sections and forceps deliveries, but the neonatal outcomes were exactly the same except for seizure rates. The difference in number of seizures was seen only among those who received oxytocin. In approximately 10,000 labors where no oxytocin was used, there were eight seizures in EFM and eight in auscultated infants.
The History of Ultrasonography in Obstetrics
Authors: Oakley Ann
Published: April 2007

ABSTRACT: Ultrasound was initially developed as a submarine detection method in World War I. In the mid‐1950s Ian Donald adapted the sonar device to scan for abdominal tumors, many of which turned out to be pregnancies. By 1965 fetal biparietal diameter and blighted ova were being detected by the technique, which had become a routine method for estimating fetal growth and maturity in many hospitals by 1968, although randomized controlled trials of safety and efficacy were still lacking. Although such trials are now being conducted, a danger of technologies like ultrasound is that they substitute objective, partial knowledge of the patient's condition for patient‐generated data. In addition, the process of obtaining technology‐generated data diminishes the social relationships of patients and caregivers in several ways.
Women's Views of Ultrasonography in Obstetrics
Authors: Stewart Nancy
Published: April 2007

ABSTRACT: Although a few studies have suggested that ultrasound scans can improve the bonding between mother and fetus, many women described themselves as more concerned or worried after a scan than they were before. It is possible that some women who feel relieved after a scan are relieved of the fears the procedure itself generated, since no significant differences were found in anxiety levels between a postscan and a no‐scan group. Excessive reliance on the technology could reduce the clinical skills of caregivers.
Infant Formula: A Mass, Uncontrolled Trial in Perinatal Care
Authors: Minchin Maureen
Published: April 2007

ABSTRACT: Widespread recognition of the immunologic value of human milk has left untouched an equally widespread belief in the nutritional adequacy of infant formula and its equivalence to human milk. Thus many believe that while “breast is best” in conditions of poor sanitation, there is little difference between formula and human milk where good hygiene is possible. Many also believe that women must be free to choose breast or bottle feeding, and that any critique of formula (though not of breastfeeding) is an intrusion upon that choice. But to be free, choice must be informed. This paper looks at the claims of nutritional adequacy and equivalence and argues that infant formula is unable to be “humanized”; that it is intrinsically hazardous; and that damage to Western children has occurred and is probably still occurring on a frightening scale. Once the risks of formula feeding are exposed, social and political change becomes necessary.
Nurses’ Responses to Changes in Maternity Care, Part II. Technologic Revolution, Legal Climate, and Economic Changes
Authors: Myers Sheila Taylor , Stolte Karen
Published: April 2007

ABSTRACT: Nurses’ responses to changes in obstetric technology, the legal climate, and economic pressures in maternity care were collected by means of a five‐question, open‐ended interview from 59 nurses practicing in 10 hospitals in Oklahoma and Kansas. The method and sample are described in Part I of this article. Forty‐eight of the nurses said that technologic advances have reduced job stress, raised professional status, increased interdisciplinary contacts, and either raised or lowered workloads. Defensive use of procedures in obstetrics has increased the need for charting and many other nursing duties not related to caring for patients. At the same time, anxiety and anger at the idea of being vulnerable to lawsuit for years after each birth did negatively affect some nurses’ attitudes toward their jobs and their patients. Despite the need for greater vigilance and more procedures, nurse‐patient staffing ratios are dropping in some hospital maternity units, while nurses are expected to market hospital services and help develop innovative programs.
Mothers’ Beginning Relationship with Twins
Authors: Anderson Arnette , Anderson Beverly
Published: April 2007

ABSTRACT: This study describes 10 mothers’ beginning relationship with their twins through the qualitative analysis of tape‐recorded, semistructured interviews at one month which focused on the mothers’ perceptions of each twin and their relationship. These mothers developed a relationship with their twin infants initially by differentiating their physical characteristics and polarizing their personality characteristics. At 1 month of age, the personalities of the twins were described by the mothers as opposites of each other and in terms of active and passive characteristics. Mothers emphasized the differences rather than similarities in the twin infants’ feeding and vocal behaviors, and their awareness of the environment.
The Clinical Significance of Breastmilk Maturation Rates
Authors: Humenick Sharron S.
Published: April 2007

ABSTRACT: Milk maturation from colostrum to mature milk occurs at rates that vary from mother to mother. The clinical significance of milk maturation rate is discussed here. Milk samples of 98 mothers were monitored in an observational study using the Maturation Index of Colostrum and Milk (MICAM). Samples were collected with each feeding during hospitalization, twice daily at home through day 7, and on days 14 and 28. Frequency and duration of early feeding were positively associated with milk maturation rates. An increased milk maturation rate was associated with an increased rate in infant weight gain at 28 days, lower transcutaneous bilimeter readings at 14 days and increased weeks of breastfeeding for those who weaned by 20 weeks. It is concluded from these associations that rapid milk maturation is desirable.
Predictors of the Duration of Breastfeeding in Low‐income Women
Authors: Hawkins Luann M. , Nichols Francine H. , Tanner James L.
Published: April 2007

ABSTRACT: To determine those factors that predicted the duration of breastfeeding in low income women, 47 participants in the Women, Infants, and Children Program (WIC) who had breastfed an infant were interviewed. Data were analyzed using descriptive statistics and stepwise multiple regression. A combination of four variables—age of the infant in weeks at the time of introduction of solid foods, maternal report of perceived success, the mother's years of education, and age of the infant in weeks at the time of introduction of formula—explained 52 percent of the variance in the duration of breastfeeding. The best predictor, the age of the infant at the time of introduction of solid foods, alone accounted for 32 percent of the variance in the duration of breastfeeding.
Psychologic, Physical, Nutritional, and Technologic Aspects of Intravenous Infusion During Labor
Authors: Newton Niles , Newton Michael , Broach Jeannine
Published: April 2007

Giving intravenous (IV) fluids in labor is currently an accepted custom in United States hospitals, although most indications for this practice have not been validated by adequate outcome research. This paper discusses the following questions: 1) Does IV therapy add pain to the woman in labor? 2) Does it have an adverse impact on the attitudes of health care workers and on the laboring woman? 3) Does partial immobilization caused by IV lines have adverse effects? 4) Does the practice introduce a possible route of infection and overdose of fluids? 5) Do IV fluids give adequate nutrition in labor? 6) Does glucose administered intravenously sometimes cause psy‐chophysical and neurologic complications? 7) Might forced feeding with glucose in IV fluids in late labor sometimes be harmful? The need for individualized treatment and much more research is emphasized. (BIRTH 15:2, June 1988)
The Use of Intravenous Fluids During Labor
Authors: Keppler Ann Blystad
Published: April 2007

This paper examines the use of intravenous fluids in labor management. Commonly used solutions are discussed, together with what is known about their effects on mother and infant. While the administration of intravenous fluids to laboring women may be appropriate and important in some instances, as a routine practice it often results in undesirable outcomes for both mother and infant. (BIRTH 15:2, June 1988)
Food and Beverages in Labor. Part I: Cross‐Cultural and Historical Practices
Authors: Broach Jeannine , Newton Niles
Published: April 2007

The diet permitted a laboring woman varies between cultures and eras. Here, cross‐cultural practices regarding food and drink during labor are reviewed, with particular attention to historical and present‐day American medical advice. In most American hospitals women are prohibited from eating or drinking in labor. This custom started in the middle of the twentieth century when general anesthesia was widely used for ordinary childbirth, creating risks of aspiration pneumonia and maternal death. Despite marked improvements in obstetric care, anesthetic agents, and anesthesia administration, women are still prohibited from eating and drinking in labor. It is posited that this reflects the phenomenon of culture lag. (BIRTH 15:2, June 1988)
Recent Trends in Family‐Centered Maternity Care for Cesarean‐Birth Families
Authors: Shearer Elizabeth L. , Shiono Patricia H. , Rhoads George G.
Published: April 2007

ABSTRACT: A survey of United States hospitals was conducted to determine policies relating to father attendance, use of anesthesia, and timing of mother‐infant contact with cesarean deliveries, as well as hospital staffs’ perceptions of mothers’ interest in vaginal birth after cesarean. We found that the number of hospitals allowing fathers to attend cesarean births increased from 35 percent in 1979 to 80 percent in 1984. Father attendance varied with size of delivery service, region of the country, and type of anesthesia used. Approximately one‐third of women with a previous cesarean were reported to have requested a trial of labor in a subsequent pregnancy. The average length of time before extended mother‐infant contact after cesarean delivery was reported to be twice that after vaginal delivery (4 vs 2 hours) and varied with size of delivery service and region of the country.
Electronic Fetal Monitoring During Premature Labor and the Occurrence of Perinatal Mortality in Very Low Birthweight Infants
Authors: Shy Kirkwood K. , Olshan Andrew F. , Hickok Durlin E. , Luthy David A.
Published: April 2007

ABSTRACT: The efficacy of intrapartum electronic fetal heart rate monitoring (EFM) in reducing perinatal mortality is uncertain. In a multihospital study in King County, Washington, we compared the effect of EFM with periodic auscultation in singleton infants with birthweights of 700 to 1500 g. Charts were reviewed for all 304 such pregnancies delivered during 1977‐1979 at the 14 area hospitals that provide obstetric care. The group with periodic auscultation showed a relatively higher proportion of risk factors for perinatal mortality: extremely low birthweight (< 1100 g), noncephalic presentation, delivery outside a tertiary obstetric center, and absence of premature rupture of membranes. Adjusted for these risk factors, the perinatal mortality of the EFM group was only slightly less than that of the group with periodic auscultation (relative risk = 0.91; 95% confidence limits = 0.65–1.3). Our results suggest that in infants of very low birthweight, the probability of perinatal death is little affected by the choice of EFM or periodic auscultation to monitor fetal heart rate.
The Role of Social Support in the Prevention of Preterm Birth
Authors: Bryce Robert L. , Stanley Fiona J. , Enkin Murray W.
Published: April 2007

ABSTRACT:Preterm birth is the major cause of perinatal mortality and morbidity. This tragic outcome occurs most frequently among mothers of lower social class and those with few psychosocial resources, including social support. Intervention studies supplying social support in other health fields have demonstrated improved psychosocial and behavioral outcomes, but not physical outcomes. This is a review of the current information about such effects and a description of studies that are attempting to test the effect of supplemental social support in pregnancy on physical outcomes such as preterm birth.
Free‐Standing Birth Centers: Prospects and Problems
Authors: Eakins Pamela S.
Published: April 2007

ABSTRACT: In this paper we examine the four major barriers to the operation of free‐standing birth centers: lack of regulation, underuse, unavailability of professional liability insurance, and lack of systematic, continuing medical outcome data‐collection systems. Recommendations for overcoming each of these barriers are offered.
A Quick Reference Table of Interventions to Assist Families to Cope with Pregnancy Loss or Neonatal Death
Authors: Hutti Marianne Hopkins
Published: April 2007

ABSTRACT: This is a quick reference table of strategies for assisting families to cope with miscarriage, stillbirth, or neonatal death. Strategies are listed, with references from the medical and nursing literature.
Views of Cesarean Birth Among Primiparous Women of Mexican Origin in Los Angeles
Authors: Cummins Laura H. , Scrimshaw Susan CM. , Engle Patricia L.
Published: April 2007

ABSTRACT: This study examined data from a larger project on the cultural context of first birth among low‐income women of Mexican origin giving birth in Los Angeles. Data on knowledge of cesarean birth and perceptions of the cesarean birth experience were collected. In addition, differences in perceptions of the experience between women giving birth vaginally and those giving birth by cesarean as reported in the literature were assessed. Five hundred eighteen women were surveyed, of whom 58 had a cesarean birth. Statistical analyses revealed few significant differences between the two groups with regard to childbirth knowledge and attitudes, which may indicate that Latinas are different from the Anglo women discussed in the literature. In their postnatal assessment, 28 percent of the women giving birth by cesarean reported dissatisfaction with the experience, the majority regarded cesareans as “normal,” and 11 percent thought they were at an advantage to have had cesarean births. These results suggest that cultural beliefs and attitudes may affect a woman's perceptions of the childbirth experience. The findings discussed here have implications for cross‐cultural research on childbirth for childbirth educators and for health care providers working in multicultural settings.
The Patient Observer: What Really Happened at the Bedside?
Authors: Perez Paulina G. (Polly) , Hays Bethany M.
Published: April 2007

ABSTRACT: This article reviews three cases of otherwise clinically normal infants who had low glucose readings via glucose meter at one hour of age. Their diagnosis and treatment is discussed. Parents’narratives as well as case records are included. Psychosocial aspects of the three cases are discussed.
Perinatal Loss: Providing Emotional Support for Bereaved Parents
Authors: Davis Deborah L. , Stewart Marguerite , Harmon Robert J.
Published: April 2007

ABSTRACT: This paper focuses on parents’emotional needs after perinatal loss and ways in which health care professionals can meet those needs. Parents must be educated about the grieving process and have their feelings acknowledged and validated. Health professionals can support parents by being available and listening, giving clear medical information, addressing parents’concerns, acknowledging the special situation, limiting the use of tranquilizers, providing follow‐up, making referrals to support groups or for psychologic counseling, and learning what is helpful to say to bereaved parents. To be able to approach parents and offer support, ealth professionals must be aware of their own reactions to the death of a baby, loss, and grief. Receiving staff support better enables them to offer effective emotional support to bereaved parents.
A Tool for Educating Parents About Their Premature Infants
Authors: Culp Rex E. , Culp Anne M. , Harmon Robert J.
Published: April 2007

ABSTRACT: This study examined the effectiveness of intervening with parents of premature infants by showing them examples of newborns' sensory, perceptual, and social capabilities. Fourteen couples and their premature infants, divided into an intervention group and a nonintervention group, were studied. Parents in the intervention group observed an assessment of premature infant behavior (APIB) examination and received feedback from the examiner prior to completing a parental assessment battery; the nonintervention group did not observe the APIB examination until after they completed the assessment battery. The assessment battery measured parental anxiety, perceptions, and awareness of neonatal behavior. Comparisons between the two groups revealed (a) intervention fathers reported significantly lower anxiety than did nonintervention fathers, (b) intervention mothers and fathers had significantly more realistic perceptions of their newborn compared to nonintervention parents, and (c) intervention mothers had significantly more accurate awareness of their newborns' abilities than nonintervention mothers, and intervention fathers had higher, but nonsignificant, awareness scores compared to nonintervention fathers. Having parents observe the administration of the APIB may be an effective way to educate them about their premature infant's behavior.
Hospital Practices and Breastfeeding Duration: A Meta‐Analysis of Controlled Trials
Authors: Bernard‐Bonnin Anne‐Claude , Stachtchenko Sylvie , Girard Guylaine , Rousseau Elizabeth
Published: April 2007

Abstract: Controlled clinical trials studying the influence of hospital practices on breastfeeding duration were combined using meta‐analysis. Nine studies were selected. Supplementation demonstrated a negative clinical effect on breastfeeding duration that was not significant. Nursing support demonstrated a positive clinical effect on breastfeeding duration that was not statistically significant if there was no telephone follow‐up, but was significant if there was telephone follow‐up. Early contact revealed a positive clinical effect that was significant. We conclude that early contact and nursing support with telephone follow‐up appear as enhancing factors of breastfeeding duration. (BIRTH 16:2, June 1989)
Management of Selected Early Breastfeeding Problems Seen in Clinical Practice
Authors: Walker Marsha
Published: April 2007

Abstract: Management guidelines for six common clusters of breastfeeding situations or problems commonly seen in clinical practice are discussed. These include inadequate infant weight gain, insufficient milk supply, nipple problems, latch‐on and sucking disorganization, high‐risk situations, and the “good baby” syndrome. Charts are provided describing devices and specialized techniques from which to choose when creating a feeding plan.
Expectations, Experiences, and Psychological Outcomes of Childbirth: A Prospective Study of 825 Women
Authors: Green Josephine M. , Coupland Vanessa A. , Kitzinger Jenny V.
Published: April 2007

ABSTRACT: A prospective study of 825 women booked for delivery in six hospitals in southeastern England was conducted to determine their expectations of childbirth. Women completed three questionnaires, two before the birth and one six weeks after. Questions covered both objective and subjective aspects of birth, and gave particular attention to control, its importance and its relevance to psychological outcomes. Four different indices of psychological outcome were considered: fulfilment, satisfaction, emotional well‐being, and the words that women used to describe their babies, which were shown to be related to different patterns of independent variables and of intra‐partum events. Our results did not support popular stereotypes: high expectations were not found to be bad for women, although low expectations often were. Information and feeling in control were consistently associated with positive psychological outcomes.