Delivery room dads do more harm than good

by JENNY HOPE, Daily Mail

Not so long ago, the father's place during childbirth was in the hospital waiting room, pacing the
floor and biting his nails.
But nowadays he is expected to be in the delivery room witnessing every stage of baby's arrival even if it is a caesarean.
While his job is to help his partner through her ordeal, however, he could be making things
worse for her and the child, it is claimed.
Instead of reassuring her, he tends to pass on his fears that something might go wrong - affecting
not only her levels of pain but also her chances of breastfeeding and bonding, says a report.
Researchers at the University of Bath and Imperial College London are calling for expectant
fathers to be better prepared for the reality of a surgical birth.
Dr Ed Keogh, who led the research, said it is now a 'social expectation' that men attend a
caesarean delivery and some felt under pressure to be there.
"Whilst some women say that birth partners improve birth experiences, others report less
positive outcomes. It is not unreasonable for the birth partner to have some feelings of anxiety
and fear about the operation they are about to witness.
"Maternal fear fluctuates during a caesarean section, but it can be influenced by the factors
around them, including their partner.
"A number of birth partners told us that they had little choice in attending the caesarean
operation and felt illprepared." The study comes amid soaring rates of caesareans, with more
than 130,000 carried out at NHS hospitals in England last year - almost one in four. More women
are also planning so-called designer births, in which they have the surgery already booked.
About seven per cent of all NHS surgical births - around 10,000 babies a year - follow a request
from the mother for no medical reason. The study, published yesterday in the journal
Psychosomatic Medicine, involved 65 women scheduled for an elective caesarean at the Chelsea
and Westminster Hospital, questioned during antenatal check-ups. Almost all chose their husband
or boyfriend to be with them at the birth.
Dr Keogh said: "When a man gets into the operating theatre it's full of people, there's his loved
one having major surgery and he doesn't know what's going to happen.

"It's a bit late then for a crash course in surgery. Probably the time to address these issues is in
advance during antenatal classes."
The study found women who had 'negative' expectations before the operation felt most fearful
during the delivery and this in turn was related to greater pain after the operation.
It also showed women staying awake during surgery were most afraid during the application of
the nerve block used to numb the lower part of the body, rather than the initial incision. Dr
Keogh said the findings nail the myth that caesareans make childbirth painfree and ultraconvenient for women who are 'too posh to push'.
"Whilst actual pain during a caesarean is usually more controlled than a vaginal delivery, the
whole procedure is not painless. Women who have had a caesarean tend to experience much
longer periods of postnatal pain and recovery."
Dr Keogh added: "Birth partners can have potentially beneficial effects on maternal birth
experiences. Rather than removing them from the operating theatre altogether, it would be better
to target the emotional well-being of the birth partner to help reduce the anxiety and fear
experienced by the mother."
Belinda Phipps, Chief Executive of the National Childbirth Trust, said: "Antenatal classes for
both parents can provide practical information and support them so they know what to expect,
should a caesarean be necessary."
But she added: "Even with preparation, not all men will feel comfortable attending the birth and
if pressured into being there they are bound to feel more anxious."
Read more: http://www.dailymail.co.uk/health/article-375150/Delivery-room-dads-harmgood.html#ixzz4WrXJqHJb
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REACTION;

Hypnosis in the Delivery Room

It isn't for every woman, but "hypnobirthing" certainly has its fans, including Carla
Breakey, a 38-year-old home business owner from Idaho. And rave reviews from women
like Breakey are helping this method of natural childbirth grow in popularity around the
globe.
Breakey used hypnobirthing for two of her three children. Hypnobirthing teaches women
how to hypnotize themselves to manage their labor, helping them to relax and let their
bodies take over. The theory is that, in the absence of fear and tension, severe pain does not
have to accompany labor. In this calm state, endorphins -- naturally occurring chemicals in
the body that can relieve pain -- replace the stress hormones that contribute to pain,
proponents say.
"I enjoyed the experience a lot more and was a lot more present when I used
hypnobirthing," Breakey tells WebMD. For her first child, Breakey had a standard
hospital birth with an epidural. That time, she says, "I felt like I was fighting the labor, and
after the epidural was administered, I couldn't feel anything, which was scary."
That's why she, along with her husband, Jeff, decided to try hypnobirthing for their second
child. "I was very skeptical the first time, but the experience was unbelievable. I was
relaxed, and it really does help with the pain," she says. "With hypnobirthing, I felt
confident, and when the contractions would come, they weren't scary at all."
And although some experts warn that undergoing any type of drug-free childbirth requires
a high level of determination and commitment, proponents say hypnobirthing really can
help ease women's fears about the birth process.
"Hypnobirthing is a childbirth process that includes a major focus on many of the
techniques used in hypnotherapy to relieve fear," Pat Burrell, RN, a hypnobirthing
therapist based in State College, Pa., tells WebMD. "It integrates factual information on
the childbirth process along with hypnosis." Burrell is also an instructor with the American
Board of Hypnotherapy and an executive board member of the Hypnobirthing Institute in
Epsom, N.H.
"Other childbirth processes approach pain as a given and try to find ways to deal with
pain, from medication to massage, but hypnobirthing teaches women to transform the
sensation of pain so that it feels like something else," she says. "The healthiest way to
deliver a baby is to be very relaxed and allow the body to do it. Once labor begins, it has its
own momentum and mom really doesn't need to do much of anything."
Hypnobirthing can also be used along with other birthing processes ranging from Lamaze
to pain-killing drugs, Burrell says.

Couples learn the technique by taking between four and six classes, starting after the first
trimester of pregnancy. "The partner is the hypnotherapist and helps the woman get into a
trance-like state, where she is fully conscious of what her body is doing," Burrell explains. "She
is very relaxed, which provides a safe and healthy environment for the baby and the mom."
Burrell says hypnobirthing creates a strong bond between the couple as well as between the
mother and her baby.
The cost varies across the country, and many insurance companies do reimburse for
hypnobirthing classes, she says.
Debbie Wagner, a clinical hypnotherapist in Bellevue, Wash., has taught hypnobirthing to
hundreds of expectant mothers since the early 1990s."I have had great success with it," she tells
WebMD. "Many women have told me that they had a sense of control that wasn't present [in
previous births] after using hypnobirthing."
But some experts warn that hypnotism may not be enough to help everyone endure the powerful
pains of labor. Yvonne Thornton, MD, PhD, a senior perinatologist at St. Luke's Roosevelt
Hospital Center in New York, says she would counsel women to think long and hard before they
decide to try hypnobirthing or any other method of drug-free delivery.
"If you really want to have a drug-free birth, you have to be committed to the program or
technique because if you are not really committed, it's a farce," she tells WebMD. "Some people
have a fairy-tale idea about the true nature of labor, but it is painful. It is one of the most painful
crisises that the woman has to endure."
For more information on hypnobirthing, call the HypnoBirthing Institute at (603) 798-3286.

REACTION;

Wiping Is as Effective as Suctioning in the

Delivery Room
Robin Steinhorn, MD reviewing Kelleher J et al. Lancet.
In low-risk newborns, wiping the nose and mouth is as effective as bulb suctioning to clear the
oropharynx of secretions.
The current Neonatal Resuscitation Program (NRP) guidelines indicate that nasal or oral
suctioning of healthy neonates is not required after delivery and that these interventions should
be reserved for infants with obvious obstruction to spontaneous breathing. In addition, small
trials have shown that suctioning of the mouth and nose is not necessarily a benign practice and
can lead to complications such as bradycardia and apnea.
In a randomized study involving 506 low-risk neonates, investigators at the University of
Alabama compared routine wiping versus suctioning with a bulb syringe in the delivery room.
Infants with depressed muscle tone or respiration or meconium-stained amniotic fluid were
excluded.
The primary endpoint of respiratory rate at 24 hours after birth was equivalent between the wipe
and suction groups (51 and 50 breaths per minute, respectively). Secondary outcomes of Apgar
score, need for advanced resuscitation, and tachypnea were also similar between the two groups.
A nonsignificant trend toward higher admission rates to the neonatal intensive care unit was
noted in the wipe group (18% vs. 12%; P=0.07).

REACTION;
These findings confirm the Neonatal Resuscitation Program guideline stating
that routine wiping of the nose and mouth is as effective as bulb suctioning
to clear the oropharynx of secretions in the delivery room. In this study,
infants were low risk; most were already vigorous and may not have required
suctioning or wiping to initiate breathing. Wiping avoids the risks for
bradycardia and injury from more invasive suctioning and can be easily used
in resource-limited settings.