This workshop is designed for both new and experienced midwives to update their skills with research based approached to assessing fetal well-being during pregnancy and labor.

Participants will be able to:

*Describe what conditions lead to “primary apnea” and then to “secondary apnea”.
*Identify both reassuring and non-reassuring fetal heart patterns.
*Describe and perform intrauterine resuscitation techniques.
*Identify reasons for performing an AAT.
*Perform an AAT.
*Assess an AAT.

Contact Maura Jansen at maura.jansen@gmail.com or 503-575-8596 with questions.

Space is Limited. Please register in advance.
Cost: Student $25, Midwives $30 plus $10 for ceus

This event is a fundraiser for OMC
To register send name, address, and checks made out to OMC to
Maura Jansen
2124 SE Oak Street
Portland, OR 97214

Start Time: 10:00
Date: 2011-12-15
End Time: 13:00

The idea of having a baby away from a traditional medical setting can be scary for some people.  Although homebirth is common in many other industrialized nations it is not the norm in the US.  This can lead to especially tense feelings if the concerned parties are family members or close friends who have chosen (or are choosing) very different paths for their birth experiences.  However, choosing to give birth at home or in a birth center can also be an amazing opportunity to help educate those around you about the facts related to the safety of birth outside of a hospital.

Analysis on the safety of home birth has been conducted by people from various fields of study and with diverse interests.  Research on risk and outcomes, analysis and reporting, patient satisfaction and public policy recommendations have all played a role in shaping the ways in which midwives provide services to birthing women.  Over the last 20 years (at least), the research that is regarded as the most sound  has supported what midwives have known for much longer than those 20 years; birthing a baby at home is at least as safe as birthing a baby in a medical setting, with lower cost and fewer interventions attached.

Among the most respected of these studies are:

• “Outcomes of planned home births with certified professional midwives: large prospective study in North America” (The British Medical Journal, 2005), Kenneth C Johnson, senior epidemiologist ,Betty-Anne Daviss, project manager

This is a study which followed a group of 5418 women who chose similarly credentialeddirect entry midwives throughout their pregnancy and birth.  Outcome measurements included intrapartum and neonatal mortality, perinatal transfer to hospital care, medical intervention during labor, breast feeding, and maternal satisfaction.

Conclusions:  Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States.

• “Perinatal mortality and morbidity in a nationwide cohort of 529 688 low-risk planned home and hospital births”.BJOG 2009. de Jonge A, van der Goes B, Ravelli A, Amelink-Verburg M, Mol B, Nijhuis J,Bennebroek Gravenhorst J, Buitendijk S.

The strength of this 2009 Dutch study is its very large sample size (529,688 women from across the Netherlands).  Its goal was to compare perinatal mortality and severe perinatal morbidity between planned home and planned hospital births, among low risk women who started their labor in primary care.

Conclusions: This study shows that planning a home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women, provided the maternity care system facilitates this choice through the availability of well-trained midwives and through a good transportation and referral system.

While research confirms that for women with low-risk pregnancies, homebirth is a safe and reasonable option, situations can arise that require transfer to a medical setting.  It is important when discussing safety and birth setting transfer to remember that the majority of women who choose to relocate to a hospital due so for non-life threatening reasons.  Common reasons for transport include maternal exhaustion, a birth whose progress lies outside of a normal range, or concerns about fetal well-being.  Midwives are trained not only in normal birth, but also in identifying factors that suggest a mother and baby would benefit from the addition of a medical provider to her birth team.  You and your midwife should discuss under what circumstances a transfer might be necessary and how you would like to handle a transfer to the hospital.  Decide upon this together well before your birth and agree upon a plan to deal with the potential necessity of changing your birth setting.

It must be noted that regardless of the place of birth, no birth will ever be risk free.  Having a baby in a hospital simply poses a different set of risks, benefits and safety concerns than choosing to birth at home.  Problems can arise regardless of setting and sometimes the results of rare, but serious or unexpected complications would be the same within a hospital or outside of one.  It is important to make an informed choice about the risks and benefits of where you choose to give birth as well as with whom, prior to having your baby.

For a summary of the research on homebirth safety click here.  This is an annotated guide to the literature available on out of hospital birth through 2010 when this document was published.  It is extremely thorough and makes finding research articles fairly easy.  Most can be accessed through databases available online from home or through your public library via the library’s website.