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Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

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Induced-Labor Necessity Notion Draws Challenge

The Best Thing You Can Do for Mothers, Babies, Birth and Families is to Become Net Savvy!

I just had my mind expanded this morning by Laureen Hudson's hour long online session on how to use the internet to get a message out. Laureen's session “Creating an Online Presence," gave me a wealth of information in a short time and impressed me with how many people are out there who completely rely on the internet for their information. I needed that, and maybe you do, too.  

  - Ina May Gaskin 

 I just hung up the phone from doing the hour long session with Laureen Hudson on “Creating an Online Presence”.  Laureen’s know-how and expertise were enough to wake up even the birth oldtimers like me and Ina May to the many unused opportunities of the internet.  Laureen’s engaging and easygoing teaching style made even those scary (to me) terms like “hypertext, streaming, wordpress, technorati, feedreader and trackback” start to make sense.  Her passion is to reach the generation of young women who have not yet given birth BEFORE they fall into the black hole of aggressive obstetrics.  I came away from the class today with lots of ways to improve my website and make it more modern, usable and interesting for readers.  This class will run again this coming Friday (August 22) and I heartily recommend it.  
- Gloria Lemay


 
REGISTER NOW! SPACE IS LIMITED! 

Cost: $35 per session 

Each session will be 60 minutes in length 

Creating An Online Presence
Sunday, September 7 at 5:00 p.m. Pacific / 8:00 p.m. Eastern
Friday, September 19 at 12:00 p.m. Pacific / 3:00 p.m. Eastern
Monday, September 22 at 9:00 a.m. Pacific / 12:00 p.m. Eastern 

Search! 
This session will include a case study of Dr. Amy and how we shoot ourselves in the collective feet by visiting and commenting on her website.  (PS Hope you enjoyed the Gotcha! page from our last email!)
Sunday, October 5 at 5:00 p.m. Pacific / 8:00 p.m. Eastern
Friday, October 24 at 12:00 p.m. Pacific / 3:00 p.m. Eastern
Monday, October 27 at 9:00 a.m. Pacific / 12:00 p.m. Eastern   

04/18/1996
BOSTON (AP) Challenging a long-held view, a new study concludes doctors don't always need to induce labor when a woman's water breaks after a full-term pregnancy. Instead, it appears that letting nature takes its course is safe for both mother and baby.

For years, many doctors have assumed that waiting for labor to start naturally after the fetal membranes break could be hazardous to the baby. The fear is that germs might get into the uterus. On the other hand, some worry that when doctors use drugs to start labor, they are more likely to have to deliver the baby by Caesarean section.

A woman's ''water'' breaks when the fetal membranes rupture before the start of labor, releasing amniotic fluid. To help resolve whether inducing labor is necessary, doctors studied 5,041 women in this situation. They were randomly assigned either to have induced labor or to wait for labor to start on its own. ''There was very little difference,'' said Dr. Mary E. Hannah of the University of Toronto, who described the results in today's New England Journal of Medicine. In both groups, about 3 percent of babies had infections, and about 10 percent were delivered by C-sections.

The study was conducted in Canada, Britain, Australia, Israel, Sweden and Denmark.


Critique of Study

I assume that the report is concerning the paper reporting the results of the TERM-PROM study. Our unit was one of the collaborating centres. As has already been discussed in this group the study randomised women to one of four protocols - early IOL with PGE2, early IOL with synto/pit, delayed IOL with PGE2, delayed IOL with synto/pit.

Results were that:

  1. The majority of women in either of the delay groups went into spont labour before the four day limit was reached.
  2. Early induction did not increase rates of CS, forceps, need for epidural, or anything else for that matter.
  3. Women were more likely to prefer early IOL ( retrospectively ).
  4. There were more pyrexias and more episodes of infection with delayed compared to early induction.
  5. Although there was no a priori hypothesis ( so no strong conclusions can be drawn ) there were no fetal/neonatal deaths in the early group whilst there were a few in the delayed group.
On this basis the newspaper report looks like either a very selective quote or a total misquote. Please don't accept the newspaper article look at the original report !


This Web page is referenced from another page containing related information about Prelabor Rupture of Membranes - PROM

 




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