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Researchers reviewed records of nearly 100,000 birthing women to determine whether a connection existed between prior cesarean and placenta previa or placenta accreta. The overall rate of placenta previa was 0.26% for women with unscarred uteri, and increased according to number of prior c-sections to 10% in women with four or more. Women with placenta previa and an unscarred uterus had a 5% risk of clinical placenta accreta. For those with placenta previa and one prior c-section, the risk of placenta accreta was 24%. That percentage went up to 67% for women with four or more c-sections.
— Obstet Gynecol 66: 89–92, 1985
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The newborn baby's placenta is the focus of many post-birth rituals around the world. As well as honoring the baby's placenta, these practices spiritually safeguard baby and mother during the major transitions of birth and the postnatal period.
In Cambodia, for example, the baby's placenta, which traditional Cambodian healers call "the globe of the origin of the soul," must be buried in the right location and orientation to protect the baby. The burial place may be covered with a spiky plant to keep evil spirits and dogs from interfering, because such interference could have long-term effects on the mother's mental health.
Dona Miriam, a traditional midwife from Costa Rica, describes wrapping the newborn placenta in paper, burying it in a dry hole, then covering it with ashes from the stove. This ritual protects the mother from entuertos: retained blood clots, cramps and infection.
The influence of the child's placenta and cord is, in many places, thought to extend long after birth. In Turkey, the placenta, which is known as the friend or comrade of the baby, is wrapped in a clean cloth and buried. The cord, however, may be buried in the courtyard of a mosque, if the parents wish their child to be devout in later life. Similarly, if the parents want their child to be well educated, they may throw the cord over a schoolyard wall. The Kwakiutl of British Columbia are reported to have buried a daughter's placenta at the high-tide mark so that she would grow up to be skilled at digging for clams. A Kwakiutl son's placenta was apparently exposed so that, as ravens devoured it, he would gain prophetic vision in later life.
In many places, the placenta represents the child's relationship to family, tribe and land. The Maori of New Zealand call the placenta whenua, which also means land. For the Maori, te whenua (the land) nourishes the people, as does the whenua (placenta) of the woman. The Maori traditionally bury the baby's whenua and pito (umbilical cord) on the marae, or tribal land. Returning the placenta to papatuanuku (Mother Earth) after birth establishes a personal, spiritual, symbolic and sacred link between the land and the child.
— Sarah Buckley, excerpted from "Placenta Rituals and Folklore from around the World," Midwifery Today Issue 80
Midwifery Today Issue 80
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According to a study at the Mayo clinic, antidepressant use among pregnant women is increasing. Data from over 25,000 deliveries between 1993 and 2005 at that Minnesota clinic showed that about 5% of the pregnant women took selective serotonin reuptake inhibiters (SSRIs) during their pregnancies, a 1% increase from 1993. This is an alarming number, considering the adverse effects now linked to Paxil and some of the related SSRIs.
— Presented at the annual meeting of the American Psychiatric Association in San Diego, May 2007
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Read this editorial by Jan Tritten in the current issue of Midwifery Today, Winter 2007, Issue 84:
- Birth Change
"Amazing islands of faith can be found all over the world though, as our ideas are passed around and people get inspired, dream and carry out those dreams. More of us are called, and our hard work is needed to turn the tide. Robbie Davis-Floyd teaches that 20% is critical mass—if we can reach that we will make it."
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Q: At 28 weeks of pregnancy I was told that I had too much amniotic fluid, the placenta was not sending enough blood to the baby and she was not moving enough or growing. She was delivered that same day by cesarean and has Trisomy 21. Could anything have been done to keep her in there longer?
— Anonymous
SEND YOUR RESPONSE to mtensubmit@midwiferytoday.com with "Question of the Week" in the subject line. Please indicate the topic of discussion *and the E-News issue number* in the message.
Q: Do find in your homebirth midwifery practice that the rate of transfers and/or c-sections has increased in the last two to five years?
— Anonymous
A: In our practice the answer is no. We have had 52–57 babies per year and last year we transfered two and this year we have transfered three. Of the five, four had c-sections and one had a previous c-section. In years past we averaged 35 babies with 2–3 transfers. So our average is less now.
— One Heart
Responses to any Question of the Week may be sent to E-News at any time. Write to mtensubmit@midwiferytoday.com. Please indicate the topic of discussion *and the E-News issue number* in the subject line or in the message.
I taught a class on the placenta for a conference long before I started Midwifery Today. A friend was working at our local hospital so she got a bag of placentas for me to use. Out of about 20 placentas only one or two looked like our homebirth placentas. I was in total shock. I had seen a few placentas that were calcified and/or full of infarcts but they were on fairly overdue babies or the occasional woman with bad nutrition. These hospital placentas were riddled with infarcts (dead areas) and calcifications. I figured they were caused by poor maternal diets. Others were very tiny and I wondered if these were premature or IUGR (intrauterine growth restriction) babies. I think it shows the general bad health of US women. I also wonder if other placentas around the world look like that, and whether they have an effect not only on the baby, but whether there would be a negative effect from using those placentas for placenta medicine.
— Jan Tritten
I am surprised that Brenda Docherty (E-News 9:24, November 21, 2007) has seen so few women who personally have experienced birth as rape or been traumatized by the violence done to them during it. With the cesarean section rate skyrocketing and the ongoing medical model of care with its inherently depersonalizing rituals, how women manage *not* to be traumatized by their births amazes me. This is much more common than Ms. Docherty realizes. See my article in your wonderful magazine of last winter, "Healing the Trauma: Entering Motherhood with Posttraumatic Stress Disorder."
— Jennifer Griebenow
I've seen this type of insinuation frequently in the literature. That somehow, if a woman has had trauma prior to childbirth, that the traumatic events that occur during childbirth are unimportant. It simply isn't so. Childbirth is often an intensely emotional experience, one that should involve a partnership with a woman's care provider. Though women have the right to informed consent about all aspects of their birth, most are not empowered to know this and the unfortunate reality is that not all care providers can be trusted to inform women of this right.
Even if, as Ms. Docherty says, an intervention becomes necessary for the life of the mother and/or baby, this does not negate the emotional reaction. Read Cesarean Voices (an International Cesarean Awareness Network publication), for example, and you hear over and over the relief for their babies' health (if they are so fortunate) and yet devastation at how the baby came into the world. These feelings need to be validated and the woman supported in resolving them, in order to avoid the devastating consequences traumatic birth can have on the woman, her partner and her family.
Providers, maternal and mental health alike, need to be aware of the far-reaching implications of birth trauma. Women need to have their experiences validated, not minimized, as Ms. Docherty has done.
— Christie Craigie-Carter, M.A., LMHC
Chair of Mental Health, International Cesarean Awareness Network
www.ican-online.net
I am glad that Brenda Docherty, Bsc, RGN, RM, has seen so little traumatic birth in Scotland that she considers "the clients' work, education or social interaction may have coloured their views of childbirth" if they equate their experience of birth as "rape."
In my work and education as a nurse, as well as in my social interaction, I never expected the experience of childbirth would leave me feeling like anything less than a proud new mother. My social interactions had led me to believe that doctors were people I could trust because they cared about me. When my plans for a natural birth turned into an unnecessary cesarean, I felt as if I had been gang-raped while others stood by and approved.
Marilyn Moran, author of Birth and the Dialogue of Love, said that just as rape is the forceful intrusion of the woman, a medically intervened birth is the forceful extrusion of the infant from the woman.
— Sheila Stubbs
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