Mary Lou Moore

Current Research Continues to Support Breastfeeding Benefits

Lamaze International and Lamaze Certified Childbirth Educators are strong supporters of breastfeeding. This paper reviews eight recent studies that are related to breastfeeding and useful to clinicians and educators.

Increasing Cesarean Birth Rates: A Clash of Cultures?

Cesarean birth rates in the United States reached a high of 27.6% in 2003, a 6% increase over 2002. A cultural conflict appears to exist between the views of those who believe that birth is normal and many cesareans are unnecessary and the views of those who feel that higher rates are justifiable. Childbirth educators can share cultural concepts of normal birth in their classroom.

Complementary and alternative therapies.

Complementary and alternative therapies are increasingly used by many pregnant women in the United States; however, limited research is available on many therapies. The number of studies should increase with the establishment of the National Center for Complementary and Alternative Medicine by the National Institutes of Health. This column reviews recent studies of both herbal medicines and alternative therapies used in pregnancy.

Perceptions of nurses and mothers in four studies of the peripartum period.

How individuals perceive themselves and how they are perceived by others are an important part of the relationships between childbirth educators, nurses, other health-care providers, and the families they serve. In this paper, four studies are reviewed. One study focused on labor nurses’ perception of their roles. Three other studies, each using a different research strategy, examined mothers’ perceptions of their experiences during the peripartum period.

Misoprostol—Is More Research Needed?

Misoprostol (Cytotec) is a synthetic prostaglandin E1 analogue that was designed for the prevention and treatment of peptic ulcer associated with the use of nonsteroidal anti-inflammatory drugs. In obstetrics, misoprostol has been administered for induction of first and second trimester abortion, for induction of labor in the third trimester, and to control postpartum hemorrhage. None of these uses has been approved by the Food and Drug Administration. Nevertheless, misoprostol is widely used in the United States and throughout the world. Advantages are cited as reduced rate of cesareans, shorter time from induction to birth and, particularly in developing countries, lower cost, oral, vaginal or rectal administration, and stability without refrigeration. Disadvantages are uterine hyperstimulation and, in rare instances, uterine rupture and death. Mothers should be informed of both the risks and the possible benefits of misoprostol. Further research with large samples is necessary to determine whether the risks outweigh any possible benefits.

Preterm birth: a continuing challenge.

Although preterm birth has been a major focus of study for the past two decades by health care providers in several disciplines, it remains more prevalent in the United States than in many developed countries and continues to be a prime reason for infant death (mortality) and illness (morbidity). In the past 10 years, preterm rates have risen in the United States from 10.6% in 1990 to 11.6% in 2000. Low birthweight rates have increased from 7.0% in 1990 to 7.6% in 2000. This column reviews recent studies addressing preterm and low birthweight births, including changing demographics, the role of assisted reproductive technology, smoking, domestic violence, the experience of women, and treatment strategies.

Recent research questions the values of routine intervention.

Under appropriate circumstances, intervention in labor and birth can be valuable, even lifesaving. But interventions can also become routine procedures. This paper reviews three recent studies in which the focus of research is common interventions: electronic fetal monitoring and epidural anesthesia. A fourth study reviewed here examines the effect of previous vaginal birth and fetal weight on the success of vaginal birth after cesarean.

Reducing the rate of cesarean birth.

This column examines recent research that illustrates the varying perspectives of cesarean birth and vaginal birth.

Adopting birth philosophies to guide successful birth practices and outcomes.

Research studies conducted recently in hospitals located in Switzerland and Canada reveal the importance of birth philosophies in attaining successful birth practices and outcomes.

Cesarean birth from three research perspectives.

Issues surrounding cesarean birth are of interest to researchers from varied disciplines and nations. In this column, three studies that examine aspects of cesarean birth are reviewed. One study presented a review of 11 studies and found differences in the perceptions of white and minority mothers toward labor, vaginal birth, and cesarean birth. In a second study on infant outcomes, Japanese researchers found differences in transient tachypnea in infants born in the first half of the 37th week gestation and those born in the second half of the 37th week and the 38th week of gestation. In a third study conducted in Norway, researchers found more complications when cesarean birth occurred at advanced dilation. The three studies’ implications for childbirth educators are discussed.