Last week, we highlighted the highly talked about study pertaining to fear of childbirth and its downstream consequences, published recently in the Scandinavian journal Acta Obstetricia et Gynecologica Scandinavica. This week, I'd like to draw your attention to some other interesting studies out of the same journal, as well as some others that have recently caught my eye:

This study reveals new (Level II) evidence that cesarean surgery should not be the automatic go-to option for twin births. In my local community, there has been a strong trend to steer mothers of multiples into the surgical suite with hardly a pause to consider the benefits of vaginal birth (although most recently, a few maternity care providers here have begun to push back against that practice and support women of twins through vaginal births).

This meta-analysis published in the same journal reveals a link between low gestational weight gain and pre-term birth, as well as low birth weight infants. I recently wrote on the topic of poor weight gain during pregnancy - especially as it pertains to pregnant teens.

Whether due to tocophobia (fear of childbirth), financial constraints, career pressures or other factors facing women of childbearing age, an interesting trend has emerged as the U.S. 2010 census results have been released: birth rates in our country have dropped, according to this USA Today article.

And have you heard? South Carolina is the latest state to put a stop to early, elective cesarean deliveries - following on the heels of Oregon's commitment to the same cause earlier this month.

In the current American Journal of Obstetrics and Gynecology issue, a compelling cohort study suggested the persistent need for maternity care providers (and those interacting with pre-/interconceptional women) to increase educational efforts with women trying to conceive. The study found that women attempting conception were decreasing their caffeine intake, but were not significantly changing/ decreasing nicotine and alcohol use. Study authors conclude more preconceptional guidance is warranted for the interpartum or pre-conception population.

Also in AJOG, is the presentation of study findings suggesting that epistiotomy does not, in fact, reduce the incidence of brachial plexus injury in the event of shoulder dystocia. Data were collected from 94,842 births between 1998 - 2009. During the study period, epistiotomy rates dropped from 40% to 4% with no change in brachial plexus injury rates, per 1,000 births. Authors of the study conclude that, 'despite historical recommendations for an episiotomy to prevent brachial plexus injury when a shoulder dystocia is encountered, the trend we observed does not suggest benefit from this practice.'

And in the journal Birth, Marian MacDorman, Eugene Declercq, and T. J. Mathews reported on the 20% increase in home birth rates in the U.S. from 2004 - 2008. You can access the full article here.

So, what's on your radar? What have you read with interest lately? Please do share with your fellow readers what you're reading and keeping an eye on.

Posted by: Kimmelin Hull, PA, LCCE, FACCE

Published: September 29, 2011

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