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Covid and Resources I Trust

10/15/2020

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Covid; it's been the talk of the town, not to mention the world since February.  Everyone is learning about it as they go.  There hasn't been much time to plan and initiate controlled research studies.  What information we do have seems to be changing faster than the Kansas weather.

In this time of social media, and constant news updates it is hard to know where to go to get the most up to date and accurate information.  While I love Google for finding information, it can be a challenge to get solid information about Covid, and there isn't much out there about the impact of Covid on pregnancy, birth and postpartum.

In looking for resources to get reliable information about Covid and evidence based recommendations, I want reliable, up to date, evidenced based sources that are staying abreast of the most recent information and data coming in. I do not want a flashy headline preying on fears and lack of information.  I do not want conjecture, supposition, or guesses.  I want to know what the experts are learning from the data.  I want information presented in an easy to understand manner, and that pertains to real world situations that I can apply in my midwifery practice.

I love evidencebasedbirth.com.  It's a great source of current, evidence based information for pregnancy, birth and postpartum.  This website has impressed me even more by having the very latest data and studies pertaining to Covid, and this is updated regularly.  It is presented in an easy to understand format with links to the actual data sources if you want to read more in depth.

A great resource focusing on women's health is avivaromm.com/category/covid-19/.  Dr Romm has easy to understand information, and answers questions such as "Can you treat Covid-19 naturally?".  Her common sense approach and background as an herbalist, midwife and doctor gives her a well rounded perspective on Covid.

Other good sources on Covid are coronavirus.jhu.edu, www.nih.gov/coronavirus and ​guidelines-research-services/coronavirus-covid-19-pregnancy-and-womens-health.  Please note that not all of these sites are focused on pregnancy, or are US based. 

As a midwife, I need to keep up to date on how Covid can affect pregnancy, birth and postpartum.  I want to be using the most current, evidence based guidelines and recommendations to provide the best care possible for my clients. 

In sharing the sources I am using, I want to encourage you to educate yourself and use that information to decide what is best for you and your family.  
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Evidence Based Care in Pregnancy and Birth

10/1/2020

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According to the Journal of the Royal Society of Medicine, it takes an average of seventeen years before research evidence reaches clinical practice.  This means that the most recent recommendations for best medical practices for pregnancy and birth won't be put into practice for almost a generation! 

In the past few years, several studies have shown that some current obstetrical practices are unnecessary and may be detrimental.
 One of many examples of the lag in applying evidence based care is eating and drinking during labor.   The evidence shows "the risk of aspiration during cesarean childbirth was 0.667 per million women, or approximately 7 events in 10 million births (Hawkins, Koonin et al. 1997).  [Side note: The probability of this occurring is less likely than being struck by lightning!]  In another study, researchers looked at 11,814 women who were given the freedom to eat and drink during labor, with some women requiring emergency C-sections. There were zero cases of morbidity or mortality reported from aspiration pneumonia, even though 22% of women had eaten solid food (Rooks, Weatherby et al. 1989)."  This evidence has been publicized since 2010, and yet in many hospitals, policy hasn't changed.  This is from the website of Sparrow Birthing Services and Mother Baby Center in Michigan: "A very serious risk of general anesthesia is that you may vomit as you go to sleep. If stomach contents are inhaled into your lungs, you could develop a serious type of pneumonia. That is why we ask that you limit your intake of food and liquids prior to surgery or when in active labor."  Closer to home, it is a challenge to find a hospital that will allow VBAC (vaginal birth after caesarean) in spite of the guidance from ACOG, the professional organization that provides practice guidelines for pregnancy care.

One of the reasons I became a home birth midwife is to offer women the opportunity to work with a provider who strives to use the most current practice recommendations and who is not constrained by hospital policies that are dictated by insurance or outdated.  Women should not have to wait seventeen years to get the best care possible!  




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    Author

    Gail Webster, CPM

    Gail is a Certified Professional Midwife serving Manhattan, Junction City, Fort Riley and other areas in Kansas.  


    When Gail is not occupied with birth work, she enjoys reading, quilting, baking, riding her motorcycle and spending time with family.
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