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Saturday, October 31, 2009

iBirth? iPhone As The Latest Obstetric Intervention

Memorial Hermann Healthcare System (Houston, Texas) have been featured on Apple's business profile website for adopting the latest in obstetric intervention technology: the iphone. Apparently the iphone and "state-of-the-art medical [applications] like AirStrip OB let Memorial Hermann’s physicians keep a finger on patients’ pulses even when they can’t be at their bedsides."* Every obstetricians dream, a technology that enables him to intefear in birth while on the golf course! The site states:
"The iPhone advantage is highlighted by [applications] like AirStrip OB, which enables obstetricians to monitor different stages of labor even when they’re not by a patient’s side. Developed by AirStrip Technologies, AirStrip OB links individual mobile devices to a central AirStrip server with HIPAA-compliant authentication, giving obstetricians remote access to live views of delivery room data — including fetal heart tracings, contraction patterns, vital statistics and nursing notes."

Years ago I wrote about the pregnant robot technology Noelle, who enabled medical students to have complete control over a patient without any capacity for independent thought, discussion or to give her consent to procedures. I was concerned that by learning how to control a robot in labour, and creating and managing emergencies during the robot's birth would lead to:

"[T]he continuing (if not exacerbated) attitude within obstetrics that birthing women should be in the complete control of medical professionals and their technologies, and the belief that birth is a surgical procedure, rather than a biosocial, personal, emotional, psychological and spiritual experience, unique for each woman."

Now thanks to the iPhone medical students don't need to concern themselves with these aspects of care provision! While a marketing officer for the healthcare system praises the iphone for helping staff to: "deliver patient care in a more efficient, productive manner" in reality the iphone serves as another obstetric tool which enables doctors to detach from the women they should be serving. It helps obstetricians provide a one-size model of "care" which focuses on data from other technologies rather than on the unique needs of the individual birthing woman. "Efficiency" and "productivity" have little to do with childbirth, these are words relevant to industrial manufacturing. Someone needs to let obstetricians know that they are not manufacturing neonates and birthing women are not factory machinery!

One doctor is quoted as saying that "AirStrip OB is an absolutely indispensable [application] on iPhone”. He goes on to say:

“It fundamentally changes the way I’m able to interact with labor and delivery [note not "the birthing mother"]. In a tenth of the time, without pulling a nurse away from what she’s doing, I get all the real-time data I need at the touch of a button.”

This doctor sees human touch, eye-contact and face-to-face conversation with the birthing mother as irrelevant to his role in "attending" a birth! "All the real-time data" he needs comes from machines. And that is the crux of the issue, the iphone AirStrip OB application (and obstetrics more widely) are concerned primarily with what the doctor needs, not the birthing woman and her baby.

It will be interesting (read devastating) in the future to see what impact this technology has had on hospital birth, such as caesarean rates, narcotic use rates during birth (and for the children born, later in life), rates of postnatal depression, birth trauma and post traumatic stress disorder, as well as a range of other important considerations the obstetrical profession appear to have ignored.

I predict that like the electronic foetal monitor and the ultrasound before it, the use of the iPhone and it's applications during birth will lead to greater rates of unnecessary intervention and trauma for families.

See AirStrip Technologies Press Release Here.


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*Why should obstetricians have the luxury of not being "able" to be at their patients bedsides? Pregnant and birthing women should expect nothing less than continuity of care, that means having their care provider by their side during childbirth! This is standard practice for the independent midwives who the Australian Government are legislating out of existence presently.

Wednesday, October 28, 2009

Australian Midwifery Dead

For months I have been writing about the Australian Government's move to outlaw midwife attended homebirth. For months bloggers like myself have been asking "what does the health minister mean when she keeps using this c word "collaboration" when she speaks of changing the maternity system?" And none of us are surprised to discover that "collaboration" in fact meant "death to independent midwifery" (or as I see it, death to Australian midwifery as midwives who work within institutions are little more than obstetric nurses on account of being bound to protocols and regulations).

This morning I was greeted with the following in an email sent to Australia's birth activist communities:

"We have just (and yes I mean in the last 24 hours) been advised that Nicola Roxon will put amendments to the midwifery legislation that will REQUIRE a midwife claiming Medicare to work WITH either an Obstetrician or GP. It is not work FOR (ie in their office) but it will be to demonstrate that you work WITH.

As we all know this spells the end of midwifery practice as we know it, and IT IS THE ABSOLUTE END OF PRIVATE HOMEBIRTH."

Australia is making it official: midwives will belong to medical men and their institutions, serving women will become a distant second. The word "midwife" means "with-woman". There will be no such thing as a midwife allowed in this country thanks to Nicola Roxon, the Australian Medical Association (AMA), The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), and The National Association of Specialist Obstetricians and Gynaecologists (NASOG). Just another dark day in The Lucky Country....

If you wish to continue trying in vain to get the Australian government to give a flying fuck about the rights of homebirthers you could check out the political party What Women Want and register as a member. But I understand if you'd prefer not to waste any more of your energy, the government have made it abundantly clear from the outset that they are here to fuck homebirthers over and they have the support of millions of ignorant voters and a very rich and powerful obstetric lobby group. So it looks like this time next year we'll be celebrating Freebirth Awareness Week instead.

Happy Fucking Homebirth Awareness Week, Australians.

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Tuesday, October 27, 2009

Homebirth Awareness Week

Oct 24th - 31st is Homebirth Awareness Week. The silence on the future of homebirth in Australia has been deafening since the protest rally held in September. But the lack of noise is not an indication that all is well. The government have been moving forward with their plans to restrict women's birthing rights, quietly. I am reminded of Sylvia Plath's poem Mushrooms:

Overnight, very
Whitely, discreetly,
Very quietly

Our toes, our noses
Take hold on the loam,
Acquire the air.

Nobody sees us,
Stops us, betrays us;
The small grains make room.

Soft fists insist on
Heaving the needles,
The leafy bedding,

Even the paving.
Our hammers, our rams,
Earless and eyeless,

Perfectly voiceless,
Widen the crannies,
Shoulder through holes. We

Diet on water,
On crumbs of shadow,
Bland-mannered, asking

Little or nothing.
So many of us!
So many of us!

We are shelves, we are
Tables, we are meek,
We are edible,

Nudgers and shovers
In spite of ourselves.
Our kind multiplies:

We shall by morning
Inherit the earth.
Our foot's in the door.
South Australian with-woman Lisa Barrett wrote in her most recent blog post The Latest in Australia:
While I've been away there were lots of meetings in Canberra on the future of midwifery with the government committees involved. The participants had to sign a confidentiality agreement. How dare the government do this. Not only are they meeting behind closed doors but nobody at the meeting can say what has happened. Until the stuff is signed, sealed and delivered the midwives and women have no clue of what is going on. So what, there is a consumer rep and midwife rep. If the rest of us don't know what is happening at the meeting how can we tell if our voices are being heard.

Despicable, isn't it? But unsurprising. At no point in this entire process, since the 2008 maternity services review were the government interested in the voices of homebirthing families/consumers.

In their press release for Homebirth Awarenes Week (Celebrate or Commiserate? Minister’s Weakness and Bureaucrats Ignorance Continues) Homebirth Australia states:

"Mainstream Australian maternity care is not about women, women are rarely consulted in the development of services, they are the main player and yet they have been silenced by practitioners who insist they ‘know better’ said Ms Caines.

Homebirth on the other hand is different. Women make decisions about their care, they invite a midwife into their home, rather than be forced to meet the needs of practitioners and organisational convenience which happens when giving birth in a hospital” said Ms Caines

“The outcomes from homebirth are also considerably better. Women experience more personalised care and fewer interventions, they also enter motherhood happier and more content.” said Ms Caines

Something that is considered a normal reasonable choice in the U.K, The Netherlands, New Zealand, and Canada is under threat of extinction in Australia"

For readers living in Melbourne and surrounds I can tell you of two upcoming meetings for homebirth activists wishing to keep the momentum going:


Tomorrow night - Wednesday October 28
7pm Selby Community House
Minak Reserve, Wombalana Rd (off charles st) Selby

A friend of mine sent me these details with a paragraph stating "Come join in the discussion of the facts, the background, and the present issues affecting us all. Presented by midwives Clare Lane and Nicola Dutton. Light supper provided. Gold coin donation."

And:

Sat 31st Oct
1030am~1230md
Australian Catholic University
115 Victoria Pde, Fitzroy
Contact: ballarat@maternitycoalition.org.au

That makes two great ways to spend your Homebirth Awareness Week. For a third why not check out Janet Fraser's new blog: http://janetfraser.id.au/blog/ "Where Birth and Feminist Intersect". In addition to some really insightful critiques of current Western maternity services, Janet has some great humour, especially on her page "Homebirth for Dummies".

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Saturday, October 24, 2009

Why We Shouldn't Use The "F" Word

Vs

Those of us committed to improving breastfeeding rates worldwide need to stop using The "F" word. It's fine (and sometimes absolutely necessary) to drop a "fuck" or "fucking" into our conversations about promotion of artificial feeding and related topics, because that "F" word is great for expressing our rage and frustration. And we need a feminist framework to help understand the patriarchal factors which contribute to widespread lactophobia. These "F" words are F-F-F-Fine. The truly abhorrent "F" word that has got to go is "formula"!

Artificial breastmilk is not "formula", despite the commonly used lingo. Formula is a word with positive connotations in Western society. It is associated with fast cars, scientific advancement, cunning strategy (think "formula for success"). By the simple act of using The "F" Word we are subtly promoting artificial feeding over breastfeeding in our everyday conversations!

One of the most famous formulas is "E=MC2". Artificial milk pushing companies know this and use this to their advantage, creating an association between their product, which they call "formula" and "Einstein", the Western world's best known genius. Sadly, however, children who are artificially fed end up with lower IQs than breastfed children (see here and here).

Artificial feeding is no formula for success and is certainly not the smart or technological advanced way to feed a child. Artificial feeding is greatly inferior to breastfeeding! Artificial feeding is associated with greater incidents of gastroenteritis, childhood cancers, obesity, multiple sclerosis, otitis media, osteoporosis, diabetes and hospitalisation for respiratory infections (to name just a few dangers of ABM).*

So-called "formula" is no substitute for breast milk, as the Australian Breastfeeding Association's Counselor Manual says (Section D.70.27):
"When we have a substitute on a playing field we take off one player and replace with another player of equal value and the game continues. Artificial baby milk is not a breastmilk substitute. It is a greatly inferior product. Breastfeeding is not special. Special indicates something extra or harder work, not everyday or normal. Breastfeeding is everyday and needs to be incorporated into the everyday rather than seen as an extra."

Refusing to use the "F" word is one very simple way lactivists can make a stand against the marketing of artificial breastmilk. Instead, by saying "artificial breastmilk" we put breastfeeding front and centre again, highlighting that it is the man-made powder that comes in cans which is abnormal and inferior.


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For more on langauge and breastfeeding see Watch Your Language! By Diane Wiessinger, MS, IBCLC (Reprinted from the Journal of Human Lactation, Vol. 12, No. 1, 1996)

Related Ilithyia Inspired pages:

Artificial Milk: Voldermort of Baby Feeding

Why is the Health of Babies Less Important?

See also:
Artificial Feeding – Nothing To Do With Breastfeeding

Consumer Research on Infant Formual and Infant Feeding

Formula for Disaster

Genetic Engineering and Infant Foods

Hot Milk - The Unbottled Truth About Formula

IBFAN

International Breastfeeding Journal

Just One Bottle

Misinformation: Redefining Baby Feeding

Myths

Suck on This

Toxic Phthalates in Infant Formulas


The Case of The Virgin Gut

The Language of Breastfeeding

The Risks of Infant Formula Feeding

What Should I Know About Infant Formula

Yes! Just One Bottle Will Hurt!


*Information concerning the dangers of artificial feeding and consequences to health were found in Jan Riordan's Breastfeeding and Human Lactation, Third Edition, see in particular pages 114-117.

Thursday, October 22, 2009

The Birth of Eloise

You might remember that back in June I had the honour of serving a Mama who was planning for her first homebirth and second child? Today that Mama posted her homebirth story on her blog. You can read it here:

http://thefruitsofsarah.blogspot.com/2009/10/birth-of-eloise.html

Thanks again Sarah and family for welcoming me into your home during such a sacred time in your lives. And thanks for the very flattering and kick-arse nickname "Super Doula"! *blush*

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Sunday, October 18, 2009

Breast Milk Is For Toddlers Too!

Friday and Saturday I volunteered my time handing out showbags for the Australian Breastfeeding Association at the Pregnancy, Babies and Children's Expo in Melbourne. During my breaks I wandered the expo seeing what was on offer to parents and accepted show bags from other stalls.

There were all manner of products there to help parents detach from their children. One company were selling a bottle attachment which enables parents to leave their babies to feed themselves. There were plenty of cots and prams, play stations and electronic swinging neglecto-matics so that parents need never touch their children. Well, there is still the pesky business of nappy changes, but any year now there will be a stall featuring a product that changes nappies for parents and then, finally, we will have achieved the great Western dream: parenting without having to do anything remotely near a child!

Because nature intended for babies to feed upright and alone?
And look, it's been on the television show of a childfree woman! Quick mums, buy now!
(I've censored the product name in an attempt not to give them free advertising)

While the ABA stall was situated right next to the feeding and change table area of the expo (meaning they got lots of traffic from parents looking to change a nappy or sit down to feed) they were in the furthermost corner, which received less light than most areas of the expo. Artificial milk pushing companies on the other hand had paid the big bucks for the most well lit stalls, taking up the most space, in central locations. One even featured a flat screen television showing a "documentary" (read "commercial") about how they came to add probiotics to their powder.

The grandfatherly figure who created this ground breaking milk powder (I write with sarcasm) stated in this commercial that it was his intention to recreate breast milk so that toddlers can continue to receive the great probiotics found in breast milk. The underlying message was clear: breast milk is for babies, not for toddlers! The commercial then cut to this man's adult granddaughter talking about the developing immune system, how frequently children get sick, and how grateful she is to have her grandfather's product to give the boost to her children's health that they so desperately need.

REALITY CHECK: Toddlers are meant to breastfeed! (See here for more info on this) The World Health Organisation recommends a minimum of 2 years breastfeeding! No artificial milk powder comes close to recreating the complex, living and changing milk created by human breasts. Toddlers who are fed artificial milk are not provided with additional immunity, they are denied the important immunological components of breast milk and for the rest of their lives are put at great disadvantage health wise, compared to people who were breastfed.

While this commercial (presented as if it were a documentary) was deceptive and unethical it did not provide me with the most jaw-dropping moment the expo had to offer. That came when I opened one of my showbags from another artificial milk company to find free samples of their powder, labelled "for children 1 to 10 years"!

In Australia it is against The International Code of Marketing Breastmilk Substitutes for AM companies to advertise ABM (artificial baby milk). They are also forbidden to give away free samples of ABM. However, the code does not extend to artificial toddler milk. The reason for this is that there was no such product prior to the code. AM companies created artificial toddler milk to fill the profit gap left when the code demanded less unethical marketing of ABM. Artificial toddler milk is marketed aggressively in Australia and AM companies take full advantage of events like the Pregnancy, Babies and Children's Expo.

Since AM companies abide by the code their ability to profit depends upon their ability to successfully convince parents that there is a need for artificial milk beyond babyhood. They concede that breast milk is the best milk for the first 12 months of a child's life. But that's it. Celebrate your 1st birthday with a refreshing glass of artificial milk powder mixed with water. And in the case of the brand above, don't feel like you have to stop when your child outgrows the bottle, simply pour it into a glass!

At a first glance it might seem totally ludicrous that a parent feed their ten year old artificial "baby" milk, but it is not so far fetched. When you consider the stress parents endure when it comes to all manner of health and safety issues, especially healthy eating and the not uncommon tendency for children to be reluctant to eat a wide variety of healthy foods (or even just one vegetable), you can begin to understand the power of AM companies to step in and ease parent's troubled minds.

This particular brand of AM marketed to children from 1 to 10 uses reassuring language that appeals to parental sensibilities about health and well-being. Underneath the brand name the packet reads "Complete Balanced Nutrition". On the front of their pamphlets inside the showbag they feature: "Complete Nutrition. Complete Peace Of Mind", further reassuring parents. Other brands highlight the "bifidus", "iron" and "omega 3 DHA" in their products. One shows a cartoon teddy bear wearing a mortar board, pointing to text that reads "For Healthy Tummies: rich in zinc, iron and calcium, with Bifidus".

Another brands' free sample (this time for 1 to 3 year olds) boasts "Supporting your toddler's immune system". It's apparently been "caring for babies since" the 1800s, a bold line to take considering breasts have been caring for babies a lot longer! This particular brand also included four pamphlets about nutrition and parenting. Each pamphlet (except the one for "iron intake for infants and toddlers") features fine print about breastfeeding on the back:
"Breast milk is best for babies. Professional advice should be followed before using an infant formula. Introducing bottle feeding could negatively affect breast feeding. Good maternal nutrition is important for breast feeding and reversing a decision not to breast feed may be difficult. Infant formula should be used as directed. Proper use of an infant formula is important to the health of the infant. Social and financial implications should be considered when selecting a method of feeding"
The same disclaimer appears on the back of another brands' brochure, almost word for word. While this may seem like a step in the right direction take another look. Mention of "good maternal nutrition" hints that breastfeeding requires more work on the part of mums and involves a special diet that is not required if feeding your child artificial milk. Further to this the "breast is best" motto has been shown to be problematic. Lactation consultant Diane Wiessinger writes:
"When we (and the artificial milk manufacturers) say that breastfeeding is the best possible way to feed babies because it provides their ideal food, perfectly balanced for optimal infant nutrition, the logical response is, "So what?" Our own experience tells us that optimal is not necessary. Normal is fine, and implied in this language is the absolute normalcy--and thus safety and adequacy--of artificial feeding. The truth is, breastfeeding is nothing more than normal. Artificial feeding, which is neither the same nor superior, is therefore deficient, incomplete, and inferior. Those are difficult words, but they have an appropriate place in our vocabulary."
Breast isn't merely the better of feeding options, it is normal! Furthermore there should be no such "choice" when it comes to feeding, there is one normal way to feed a human child: at the breast and there is one inferior substitute for the extremely rare cases when there is no other way to keep a human baby alive. Much like there is one normal way of breathing: using your lungs and there is the option of oxygen tanks, masks and other respiratory aids in extenuating circumstances.

Returning to this particular brand of AM and it's promotion at the expo. This showbag also included a fridge magnet featuring a free helpline for "any questions" about "feeding young children". Calls are allegedly taken by their "healthcare professionals". Similarly yet another brand have a free "careline" for the same purpose.

Other freebies to be found in showbags from AM companies include: a colourful height chart to track childhood growth and a cookbook of recipes for foods for children "from 26 weeks" onwards. And balloons! Southbank was a sea of golden balloons featuring the logo and brand name of one brand of AM in particular. Once inside the exhibition centre there were even more balloons advertising more AM companies. This particular marketing strategy obviously involves using children: seduce the children with beautiful balloons and the parents take home and commit to memory (whether they realise it or not) the name and logo of that product. And if ever the time should come when that parent is faced with shelves of artificial milk cans, all the same shape and size, so many colours, so much information, sensory overload, the familiarity of that name and that logo gained from a balloon once upon a time will give that company the edge.

Clearly The International Code of Marketing Breastmilk Substitutes needs to be updated. Where once it was only infant breastfeeding in need of protection from the aggressive and unethical marketing of artificial substitutes. Now sustained/full-term breastfeeding needs desperate attention.

Promotion of any artificial milk, including for toddlers (and ten year olds!) undermines breastfeeding. It further normalises a culture of bottle feeding, therefore making breastfeeding "other". Marketing of artificial milk for toddlers suggests (or as was the case in the commercial showing on a flat screen at the expo, it outright states) that breastfeeding ends with babyhood, thus robbing toddlers of breastmilk which they need for healthy development (I have not even mentioned issues of bonding and psychological well-being in this article, which are also essential to consider in any discussion about childhood health!).

Perhaps the most insidious aspect of the marketing of artificial milk for toddlers is how it subversively promotes artificial milk for babies as well. Without explicitly doing so, by convincing parents that artificial milk is healthy enough for their toddlers instead of breastmilk it can lead to parents jumping to the conclusion that substituting breastmilk for babies before 1 year of age is not such a big deal either.

Ultimately parents are being swindled for millions, as are governments who pay the price* in the long term due to ongoing health problems that could have been prevented by breastfeeding (or by breastfeeding for longer). Worst of all, babies and children, who have no choice and no voice in these discussions, are robbed of their health when fed these inferior and almost always unnecessary artificial milk products. This needs to change! I for one am going to start lobbying for a stricter and more encompassing code on marketing artificial milk, for a start.

Breastfeeding 20 month old

*One source states "Based on Australian research, the cost attributed to the hospitalisation of prematurely weaned babies alone is estimated to be between $60-120 million annually" (Jen Hocking "Community education" Essence 45(6) Nov 2009: 6.)

See also: Breastfeeding Two Years & Beyond (lots of links on feeding toddlers and beyond)
Suck on This
Why is Artificial Milk so Bad
Natural Weaning
Artificial Feeding - Nothing To Do With Breastfeeding
Extended Breastfeeding

Nursing After The First Year
Sustained Breastfeeding

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***All brand names of artificial milk have been purposefully omitted from this article with a mind not to advertise on their behalf***

Tuesday, October 13, 2009

Need A Calendar For The New Year?

Why not buy the Australian Breastfeeding Association's 2010 calendar featuring glossy professional photos of breastfeeding families?

You can take a look at all fourteen photos featured in the calendar on ABA's website:

© 2007 - 2013 Ilithyia Inspired | No reproduction without docmentation of permission from blog author and/or providing full bibliographic details including a link to the exact page quoted.

All the opinions expressed on this site are the author's, unless otherwise stated, and are independent from any of the organisations I am affiliated with| Any information provided on this site should be used as an introduction to ideas that hopefully inspire further research and education elsewhere. Information and opinions provided on this site should not used in place of professional midwifery or medical advice.

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