Novel third stage protocol https://www.youtube.com/watch?v=AAJPW4p6rzU reduces postpartum hemorrhage at vaginal birth.

Objective: To reproduce the absence of postpartum hemorrhage (PPH) experienced by all mammals except humans, in humans, by implementation of the 1, 2, 3 min expedient squatting protocol www.youtube.com/watch?v=AAJPW4p6rzU.

Spontaneous first trimester miscarriage rates per woman among parous women with 1 or more pregnancies of 24 weeks or more.

Background: The purpose of this study was to quantify spontaneous first trimester miscarriage rates per woman among parous women. A vast amount of data has accumulated regarding miscarriage rates per recognized pregnancy as well as about recurrent miscarriage. This is the second study of miscarriage rates per woman in a parous population and the first study of recurrent and non-recurrent, spontaneous first trimester miscarriage rates per woman in a large parous population.

Midwifery management of face presentation.

The 1980 edition of Oxorn and Foote (1980) urges the midwife not to be hasty in employing cosarean (CS) for face presentation because, with patience, babies are usually born vaginally, with better outcomes. Reviewing how to manage face presentation can prepare the practitioner for this rare event, and decrease CS management. A hundred and ninety six midwives from the US, UK, Hungary and Israel were emailed, asking them to describe their experience, if any, with face presentation.

Amniotomy and cord prolapse.

Research shows that artificially rupturing the amniotic sac (amniotomy) can cause umbilical cord prolapse. Amniotomy became a routine part of obstetrical care with the introduction of active management, without evidence of benefit. In the 30 years since active management was introduced, the rate at which amniotomy causes umbilical cord prolapse has not been directly studied.

The latest research on preconception and prenatal nutrition.

The quality of daily food intake is the most important and most ignored factor determining pregnancy outcomes. In the absence of chromosomal issues, the health of the fetus is determined by the woman's diet, exercise and lifestyle choices. The placenta is continuously remodeled with old villi being constantly replaced by new ones as the placenta migrates upward, giving women the ability to improve fetal nutrition during pregnancy.

The less studied effects of Amniotomy.

Amniotomy has become a routine part of obstetrical care. It was added along with other procedures adopted 50+ years ago without strong evidence. The scientific data supporting this procedure is poor while there is data suggesting it may increase the frequency of cord prolapse, neonatal GBS infection, pain and fetal blood loss if placental blood vessels are punctured.

AJOG against homebirth.

In 2009, while 99.3% of US women delivered in hospital, 0.7% delivered at home.

Management of true shoulder dystocia at attended homebirth.

At attended homebirth, shoulder dystocia poses less of a challenge and has better outcomes compared to hospital birth. If you don't panic, but do call someone into the room to help you with suprapubic pressure if needed and run thru the maneuvers systematically, you will get the baby out by six minutes avoiding damaging long-term consequences. At hospital birth, it is estimated to take a minimum of two minutes to turn the woman onto all fours from the usual position in a hospital bed while connected to a monitor, IV and epidural.

Prenatal ultrasound does not improve perinatal outcomes.

Based on accurate randomized controlled studies, the correct evidence-based recommendation would be for women not to undergo prenatal ultrasound except to assist with turning a breech baby to head down, evaluating ectopic pregnancy and directing the needle during amniocentesis and fetal blood transfusions. First and second trimester organ scans, biophysical profile (BPP), amniotic fluid index (AFI), placental grading 0-III and Doppler umbilical, uterine and fetal artery velocity testing have been tested in randomized controlled studies on tens of thousands of women. They are used to attempt to predict suspected fetal growth restriction (FGR or IUGR), suspected placental insufficiency and suspected postdate pregnancy.

Alligators, hospital birth and other urban legends.

The belief that hospital birth for low risk pregnancies has better outcomes than planned, attended homebirth is an urban legend. The choice of low-risk women to deliver in hospital is a result of the dominant and irrational human propensities to gossip, to follow the crowd and to cling to irrational hope. Rational analysis shows that planned homebirth with experienced trained attendants has the best outcomes for both mother and newborn for low risk pregnancy.

Response to wax meta-analysis.

The recent Wax et al. meta-analysis (1) review of previously published homebirth research reflects the willingness of some medical journals to publish faulty conclusions based on misinformation regarding the need for more data on maternal mortality and on data long ago dismissed as unreliable, in an attempt to discredit homebirth.

Waterbirth and GBS.

The literature provides a single case of early onset newborn Group B Strep (GBS) among 4432 waterbirths, suggesting that low-risk women who give birth in water may have a far lower rate of newborn GBS than women who have a dry birth. The last reported rate of newborn GBS for dry births was 1 in 1450. Several theories for this phenomenon are suggested in this article: (1) inoculating the baby with mother's intestinal flora at birth protects against GBS infection; (2) water washes off the GBS bacteria acquired during the descent through the vagina; (3) the water dilutes the GBS bacteria and mixes it with a multitude of other intestinal bacteria that compete with GBS; (4) early onset GBS is elicited by complications and interventions at birth, which occur less often at water-births; (5) kangaroo care at birth promotes healthy newborns; (6) GBS and antibiotic-resistant GBS are more prevalent in hospital environments, where waterbirths are not an option; (7) a higher rate of underreporting of adverse events at waterbirths compared to dry births; and/or (8) a massively successful international campaign has covered up the reporting of all deaths and disease from GBS after waterbirths.