New Natural Childbirth Website

3. May 2011 by admin.

I’ve been invited by a new natural childbirth website, called Naturally Born, to be a Founding Member.  This is a growing site where you can find answers to your natural childbirth questions, and find recommendations for doctors, midwives, and doulas.  I’d love for you to take a look!

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26. January 2011 by admin.

Dana Nassau Birth Doula

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Clamping the Umbilical Cord

2. December 2010 by admin.

When I go over birth plans with my clients I always tell them about allowing the umbilical cord to stop pulsing before it is clamped. There are a variety of reasons for this. Pasted Below is an article I came across on Dr. Mercola’s Website that discusses some of the risks of early clamping.  At the end it gives some suggestions for navigating delayed clamping with your care provider and I would like to add that a simple discussion with your care provider before your birth begins could make a huge difference.  If you discover that the doctor generally clamps immediately after birth, but is open to delaying you can let them you know you or your birth support team will help them remember when the time comes.

Why do Obstetricians Still Rush to Clamp the Cord?

For many years, the World Health Organization and the International Federation of Gynecology and Obstetrics have advised against early umbilical cord clamping. But obstetricians have been reluctant to change their habits.

Although no clamping occurs in nature, cord clamping has become such an accepted norm that delayed clamping is generally considered a new or unproved intervention.

Basic teaching of physiology could be a factor — most textbooks state or imply that the cord circulation closes only because of the application of the cord clamp, which is not accurate.

Writing in the British Medical Journal, Dr. David Hutchon argues:

“Clamping the functioning umbilical cord at birth is an unproved intervention. Lack of awareness of current evidence, pragmatism, and conflicting guidelines are all preventing change. To prevent further injury to babies we would be better to rush to change.”

A separate review in the Journal of Cellular and Molecular Medicine also highlights the importance of delayed cord clamping, stating:

“Many clinical studies have revealed that the delayed cord clamping elevates blood volume and hemoglobin and prevents anemia in infants.

Moreover, since it was known that umbilical cord blood contains various valuable stem cells such as hematopoietic stem cells, endothelial cell precursors, mesenchymal progenitors and multipotent/pluripotent lineage stem cells, the merit of delayed cord clamping has been magnified.”

Dr. Mercola’s Comments:

In U.S. hospitals, the clamping and cutting of the umbilical cord is typically performed within 30 seconds of birth, sometimes sooner. This is done because immediate cord clamping is generally believed to reduce the mother’s risk of excess bleeding and the baby’s risk of jaundice … but this practice may actually be detrimental to the baby’s health.

When a baby is born it must transfer from receiving oxygen from the placenta to receiving oxygen from its lungs. For this to happen, the baby’s lungs must first expand, and the burst of blood from the umbilical cord helps to get the newborn’s lungs to expand properly.

Without the burst of blood from the placenta, the infant suffers a drop in blood pressure as its lungs fail to open as they should, creating a chain reaction of effects that can include brain damage and lung damage. Immediate cord clamping can cause hypotension, hypovolemia (decreased blood volume) and infant anemia, resulting in cognitive deficits.

Some have even theorized that the rise in autism could be linked at least in part to premature cord clamping.

World Health Organization, Extensive Research Supports Delayed Cord Clamping

In the United States there is absolutely no consensus about the optimal time to clamp the umbilical cord after birth, yet research is increasingly revealing that clamping the umbilical cord prematurely, before two or even three full minutes have elapsed, robs your baby of much-needed blood and oxygen.

The World Health Organization’s (WHO) policy supports delayed cord clamping, stating:

“The optimal time to clamp the umbilical cord for all infants regardless of gestational age or fetal weight is when the circulation in the cord has ceased, and the cord is flat and pulseless (approximately 3 minutes or more after birth).”

They continue:

“Clamping the umbilical cord immediately (within the first 10 to 15 seconds after delivery) prevents the newborn from receiving adequate blood volume and consequently sufficient iron stores.

Immediate cord clamping has been shown to increase the incidence of iron deficiency and anemia during the first half of infancy, with lower birth weight infants and infants born to iron-deficient mothers being at particular risk …

Waiting to clamp the umbilical cord allows a physiological transfer of placental blood to the infant which provides sufficient iron reserves for the first 6 to 8 months of life, preventing or delaying the development of iron deficiency …

For premature and low birth weight infants, immediate cord clamping can also increase the risk of intraventricular hemorrhage and late-onset sepsis.13 In addition, immediate cord clamping in these infants increases the need for blood transfusions for anemia and low blood pressure.”

Numerous research studies and experts are also confirming that waiting to clamp the cord offers significant benefits. Among them:

* Andrew Weeks, senior lecturer in obstetrics, advises it’s “better not to rush” umbilical cord clamping after birth.

  * In the Journal of Cellular and Molecular Medicine, researchers say delayed cord clamping is “mankind’s first stem cell transfer and propose that it should be encouraged in normal births.”

  * In a BMJ editorial, James Neilson, professor of obstetrics and gynecology, states that delayed clamping should be practiced.

Why is Immediate Cord Clamping Routine?

This is a question many experts are now seeking to answer, but it seems this is another example of an outdated medical practice that has become routine before anyone stopped to consider if it was actually beneficial.

As David Hutchon, retired consultant obstetrician, said in BMJ:

“Cord clamping has become the accepted norm so much so that delayed clamping is generally considered a new or unproved intervention.

Thus, showing that immediate or early cord clamping offers no advantage to the baby is not enough; it has to be proved beyond reasonable doubt that it is harmful. Other interventions such as routine episiotomy were quickly abandoned when it was shown that they gave no advantage.”

Very often cords are now also clamped early to collect cord blood and cord stem cells to be used for various medical and commercial purposes. But the evidence is clearly emerging that the most beneficial use for cord blood may be to allow it to transfer to the baby immediately at birth.

While most full-term babies have enough blood to establish lung function and prevent brain damage from early clamping, the process often leaves them pale and weak. For premature babies, the process can be even more devastating. And no matter what, immediate cord clamping will cause some degree of asphyxia and loss of blood volume because it:

1. Completely cuts off the infant brain’s oxygen supply from the placenta before lungs begin to function.

  2. Stops placental transfusion — the transfer of a large volume of blood (up to 50% increase in total blood volume) that is used mainly to establish circulation through the baby’s lungs to start them functioning.

Keeping valuable oxygen and blood from an infant by clamping the umbilical cord prematurely increases the baby’s risk of brain hemorrhage and breathing problems. It has also been implicated as a contributing factor to:

1. Autism

  2. Cerebral Palsy

  3. Anemia

  4. Learning disorders and mental deficiency

  5. Behavioral disorders

  6. Respiratory distress

Remember, You Have a Choice

As with many areas of medical care it’s easy to get swept up in the system once you enter a hospital setting. But if you are currently pregnant and weighing your birth options, it’s important to know that you have a choice.

First and foremost, you can choose a practitioner, such as a midwife or holistically oriented obstetrician, who is aware of the benefits of delayed cord clamping and will work with you on your desire to have this during your birth.

Next, be sure and make it known to your practitioner both before you go into labor and again when you enter the hospital that you desire delayed cord clamping. If you choose to give birth at home you should discuss this choice with your practitioner in advance as well.

If your practitioner tells you that he or she will only perform immediate cord clamping, and this is not in line with your beliefs, it’s time to find a new practitioner who will work with you on these potentially life-changing birth choices.

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Birth Project

22. November 2010 by admin.

I always tell clients that it is best to ignore labor as long as possible.  Focusing on the birthing process too early can be mentally and physically exhausting. The early part of the birth process is preparing your body for active phase and can take many, many hours and even days. The best way to handle the early phase is to ignore it. If the pressure waves don’t command your attention, it is better not to use your comfort techniques yet. Try to keep busy and keep your mind off of what your body is doing. You will know when you need to focus on birthing your baby because you won’t have a choice but give it all of your attention.

I stand by this advice whole-heartedly, but I know it can be sooo hard for couples to do. That’s why I was so excited when I read the idea for a Birth Project from Birthing From Within last night!  Essentially, you set aside a project that you can work on during the early part of birth that will help you remain active and distracted. According to the book a good birth project involves physical movement, contact with your normal daily life, and mental engagement in a way that blocks obsessive focusing on your labor process. With a little thought I bet you can think of something fun and/or meaningful to do while your body gets ready to have your baby. Here are some suggestions:

Bringing a photo album up to date
Sewing something for the baby
Cutting quilt pieces
Gardening
Baking or cooking something for after the baby is born
Washing and folding baby clothes
Writing letters or holiday cards
Cleaning
Blogging
Taking a favorite walk
Do some of the things you know you won’t get to do for a while after the baby is born
Finish an aspect of the baby’s room
Make a drawing or painting
Make a trip to the grocery store for things you know you’ll need when you return from the hospital

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Woman Gives Birth on Flight from LA to Manilla

20. November 2010 by admin.

This e-mail was posted on the Doulas Association of Southern California Message Board. Thought you might like to read about it!

 Korean Airlines Flight #12 on November 15, 2010 took off from LAX on time with Scott and I on-board, en route to Manila to start a new charity maternity clinic for the poor. We scored the exit row seats in economy, so had plenty of leg room and slept for a few hours.

When I woke up about 6 hours into the flight, I noticed a flight attendant was bringing a woman to the jump seat in front of us, and she was sitting like she was in pain. My subconscious brain immediately recognized the unique type of squirming and sideways twisting that I had seen thousands of times…but my conscious brain said “no, people don’t go into labor on airplanes except in the movies!” and anyway, in the dark I could not even tell if she was pregnant. But being medically trained in emergency and primary care as well as being a midwife, and being a generally helpful person, I got up and approached the scene to see if I could lend assistance.

A short history revealed that the woman (a Korean citizen named Jannie, who lived in Los Angeles) had boarded the plane feeling fine but had been having stomach pains the past 4 hours, and had just gone to the bathroom and discovered she was bleeding. This was her third baby, due Jan 1. Her squirming had now turned into low moaning as well, and the steward looked terribly uncomfortable, unsure of what to do. He helpfully approached her with an oxygen mask, which is what you do for heart attacks, but was not much help for this situation. I told the steward we needed to get her to a private place, that she was going to deliver. He looked shocked and in denial and so did the woman. I insisted he think of a plan for a private place…perhaps clear out the back row of seats?

Finally making up his mind, the steward turned and led the way, so we walked forward, me supporting the laboring woman, all the way through the plane to the very front (the part I had never seen) where the first class passengers live in a world apart. It was like a small apartment, with wide seats that made into fully reclining beds, and very wide isles. We got the woman situated on a makeshift bed. By now she was really in hard labor. The steward in charge came up and demanded some medical ID from me, which Scott produced out of my handbag. It was pretty obvious the word “midwife” did not register with them. They were scared, understandably; they called on the intercom for any other medical assistance, and a Korean cardiologist came forward. However, since delivering babies was not in his scope of practice, he deferred to me and seemed very relieved at my answers to all his questions; “had I done this before, because he had not”…”yes” I said, “over 2,500 deliveries”…”did I know how to resuscitate a baby?”…”yes, I am trained in Neonatal Resuscitation”…”did I know how to stop bleeding if she hemorrhaged?”…”yes”, …and on and on.

The woman’s water broke with a splash at this point, and discussion ceased. They all agreed I was in charge and they seemed very happy for it. The stewardesses tripped over each other each time I would ask for something, and rounded up every bit of medical supplies they had on the plane, though most were for heart attack emergencies. Since by dates the baby would be 6 weeks premature, I asked for lots of blankets, and told everyone we would be doing kangaroo care, with the baby skin to skin on the mother covered by blankets after birth. Since the doctor was worried that we had no anti-hemorrhage drugs, I told them all we would use breastfeeding and massage to contract the uterus. Since we had no resuscitation equipment or suction, I figured out a plan how to that if necessary with what we had on hand.

At the time of the birth, there were about 6 stewardesses up there helping, holding the woman’s hands, wiping her brow, giving her sips of water through a straw. it was like a homebirth and they were all her sisters! Scott was standing at my shoulder to hand me the improvised items I had found to use for emergencies should I need it. Fortunately I did not.

Ten hours after take-off, and with 4 hours left to go before landing, a nice baby boy was born, and with a little stimulation he cried and pinked right up. The stewardesses clapped and laughed and cried. The Apgar score was 9/9, meaning he transitioned well to extra-uterine life at 37,000 feet! By exam the baby was 38 weeks, meaning her dates had been a month off and he was really full-term. The placenta came after about 45 minutes, and the baby began to nurse like a champ. Airline policy actually forbids cutting the cord after an in-flight birth, so that was great; I just wrapped it up in a first class linen napkin, and tucked it in the blankets, preventing any chance of infection.

For the rest of the plane ride into Seoul, Scott and I sat up in first class and I monitored the mother and baby. It was a very joyful atmosphere.
The mother was so thankful and happy, and appreciative, and so were all the airline personnel.

An ambulance crew came on and got the mother and baby when we landed, and Korean airlines officials guided Scott and I personally to our next gate on to Manila, and changed our tickets to business class. The pilot himself on the Manila leg came back and said thank you for my help. It was pretty great, even though I landed in Manila exhausted with that unique feeling all midwives know of having been up all night at a birth, with jet-lag on top!

The really interesting thing is, a few days ago I was wondering why we had decided to leave the states a week before Thanksgiving holiday, and was pondering if we had made a mistake…now I see that God had a plan that I was to be on that particular airplane on that night…nothing happens by chance when our lives are totally given over to God to be used for His good purposes in the world. In mysterious ways He leads and directs our every step, and puts us in position to be helpful to those in need.

Scott and Vicki Penwell are the founders of Mercy In Action, a non-profit organization that seeks to provide medical and midwifery services to the poor in Asia, Latin America and Alaska.

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Triclosan as an Estrogen Inhibitor

9. November 2010 by admin.

Recently a friend, fellow doula and midwife Katie McCall posted an article about an antibacterial agent called triclosan, commonly used in household products, that may have serious negative effects on babies while in the womb.  When I read “commonly used” I had to wonder what in my cabinets contains this ingredient.  I did a little search and found this list (reproduced from a Triclosan Fact Sheet from Beyond Pesticides):

Products That Contain Triclosan

Posted By Dr. Ben Kim on Nov 29, 2006

Soaps:

* Dial® Liquid Soap
* Softsoap® Antibacterial Liquid Hand Soap
* Tea Tree Therapy™ Liquid Soap
* Provon® Soap
* Clearasil® Daily Face Wash
* Dermatologica® Skin Purifying Wipes
* Clean & Clear Foaming Facial Cleanser
* DermaKleen™ Antibacterial Lotion Soap
* Naturade Aloe Vera 80® Antibacterial Soap
* CVS Antibacterial Soap
* pHisoderm Antibacterial Skin Cleanser

Dental Care:

* Colgate Total®; Breeze™ Triclosan Mouthwash
* Reach® Antibacterial Toothbrush
* Janina Diamond Whitening Toothpaste

Cosmetics:

* Supre® Café Bronzer™
* TotalSkinCare Makeup Kit
* Garden Botanika® Powder Foundation
* Mavala Lip Base
* Jason Natural Cosmetics
* Blemish Cover Stick
* Movate® Skin Litening Cream HQ
* Paul Mitchell Detangler Comb
* Revlon ColorStay LipSHINE Lipcolor Plus Gloss
* Dazzle

Deodorant:

* Old Spice High Endurance Stick Deodorant
* Right Guard Sport Deodorant
* Queen Helene® Tea Trea Oil Deodorant and Aloe Deodorant
* Nature De France Le Stick Natural Stick Deodorant
* DeCleor Deodorant Stick
* Epoch® Deodorant with Citrisomes
* X Air Maximum Strength Deodorant

Other Personal Care Products:

* Gillette® Complete Skin Care MultiGel Aerosol Shave Gel
* Murad Acne Complex® Kit®
* Diabet-x™ Cream
* T.Taio™ sponges and wipes
* Aveeno Therapeutic Shave Gel

First Aid:

* SyDERMA® Skin Protectant plus First Aid Antiseptic
* Solarcaine®
* First Aid Medicated Spray;
Nexcare™ First Aid
* Skin Crack Care
* First Aid/Burn Cream
* HealWell® Night Splint
* 11-1X1: Universal Cervical Collar with Microban

Kitchenware:

* Farberware® Microban Steakknife Set and Cutting Boards
* Franklin Machine Products FMP Ice Cream Scoop SZ 20 Microban
* Hobart Semi-Automatic Slicer
* Chix® Food Service Wipes with Microban
* Compact Web Foot® Wet Mop Heads

Computer Equipment:

* Fellowes Cordless Microban Keyboard and Microban Mouse Pad

Clothes:

* Merrell Shoes
* Sabatier Chef’s Apron
* Dickies Socks
* Fruit of the Loom Socks
* Biofresh® Socks

Children’s Toys:

* Playskool® :
o Stack ‘n Scoop Whale
o Rockin’ Radio
o Hourglass
o Sounds Around Driver
o Roll ‘n’ Rattle Ball
o Animal Sounds Phone
o Busy Beads Pal
o Pop ‘n’ Spin Top
o Lights ‘n’ Surprise Laptop

Other:

* Bionare® Cool Mist Humidifier
* Microban® All Weather Reinforced Hose
* Thomasville® Furniture
* Deciguard AB Ear Plugs
* Bauer® 5000 Helmet
* Aquatic Whirlpools
* Miller Paint Interior Paint
* QVC® Collapsible 40-Can Cooler
* Holmes Foot Buddy™ Foot Warmer
* Blue Mountain Wall Coverings
* California Paints®
* EHC AMRail Escalator Handrails
* Dupont™ Air Filters
* Durelle™ Carpet Cushions
* Advanta One Laminate Floors
* San Luis Blankets
* J Cloth® towels
* JERMEX mops

Source: BeyondPesticides.org

Please share this information with your families and groups of friends, particularly those that include young children and pregnant women.

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Bishop’s Score and Induction

7. November 2010 by admin.

Something few soon-to-be mothers know about is their Bishop’s score.  But if you are up against and induction, your score is very important for you to understand.  There are several ways a woman’s body prepares for childbirth.  As your care-provider examines each of these means, they are assigned a number and the sum of these numbers indicates how likely your induction is to succeed.  A high score (above eight) indicates that an induction is likely to succeed and a low Bishop score is less likely to succeed.

How your body prepares for birth:

1. Position of the Cervix - The cervix moves forward (anterior) so that uterus is aligned with the vagina and the baby can move smoothly down the birth canal.   A posterior cervix is less ready for childbirth.
2. Consistency of the Cervix - The neck of the cervix softens.  Often a firm cervix is said to feel like the end of your nose.  As it softens it will feel like your ear lobe.  The cervix must soften so that it can dilate and move around the baby’s head.
3. Effacement of the Cervix - Your cervix starts of being about 2 inches long and as your body prepares for labor or is in labor it will shorten.  This number is usually given in a percentage, say 30% effaced.
4. Dilation of the Cervix - The cervix goes from a closed position, sealed by a mucous plug, to complete dilation at 10 centimeters.  The cervix must be completely dilated for the mother to give birth.
5. Fetal Station - The baby’s is assigned a station based on where his/her head is in relationship to the pelvis.  Negative stations -3,-2, -1 indicate that the baby is high and has not engaged in the pelvis.  At 0 station the baby is engaged at the ischial spines of the pelvis.  Plus stations indicate movement through the pelvis and birth.

Additional factors included in your Bishop’s Score is whether or not you are past your estimated due date (increases the score) or if you have given birth previously (increases the score).

 If your body has not made progress toward these goals, or very slight progress you may want to have a discussion with your doctor about the necessity of induction.  Unless induction is medically necessary, it is always best to wait for your body to go into labor naturally - no matter how uncomfortable you are, when your doctor is on vacation, or how big the baby’s head is believed to be.

www.douladana.com

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Pregnancy and Loss

22. September 2010 by admin.

I’ve been thinking a lot lately about how women feel after their birth experiences, particularly the sense of loss many women feel even after giving birth to a healthy baby.  Childbirth is one of the most important events in a woman’s life, yet for many women it is clouded with guilt, shame, anger and regret.  Regardless of whether a woman had a c-section or vaginal delivery, forceps, epidural, ruptured membrane or a completely unmedicated and intervention-free birth, the feelings a woman has about the experience depend a lot on her feelings of empowerment prior to and during childbirth.

There was an article called Who Controls Childbirth? in the July 2010 issue of SELF Magazine about one woman’s traumatic birth experience and her hopes for her second birth.  It was an astonishing article and will probably shed some light on where I am coming from in this post, but when I scrolled down I noticed in the comments (” Stop the process evaluation and count your freaking blessings!!” “Keep your eye on the prize” etc.) there was a clear misunderstanding of what these women were going through.

When a woman gets married she spends months putting together a wedding, giving attention to some of the smallest details.  With childbirth a woman can do everything to prepare and then she must wait to see how it will all turn out.  Often a woman won’t find out that her doctor doesn’t support her wishes until she brings in her birth plan toward the end of her pregnancy or they start talking about the baby being too big, the woman starts edging past her due date, or the doctor is scheduled for vacation the week she is due.  A woman who has strong opinions about her birth may butt heads with her doctor and feel bullied (whether perceived or actual) into procedures she’s not confident are necessary but consents to because she wants a healthy baby.  The hardship here is the doubt…was x or y really necessary?  Often there is no clear answer.   This isn’t to incriminate the doctors - they are often doing what they think is best and generally have a less severe perspective of medical interventions (Of course!  They are taught to manage birth).   The way the doctor handles these differences can make a world of difference.

Informed consent is a huge start.  A conscientious woman, even if she didn’t come into childbirth with certain expectations, wants to know what the doctor wants to do to her body and why it is necessary so that she can give her consent.  Most women who believe something is truthfully in the best interest of their baby will consent, but it requires the doctor to explain themselves. Unfortunately, some doctors take objection to the idea that a patient wants more information other than the knowledge that the doctor thinks it is the best decision.   If the element of doubt and the feeling of coercion are removed, most women would look back on their birth experience, regardless of the methods or interventions, and feel confident that they made the right decision given the circumstances.  If a woman feels like she doesn’t have a voice, the doctor is in any way belittling, or there is doubt about the necessity of the intervention often women will have residual negative feelings about their birth.  At the heart of the issue is the fact that many woman are coming away for their birth experience feeling as though they have been victimized instead of supported.  After reading the article in SELF it felt like there was an obvious correlation between this woman’s experience and sexual assault.  The doctor was doing something to her body in what appeared to be an act of domination over her.  This is an extreme example, but you can see the powerlessness many women feel over there bodies during what should be a normal physiological process.

I resent the voice in our culture that tells these women to suck it up and enjoy their babies.  The fact is that a traumatic birth experience can interfere with a woman’s ability to bond with her baby: it is a very serious matter.  These women need a voice to acknowledge their feelings and process them.

Honestly, this is the main reason I became a doula.  What a better way to help women have a positive birth experience than to help them make informed decisions and really help them advocate for themselves.  There is one piece of advice that I give to all of my clients and pretty much any woman I meet who is pregnant - choose the right doctor/care provider.  Ask specific questions and find out if they support your preferences.  How do they handle your questions?  Do you feel like they are condescending?  Are they taking the time with you that you feel you need?  If you have a doctor that you feel is on the same page as you, and will answer any questions you have then you will have an easier time trusting their medical recommendations.  The worst possible situation to be in is when you don’t have the same view of medical intervention as your doctor and there are complications (or apparent complications): you will feel pressured into something you are not sure is necessary and you will feel confused as you try to navigate what really is best for your baby.

www.douladana.com

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Birth Plan Workshops

17. September 2010 by admin.

A birth plan is a guide for your doctors and nurses to understand your preferences during the birth of your baby.  It may include information about who you would like in the room, how you would like to manage your pain, preferences in the event that a c-section is necessary, and information about how to care for your baby after he/she is born.

Come learn about your birth options and how to create a personalized plan that includes your preferences for birth.  We’ll discuss various interventions, pain management, labor and birth positions, creating a positive and relaxing environment for birth, pushing and baby care.This workshop is free and open to all who are expecting.  Feel free to invite others who might like to come.

DATES:

September 20, 2010, 7:30 PM at My Gym Beverly Hills (1837 South La Cienega Blvd., Los Angeles)
My Gym Beverly Hills will be providing certificates for free Mommy and Me classes to all who RSVP.

October 28, 2010, 7:00 PM at Park Place Chiropractic (263 S Euclid Ave., Pasadena)

Contact Dana (310) 993-7238 or dana@douladana.com.

www.douladana.com

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Money, Lawsuits, Time and C-Sections

17. September 2010 by admin.

This is a really interesting article that opens up a conversation about money being a factor in cesarean rates, specifically, that hospitals that are for-profit tend to have higher c-section rates.  Something I hadn’t considered before was that the method Kaiser uses could actually reduce the rate of c-section.  I’ve not been a fan of Kaiser because a woman may see the same doctor her whole pregnancy, but her chance of having that doctor assist her when she goes into labor is slim.  The benefit in this case is that the doctors and midwives work in shifts, so whoever is on shift delivers the babies.  Since the doctor is going to be at the hospital whether or not the mom gives birth, there is less pressure to speed things up (pitocin, rupture of membranes, c-section, etc.).

Anyway, here’s the article if you’re interested:For-profit hospitals performing more C-sections | California Watch

www.douladana.com

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