Pregnancy and maternity

Pregnancy and maternity

Resources

  • Women's Health Action's Pamphlet Vitamin K- does my baby need it?
  • WHIS Pamphlet: Ultrasound scans during pregnancy
  • WHIS Information Pack: Caesarean Section

See Also: Breastfeeding

Smile for the camera

In addition to their medical diagnostic purposes, ultrasound scans in pregnancy are increasingly becoming a highly sought after social experience. Jessica Glen, Women's Health Action Intern, considers the changing meanings of ultrasound for women and their families/whanau, and the implications for women's "choice" to be scanned. Full article (pdf)

Study finds pregnant "obese" women are at risk of stigma and discrimination in maternity care

A recent UK study has found that pregnant women labeled as "obese" are at risk of stigmatising and discriminatory treatment by maternity care providers which can negatively impact on the provision of maternity care, and thus on pregnancy outcome, and the childbirth experience. Given the increasing focus on the relationship between women's weight and pregnancy outcome in Aotearoa New Zealand it is important to reflect on these research findings to ensure consideration is given to the impact of practitioner bias and fatphobia on pregnant women labeled as "obese" and how this can be countered. Christy Parker, Women's Health Action Policy Analyst, reviews the research and its recommendations for maternity care providers and service planners... Full article (pdf)

Mothers and mental health webiste:

An excellent new website on 'mothers and mental health' has been launched by the Postnatal Depression Family/Whanau New Zealand Trust. The trust was set up as a Charitable Trust in 2006 to improve awareness and understanding of postnatal depression (PND) and related mental illnesses in pregnancy and after childbirth. Members of the Trust include women who have experienced PND, family members, health professionals, and other interested people. Their hope is that women in the community and their families/whanau will feel less isolated and be more able to access help by using this information.

The website aims to:

  • Provide information for mothers, fathers & families on PND & related conditions, such as anxiety & bipolar disorder.
  • Contain local supports available in NZ.
  • Relates to the cultural diversity in NZ.
  • Has NZ based information and treatments.
  • Has information for medical professionals in NZ to help keep up with new developments.

The Trust has set up this website to provide up to date information for these mothers, fathers and their families/whanau and for those health professionals who are treating them.

This website is unique in that it is New Zealand based and relates to our New Zealand culture with kiwi mums, dads and family/whanau members talking about their personal experiences living with postnatal depression and anxiety.

The site provides relevant information regarding health and support systems in New Zealand. Unfortunately accessibility to perinatal or maternal mental health services is not consistent across the country. For instance, if you live in the North island, there are no designated psychiatric ‘mother and baby' beds therefore it is unlikely that a baby will be able to be admitted when their mother is unwell (some smaller hospitals may allow this).

The only specialised perinatal psychiatric inpatient unit is in Christchurch and the Trust is grateful to that service for the support they have provided in setting up this site. One of the reasons for the greater number of support systems listed for Canterbury is the fact that this is where both the Trust and The Mothers and Babies Service are located. We welcome input from other regions.

This site provides more in depth information on the medications that are available in New Zealand than other sites.

Trust members have used their own professional and personal knowledge and that of other health professionals, contacts, and friends to contribute to this site. The information from this site is not designed to take the place of a personal consultation with a medical professional.

The website can be accessed at:

http://www.mothersmatter.co.nz

 

New Zealand Research on Place of Birth

January 2008 Women's Health Update

Women and midwives have long been aware that the place they give birth can have an enormous impact on the experience. Jesse Solomon looks into some recent research which considers the impact place has on women birthing in New Zealand.

Because the Lead Maternity Carer (LMC) model in New Zealand enables the same practitioners (usually midwives) to care for women in different settings, New Zealand is in a unique position to compare birth experiences and outcomes in different environments. Internationally, midwives often work only in primary birth environments such as in homebirth or primary maternity units such as birthing centres or small hospitals. Secondary and Tertiary hospitals, those that can undertake surgical deliveries and care for tiny and ill babies, are often the domain of obstetricians with midwives not taking the lead for the care of women in these settings....Read More (pdf)

Home Birth Undergoing Renaissance

January 2008 Women's Health Update

It has been an exciting time for home birth recently. The energy from the Home Birth Conference and Hui at the end of September trickled down through Home Birth Week. The Australian Homebirth Conference in Sydney in early November was also exciting, featuring keynote speakers Sheila Kitzinger and RickiLake. Jeanette Lazet & Jesse Solomon report....Read More (pdf)

The Maternity Services Consumer Satisfaction Survey 2007. High satisfaction or low expectation?

June 2008 Women's Health Update

 

The 2007 Maternity Services Consumer Satisfaction Survey released this month has been celebrated for its overwhelmingly positive results and the gains made since the last survey in 2002. The survey, of 2,936 women who gave birth to a live baby (or babies) in March and April 2007, was commissioned by the Ministry of Health. It included both the rating of satisfaction levels and open ended questions. Satisfaction levels of 90% or higher were recorded for every area of NZ's maternity service. High satisfaction indeed, but is there more to the numbers than meets the eye? Christy Parker looks at the history and research around maternity consumer satisfaction surveys....Read More (pdf)
 

The national rollout for HIV screening

May 2007 Women's Health Update

The National Antenatal HIV Screening Implementation Advisory Group (NAHSIAG) was established by the National Screening Unit in 2005 to oversee and provide advice on the establishment and roll out of a national HIV screening programme for pregnant women. The advisory group was scheduled to meet in Auckland at quarterly intervals throughout the year but due to the cancellation of the meeting in November met only three times in 2006. Four meetings have been planned for this year. Lynda Williams reports on work to date. Read More (pdf)

Screening for HIV in pregnancy

May 2007 Women's Health Update

Antenatal blood tests are accepted medical practice in New Zealand as in other countries. Wende Jowsey looks at the reasons for adding HIV screening and the issues raised for informed consent. In March of 2006, testing for HIV was added to the current list of five antenatal blood tests by the Waikato District Board of Health. The aim is to prevent the spread of the virus from a mother to her unborn child. According to HIV Specialist Dr Jane Morgan, if a woman is untreated during pregnancy, transmission occurs approximately 25-30% of the time, as opposed to a 1% transmission rate if treated. Read More (pdf)

Third trimester routine ultrasound does not reduce perinatal mortality

December 2006 Women's Health Watch

This large Scandinavian study sought to evaluate the effects of third trimester ultrasound screening on prognosis. Over 200,000 deliveries between 1985 and 1996 were evaluated by observational design using data stored on the Swedish Medical Birth Registry and the National Board of Health and Welfare. In non-screening areas SGA (small for gestational age) suspicions were based on clinical examination rather than the routine ultrasound. The study found no significant difference in outcomes at birth comparing perinatal infant mortality, Apgar score and rate of caesarean or instrumental delivery between routine screening and non-screening areas. The study concludes that routine ultrasound screening in the third trimester to detect SGA infants lacks a significant effect on perinatal/infant mortality and morbidity.

Reference
Sylvan, K et al (2005) Routine ultrasound screening in the third trimester: A population-based study. Acta Obstetricia et Gynecologica Scandinavica 84:1154-58.

Voluntary caesareans more risky

December 2006 Women's Health Watch

A large US study has found that the risk of death to newborns delivered by voluntary Caesarean section is much higher than by vaginal delivery.
The study concludes that the neonatal mortality rate for Caesarean delivery among low-risk women is 1.77 deaths per 1,000 live births; 2.9 times the rate for vaginal delivery (0.62 deaths per 1,000).... Read More
 

The Latest on Aropax and Pregnancy

December 2006 Women's Health Watch

Women's Health Action reported on the risks associated with Aropax (Paxil, or paroxetine) in January 2006. (Update, Jan 2006) Aropax, an SSRI antidepressant produced by GlaxoSmithKline was found in a large retrospective study to increase the risk of birth defects, mostly heart defects, when taken by pregnant women. A year after that study was released the American College of Obstetrics and Gynaecologists have issued a recommendation that women who are pregnant or trying to become pregnant avoid the medication. There are currently a series of lawsuits occurring in the US against GlaxoSmithKline alleging that GSK was aware of the drug's risk before the FDA urged them to change the labelling to warn of possible birth defects in September 2005. ACOG currently recommends that 'paroxetine use among pregnant women or women planning to become pregnant be avoided, if possible'.
Reference: American College of OBGYN
 

Pregnancy police close in on women's rights in the U.S.

December 2006 Women's Health Watch

In a frighteningly Orwellian world women are being treated as baby machines as governments step in to regulate what a woman can do with her body1. This obsession with controlling women's bodies is reflective of the conservative Christian discourse of family and a focus on the ostensible reason for women's existence- reproduction. In the overwhelming focus on the baby's health, the health of the mother is being subsumed for that of her child. This dangerous precedent allows third parties to decide what is best for both mother and child. Women are being punished for behaviours that are not considered criminal for other members of society.... Read More

National Women's Hospital Annual Report 2005

December 2006 Women's Health Watch

 

National Women's Hospital released its Annual Clinical Report for 2005 in September and held the customary public seminar examining the information contained in the report on 22 September 2006. This is the thirteenth report in the current series. Lynda Williams has written the following summary for us.
The 232-page report contains a wealth of statistical information on the 7178 women who gave birth at NWH in 2005 and the 7368 babies they gave birth to and the 16 women who gave birth before they actually got to the delivery unit. This is a further drop in the numbers from 2004 when 7471 mothers gave birth to 7659 babies. In 2005 there were 184 sets of twins (188 in 2004) and 3 sets of triplets (there were no triplets in 2004).... Read More
 

Epidurals associated with early breastfeeding cessation

December 2006 Women's Health Watch

Australian researchers studied a group of 1280 women aged 16 years or older who gave birth to a single live infant in the Australian Capital Territory in 1997. The aim of the research was to test the anecdotal reports suggesting fentanyl (an opioid) added to epidurals during childbirth resulted in difficulties with breastfeeding. Women who had epidurals were less likely to be fully breastfeeding their infant in the few days after birth... Read More
 

DIY Healthcare

June 2006 Women's Health Watch

Recent developments in DIY healthcare are verging on the ridiculous.

WHA has been approached by a group selling a DIY cervical smear kit. Coming in a video type case, the leg crossing kit comes with a fearsome looking brush and some utterly hilarious instructions. It is hard to figure out just how you ensure that the guiding tube is lined up with your cervix and once having accomplished this rather unlikely feat, you then keep it in place - while you insert the brush in to give it a twirl. Even a relatively athletic woman would find this a challenge but try being older with a little bit of middle age spread and an elusive cervix. Truly an exercise in frustration. We say stick to WONS and Family Planning for this one.
Then there's this little gem from the Herald on Sunday. For a mere $6,000, you can plug in to your computer and keep tabs on your baby in utero.

It's not clear whether this is for internal or external application but both are equally ridiculous. What do you think the poor little blighter is trying to get away with in there?

For a balanced approach to untrasound scans in pregnancy, try reading our WHA pamphlet.
 

Plastics and infant feeding

January 2006 Women's Health Update

We protect our babies to give them the best start in life. We have long known that the healthiest baby food is breast milk, yet at times we may need to use bottles to store expressed milk or use plastic toys and containers.

There is growing concern about the potential health effects of plastics on babies and young children. Plastic products and packaging are everywhere; unfortunately many plastics contain harmful chemicals. Recently the US Public Interest Research Group released a report which found wide spread use of toxic chemicals in nine popular baby products. A 2004 study showed that bispheno-A, a compound found in many types of baby bottles, has the potential to cause structural abnormalities in human cells and inhibits their growth. Early childhood exposure to toxics can cause neurological effects and behavioral disorders....Read More (pdf)

Aropax and pregnancy

January 2006 Women's Health Update

In September 2005 GlascoSmithKlien issued a warning for their popular anti-depressant Aropax. A new study found increased risk of birth defects for pregnant women taking Aropax (also known as paroxetine, or Paxil in the US) in their first trimester.

GlascoSmithKlien (GSK) sponsored a retrospective study of 3,581 pregnant women in the US. The research compared the rate of birth defects among pregnant women who took the antidepressant in their first trimester with the rate of birth defects in the general population. They found a 1% increase in the rate of birth defects (most frequently heart defects) in the children of women taking paroxetine. "Paroxetine is the most popular type of antidepressant in New Zealand taken by more than 54,000n people". Read More (pdf)

HIV screening in Pregnancy

January 2004 Women's Health Update

When pregnant, almost all women have contact with health professionals. Most women are well and deliver healthy babies. However, between one and four per 10,000 pregnant women is HIV positive and some will not know. The National Health Committee is currently considering proposals to offer HIV screening to all pregnant women. We asked Jo Fitzpatrick about the issues for women... Read More

Giving birth between two worlds - Goan women in NZ

April 2003 Women's Health Update

Ruth De Souza recently completed a masters degree on migration, mental health and motherhood. Ruth, born in East Africa of Goan Indian origin, works in NZ as a mental health nurse and nursing educator. Camille Guy asked her about the research and the birthing experiences of recently immigrated Goan women....While working in maternal mental health and in post-natal wards in Auckland, Ruth De Souza became curious about why mental health services are under-utilised by migrant women. White, articulate and affluent women certainly used them. So how were migrant women, deprived of their traditional safety nets, coping?... Read More

Resources