I wasn't sure if anyone has posted this yet so sorry if it's a repeat...another interesting study published in AJOG.



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I don't see the link!
That's interesting. I wonder if the 5-minute APGAR score means anything. It sounds like outcomes are overall better with birthing center and home birth, and that the initial low APGAR scores don't indicate a problem. Perhaps the scores are connected with the prolonged labors?
Not sure...plus, this doesn't mention mortality. APGAR scores are not very accurate as far as I know, in showing how a baby will do after birth. It could be that in the hospital they are doing more to get baby to cry and pink up right away, while at home I would guess they are attached to the cord longer and thus stay blue longer and aren't breathing on their own right away. I guess the question to ask is if this has any negative outcomes for baby or not.
I think you make a good point about hospitals getting the baby to pink up, breathe and cry immediately. From my limited experience with home birth it's a much more relaxed and gradual transition, and it may take the baby a bit longer to do those things. I don't think it would have any negative impacts on babies, and in fact I think it's a better transition compared to the normal hospital protocol. That's my opinion however, and I would really be interested to see a study done on some of those aspects as well :)
When I began attending home births I noticed that sometimes the babies were bluer at birth-- and the cord was left intact if it was still pulsating. This assisted the transition for the baby. Placing the baby on the mother's chest, skin to skin with opportunity for breastfeeding also assisted the transition. Babies born without the use of narcotics, pitocin, etc. have more reserves left for the stress of birth.

The other point made in the article about "normal labor" left me wondering about the definition of "normal labor". Who decides what is normal? Is average labor normal labor?
The other point made in the article about "normal labor" left me wondering about the definition of "normal labor". Who decides what is normal? Is average labor normal labor?

I wondered that too. And really what does a baby normally look like at birth? We are intervene so much that our normals are based on how we intervene not what. I would be ok with that if we were for sure that it is what is best for mom and baby. I'm not sure we really do know.
One other comment, I attended over 60 home births and the 20% number given for apgars less than 7 was not true in my experience. I rarely saw an infant with an apgar less than 7 at five minutes.

I recently wrote a post about a doctor who directed the Chicago Maternity Center.
The Center provided care for women delivering at home from 1930 to 1973.
www.carolvanderwoude.authorweblog.com

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