Predicting problems in labor

How great would it be to be able to tell in advance whether a particular birth would go smoothly or need intervention!

A French team of physicians reported this week at the annual meeting of the Radiological Society of North America that it has developed a new computer model that uses magnetic resonance imaging to predict whether a birth will go smoothly or have problems.Pregnant Graffiti

Olivier Ami MD told a session of the RSNA meeting in Chicago that his team applied the new software, called Predibirth, to 24 MR images of pregnant women, and created a three-dimensional model of the woman's pelvis and the fetus. Using these images, Predibirth calculated the likelihood that the babies could find their way out of their mothers' bodies without assistance.

Of the 24 women studied, 13 delivered normally. Predibirth had predicted normal births for all of these women. Predibirth had tagged three women who opted for elective Cesarean sections as being at risk for dystocia.

Of five women who had emergency C-sections, Predibirth had predicted three might have problems — all three involved instructed labor. However, Predibirth had given thumbs up to two of the mothers, whose problems involved heart arrhythmia.

Predibirth had declared "mildly favorable" three additional moms who wound up resorting to vacuum extraction during birth.

Not perfect, but not bad.

"With this virtual childbirth software, the majority of C-sections could be planned rather than emergency, and difficult instrumental extractions might disappear in the near future," Dr. Ami told his audience in Chicago.

Dr. Ami M.D. is an obstetrician in the radiology department at Antoine Béclère Hospital, Université Paris Sud, France.

Image by Petteri Sulonen

Bella Swan’s birth story

The birth in Twilight: Breaking Dawn Part I was not as scary as I thought it would be. (If you don't want to read about the film's ending, stop reading here.) Breaking Dawn is a preteen fantasy through and through, so the birth of Bella's half-human, half-vampire baby winds up looking fairly tidy and vaguely menstrual, even if it does involve blades and teeth. (No trial of labor for Bella.)

Bella Swan

Kristen Stewart as Bella Swan

Will Breaking Dawn leave a generation of young girls with tocophobia — fear of childbirth? My guess is that it will not. The birth happens fast, for one thing, and it's all pretty implausible. The baby appears to be a normal baby, though about six months old, and functions for the rest of the movie in a doll-like capacity.

But Bella Swan — the teenager who falls in love with the vampire Edward Cullen (Robert Pattinson) and marries him in this, the first half of the screen adaptation of the fourth and final book in Stephenie Meyers' Twilight saga — does die in childbirth in the film. Her death has been prophesied, so it isn't unexpected, but the sight of her still, gray form on the table where her baby was born is upsetting.

However, the second half of Breaking Dawn is scheduled for release one year from now, so let's just say that birth transforms Bella. We haven't seen the last of her.

Breaking Dawn is rated PG-13.

A fish / birth story

It is officially the silly season, the last days of summer, when news traditionally slows down to a trickle and publications fill their pages with stories so fluffy they practically float.

Koi

Koi

My candidate for this year's silly-season birth story is "Koi-Assisted Birth," a winsome website about a couple, "Jane" and "Shane," who are planning a water birth in the fall. The two have decided to enlist their 15 koi to help them and their midwife usher their new baby into the world.

The website has generated some controversy. My guess is that Jane is pulling our leg.

She says that "koi are excellent birthing partners," their skills honed by giving birth to thousands, or even tens of thousands, of baby fish, with help from koi dads.

"That's exactly the kind of birthing energy I want!" Jane writes.

But Shane will have a net at the ready to catch the baby, just in case.

Image courtesty of Wikimedia Commons

Colbert: Free birth control = havoc

Free birth-control and breast pumps? Government subsidies for domestic-abuse interventions? Some people have no trouble conjuring the moral slide those new policies will precipitate.

Modeled on recommendations by the independent Institute of Medicine and announced by the U. S. Dept. of Health and Human Services this week, the new provisions set off a firestorm of protest in some conservative circles, including this diatribe from Stephen Colbert's conservative  character on Comedy Central.

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IOM recommends women’s services, for free

The Institute of Medicine issued a report this week that added eight preventive services for women to the provisions that will be provided free of charge under the Patient Protection and Affordable Care Act.

One noteworthy recommendation calls for free contraception and counseling on how to prevent unintended pregnancy.

In addition, pregnant women would be screened for gestational diabetes and new mothers would receive counseling and equipment to support them in efforts to breastfeed their babies.

The report "provides a road map for improving the health and well-being of women," said committee chair Linda Rosenstock, dean of the School of Public Health at the University of California at Los Angeles.  Each of the eight services "stands on a foundation of evidence supporting its effectiveness," she said.

The recommendations would fill "gaps" in care that bedevil women in the present system, the report said.

The seven additional recommendations are these:

  • contraceptive methods and counseling to prevent unintended pregnancies
  • screening for gestational diabetes
  • cervical cancer screening, including human papillomavirus testing, for women over 30
  • counseling on sexually transmitted infections
  • counseling and screening for HIVAIDS
  • lactation counseling and equipment to promote breast-feeding
  • screening and counseling to detect and prevent interpersonal and domestic violence
  • yearly well-woman preventive care visits to obtain recommended preventive services