According to a new study conducted by the American Association of Birth Centers and published in the Journal of Midwifery and Women's Health (Jan-Feb 2013), increasing the number of women who choose birth centers to have their babies would significantly decrease the number of cesarean sections and save "billions" in healthcare dollars.

In a story on Weekend Edition Sunday on January 6, Monica Ortiz Uribe recounts an effort to reduce the high Mexican maternal mortality rate, especially in poorer, more rural and isolated areas of the country, by training modern professional midwives. Many of these "new" midwives are the daughters and grand-daughters of traditional midwives who have provided care for centuries.

This is fascinating - although an oxymoron (natural cesarean?), it immediately and instinctively appealed to me as a midwife. In recent years, even as the cesarean rate has soared, research has acknowledged and supported the advantages of natural vaginal birth including physiological resuscitation as the baby descends through the birth canal, close and immediate parental contact, and early initiation of breastfeeding (enhanced by the baby’s association of the smell of amniotic fluid with that of mother’s milk), in addition to minimizing unnecessary technological interventions. However, those women who undergo cesarean section are deprived of these advantages.

This is fascinating - although an oxymoron (natural cesarean?), it immediately and instinctively appealed to me as a midwife. (Photo is of a cesarean in rural Nepal)

As reported in the Yale News (Karen N. Peart, Aug 8, 2012) "Vaginal birth triggers the expression of a protein in the brains of newborns that improves brain development and function in adulthood, according to a new study by Yale School of Medicine researchers, who also found that this protein expression is impaired in the brains of offspring delivered by caesarean section (C-sections)."

According to the June 25, 2012 issue of Time, midwives delivered 8% of all babies born in the U.S. in 2009 — an all-time high. In New Mexico, with the most midwife-attended births, the rate is 24%. Time's story is based on a study just published in The Journal of Midwifery and Women's Health (Vol 57(4) July/Aug 2012).

The New York Times writes in the Sunday, June 17, 2012 edition that midwives have suddenly become a "status symbol." I guess that, after years of struggling to become known as a profession, we should feel good about that. But I am not sure this is a new phenomenon. Midwives have given superb care to thousands of women, many of them indigent, immigrant, and underserved, for many years.

According to the International Confederation of Midwives, a midwife is "a person who meets the ICM Definition of the Midwife who has been educated and trained to proficiency in the ICM Essential Competencies for Basic Midwifery Practice, demonstrates competency in the practice of midwifery and is legally permitted to use this title."

Consumer Reports.org has just published an excellent article about ten procedures that may be more harmful than helpful during pregnancy and birth, as well as ten things to do during your pregnancy and five things to do before you become pregnant which can optimize your chances for a positive outcome. Tops on their list of things to avoid is a cesarean for a low-risk first birth.