Free Birth Research Articles

Effects of dam prepartum supplement level on performance and reproduction of heifer progeny

Objectives were to determine the effect of dam prepartum supplement level on growth performance, feed efficiency and reproductive performance of female progeny (127 heifers in year 1, 138 heifers in year 2). Mature, multiparous, fall-calving, Angus × Simmental cows (initial age = 5.6 ± 1.9 years, BW = 623 ± 70 kg, BCS = 5.7 ± 0.7) were used in a completely randomised design that included three supplement levels: no supplement (NS), low supplement, 2.16 kg·cow−1·d−1 (LS), or high supplement, 8.61 kg·cow−1·d−1 (HS). Cows grazed endophyte-infected tall fescue/red clover pastures and were bunk-fed supplement (70% dried distiller’s grains plus solubles [DDGS] and 30% soybean hulls) 103 ± 11 d prepartum to 2 ± 11 d postpartum. Dam prepartum supplementation did not affect (p ≥ .60) heifer progeny BW at weaning, breeding, nor at pregnancy verification. Dam prepartum supplementation did not affect (p ≥ .18) heifer progeny AI conception rate, overall pregnancy rate, nor calving rate. Calving date, calf birth BW, percentage of unassisted births, milk production and calf BW at 73 ± 16 d of age were not different (p ≥ .24) among heifer progeny, regardless of dam supplement level. In conclusion, these data suggest within a fall-calving, fescue-based production system, supplementing dams with 2.16 or 8.61 kg·cow−1·d−1 of a DDGS-based supplement does not affect growth performance and reproductive performance of subsequent female progeny.

Why do some women choose to freebirth in the UK? An interpretative phenomenological study.

BackgroundFreebirthing or unassisted birth is the active choice made by a woman to birth without a trained professional present, even where there is access to maternity provision. This is a radical childbirth choice, which has potential morbidity and mortality risks for mother and baby. While a number of studies have explored women’s freebirth experiences, there has been no research undertaken in the UK. The aim of this study was to explore and identify what influenced women’s decision to freebirth in a UK context.MethodsAn interpretive phenomenological approach was adopted. Advertisements were posted on freebirth websites, and ten women participated in the study by completing a narrative (n = 9) and/or taking part in an in-depth interview (n = 10). Data analysis was carried out using interpretative methods informed by Heidegger and Gadamer’s hermeneutic-phenomenological concepts.ResultsThree main themes emerged from the data. Contextualising herstory describes how the participants’ backgrounds (personal and/or childbirth related) influenced their decision making. Diverging paths of decision making provides more detailed insights into how and why women’s different backgrounds and experiences of childbirth and maternity care influenced their decision to freebirth. Converging path of decision making, outlines the commonalities in women’s narratives in terms of how they sought to validate their decision to freebirth, such as through self-directed research, enlisting the support of others and conceptualising risk.ConclusionThe UK based midwifery philosophy of woman-centred care that tailors care to individual needs is not always carried out, leaving women to feel disillusioned, unsafe and opting out of any form of professionalised care for their births. Maternity services need to provide support for women who have experienced a previous traumatic birth. Midwives also need to help restore relationships with women, and co-create birth plans that enable women to be active agents in their birthing decisions even if they challenge normative practices. The fact that women choose to freebirth in order to create a calm, quiet birthing space that is free from clinical interruptions and that enhances the physiology of labour, should be a key consideration.

Women׳s motivations for having unassisted childbirth or high-risk homebirth: An exploration of the literature on ‘birthing outside the system’

Objectiveto identify and analyze literature exploring women׳s motivations to ‘birth outside the system’. Designscoping review and thematic analysis of (mostly) qualitative studies. Findingsfifteen studies of women choosing an unassisted birth, homebirth in countries where homebirth was not integrated into the maternity care system, or a midwife-attended high-risk homebirth were identified from Sweden, USA, Australia, Canada and Finland. Five main themes emerged as the most important factors: (1) resisting the biomedical model of birth by trusting intuition, (2) challenging the dominant discourse on risk by considering the hospital as a dangerous place, (3) feeling that true autonomous choice is only possible at home, (4) perceiving birth as an intimate or religious experience, and (5) taking responsibility as a reflection of true control over decision-making. Key conclusionsconcerns over consent, intervention and loss of the birthing experience may be driving women away from formal healthcare. There is a lack of fit between the health needs of pregnant women and the current system of maternity care. Biomedical and alternative ׳outside the system׳ discourses on authoritative knowledge, risk, autonomy and responsibility must be negotiated to find a common ground wherein a dialogue can take place between client and health professional. Implications for practicemore research is needed to explore the scope of the phenomenon of women birthing outside the system and the experiences of midwives and obstetricians in the care of such women. This knowledge can be used to improve the maternity care system, so that fewer women will choose to withdraw from it.

Deliberately unassisted birth in Ireland: Understanding choice in Irish maternity services

Four individual cases of professionally unattended birth are used to explore the larger ‘case’ of homebirth service provision in Ireland. The women in these cases were unable to access midwife-attended homebirth. They depended on emergency services for hospital transfer. They hid their intention to birth unattended in order to avoid criticism of themselves or their lay attendants. Current Irish Health Service Executive (HSE) homebirth provision does not adequately address demand for homebirth in Ireland. Some women, including those considered too high-risk for homebirth, will choose to birth alone if midwifery attendance is unavailable.

Educação para o trabalho rural: o Asilo Agrícola do Imperial Instituto Fluminense de Agricultura, 1869 - 1889

The Agricultural School, an establishment of the Imperial Agricultural Institute of Rio de Janeiro, founded in 1869, housed orphans and poor boys so that they could be schooled in basic education and, at the same time, capacitated to field work. The main debates on agronomy and the difficulties that the Brazilian Empire met to deploy agricultural schools are discussed. Evidence exists that Agricultural Schools became feasible due to the fact that agricultural teaching was provided to poor children and orphans during a period prior to the Law of Free Birth (Lei do Ventre Livre). Since the Agricultural School is almost unknown by historiography, current paper contributes towards research on the history of Education, agricultural education and abandoned children.

Influence of prepartum dietary energy on beef cow performance and calf growth and carcass characteristics

Objectives were to evaluate the effects of prepartum dietary energy intake on cow performance as well as performance and carcass characteristics of subsequent progeny. Spring-calving, mature cows (n=106 total) were blocked by BW and allotted to 1 of 2 treatments: ground hay and dried distillers grains plus solubles (REQ: TDN=61.8%, CP=11.0%, fat=2.1%), or corn bran and ground cornstalks (HE: TDN=70.3%, CP=10.0%, fat=5.7%). Treatments were limit-fed as isonitrogenous rations with REQ and HE providing 100% and 125% of TDN requirements, respectively, and were fed from 83±10d prepartum to calving. All cows were fed a common diet postpartum. Cow BW and BCS were recorded at the beginning of the feeding period, 24h post-calving, and at breeding. Milk production was estimated via the weigh–suckle–weigh technique 65±9 and 120±9d postpartum. Calf BW was measured at birth and at weaning (120±9d of age). Calves (n=86) were fed a common feedlot diet beginning 2d after weaning, and individual feed intake was monitored using GrowSafe. Progeny were slaughtered in 3 groups at an average 12th rib fat thickness of 1.3cm. From initiation of experiment to breeding, cow BW change was greater (P<0.01) and BCS change tended to be greater (P=0.09) for HE relative to REQ cows. Birth BW was greater (P=0.02) for calves born to cows fed HE with no increase (P=0.30) in percentage of unassisted births. There were no effects (P≥0.27) of treatment on calving date, milk production, or subsequent pregnancy rate. Calf weaning BW, initial feedlot BW, final BW, and days on feed were not affected (P≥0.20) by treatment. Feedlot DMI, ADG, and G:F were not different (P≥0.35). There was no effect (P≥0.27) of treatment on progeny morbidity. Although progeny born to HE dams tended (P=0.10) to have greater marbling scores at weaning, there was no effect (P≥0.60) of treatment on carcass marbling score or other carcass traits. Feeding cows 125% of TDN requirement during late gestation increased cow BW change and progeny birth body weight. Feeding cows 125% of TDN requirement during late gestation had no effect on pregnancy rate or progeny performance.

Influence of late gestation drylot rations differing in protein degradability and fat content on beef cow and subsequent calf performance.

Spring-calving, mature cows ( = 191 total) and their progeny were used to evaluate the effects of late gestation drylot rations differing in RUP and fat content on cow performance as well as performance and carcass characteristics of subsequent progeny. Cows were blocked by BW and anticipated calving date and assigned to 16 pens. Pens were randomly allotted to 1 of 2 treatments: limit-fed corn coproducts and ground cornstalks (COP; TDN = 64.4%, CP = 11.1%, RDP = 60.2% of CP, and fat = 5.1%) or limit-fed ground mixed, cool-season grass hay (HY; TDN = 55.7%, CP = 9.5%, RDP = 86.0% of CP, and fat = 2.3%). Treatments were limit fed as isocaloric, isonitrogenous rations from 88 ± 11 d prepartum to calving. All cows were fed a common diet postpartum. Cow BW and BCS were collected at the beginning of the feeding period, within 48 h after calving, and at breeding. Calf BW was collected at birth and at 64 ± 11 and 124 ± 11 d of age. Milk production was determined using the weigh-suckle-weigh technique at 64 ± 11 and 124 ± 11 d postpartum. At 124 ± 11 d of age, steers ( = 68) and nonreplacement heifer calves ( = 25) were weaned and placed on a common feedlot diet with individual feed intake monitored using GrowSafe. Feedlot calves were slaughtered at a commercial facility 35 ± 10 d after a minimum ultrasound 12-rib fat thickness estimation of 0.9 cm. After calving, cow BW was greater ( < 0.01) and BCS was greater ( < 0.01) for cows fed COP than for cows fed HY. Calf birth BW was greater ( = 0.04) for those born to cows fed COP with no difference ( = 0.43) in percentage of unassisted births across treatment. Cows fed HY were lighter ( < 0.01) at breeding with lower BCS ( = 0.03); nevertheless, overall pregnancy rate was not different ( = 0.80). No differences ( ≥ 0.22) in milk production were detected. For feedlot progeny, initial feedlot BW, final BW, and days on feed were not different ( ≥ 0.23), and as a result, no difference ( = 0.21) in feedlot ADG was detected. Feedlot DMI and G:F were not different ( ≥ 0.19) across treatments. Feedlot calf health was monitored with no differences ( ≥ 0.68) in morbidity and mortality observed. No differences ( ≥ 0.27) were detected for HCW, LM area, backfat, marbling score, yield grade, or KPH. Increased dietary RUP and fat content during late gestation increased cow BW and BCS but did not alter milk production, subsequent reproduction, or subsequent calf performance or carcass characteristics.

Prediction of parturition in Holstein dairy cattle using electronic data loggers

The objective of the present study was to assess the effect of parturition on behavioral activity [steps, standing time, lying time, lying bouts (LB), and duration of LB] 4 d before calving using electronic data loggers. Animals (n=132) from 3 herds were housed in similar freestall barns using a prepartum pen 21 d before the expected calving date and were moved into a contiguous individual maternity pen for parturition. Electronic data loggers were placed on a hind leg of prepartum heifers (heifers, n=33) and cows (cows, n=99) at 7±3 d before the expected calving date and removed at 14±3 d in milk. Calving ease (scale 1–4), parity, calving date and time, and stillbirth (born dead or died within 24h) were recorded. The number of steps (no./d), standing time (min/d), lying time (min/d), number of LB (no./d), and duration of LB (min/b) were recorded. Data were analyzed using MIXED procedures of SAS, adjusting for the herd effect. Only cows experiencing unassisted births (calving ease=1) were included in the study. An activity index was developed to predict calving time. Heifers and cows with unassisted births had significantly higher number of steps and longer standing time, decreased lying time, and more LB of shorter duration 24h before calving compared with d −4, −3, and −2. Additionally, the number of LB increased as both heifers and cows approached labor starting on d −2 and peaked at the day of calving. The time since the activity index increased over 50% to parturition did not differ between heifers and cows, and the activity index revealed the shift in activity on average 6h 14min (range from 2h to 14h 15min) before calf birth. This study provided evidence that heifers and cows approaching parturition showed a similar, but distinct, behavioral pattern that can be observed on average 6h before calf birth. The potential benefits of electronic data loggers as predictors of parturition along with proactive management practices should improve the overall survival and welfare of both the dam and calf.

Postpartum sexual health: a principle-based concept analysis.

The aim of this study is to report an analysis of the concept of postpartum sexual health. Postpartum sexual health is a minimally understood concept, most often framed within physical/biological dimensions or as a 'checklist' task in postpartum information provision. This has the potential to leave women unprepared to manage transient or normative sexual health changes after childbirth. For meaningful discussions, clarity and understanding of postpartum sexual health is required. A principle-based method of concept analysis. The databases of PubMed, CINAHL, Maternity and Infant Care, PsychInfo, Web of Science, EMBASE, SCOPUS and Social Science Index were systematically searched, from their earliest dates, using a combination of key terms, including; 'sexual health', 'sexual function', 'dyspareunia', 'sexuality', 'sexual desire', 'sexual dysfunction', 'postnatal' and 'postpartum', resulting in a final included dataset of 91 studies. Using the principle-based approach, postpartum sexual health was analysed under the four philosophical principles of epistemological, pragmatic, linguistic and logical. Philosophically, postpartum sexual health is underdeveloped as a concept. A precise theoretical definition remains elusive and, presently, postpartum sexual health cannot be separated theoretically from sexuality and sexual function. Identified antecedents include an instrument free birth, an intact perineum and avoidance of episiotomy. Attributes include sexual arousal, desire, orgasm, sexual satisfaction and resumption of sexual intercourse. Outcomes are sexual satisfaction and a satisfying intimate relationship with one's partner. Postpartum sexual health is conceptually immature with limited applicability in current midwifery practice.

Exploration of preterm birth rates associated with different models of antenatal midwifery care in Scotland: Unmatched retrospective cohort analysis

Objectivespreterm birth represents a significant personal, clinical, organisational and financial burden. Strategies to reduce the preterm birth rate have had limited success. Limited evidence indicates that certain antenatal care models may offer some protection, although the causal mechanism is not understood. We sought to compare preterm birth rates for mixed-risk pregnant women accessing antenatal care organised at a freestanding midwifery unit (FMU) and mixed-risk pregnant women attending an obstetric unit (OU) with related community-based antenatal care. Methodsunmatched retrospective 4-year Scottish cohort analysis (2008–2011) of mixed-risk pregnant women accessing (i) FMU antenatal care (n=1107); (ii) combined community-based and OU antenatal care (n=7567). Data were accessed via the Information and Statistics Division of the NHS in Scotland. Aggregates analysis and binary logistic regression were used to compare the cohorts׳ rates of preterm birth; and of spontaneous labour onset, use of pharmacological analgesia, unassisted vertex birth, and low birth weight. Odds ratios were adjusted for age, parity, deprivation score and smoking status in pregnancy. Findingsafter adjustment the ‘mixed risk’ FMU cohort had a statistically significantly reduced risk of preterm birth (5.1% [n=57] versus 7.7% [n=583]; AOR 0.73 [95% CI 0.55–0.98]; p=0.034). Differences in these secondary outcome measures were also statistically significant: spontaneous labour onset (FMU 83.9% versus OU 74.6%; AOR 1.74 [95% CI 1.46–2.08]; p<0.001); minimal intrapartum analgesia (FMU 53.7% versus OU 34.4%; AOR 2.17 [95% CI 1.90–2.49]; p<0.001); spontaneous vertex delivery (FMU 71.9% versus OU 63.5%; AOR 1.46 [95% CI 1.32–1.78]; p<0.001). Incidence of low birth weight was not statistically significant after adjustment for other variables. There was no significant difference in the rate of perinatal or neonatal death. Conclusionsgiven this study׳s methodological limitations, we can only claim associations between the care model and or chosen outcomes. Although both cohorts were mixed risk, differences in risk levels could have contributed to these findings. Nevertheless, the significant difference in preterm birth rates in this study resonates with other research, including the recent Cochrane review of midwife-led continuity models. Because of the multiplicity of risk factors for preterm birth we need to explore the salient features of the FMU model which may be contributing to this apparent protective effect. Because a randomised controlled trial would necessarily restrict choice to pregnant women, we feel that this option is problematic in exploring this further. We therefore plan to conduct a prospective matched cohort analysis together with a survey of unit practices and experiences.

ANALISIS KUALITAS PELAYANAN AKTA KELAHIRAN GRATIS (BEBAS BEA) DI DINAS KEPENDUDUKAN DAN PENCATATAN SIPIL KABUPATEN KLATEN

In deal with a public demand of an excellent public service, it becomes a challenge for the Department of Population and Civil Registry of District Klaten in order to create a service quality in accordance with public expectations. Through this study, the researcher wanted to analyze the quality of free birth certificate services that available in Department of Population and Civil Registry of District Klaten. The dimensions of service quality that will be investigated are tangible dimension, reliability dimension, responsiveness dimension, assurance dimension, and empathy dimension. Based on the research that has been done, it can be seen that the service quality of free birth certificate in the Department of Population and Civil Registry of District Klaten is not optimal or unsatisfactory. The problems are found in the dimensions of reliability, responsiveness, and assurance. In connection with the service quality that has not been optimal, it is necessary to do improvement to the problems that found in every dimension.

Embodied knowledge and emotional labour in family conversations about breastfeeding: A discourse analysis

this presentation is to present the findings of the completed PhD research thesis ‘Birthing Outside the System’ which explores what motivates women to choose homebirth in high risk circumstances or to choose free birth in Australia. A qualitative study design using Grounded Theory was used to complete this research. Data was predominantly gathered using in-depth interviews with women who hadmade the choice to birth outside the system. This research found that in women were motivated togive birth outside the system because they ‘wanted the best and safest’ for themselves, their babies and their families. Through the process of ‘finding a better way’, than what is currently offered in mainstream maternity services, the participants concluded that birth outside the system was the best and safest option. This presentation will explain how women came to these conclusions by explaining their perceptions of risk and safety. Understanding what makes women choose birth outside the system can help midwives and policy makers understand the shortfalls of the currentmaternity care system and seek ways to make it more acceptable to birthing women. This research will also aid midwives’ understanding of the women who make these choices and change the perception that they are ‘risk-takers’.

Unassisted childbirth: why mothers are leaving the system

Unassisted childbirth is a topical subject that has sparked ethical and legal debate. Although there are little data surrounding unassisted birthing practice, concerns over consent, procedural intervention and loss of...

Why Progressives Should Follow Feminism’s Lead in 2012

Some progressives, disappointed in Obama’s performance, are expressing apathy about the 2012 election. Feminists, however, facing an escalating “war on women” and recognizing the enormous political stakes, have been organizing with renewed energy. The “gender gap” that emerged from 1970s feminism has made women’s votes such an important force that politicians who attack women’s rights in order to rouse their base are at peril of rousing the ire of an expanding female voting bloc. It’s time for progressives of every gender identity to join this bloc and follow our lead.An overwhelming majority of female voters favor contraception and abortion — those most basic of women’s rights. Many are so outraged by current attempts to limit reproductive freedom that they are organizing new boycotts, petition drives, debates, and mass demonstrations on behalf of gender justice. Women know that winning this election is essential because one party supports abortion and one opposes it, and because the Supreme Court balance — holding the fate of Roe vs. Wade — will be determined this year for a generation.Recent events that have so provoked women focus on reproductive issues, particularly right‐wing attempts to defund Planned Parenthood and to remove free birth control from comprehensive health care under the Affordable Care Act. These maneuvers generated so much organized resistance that they have mostly failed. In addition, Romney’s proposals to increase military spending and balance the budget would drastically reduce social programs for mothers and children, the elderly, and the poor — all groups with female majorities. Even nuns are assailed as the Vatican formally reprimands the largest group of U.S. nuns for promoting “radical feminist themes” and focusing on poverty and economic justice while remaining “silent” about abortion and same‐sex marriage.These attacks are inciting a raucous feminist renewal, even within the Occupy movement. In New York’s Occupy movement, at first feminism had so little voice and some women felt so unsafe at Zuccotti Park that in protest they formed the women’s caucus, Women Occupying Wall Street (WOW), which quickly took hold in other cities too. The founding statement of Occupy Austin, Texas, which explicitly rejected taking a position on such “divisive” issues as abortion, has provoked feminist outrage. Some women activists report that before WOW they were wary of the F‐word, but they are now proud to organize explicitly as feminists. In New York City alone, important new feminist working groups have emerged from Occupy: one mounted the First Feminist General Assembly, which took place on May 17, attracted 300 people who agreed to assemble monthly, and has been taken up in other cities; an Occupy group called Feminist Resistance held an initial large public forum; and feminists have organized a series of fall courses on feminism in OccU, Occupy’s Free University. What’s more, these groups are doing out‐reach to every existing feminist organization they can locate of whatever wave and to people of every gender identity. As an organizing model for progressives for 2012, this may be it.These are dangerous times and this election matters. A Romney victory would be a disaster for everyone, but particularly for women. In solidarity with feminists, all progressives, including those hesitant to engage in electoral politics, owe it to their sisters not only to vote but to become actively engaged.

O391 SOCIOECONOMIC INEQUALITIES, BIRTH COMPANION AND MOTHER-BABY CONTACT AT BIRTH IN BRAZIL

International Journal of Gynecology & ObstetricsVolume 119, Issue S3 p. S399-S399 Free communication (oral) presentations O391 SOCIOECONOMIC INEQUALITIES, BIRTH COMPANION AND MOTHER-BABY CONTACT AT BIRTH IN BRAZIL A.P.E. Pereira, A.P.E. PereiraSearch for more papers by this authorM.H. da S. Bastos, M.H. da S. BastosSearch for more papers by this authorM.M. Theme, M.M. ThemeSearch for more papers by this authorM. do C. Leal, M. do C. LealSearch for more papers by this author A.P.E. Pereira, A.P.E. PereiraSearch for more papers by this authorM.H. da S. Bastos, M.H. da S. BastosSearch for more papers by this authorM.M. Theme, M.M. ThemeSearch for more papers by this authorM. do C. Leal, M. do C. LealSearch for more papers by this author First published: 22 October 2012 https://doi.org/10.1016/S0020-7292(12)60821-2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume119, IssueS3Abstracts of XX FIGO World Congress of Gynecology and ObstetricsOctober 2012Pages S399-S399 RelatedInformation

On the Margins of the Periphery: Unassisted Childbirth and the Management of Layered Stigma

This article examines an unusual practice—unassisted childbirth—and the ways in which advocates and practitioners manage the stigma they are accorded. Given their “doubly deviant” status as not only women who birth at home but also as women who choose to give birth without professional assistance, these women provide a unique case for our theoretical understanding of stigma management. As members of homebirth social networks, the women must reckon with what I term layered stigma, the broad stigma of homebirth as well as the deeper in-group stigma within their deviant community that results from their rejection of midwives as appropriate care providers. By examining the dynamics of stigma management among practitioners of unassisted childbirth, I highlight the complex, situation-dependent nature of stigma and the impact of its management on women's sense of self.

Risk Models for Benchmarking Severe Perineal Tears during Vaginal Childbirth: a Cross‐sectional Study of Public Hospitals in South Australia, 2002–08

The incidence of third- and fourth-degree perineal tears during vaginal childbirth is being increasingly used as an indicator of the safety and quality of maternity health care services. In order to make fair comparisons across hospitals it may be necessary to estimate a probability of severe perineal tears for every woman, taking into account her risk profile. Logistic regression analysis was used to estimate the probabilities of third- and fourth-degree tears (n = 1582; 2.4%) in 65 598 vaginal births in publicly funded hospitals in South Australia, 2002-08. Maternal age ≥25 years, primiparity, instrument assistance, Asian or African ethnicity, shoulder dystocia and increasing birthweight were all identified as factors that are associated with an increased risk of perineal tears. In parous women, episiotomy, with or without instrument assistance, was associated with more tears; but among nulliparous women, episiotomy was associated with significantly fewer tears when forceps assistance was required, and showed little or no association with tearing in vacuum-assisted or unassisted (spontaneous) births. The probabilities of severe perineal tears in first-time mothers giving birth to a term singleton with cephalic presentation, may range from under 1% to over 40%, according to a minimalist model containing only predictors unrelated to clinical management. If instrument assistance and episiotomy are also incorporated into the modelling, the estimated probability of tearing may exceed 50% in high risk individuals. Such variation highlights the need for risk adjustment when comparing hospitals with respect to their incidence of third or fourth degree perineal tears.

The commonalities and differences in health professionals’ views on home birth in Tasmania, Australia: A qualitative study

Home birth has attracted great controversy in the current context. There is a need for the public and health professionals to understand why maternity care providers have such different views on home birth, why they debate, what divides them into two opposite sides and if they have anything in common. A qualitative study involving twenty maternity health providers in Tasmania was conducted. It used semi-structured interview which included closed and open-ended questions to provide opportunities for exploring emerging insights from the voices of the participants. Health practitioners who support home birth do so for three reasons. Firstly, women have the right to choose the place of birth. Secondly, home birth may be more cost effective compared to hospital birth. Thirdly, if home birth is not supported, some women might choose to have a free birth. Those who opposed home birth argue that complications could occur at childbirth and the transfer time is critical for women's and babies' safety. These differences in opinions can be due to the differences in the training and philosophy of the maternity care providers. Despite the differing views on home births, health professionals share a common goal to protect the women and the newborns from unexpected situations during childbirth. This article provides some significant insights derived from the study of home birth from the maternity health professionals' perspectives and could contribute to the enhancement of mutual understanding and collaboration of health professionals in their services to expectant mothers.

Freebirth

This column is a literary, personal essay about the author's spouse and her experience with unassisted birth.

Assessment of calving progress and reference times for obstetric intervention during dystocia in Holstein dairy cows

The objectives of this observational study were (1) to assess the time from the appearance of the amniotic sac (AS) or feet outside the vulva to birth in Holstein cows (primiparous and multiparous) with (dystocia) or without assistance (eutocia) at calving, and (2) to estimate reference times to be used as guidelines for obstetric intervention in Holstein cows that need assistance during difficult births. Cows (n=92) from 1 commercial dairy operation were used in this study. Periparturient dairy cows (primiparous, n=58; multiparous, n=34) were placed in a maternity pen and constantly monitored until birth. The calving ease of cows, time from AS or feet appearance to birth, calving progress from a subset of 15 cows (frequency and duration of abdominal contractions during labor), calf birth weight, calf sex, and stillbirths (born dead or died within 24h after birth) were recorded. The reference times for obstetric intervention during dystocia were estimated based on values from unassisted births (normal). The normal range of times from the appearance of AS or feet outside the vulva to birth was estimated based on the mean+2 standard deviations (SD) of unassisted births. According to farm protocol, assistance was provided to cows without calving progress 80min after AS appearance or earlier (e.g., to correct malpositions). Cows with dystocic births had a longer time from AS appearance to birth and increased incidence of stillbirth compared with cows with eutocic calvings. After the appearance of the AS, calving progress was evident every 15min for eutocic births. The estimated reference times (mean+2 SD) from AS appearance to birth were 69.7min and from feet appearance to birth were 64.6min for eutocic births. Findings from this study suggested that calving personnel should start assisting cows 70min after AS appearance (or 65min after feet appearance) outside the vulva. The time spent in labor (straining) combined with the time from the appearance of the AS or feet to birth, and the assessment of calving progress (as described for eutocic births) should be used as guidelines for obstetric intervention during difficult births under field conditions. These reference times should be interpreted in combination with adequate obstetrical knowledge and examination.