Articles of Interest  from peer-reviewed professional journal and other reliable sources  for Professional Midwives & Home-birth Physicians
Professional Articles of Interest to Midwives  ~ Practice Issues		Breastfeeding Research   For  Maternity Care Professionals
Twin Peaks of Denali Summit, Alaska, August 2000
Book Review	News du jour  Latest tidbits healthcare, childbearing,  maternity services and other interesting topics	MedLine, Grateful Med & Library of Congress

 Links to Important Midwifery-related Sites 
or Clinical Information

 University of California at San Francisco / Pew Charitable Trust
Index page for Midwifery-Related Reports and 
Press Releases from the Center for the Health Professions  

    The British Journal of Midwifery - now available on the Internet

Excellent Book Review ~ Dr. Tom Strong, "Expecting Trouple", an expose
on the failure of current obstetrician-dominated form of maternity care **

PRACTICE UPDATES

 Newly posted ~ Excerpts from Synopsis Cochrane Data Base
~ Systemic Review of Effective, Evidence-based Maternity Care
Tables 1-6 + Women's Position in 2nd Stage

  Newly posted ~ Technical Bulletin No. 5 ~ Characteristics of Clinical Competency
Meconium ~ Delivery Management of light to moderate Mec in Vigorous Term Neonates -- Cochrane Date Base Abstract recommends against routine endotrechael intubation

Auditory Evoked Response Test to Evaluate Fetal Health:
a new method to evaluate intrauterine fetal asphyxia 
(& reduce the need for continuous EFM 
during labor by identifying at-risk babies)

Screening for Gestational Diabetes Mellitus   x
-- The New England Journal of Medicine --   
November 27, 1997 -- Volume 337, Number 22

(Sorry, not a good study or helpful article)

Cited article on Management Options for Shoulder Dystocia x
-- by UK midwife, originally published on ARM web site 

  The Use of Medical Grade Super Glue  x
~ for Skin Repair in Perineal Lacerations  
~ for Skin Repair in Perineal Lacerations ~ for Skin Repair in Perineal Lacerations

Fetal Monitoring -- the Nouns and the Verbs

Auscultation to Determine FHT variability or "reassuring patterns" x

    Excerpts from April 1998 OB GYN News OB GYN News  x
"Normal Baseline FHR - Doesn't Rule Out Hypoxia" 
-- identifying the 4 types of   intrapartum fetal distress, 
how to recognize them using intermittent auscultation

Shoulder Dystocia and the Maternal Hands and Knees Position x
  - an obstetrician explains the principle

  Shoulder Dystocia Articles on UK "Radical Midwives" web site x

Cesarean Prevention, Complications, VBAC issues x

    CS for Fetal Distress  -- A Practical Approach -- OBG Management

Placenta Previa / Placenta Accreta / Percreta -- 
Predictable Complication of Cesarean and other Instrumentation of the Uterus -- 

 VAGINAL BIRTH AFTER CESAREAN SECTION x

 . ONCE A CESAREAN, ALWAYS A CONTROVERSY - 
VBAC article by Dr. Bruce Flamm. MD, 
reprinted Obstetrics and Gynecology

VBAC Alert - Placenta Previa / Placenta Accreta/Percreta

ACOG Guidelines  -- the bad news is that in Oct of 1998 ACOG took a big step backwards, re-classifying labor subsequent to CS as the highest risk, with mandatory continuous EFM and the re-emergence of scheduled elective Cesareans for mothers who plan to give birth in community hospitals which do no have 24 hours anesthesia and surgical scrub teams

The Birth and Life of Catherine Grace -- one family's story of  an attempted VBAC & subsequent uterine rupture occurred (for peace of mind, please don't read if your currently pregnant)

Annotated VBAC Bibliography -- compilied, maintained &   updated quarterly by Ken Turkowski, research scientist & VBAC father of Catherine Grace (see file above)

Sample Informed Consent / Informed Declination -- VBAC 

Epidrual Facts / Side-effects x

Epidurals increase caesarean section rate

  Study on the effects of epidural anesthesia reveals  
longer labors and increased rate of Cesarean surgery

  Epidurals lead to more invasive tests for newborns

63% of the women (1,047) studied received epidurals, but their number accounted for 96% of those who developed fevers during labor. Their babies accounted for around 86% of all newborns tested for sepsis and about 87% of those given some form of antibiotics.

Episiotomy  x
~ Political Controversies Surrounding Routine use of Episiotomy ~

  Episiotomy Revisited -- Contemporary evidenced-based  research 
leads to the conclusion the we should " reduce dramatically 
the use of this injurious procedure." Brody 1981

  Aetna US Healthcare Denies Coverage for Home-based Birth Services, terminates CNM for providing domiciliary midwifery care
--  ACDM letter to Aetna in reponse

Five great  articles from Bandolier Evidence-based health care web site   
~  produced monthly in Oxford for the NHS R&D Evidence-based health care web site   ~  produced monthly in Oxford for the NHS R&D  /   August 1998 Issue  54

The GP's guide to home birth --
        advise for General Practitioners in the UK

Antibiotics for Acute Otitis Media

Evidence-informed Patient Choice

Latex Allergy

Alligator alley - The Paling Perspective Scale --  a simple way of communicating risks (to the public and each other), and is the central feature of a book Up to your Armpits in Alligators by John Paling

Articles of Interest / Informed Consent Documents

Intrapartum Administration of Ampicilln Prophylaxis in GBS Mothers May Raise Risk of  Neonatal E. Coli Infection

Client Information & Consent  for Group B Streptococcal Infections

Special Circumstances Informed Consent / Informed Declination -- VBAC, Macrosomia, Twins, postdates

Recent Ob.Gyn publication carries 3 articles praising  midwives --
Midwife's Level of Experience Key plus Rules for Successful Collaboration
MDs find Midwives Offer High Standard of Care
Midwife present Solutions to Arrested Second Stage Labor

"The Battle Over Home Delivery" by Karen  Ann Coburn -- an interesting article in the October issue of  GOVERNING  magazine

"Midwives Under Fire" -- this month's cover story in Minnesota Parents Magazine by Katie Allison Granju

Commentary by Susan Hodges,Citizens for Midwifery,  on the ACNM "Issue Brief" regarding the establishments of training programs for direct entry midwives by ACNM

Text of ACNM's Recent Developments in Midwifery Certification refered to above (CfM Commentary by Susan Hodges)