BirthKuwait Inagural Gala

BirthKuwait Inagural Gala
celebrating 4 years of giving (note: it's by invite only)

Tuesday, March 3, 2015

Birthing With Confidence in the GCC 2014 - Evaluation Report

Evaluation Report of BirthKuwait’s Conference
‘Birthingwith Confidence in the GCC 2014’

The Year 2014 marked to be a highly significant year for BirthKuwait as it successfully marked one of its key milestones - conducting the ‘Birthing with Confidence in the GCC’ which was the first conference to be held in this region of this kind.The exposure and growth which was established from this was remarkable because not only we had trainees from Kuwait, we had some coming in from neighboring GCC countries hence proclaiming the success of the mission of targeting the whole region as intended.

BirthKuwait managed to attain many loyal sponsors, some of which are continuing to collaborate with the branches and affiliates of BirthKuwait. And we have more sponsors and partners on board, post conference, all as a result to the success accomplished.
Most fruitful outcome of this conference was the establishment of Breastfeeding Support Program (BFSKW), the first of its kind in Kuwait. Offering monthly workshops in Arabic and English which have acclaimed great acceptance and seats get full weeks in advance. They have launched a Breastfeeding Support Hotline which provides daily support to moms via phone calls and messages as well as home visits.

Alongside this many private and public hospitals have expressed an interest in becoming more supportive of breastfeeding and invested in this goal by getting their staff trained  hence many nurses and doctors were trained by BK to become Doulas, Breastfeeding Counselors, Lamaze Childbirth Educators and Lactation Educators during our conference.
Following are the statistics of number of trained personals:

Breastfeeding Counselors
16
Lactation Educators
18
Doulas
7
Childbirth Educators
16


                                                              Childbirth Educators



                                                                       Doulas 


                                        Breastfeeding Counselors and Lactation Educators 

    
Productive outcomes:
-Establishment of BFSKW- providing workshops, hotline support, home visits and Breastfeeding awareness.
-@bfskw Instagram account having a rapid growth of followers and people benefiting from informative bilingual posts.
-Childbirth Education classes conducted privately and in groups.
- Media exposure on TV interviews and famous magazines (Watan TV, City pages, Marie Claire, …..)
-Significant Growth in the number of volunteers.


Kindly note that financial review is available upon request via email
info@birthkuwait.com



Thursday, January 22, 2015

Be a Savvy Birth Consumer Part 2

City Pages March 2014 Article 
http://issuu.com/citypageskuwait/docs/cp_april_2014_online
* see page 32

Do you want to get the most out of your birth experience? Be savvy. Understand the language used during birth and make informed decisions.


While birth is a normal process and research shows that many of the routines at hospitals today are not necessarily beneficial and may even be harmful[1], the fact remains that birth today has become intervention-intensive and the majority of moms in Kuwait will likely experience one or more intervention during their birth. Most of the statistics for these interventions are not publicly available in Kuwait, so I will use the most recent statistics for women in America. The most recent Listening to Mothers Survey[2] showed that the majority of women surveyed experienced one or more of the following interventions during labor:

   Continuous electronic fetal monitoring (EFM)(93 percent)
   Restrictions on eating (87 percent)
   IV fluids (86 percent)
   Restrictions on drinking (66 percent)
   Episiotomy (35 percent)
   Epidural anesthesia (63 percent)
   Artificially ruptured membranes (55 percent)
   Artificial oxytocin augmentation (53 percent)
   Cesarean surgery (24 percent)

What would those numbers look like in Kuwait? Perhaps some would be higher and some would be lower. The point is that you should be familiar with some technical medical terminology before you give birth. This is the second of two articles designed to empower moms to make informed decisions during birth. The previous article discussed Continuous Electronic Fetal Monitoring (EFM), Restrictions on Eating and IV Fluids, and Episiotomies. In this article we will discuss Artificial Induction or Augmentation (Syntocin), Epidurals, and Cesarean Surgery.

Artificial Induction or Augmentation (Syntocin):

Oxytocin is the central hormone that orchestrates a normal birth. It is nicknamed the hormone of “love” and is essential to bonding, creating feelings of euphoria, and produces uterine contractions. More than 50% of moms give birth using synthetic oxytocin (Syntocin or Pitocin), either to induce the beginning of the labor or to augment their labor once it has already begun.

While synthetic oxytocin and natural oxytocin are chemically identical, their affect on the body has significant differences. For example, natural oxytocin that is produced in the brain circulates in the cerebral-spinal fluid, whereas synthetic oxytocin is pumped into the veins and never crosses the blood-brain barrier. In addition, the body only produces enough oxytocin to meet its needs, where as synthetic oxytocin is pumped by steadily increasing amounts over a short period of time to much higher levels than what the body would naturally produce. Furthermore, while naturally produced oxytocin is responsible for creating the mothers powerful and rhythmic contractions that eventually birth her baby, it also has a softer side: oxcytocin floods a mothers body, reaching its highest peaks during the most intense part of labor, and helping the mother move into an alternative state of mind ((elation) in order to cope with labor and filling her body with love and affection for her baby and partner. A whole series of feedback hormones are also triggered with the natural production of oxytocin, including endorphins (euphoria) and prolactin (for milk production) to prepare her for the final moments of birth and her initial encounters with her baby. This feedback process does not accompany artificial oxytocin.

Synthetic oxytocin, on the other hand, produces more intense contractions over a shorter period of time, without the softening effects of natural oxytocin or the benefits of endorphins. This does more than just change the quality of the contractions- making them more intense and painful for the poor mother. It also increases the mother and baby’s risks for harm, necessitating continuous fetal monitoring. These risks include postpartum hemorrhage through what is called uterine atony: essentially, synthetic oxytocin has a diminishing return of effectiveness by the end of labor, leaving the uterus soft and weak, unable to contract to stop postpartum bleeding; and fetal distress: the sudden-hard and fast-squeezing contractions produced by synthetic oxytocin induced contractions diminishes the baby’s placental oxygen supply more often and for longer periods of time than natural contractions creating disturbing fetal heart rate patterns and necessitating continuous fetal monitoring, vaccum/forceps assisted deliver, and cesarean surgery.

The best way to avoid the use of synthetic oxytocin in your labor is to wait for your labor to begin on it’s own and to use movement throughout your labor to keep your labor progressing, and use a doula or other support person throughout your labor.


Epidurals:

I’m just going to skip other pain medication options and speak directly to the most commonly used pain medication: Epidurals. Epidurals are popular because they allow women to be awake and aware yet free from pain during labor and birth. They permit an exhausted woman to rest or sleep. And while their usual effect is to slow labor, the profound relaxation they offer can sometimes put a stalled labor back on track. They can be very effective.

But like all medical interventions, epidurals also have potential harms, including an increased risk of

·         a vacuum or forceps delivery
·         a drop in blood pressure, which may pose a risk to the baby
·         nausea and itching attributed to the narcotics in epidurals
·         difficulty with breastfeeding, linked to fentanyl, a common narcotic component in most epidurals
·         developing a life-threatening complication
·         breathing problems or difficulty swallowing
·         a baby who experiences a prolonged episode of abnormally slow fetal heart rate

Still, labor is unpredictable, and you want to keep all your options available. Just be sure that you make your decision freely, not because you feel pressure or lack an alternative. Here are some ways to do that as well as minimize potential harms:
Choose a care provider with a cesarean surgery rate of 15% or less. Studies show that in the hands of care providers with low rates, epidurals do not increase cesarean odds. 

Choose a mother-friendly birth environment. In most hospitals, confinement to bed, continuous fetal monitoring, and restricting labor support companions such as doulas, along with lack of amenities such as showers, deep tubs, and birth balls make it difficult to cope with labor without an epidural. Where epidurals are the norm, nurses may not know how to support a laboring woman without one, and staff may actively promote their use. And finally, delay an epidural until active, progressive labor (6-7 cm dilation) to reduce your risk of complications arising from epidurals.


Cesarean Surgery:

When the cesarean rate is between 10-15%, maternal mortality goes down and lives are saved. However, when a cesarean rate goes above 15%, there are no overall improvements for maternal or infant health outcomes. The risks of harm increase for both mother and baby, future pregnancies can be endangered, and health care resources are squandered on interventions that do not provide a positive net gain in health outcomes. The World Health Organization states that cesareans should only be performed for medically indicated reasons. These include placenta previa, malformed or injured pelvis, severe pre-eclampsia, active genital herpes, advanced HIV, transverse (side-lying) baby, twins if the first baby is breech and triplets, certain birth defects, medical problems with the baby or mother (emergency or chronic), placental abruption, prolapsed cord, or uterine rupture.

The following are NOT necessarily a medically indicated reason for a cesarean: prior cesarean, breech presentation, failure to progress, CPD (Cephalo-pelvic disproportion, or your baby's head is too big), twins if the first baby is presenting head down, large baby, fear, convenience, or wanting to give birth on a particular day.

Risks to the mother include:

   4xs higher risk of death than vaginal birth
   20%-40% mothers after cesareans have post-operative complications - uterine, wound or urinary tract infections are the most common.
   increased risk of serious infections such as pelvic abcess, septic shock and pelvic thromboembolism.
   up to 1 in 10 have a surgical laceration in their uterus.
   6xs increase in postpartum depressions three months after surgery.
   reduced fertility
   increased risk of ectopic (outside of uterus) pregnancy
   increased risk of unexplained still birth
   increased risk of rupture of the uterus before or during labor, 2-4xs higher when subsequent labors are induced or augmented with pitocin.
   risk of placental problems (placenta praevia or low-lying placenta; placental abruption where placenta separates early; placenta accreta, where placenta won't separate) increased by 2-4xs.
   7-15xs increased risk of emergency hystorectomy after birth for the above reasons
   increased risk of bleeding after birth, severe anaemia, blood transfusion, repeat cesarean, and infection, for all the reasons mentioned.

Risks to the baby include (for non-emergency cesareans):

   5xs increased risk of needing intensive care treatment after birth
   increased risk of prematurity; even with ultrasound scans, around 10% of babies are born more than two weeks early
   increased risk of breathing difficulties after birth: minor problems around 6% compared to 3% vaginal delivery, even when born at term.
   with ceasareans, 1.6% of babies require a machine for severe breathing difficulties compared to .3% of vaginal births.
   Persistent pulmonary hypertension. of which 40%-60% of affected babies die, can affect up to 4 per 1,000  cesarean babies, compared to .8 per 1,000 vaginal babies.
   1-2% risk of laceration (surgical cut) during the operation
   all future pregnancies have an increased risk of prematurity, low birth weight, poor condition at birth, and death, for the reasons mentioned above.

To decrease your risk of having an unnecessary cesarean surgery, find a care provider with a low cesarean rate, let your labor begin on it’s own, move around and stay active during labor, work with a doula or other labor support, avoid unnecessary medical interventions, and push your baby out in an upright position.














Sunday, January 18, 2015


Our workshops are based on recent and up-to-date scientific studies and research. We try to educate new parents, their families and friends about breastfeeding. The more educated and prepared a mom is before breastfeeding the more successful she will be in breastfeeding her child for longer periods. We strive for a healthier generation of kids and adults. It all starts with breastfeeding!

Everyone will benefit from this workshop. Mom, baby and the whole society! That’s what matters the most to us!

We are currently accepting reservations for our February workshops. Seats are limited, reserve your seat today!


                                                To register: http://instagram.com/bfskw

Thursday, December 11, 2014

Be a Savvy Birth Consumer Part I

City Pages February 2014 Article 
http://issuu.com/citypageskuwait/docs/cp_feb_2014_online
* see page 34


Do you want to get the most out of your birth experience? Be savvy. Understand the language used during birth and make informed decisions.
While birth is a normal process and research shows that many of the routines at hospitals today are not necessarily beneficial and may even be harmful[1], the fact remains that birth today has become intervention-intensive and the majority of moms in Kuwait will likely experience one or more intervention during their birth. Most of the statistics for these interventions are not publicly available in Kuwait, so I will use the most recent statistics for women in America. The most recent Listening to Mothers Survey[2] showed that the majority of women surveyed experienced one or more of the following interventions during labor:
   Continuous electronic fetal monitoring (EFM)(93 percent)
   Restrictions on eating (87 percent)
   IV fluids (86 percent)
   Restrictions on drinking (66 percent)
   Episiotomy (35 percent)
   Epidural anesthesia (63 percent)
   Artificially ruptured membranes (55 percent)
   Artificial oxytocin augmentation (53 percent)
   Cesarean surgery (24 percent)

What would those numbers look like in Kuwait? Perhaps some would be higher and some would be lower. The point is that you should be familiar with some technical medical terminology before you give birth. In the next two articles we will provide you with a brief explanation of the terms you should be familiar with before you give birth:

Continuous Electronic Fetal Monitoring (EFM):

You know the machine they hook you up to by wrapping stretchy cloth around the top and bottom of your belly to hold in place two little circles? Yep, that is the EFM machine. The EFM was designed to continuously monitor the baby’s heart rate in an effort to detect fetal distress and prevent injury. Sounds innocuous, yes? However, research shows that one of the unintended consequences of the routine use of continuous EFM is an increase in cesareans without any improved outcomes for babies.[3] (Translation: harmful for mom, no benefit to baby.)

The key words are: Routine and Continuous. The WHO and ACOG (American College of Obstetrics & Gynecologists) recommend intermittent monitoring with a Doppler or stethoscope during labor for low-risk healthy moms, every 30 minutes during active labor and every 15 minutes during pushing.[4] This also allows mom to be active and upright during labor which will help keep her comfortable and move things along.

Research shows that there are benefits to continuous EFM if you are using Syntocin/Pitocin, have an epidural, your baby is experiencing changes in heart rate, or if your or your baby are not in good health. But if you are a healthy low-risk mom, research shows that you would benefit more if your doctor monitored you and your baby intermittently with a Doppler or stethoscope.

Restrictions on Eating and IV Fluids:

OK, so doesn’t it sound a little crazy in the same sentence: Restricting normal eating and drinking, but then trying to keep mom nourished through an IV? The practice of restricting moms eating and drinking began when the majority of moms gave birth under anesthesia and the accompanying fear of aspiration. In addition, studies have confirmed that that are no medical benefits to routinely restricting eating and drinking during labor.[5] Instead it deprives a woman of energy when she needs it most. In addition, routinely hooking up mom to an IV during labor restricts movement, may adversely impact labor progression if mom becomes over-hydrated, and increases risk of low blood sugar in babies.[6] The WHO and ACOG recommend fluids be offered to mom by mouth, and the routine use of IV fluids be eliminated. If you are a healthy low-risk mom ask your doctor about a hep-lock, an IV started in your hand/arm that is capped off so that it is in place and available but does not interfere with mom’s movement and normal labor progression.

Episiotomy:

This is a controversial procedure with no easy explanation. Sometimes when moms are pushing their babies out, the doctor makes an incision to widen the birth canal (yeah- they cut down there!) This is a controversial procedure because research has provided no evidence that an episiotomy reduces the risk of perineal injury, improves perineal healing, prevents birth injury to babies, or reduces the risk of future incontinence (these are all reasons cited by doctors for the routine use of episiotomies).[7][8] Research does show that routine or liberal use of episiotomy is likely to be ineffective and harmful to mother[9] (the list of risks to mom are too long for this article). In addition, the WHO recommends eliminating routine or liberal episiotomy.

Of course there are times an episiotomy would be beneficial. For example, if a change of position or taking a break from pushing does not resolve signs of distress in your baby, or if your baby is very large or in an unusual position (again, first try changing your positions to see if it helps) an episiotomy might be necessary. If you want to avoid an episiotomy, discuss your concerns with your doctor before hand and choose your care provider carefully, push in an upright position that lets your birth canal stretch gently as your baby descends, change positions often while you’re pushing, push spontaneously when you feel urges rather than directed, and remember your body knows how to give birth and be patient!







[1] Lamaze Healthy Birth Practice 4: Avoid Interventions That Are Not Medically Necessary, The Official Lamaze Guide: Giving Birth With Confidence

[2] Declerq ER, Sakala C, Corry MP, Applebaum S, Herrlich A. Listening to MothersIII: Pregnancy and Birth. New York: Childbirth Connection, May 2013

[3] Goer, H., Leslie, M. S., & Romano, A. (2007). The Coalition for Improving Maternity Services: Evidence basis for the ten steps of mother-friendly care. Step 6: Does not routinely employ practices, procedures unsupported by scientific evidence. The Journal of Perinatal Education, 16(Suppl. 1), 32S– 64S.
[4] American College of Obstetricians and Gynecologists [ACOG]. (2005). ACOG practice bulletin #70: Intrapartum fetal heart rate monitoring. Obstetrics and Gynecology, 106(6), 1453–1460.

[5] Goer, et al, (2007)

[6] Enkin, M., Keirse, M., Neilson, J., Crowther, C., Duley, L., Hodnett, E., et al. (2000). A guide to effective care in pregnancy and childbirth. New York: Oxford University Press.

[7] Goer et al, (2007)

[8] Hartmann, K., Viswanathan, M., Palmieri, R., Gartlehner, G., Thorp, J., & Lohr, K. N. (2005). Outcomes of routine episiotomy: A systematic review. Journal of the American Medical Association, 293(17), 2141–2148.

[9] Klein, M., Gauthier, R., Robbins, J., Kaczorowski, J., Jorgensen, S., Franco, E., et al. (1994). Relationship of episiotomy to perineal trauma and morbidity, sexual dysfunction, and pelvic floor relaxation. American Journal of Obstetrics and Gynecology, 171(3), 591–598.



Saturday, November 29, 2014

Car Seat Safety For Infants

How many of you use car seats for their kids? Up to what age are you using them? Do you know when you are supposed to switch to the next category?


To know more, read our article in the November issue of City Pages magazine:

http://issuu.com/citypageskuwait/docs/cp_november_2014_online/1
click next 23 times to reach the page


Saturday, August 2, 2014

Birthing With Confidence in the GCC

 


BirthKuwait is pleased to announce an upcoming Conference: Birthing With Confidence in the GCC, Promoting Maternal and Infant Health Through Training Workshops for Professionals, Community Health Care Workers and Maternal Health Care Advocates, which will take place in October from the 14th to the 18th include:

1. Lamaze Childbirth Education Workshop (5 days Oct 14th-18th)

2. Breastfeeding Counselor Training (4 days, Oct 14th-17th)

3. "Breastfeeding Your Baby" Lactation Educator Workshop (For Professionals Only, 1 day on Oct 18th)

4. DONA Doula Training Workshop (3 days, Oct 16-18).

For more information check below:
VERY IMPORTANT TO READ
(This document opens in google drive document)
Course Description

Training Workshops are facilitated and approved by renowned international maternal and infant health advocates: Lamaze International, EPI,  DUKE AHEC, DONA, and our local partner FSRI.


Please fill in the Application Form and e-mail it back to us on the e-mail below.
Kindly note that you need to fill this application on your pc or laptop
INSTRUCTIONS
Here are some simple steps to fill the form:
1. Download the application
2. Open the application
3. Fill the application  ( by using sign mode )
4. Save as : add your name to the saved file ( save as a file on your pc or laptop)
5. Email to : info@birthkuwait.com with the attachment
6. Send


For details and registration, please visit www.birthkuwait.com or e-mail: info@birthkuwait.com

Wednesday, July 30, 2014

Make the Most of Your Epidural

The majority of birthing mothers at private hospitals today decide to get an epidural. Sometimes this is a decision made before labor ever began or a change in plans after a long and drawn our labor. The great thing about an epidural is it allows women to be awake and aware yet free from pain during labor and birth. It allows an exhausted mother to rest or sleep. And while an epidural’s usual effect is to slow labor, the profound relaxation they offer can sometimes put a stalled labor back on track.

However, epidurals, like all medical interventions, come with inherent risks, including the increased risk of a vacuum or forceps assisted delivery, an increased risk of an episiotomy or tear, an increased risk in a drop in blood pressure, possible nausea and itching as side effects of the narcotics, and the possibility of problems with breastfeeding. A very small percentage of mothers may experience life-threatening complications. Some mothers may also feel more anxious or stressed by all of the cords and beeps and noises associated with the epidural, and the common side effects (drop in blood pressure, difficulty breathing or swallowing) may case temporary psychological distress.

But most women experience epidurals as they are meant to be: almost complete pain relief with minimal side effects. To make sure you get the most out of your epidural and lower your risk of complications, I would suggest the following:

First, choose a care provider with a cesarean surgery rate of 15% or less. Studies show that in the hands of care providers with low rates, epidurals do not increase cesarean odds. Practitioners who have vaginal birth as a goal will have more patience and manage labor and epidurals differently than others.

Second, delay an epidural until active, progressive labor (around 5-6 cm). This will help prevent two problems: running a fever, which becomes more likely the longer the epidural is in place, and the baby persisting in the occiput posterior position (head down, facing the mother’s belly). These complications increase the likelihood of cesarean or instrumental vaginal delivery. And because epidural-related fever cannot be distinguished from fevers caused by infection, babies are more likely to be kept in the nursery for observation, undergo blood tests and possibly a spinal tap, and be given precautionary I.V. antibiotics.

Third, move every 30-60 minutes by rotating from your left to right side. If you baby is in an anterior position, keeping a pillow between your legs will be sufficient. If your baby is in a posterior position, trying extending your top leg far over the bottom leg and lie with a pillow supporting your top shoulder and arm so that you are almost lying on your belly (but obviously not fully on your belly!!) This often helps the baby to navigate the pelvis during a posterior birth.

Fourth, many mothers begin to shake and their teeth chatter as the hormones of birth, including adrenaline, fill their body. A wise midwife once showed me a way to help keep a mother “centered” during these episodes and help the shaking to stop. Place the father’s (or other support person) hand over the mother’s heart, directly on her skin, providing firm pressure over her heart chakra. Encourage the mother to draw on the strength of her partner or other support person to become centered and grounded once again and to reestablish calm and steady breathing. Keep the firm pressure of the hand over the heart for as long as needed or every time the shaking returns.

Finally, whether an epidural is Plan A or B, take classes that prepare you for coping with labor without one and consider hiring a doula. You will want a variety of comfort measures and coping strategies at your fingertips. For one thing, you may need them if you are delaying an epidural until active labor. For another, the anesthesiologist may not be available when you want your epidural, or you may be among the 1 in 10 women for whom it does not work. It is also possible that labor will turn out to be easier than you thought and you decide you don’t need one after all.

Epidurals can be a great medical tool when used wisely and with caution by mothers who are informed and supported.

Previously published in CityPages July 2014
By Sarah Paksima, BirthKuwait President Emeritus, Doula, Lamaze Childbirth Educator, Prenatal Yoga Instructor