New data have changed the conclusions of the Cochrane review on vitamin D supplementation in pregnancy.
Vitamin D supplementation in pregnancy
Love, kisses and other ways of knowing…
Sara Wickham asks whether maternity care providers and those who attend births are focusing on the right things.
EFM: ubiquitous yet flawed
“EFM has become a quintessential example of the perils of adopting new medical technologies without proper study of risks and benefits,” says a Clinical Professor of Obstetrics and Gynecology.
Vaginal examination in pregnancy
“There are clearly few reasons to do vaginal exams during pregnancy,” says Nancy Wainer. But such a practice does carry risks.
Giant Breakthrough in Screening or Great Big Stressor?
Sara Wickham’s 2004 article in which she looks at the pros and cons of offering screening for the group B strep bacteria in pregnancy.
Microbiome seeding and woman-centred care
Sara Wickham discusses a woman-centred paper on vaginal seeding, whose authors highlight complex but really important elements of this conversation.
Screening and the consequences of knowledge (part three)
The third part of Sara Wickham’s article in which she discusses the consquences of knowledge gained from medical screening, which aren’t always anticipated.
Screening and the consequences of knowledge (part two)
The consequences of screening: downsides as well as advantages. Sara Wickham looks at the issues in the second part of her article on this topic.
Caseload midwifery continues to outperform standard maternity care
Sara Wickham shares links to evidence showing that caseload midwifery outperforms standard maternity care – time and time again.
Screening and the consequences of knowledge (part one)
Is it always good to know things, just because we can? Sara Wickham explores this idea in a series of blog posts about the consequences of knowledge.
Another way of helping babies with shoulder dystocia?
Sara Wickham discusses a paper on the shoulder shrug maneuver, designed to facilitate birth in cases where a baby experiences shoulder dystocia.
Prophylactic antibiotics after instrumental birth?
A large trial on prophylactic antibiotics after instrumental birth which shows that this reduces the chance of infection from one in five to one in ten.
“EFM is a waste of extremely scarce resources…”
A new paper analysing the evidence for electronic fetal monitoring shows this to be ineffective as a means of reducing cerebral palsy in sub-Saharan Africa.
Recurrent episodes of reduced fetal movement and pregnancy risk
New research from the UK has found no evidence to suggest that recurrent episodes of reduced fetal movement increase pregnancy risk.
Nutrition and the wisdom of craving
Sara Wickham’s 2005 article in which she riffs about nutritional advice, pregnancy cravings and whether there is a case for optimism…
What I knew about placental birth that my obstetrician friend didn’t…
Evidence is important, but it isn’t enough. Sara Wickham explains why we need to learn from stories as well as science.
We are all biased by what we see…
Sara Wickham looks at how we are all biased by our experiences, and how different viewpoints can develop and solidify, depending on what we see.
Women’s experiences of birthing their placenta
Australian researchers have carried out an important study looking at women’s decisions about, and experiences of birthing their placenta.
Are birth seats beneficial?
Sara Wickham looks at research which considered the relationship between birth seats and tears in healthy women.
Sharing resources with families…
Sara Wickham offers links to informative blog posts which childbirth educators and others might like to share with families.
Group B Strep Explained – now updated and available!
Sara Wickham’s updated book on Group B Strep is now available! Aims to help parents and professionals understand the issues.
A break for crafting and self-care…
The ARRIVE Trial: another perspective
Sara Wickham shares the work of an obstetrician who has added further doubt to the value of the results of the ARRIVE Trial.
A few reasons to be cautious about the idea of routinely scanning for breech presentation near term
Sara Wickham looks at the ides of routinely offering a scan to see if a baby is breech. This raises more issues than many people realise.
Three questions to ask before using a guideline
When is it appropriate to use a guideline and when is it not? The questions that we should ask before deciciding whether to use the guidance or walk away.
Obstetric cholestasis – who is really at risk?
Sara Wickham looks at new research into obstetric cholestasis, which may help determine which babies are really at risk and thus reduce over-intervention.
“Birth is the beginning of everything else.”
Does oxytocin use affect the severity of OASI symptoms?
Research shows that modifiable factors such as forceps and oxytocin may affect the severity of symptoms after obstetric anal sphincter injury.
New UK VBAC guidelines welcomed
Sara Wickham discusses the changes to the NICE guidance around vaginal birth after previous caesarean, which have been welcomed by midwives.
The language of information: obscuring choice
Sara Wickham discusses how language can be used to obscure choice, or as a tool to exercise power, often in subtle ways that aren’t easily spotted.
“We have reached the limits of the domination of Nature…”
Michel Odent suggests that we have reached the limits of the domination of nature, and describes the kind of environment needed for birth.
The trusty toilet
Sara Wickham discusses midwives’ experience of using toilets as birth stools, and looks at their effectiveness at facilitating normal birth.
You were born to do this
Potential harms of GBS screening “outweigh benefits”
A review published in the BMJ shows that universal antenatal screening for group B streptococcus may cause more harm than good.
When I am an old midwife…
Induction of labour for larger women: what are the consequences?
Sara Wickham looks at research which has analysed the consequences of induction of labour for larger women.
Update to the Cochrane review on approaches to the birth of the placenta
An updated version of the Cochrane review on Active versus expectant management for women in the third stage of labour has just been published.
Research: the hidden stories
Sara Wickham considers the hidden stories behind research, and shows how what goes on behind the scenes can influence a study’s results.
Places of trust and “a velvet ear”
Wimyn need wimyn’s circles, says Sister MorningStar. Places of trust, honesty, innate community building, storytelling and the passing on of wisdom.
Body wisdom: detecting birth by smell (part 2)
Sara Wickham discusses the experience of midwives who can smell when birth is imminent (part 2).
Body wisdom: detecting birth by smell (part 1)
Risk: the game of life
Sara Wickham considers women who decline to accept the “high-risk” label applied by risk-focused caregivers and make the decisions that are right for them.
More evidence on why women are dissatisfied after induction of labour
Sara Wickham writes about research looking at why some women dislike induction of labour. Delays and a lack of information are key issues.
The value of leaving the umbilical cord intact
A summary of the advantages of leaving the umbilical cord intact for longer after birth.
The myth of the aging placenta
Sara Wickham recommends a resource discussing the myth of the aging placenta and adds her own thoughts to the discussion.
How do women feel about induction of labour for post-term pregnancy?
What are women’s feelings about induction of labour for post-term pregnancy? Sara Wickham looks at research which asked this very question.
“No room for complacency…”
“No amount of resilience training, and telling us to be kind and compassionate, will address the serious and undermining deep-rooted challenges…”
My eight favourite blog posts of 2018
Sara Wickham revisits her favourite and most popular blog posts from 2018. Includes book announcements, induction research and shoelaces!
The language of the complicated
Sara Wickham discusses how our languages focuses more on complication and risk than normality, and considers how this might affect women.
In celebration of plateaus
In celebration of plateaus; Sara Wickham quotes from Elizabeth Davis’ wonderful article on plateaus, in which she compares how these occur in birth and sex.
Why some research results are more likely to be published than others
A Cochrane review confirms that some research results are more likely to get published than others; one reason why evidence isn’t as reliable as we’d like.
Word-thought for the day: replacing risk with chance
Midwifery care is shown to lead to better outcomes (again)
Another study has shown that receiving pregnancy care from a midwife can reduce the chance of having problems, says Sara Wickham.
Bring back the bed bath?
Sara Wickham discusses the practice of midwives offering a bed bath to a woman who has just given birth, and the value of this.
Positive benefits of physiological birth
Sara Wickham highlights a research study showing the transformative benefits of physiological birth; an ’empowering journey for women’.
Your birth: stories from midwifery-led areas
Sara Wickham reviews the book, “Your birth: stories from midwifery-led areas”, a project about women’s stories led by a midwife from Wales.
Induction of labour: the gap between theory and reality
Research into women’s experiences of induction of labour show a big gap between what women need and want and the reality of what they experience.
Oxytocin-related resources
Sara Wickham provides a guide to the oxytocin-related resources available on her website. Benefits of physiology and information about synthetic oxytocin.
Routine early induction in healthy women not supported by evidence
Research looking at the effects of early induction of labour shows this is associated with few beneficial outcomes and several adverse outcomes.
Is it any wonder? Enough of the body shaming…
Enough of the body shaming, says Sara Wickham. Is it any wonder that many women don’t know how to trust their bodies or decisions?