Ethically, medical intervention has to prove itself against nature. Not the other way around. Sara Wickham on induction and the precautionary principle.
Whatever happened to the precautionary principle?
Further evidence that inducing labour in healthy women increases the chance of caesarean
Induction of labour in medically uncomplicated nulliparous women at term carries a more than doubling of risk of emergency caesarean
A bit of good news for older mums…
Good news for older mums, says Sara Wickham. A study shows that there are advantages to having babies later in life.
Assessing cervical dilatation without VEs: Watching the purple line
Not evidence that early induction of labour makes a difference in older women (35/39 trial)
The 35/39 trial: not evidence that early induction of labour makes a difference in older women. Sara Wickham analyses the findings.
Pondering placentophagy
Sara Wickham looks at the issues relating to eating placenta, or placentophagy, and a large research review of this area.
Pelvic checks at the 6-week check
Is there value in doing a vaginal or pelvic examination at the 6 week postnatal check? Sometimes, the combination of my travelling and reading of the midwifery and obstetric literature highlights variation in what is seen as standard or usual…
Unassisted birth: listening and learning from the minority
Sara Wickham discusses freebirth and women who, for one reason or another, decide to give birth without professional assistance.
On acceptance without need for cause
I had a great reminder about acceptance when I called my dad one morning, says Sara Wickham. And how we don’t always need to find the cause.
How are you sleeping?
In your midwifery practice, do you routinely ask women how they’re sleeping? And if you do, what do you do with that information?
Making a difference with birth room photos…
Sara Wickham suggests that those interested in promoting active birth could make a difference by sharing photos depicting alternatives to the delivery bed.
When the simplest ideas are the best…
Having a wrap skirt available for women is one of the most effective and simplest ways to make pelvic exam better for women.
Keeping birth normal by reducing inductions
Research shows that, for most women, having labour induced means they are two or three times more likely to have an unplanned caesarean section
Pronurturance Plus … great food for thought
What is pronurturance? And pronurturance plus? Sara Wickham looks at research which defines and explores these age-old concepts with modern names.
Being clear about continuity
Sara Wickham looks at continuity of care, and the difference between continuity of care and continuity of carer.
What’s the evidence for raspberry leaf tea?
Dissertation tip #102: don’t reference Wikipedia!
Can you reference Wikipedia in an essay or assignment? It depends whether you’re citing a band line-up or undertaking academic work, says Sara Wickham.
The most important thing women can do for themselves in the quest for a normal birth?
One of the most important things that a woman can do in order to help give herself the best chance of a straightforward normal birth with as little intervention as possible.
The Elephant Collective: a story of women’s creativity
Sara Wickham shares a bit of the story of The Elephant Collective, a group using knitting and activitism to honour and draw attention to maternal death
Dissertation tip #72 – if you get bored, get creative…
This is officially the naughtiest tip in Sara Wickham’s ‘101 dissertation tips’ book: if you get bored, get creative! Sometimes, light relief can make all the difference!
Stimulating conversation: does cold water wake babies in utero?
I describe facilitating a series of discussions about the practice of offering a woman a cold drink to encourage fetal movement or improve the reactivity of a CTG trace.
Dissertation tip #55 – Vary your language…
Vary your language when writing dissertations and essays, says Dr Sara Wickham. It will make your work more interesting to read. Click for more tips.
Dissertation tip #51 – use headings to help you find your way
This is the first of a series of posts which offer study tips and share sneaky peeks at some of the tips in my new book. It’s called 101 tips for planning, writing and surviving your dissertation. I’m going to…
Understanding dads’ experiences of birth complications…
Sara Wickham writes about dads’ experience of birth, especially when there are complications, and why they need to talk it through.
Rethinking Bugs
Sara Wickham asks whether bacteria are ‘trending’ and whether it’s a good thing that our attention is being drawn to this area.
Fundal pressure isn’t beneficial and can be dangerous
Sara Wickham discusses why fundal pressure (the Kristellar manouvre) is dangerous and should not be performed during labour and birth.
Don’t deny our experiences!
Sara Wickham writes about the importance of acknowleding someone’s lived experience. And it’s even more important not to deny it.
Cervical dilation is (now mathematically shown to be) unpredictable
Research has confirmed that, in spontaneous, naturally progressing labour, the rate of cervical dilatation is largely unpredictable.
Alien environments and the hormone of love
What do we know about alien environments and the hormone of love? Sara Wickham looks at spaceflight, oxytocin and the environment of birth.
How midwives make a difference when there’s an emergency at home…
How midwives make a difference when there’s an emergency at home. Sara Wickham shares evidence and experience.
Synthetic oxytocin: looking beyond the benefits
There is increasing concern about the downsides of synthetic oxytocin. Sara Wickham highlights some of the reasons for this concern.
Women’s experiences of cervical ripening
What do women think about cervical ripening? Sara Wickham looks at a research study which set out to find out?
Let’s be clear: labour onset is either spontaneous OR induced!
It’s important to be clear that labour is either spontaneous or induced. And to understand what those terms mean. Sara Wickham explains.
Who safeguards mothers?
Who safeguards mothers, asks Sara Wickham. Especially those who want to decline treatment for things like GBS and are treated badly as a consequence.
Who is most at risk of caesarean section?
Who is most at risk of caesarean? Sara Wickham looks at research which highlights women who may need particular protection from unnecessary surgery.
Are emergency mnemonics help(err)ful?
A duo of thought-provoking articles on risk
Sara Wickham shares and discusses a couple of research articles relating to the notion of risk.
Holistic Tensions: is west really best?
Sharing an article that Sara Wickham wrote a few years ago about holistic healing modalities. Is the western approach to research really best?
Denying ‘at risk’ women access to midwifery-led units
Why are so-called ‘at risk’ women denied access to the very places that could help reduce the chance of adverse events?
Does induction really reduce the likelihood of caesarean section?
Does induction reduce caesarean? Sara Wickham looks at two systematic reviews which claims it does, but finds that all is not as it might seem.
Choice, Liberty and Public Health
The Changing Face of A and P
The Changing Face of A and P. Sara Wickham’s poem about the changing nature of knowledge.
Home birth also safer for ‘higher risk’ women
What’s the evidence on so-called high risk home birth? Sara Wickham looks at more evidence which can help answer this question.
NZ COMCORD data adds yet more evidence of home birth safety
Sara Wickham shares more research on NZ home birth safety. Evidence shows home and primary unit settings a safe option for birthing women and their babies
Is yoga safe in the first trimester of pregnancy?
Do you have any evidence around when women can start yoga in pregnancy if they haven’t practiced before pregnancy? Sara Wickham answers.
Fathers describe home birth as magical
What do fathers think of home birth? Sara Wickham looks at a research study which set out to answer that question.
How to train your obstetrician
Sara Wickham looks at the difference between the technocratic and holistic approaches, and how we can help colleagues to be more woman-centred.
The knee-jerk effect in maternity care
Sara Wickham looks at the knee-jerk effect in maternity care. When one or two adverse outcomes lead to sweeping policy changes, often with no evidence.
Putting paradigms into perspective…
Epidural Fever
Sara Wickham looks at the research relating to ‘epidural fever’, which has considerable implications for women and babies.
Yet more evidence to help women avoid unnecessary anti-D
Researchers in the UK have taken the next step towards the introduction of a test which could help identify the rhesus negative pregnant women who are carrying a rhesus negative baby. These women would then not even need to consider…
What was the Canadian Term Breech trial?
Sara Wickham gives an overview of the Canadian Term Breech Trial and offers a number of resources for those seeking to learn more about this flawed trial.
Hands-off midwifery and the art of balance
Sara Wickham’s 2009 article on hands-off midwifery and the art of balance, which discusses topics from vaginal examination to breech birth.
Cochrane’s aphorism applied to birth and midwifery
In memory of Marsden Wagner
Questioning screening: food for thought
Are you aware that the vast majority of the things that midwives do during antenatal and postnatal checks and when looking after women in labour are actually screening tests? No matter whether we are checking a woman’s blood pressure, urine…
A recipe for knitting a hat for a baby…
Sara Wickham offers a recipe for a knitted baby hat. Includes reminders to breathe, dream and drink tea as well as the actual knitting steps.
The importance of consent: rant, rinse, repeat…
Sara Wickham looks at the concept of risk assessment in pregnancy and childbirth and asks why women aren’t being asked to consent to this.
What is cervical recoil?
What is cervical recoil, and why is it important? Sara Wickham explains why it can be normal for cervical dilation to go backwards in labour.
15 ways to knit a uterus
Sara Wickham offers links to a range of knitted uterus patterns and related crafts, all freely available online for those seeking some craft ideas!