Is it time be stopped treating childbirth like a disease?

The No. 1 reason for hospitalization in Canada is childbirth. The most commonly performed surgery in this country is the cesarean section. Those facts should give us all a case of morning sickness. And they should prompt a lot of hard questions. Is pregnancy a disease? Is a hospital really the best place to give birth? Are women ending up there by choice or by default? Is surgery actually required to deliver one in every five babies? There were 389,822 live births in Canada in 2012-13, according to Statistics Canada; there were 369,454 births in hospitals, according to the Canadian Institute for Health Information (CIHI). The balance were home births or babies born in birthing centres not located in a hospital. (Also, Statscan counts actual babies; for CIHI, multiple births – twins and up – count as a single birth.) All that to say that roughly 98 per cent of Canadian babies are born in hospitals. And virtually every baby in this country is still delivered under the supervision of a physician – either a specialist obstetrician-gynecologist or a general practitioner. Fewer than 5 per cent of births involve a midwife. Let’s face it, the vast majority of births are uncomplicated. That doesn’t mean easy – it means not requiring medical intervention. Where and how you give birth matters. It’s worth recalling the old adage: “If all you have is a hammer, everything looks like a nail.” Similarly, put a perfectly healthy pregnant woman in a hospital and she becomes a patient – someone to be monitored, sedated, drugged, “assisted,” operated on and so on. When someone is placed in an institutional setting, there is often a cascade of dubious and not-always useful interventions that occur: Shaving of pubic hair, fetal monitoring, IV drips, inducement, epidurals, forceps, episiotomy and, of course, a cesarean section. (Again, this is not to suggest that epidurals are unnecessary, and 58 per cent of women opt for one during delivery, but pain relief can be done outside the hospital, too.) There were 100,636 C-sections performed in Canada in 2012-13. Fully 23 per cent of women over 35 and 17 per cent of women under 35 delivered their babies through a surgical intervention. Does anyone seriously believe that level is justified? The World Health Organization suggests that the optimum rate is somewhere between 5 and 15 per cent. Too many C-sections are done for the sake of convenience (of the physician, rarely the patient) and out of fear. Don’t buy the “too posh to push” nonsense. Yes, an increasing number of women are “choosing” a cesarean, but when you medicalize pregnancy and labour, and don’t offer reasonable alternatives, you create uncertainty and fear. Just as troubling as the high rate of C-sections over all is the wide variability in rates around the country, ranging from 15 per cent in Quebec to 22 per cent in British Columbia. (The C-section rate in Nunavut is only 6 per cent, but high-risk pregnancies are handled out-of-territory so it’s not a fair comparison.) Yes, surgery can be lifesaving. But too much surgery is harmful. Physicians should be handling the complex, high-risk cases – women with conditions such as obesity and heart disease that compromise the pregnancy, mothers over 35 (though the risks to “older” women are debatable) etc. Most births should be handled by midwives, preferably in a home-like setting, such as a birthing centre. This is not an attempt to romanticize “natural” childbirth or a call to return to the “good old days” – because they weren’t so good. Until the last century, babies were born at home with little support, and many tragic complications for moms and babies alike. Maternal mortality fell precipitously in the 20th century, but only a small portion of those improvements were due to obstetrical interventions. We have a much higher standard of living (hence healthier mothers), we have contraception and emancipation (so the days of 17 children are mercifully behind us) and, most of all, we have better infection control, including vaccination and antiseptic environments. The greatest risks to our foremothers were infectious diseases and excessive bleeding. Those are still the biggest risks today. But they are manageable risks. In a bid to totally remove risk (which is not possible), we have made pregnancy and birth unnecessarily tedious and costly and created new risks to boot. To make our health system patient-centred, efficient and cost-effective, the aim should be to deliver appropriate care in the right place at the right time with the right health professional. Profound cultural change is required – and what better place to start than by tackling the leading cause of hospitalization and in-patient surgery. Pregnancy and birthing are part of a normal physiological process that should be celebrated. Bringing a child into the world should be beautiful and memorable, messy and magical. Why have we reduced it to a series of billable acts where moms-to-be are institutionalized and the process is unnecessarily medicalized? Mothers and their babies deserve better. Article: 15th June www.theglobeandmail.com

A gay dad's Father's Day

Becoming a father once had this dreamy quality to it. I was seven years old when I first knew the names of my future kids: Sascha, Pascal and a third that got lost in the passage of time. There was also a wife in that picture somewhere. As a kid, the concept of marriage and sexuality was nothing to be concerned with. Later, when I realized that I was gay, fatherhood became an illusion, something I knew I’d never achieve. In the 1980s, finding a boyfriend was the height of gay aspirations. Living together was really a stretch goal. That all changed, when civil unions were introduced. All of a sudden, the prospect of family moved from the realm of illusion to the land of possibility. My husband Alex and I had been thinking about becoming parents since before we met. It was a prerequisite for any future partner of mine as I had a real wish to start a family. As Alex is 12 years my junior, he felt it important to first finish his studies and get his career going before we explored our parenting options. We started slowly, with two exchange students, before finally trying to become full-time parents. We first opted for foster care. We were evaluated, probed, prodded and finally approved as foster parents just before Christmas of 2011. Yet, due to the raging homophobia still permeating society, we were never awarded a child to foster. Desperately, we resorted to surrogacy and in March last year, our son Sascha was born. Since then, we’ve been asked countless times what it means to be gay parents. It’s a difficult question. Being a “gay” parent per se does not mean much to me or my husband or even Sascha. It seems to have more of an impact on the people around us as they witness two men raising happy and healthy children. I’ve come to believe that gays as parents may result in shifting attitudes toward the LGBT community as a whole. So much of homophobia is based on fear of the unknown. The more people see LGBT families, the less they will fear us or listen to hate speech from politicians and religious leaders. Gay parenting may one day reduce prejudice, make it easier for gays to come out and for gay teens to face bullies. Every now and then, there are people out there who will frown upon seeing us with our son. We recently had such an encounter. But more and more, they are becoming the exception rather than the rule. For me, Father’s Day isn’t about getting a tie from my son (heaven forbid, as I don’t wear them). The day is to celebrate Alex and me, and our united contribution in raising our son, Sascha. Just as my dad once joined my brother and me in celebrating mom, paying to take her out to lunch and helping us make dinner and breakfast in bed, so too will we do for our boy. Happy Father’s Day, gay dads. Article 12th June 2014 www.washingtonblade.com Gay? wanting to become a dad? register as a co-parent on www.prideangel.com

Do mobile phones affect sperm and male fertility?

A review of the evidence, by the University of Exeter, suggested sperm number and movement were affected by keeping mobile phones in pockets. However, one sperm scientist said the evidence was still too sketchy and his phone was staying in his pocket. The study, published in the journal Environment International, suggested electromagnetic radiation was to blame. It analysed 10 separate studies on sperm quality involving 1,492 men. These included laboratory tests on sperm exposed to mobile phone radiation and questionnaires of men at fertility clinics. Lead researcher Dr Fiona Mathews told the BBC that all but one of the studies showed a link between mobile phone exposure and poorer sperm quality. She added: "The studies are coming out with a consistent message that sperm motility declines with exposure to mobile telephones and similarly proportion which are alive, it's about an eight percentage point fall. "I think for your average man there's certainly no need to panic, if you already know you have a potential fertility issue then it might be an additional thing to consider - just as you might change your diet - you might want to change where you keep your phone." She acknowledged criticisms from other scientists about the quality of the evidence saying she "absolutely calls for more research". Dr Mathews concluded: "This is interesting, but we're obviously not saying that everyone who carries a phone in their pocket is going to become infertile." How sperm would be damaged by mobile phones is unclear. Ideas include radio-frequency electromagnetic radiation from the phone disrupting the cycle of sperm production or damaging the DNA. Another suggestion is that heat either directly from the phone or through the radiation, may affect the sperm. 'Crazy' Dr Allan Pacey, from Sheffield University, who researches sperm, remains unconvinced, saying the quality of the evidence is poor and he would not change where he kept his phone. He told the BBC: "There has been concern for some time about whether keeping a mobile phone in a trouser pocket might affect semen quality and male fertility in some way. "There have been some crazy and alarming headlines, but, in my opinion, the studies undertaken to date have been somewhat limited in scope because they have either irradiated sperm kept in a dish or they have made assessments of men's phone habits without adequately controlling for confounding variables, such as other aspects of their lifestyle. "What we need are some properly designed epidemiological studies where mobile phone use is considered alongside other other lifestyle habits. "Until that time, I will be continuing to keep my iPhone in my right-hand trouser pocket!" Article: 10th June 2014 www.bbc.co.uk/news

Kirsty Allsopp says for women 'fertility falls off a cliff'

TV presenter Kirstie Allsopp has urged women to put off higher education and a career in favour of having children because their "fertility falls off a cliff". In a recent interview with Jeremy Paxman on BBC Newsnight, Ms Allsopp, who met her husband when she was 32 and then had two children, said: "Nature is not with you and I. Nature is not a feminist." She also encouraged women to be "more honest" with one another about their biological clock, saying the topic was still "taboo". So what is the truth about the female fertility window? Guidance from the National Institute for Health and Care Excellence (NICE), which was updated in 2013, is pretty encouraging. It says that "over 80% of couples in the general population will conceive within one year if the woman is aged under 40 years", if they have regular sexual intercourse and do not use contraception. NICE guidelines go on to state that "of those who do not conceive in the first year, about half will do so in the second year". That leaves around 10% of women - the percentage said to be affected by infertility in the UK. We know, of course, that female fertility declines with age, but is there really a dramatic drop-off at a certain point? No rule Mr Yacoub Khalaf, head of assisted reproduction at Guy's and St Thomas' Hospital in London, says it is not quite as simple as that. "It is tempting to want a black and white answer, but biology doesn't work that way. "Some women find it difficult to conceive in their late 20s, while others don't have a problem into their 40s." So there is no rule, but science tells us that a woman's body does gradually change and there is nothing that can be done to alter that process. Mr Khalaf explains that from the age of 35, the rate of depletion of the follicles in the ovaries speeds up, and from the age of 40 they start to deplete even faster. These follicles are important because they house the eggs which will develop and mature before finally being released during ovulation. Hence, the quality and quantity of a women's eggs also begins declining sharply from around the age of 35 onwards. Read more ... Article: 7th June 2014 www.bbc.co.uk For more on testing your fertility visit www.prideangel.com/shop

Pride Angel Journey | Niche Parenting

The thing with parents is, there's just so many different sorts. And no matter what efforts we made in those early weeks, it just felt as though we were trying to climb through the wrong shaped hole in the shape-sorter. We've never considered ourselves particularly 'mainstream' in any area of our lives and so some sort of 'niche' parenting was always going to suit us best. Perhaps we'd get on better with the gay parents? Keen for Luna to grow up feeling 'normal', it seemed a good idea to find some other kids for her to hang out with whose conception had involved a sperm-donor, syringe and two lesbians. As I was spending around 12-14 hours a day breastfeeding, I had plenty of time to do a bit of Internet searching. And I did manage to locate a few gay parenting groups online: pockets of same-sex parents with children of all ages keen to discuss teething and tantrums and toilet-training. However somehow, the niche just wasn't quite right. It was too big and vague - more 'spacious alcove' than 'niche.' What we needed was a niche where people actually had a new baby and did the stuff we did, the stuff the books and our instincts had told us to do, which was co-sleeping and baby-wearing and breastfeeding on demand - sometimes for hours at a time. And eventually, I stumbled upon a name for this business - Attachment Parenting. The potential for an alternative niche was developing, and sure enough I found our local AP Facebook group where we could discuss bed-guards and slings and cluster feeding to our heart's content. But I can't help thinking that really, the answer lies in the Lesbian Attachment Parenting niche. The search continues... Article: by Lindsey, West Yorkshire 5th June 2014 Read more Lesbian parenting blogs at www.prideangel.com

Parents share video: touching story of their transgender son

Ryland Whittington was born a girl but now lives as a boy. The seven-minute video explains the story of a six-year-old transgender child, Ryland Whittington, who was born a girl but, according to her parents, began insisting she was a boy as soon as she could speak. “This is my sister Brynly, and I’m her brother, Ryland,” a young Ryland can be heard saying in the video, posted last week to his family’s YouTube page. The video’s narrative explains that Ryland’s parents, Jeff and Hillary Whittington, discovered around Ryland’s first birthday that their daughter was deaf. After being fitted with cochlear implants and learning to hear and speak, some of Ryland’s first words were, “I am a boy.” The Whittingtons, who declined to comment, said they consulted with professionals and soon realized that Ryland’s desire to be a boy was more than just a tomboy phase. “With phases they just come and go or kids try things on for a little while,” San Diego-based gender therapist Darlene Tando told ABC News. “But with gender identity, when a child is transgender, typically nothing fades in or out. It just really stays the same for a long time.” The Whittingtons then made the decision to change Ryland’s identity, cutting his hair, referring to Ryland only as “he” and sending a letter to family and friends about the change. “There are huge benefits of doing this earlier in life,” said Tando. “It’s really just like they have been given this gift that everyone around them starts seeing them for who they are.” Ryland himself spoke out about his transition at an event last month in the family’s home state of California honoring the Whittington family. “My name is Ryland Michael Whittington,” he said at the 6th annual Harvey Milk Diversity Breakfast in San Diego. I’m a transgender kid. I am six. I am a cool kid.” “I am the happiest I have ever been in my whole life,” Ryland said at the breakfast. “Thank you to my parents.” Article: 2nd June 2014 www.krdo.com

Stress linked to reduced male fertility

Past research has associated stress with a number of health problems, including heart disease, asthma, obesity and depression. Now, a new study suggests stress can reduce sperm and semen quality, which could have implications for male fertility. According to the American Society for Reproductive Medicine, in around 40% of infertile couples the male partner is the sole cause or contributing cause of infertility. The main cause of male infertility is sperm abnormalities, including low sperm production or misshapen or immobile sperm. Medical conditions - such as undescended testicles or ejaculation problems - can lead to sperm abnormalities, as well as health and lifestyle factors. In this latest study - published in the journal Fertility and Sterility and led by researchers from Columbia University's Mailman School of Public Health in New York, NY, and Rutgers School of Public Health in Piscataway, NJ - the team investigated whether stress may affect sperm and semen quality. Life stress 'led to lower semen quality'To reach their findings, the researchers assessed 193 men aged 38 to 49 between 2005 and 2008. All men were a part of the Study of the Environment and Reproduction at the Kaiser Foundation Health Plan in Oakland, CA. Men who experienced two or more stressful life events in the past year had lower sperm quality than men who did not experience any stressful life events, according to researchers.As part of the study, the men were required to complete a series of tests that measured levels of stress, including that from the workplace, stressful life events and overall perceived stress. They were also required to provide semen samples. Using standard fertility testing methods, researchers from the University of California, Davis, analyzed semen concentration, and sperm shape (morphology) and movement (motility) in each sample. The researchers found that men who experienced two or more stressful life events in the past year had a lower percentage of sperm motility and a lower percentage of sperm of normal morphology, compared with men who did not experience any stressful life events. They note this finding remained even after accounting for other factors that may influence semen quality, such as age, other health problems and history of reproductive health problems. Although workplace stress did not directly affect semen quality in the men, the researchers found that those who experienced job strains had lower levels of the hormone testosterone in their semen, which could affect reproductive health. In addition, they found that regardless of the levels of stress experienced, men who were unemployed had lower semen quality than those who were employed. How can stress affect semen quality?Although the researchers are unable to pinpoint exactly how stress affects the quality of semen, they do present some theories. They say stress could activate the release of glucocorticoids - steroid hormones that affect the metabolism of carbohydrates, fats and proteins - which could reduce testosterone levels and sperm production. Furthermore, they say stress could trigger oxidative stress - physiological stress on the body caused by damage from unneutralized free radicals - which has been associated with semen quality and fertility. Commenting on the findings, first study author Teresa Janevic, PhD, an assistant professor at Rutgers School of Public Health, says: "Stress has long been identified as having an influence on health. Our research suggests that men's reproductive health may also be affected by their social environment." The researchers note that this is the first study to use subjective and objective measures of stress and, as a result, find links with reduced semen quality. In a recent spotlight feature, Medical News Today looked at whether infertility is primarily seen as woman's problem, and whether there needs to be more awareness surrounding male infertility. Article: 1st June 2014 www.medicalnewstoday.com