Doulas In the News

​

​

"Vitamin D supplementation and optimal vitamin D levels decrease both maternal and fetal risk for complications and adverse events. Furthermore, vitamin D supplementation may ameliorate or even prevent pregnancy-related reversible bone loss in mothers"

"Training women to identify their fertile window in the menstrual cycle seems to be a reasonable first-line therapy in the management of subfertility."

"The relative cost of birth increased by up to 50% for low risk primiparous women and up to 36% for low risk multiparous women as labour interventions accumulated. An epidural was associated with a sharp increase in cost of up to 32% for some primiparous low risk women, and up to 36% for some multiparous low risk women. Private obstetric care increased the overall relative cost by 9% for primiparous low risk women and 4% for multiparous low risk women."

"This study underlines the need for better clinical evidence of the effects of epidurals and pharmacological agents introduced in labour…The magnitude of the fall in rates of unassisted vaginal birth in association with a cascade of interventions in labour and interventions at birth particularly amongst women with no identified risk markers and having their first baby."

"Labor duration and operative deliveries increased as interventions increased."

"
The routine use of intravenous fluids, restrictions on eating and drinking, continuous electronic fetal monitoring, epidural analgesia, and augmentation of labor characterize most U.S. births. The use of episiotomy is far from restrictive. These interventions disturb the normal physiology of labor and birth and restrict women’s ability to cope with labor. The result is a cascade of interventions that increase risk, including the risk of cesarean surgery, for women and babies."

“Women who received doula support had lower preterm and cesarean birth rates than Medicaid beneficiaries regionally. After adjustment for covariates, women with doula care had 22 percent lower odds of preterm birth. Cost-effectiveness analyses indicate potential savings associated with doula support… Based on associations between doula care and preterm and cesarean birth, coverage reimbursement for doula services would likely be cost saving or cost-effective for state Medicaid programs.”

“Adjusting for baseline differences, women receiving doula care were significantly more likely to have a short stage II labor, a noninstrumental vaginal delivery, and to experience onset of lactogenesis within 72 hours postpartum (timely onset of lactogenesis). Overall, 68% of women receiving doula care and 54% of women receiving standard care were breastfeeding at 6 weeks. In the subset with a prenatal stressor (n=63), the doula care group was more than twice as likely to be breastfeeding at 6 weeks (89% vs. standard care, 40%).”

"Women who received doula care had 52.9% lower odds of cesarean delivery and and 57.5% lower odds of postpartum depression/postpartum anxiety... Doulas who provided care with a clinical team that included a midwife most consistently showed a reduction in odds of cesarean delivery, regardless of the trimester when doula care was received. Women who received doula care during labor and birth, but not necessarily during pregnancy, showed a 64.7%".

"The literature demonstrates that doula support increases vaginal delivery while decreasing preterm birth and low birth weight."

“The authors support the concept of a correlation between the pineal gland and pituitary gland and hypothalamus, also because previous studies have demonstrated the presence of melatonin in follicular and peritoneal fluid. They conclude that there is a role for melatonin in the regulation of the menstrual cycle even though they have not as yet uncovered the specific mechanism.”

“Both stable circadian rhythms and cyclic melatonin availability are critical for optimal ovarian physiology and placental function. Because light exposure after darkness onset at night disrupts the master circadian clock and suppresses elevated nocturnal melatonin levels, light at night should be avoided.”

“Compared to other diseases, disease research in the reproductive system is complicated, especially in humans or females during pregnancy… OS is involved in the development of diseases of the reproductive system, and it plays the role of a double-edged sword. Second, to a large extent, OS impairs the reproductive organs, including the placenta. Third, the inflammatory environment caused by OS causes a series of signal activations in the uterus. Fourth, the connection between OS and progesterone causes the reproductive process to become obstructed.”

“Within the last decade, the synthesis of melatonin in and its functions at the level of the peripheral reproductive organs has come into better focus. Melatonin is produced at several reproductive organ sites, e.g., the oocyte, ovarian follicular cells and the placental cytotrophoblasts … free radical scavenging activity of melatonin and its metabolites, oxidative stress is reduced in all reproductive organ cells ensuring their optimal function … Oocyte damage reduces successful fertilization and the development of a healthy fetus. The findings that melatonin protects the oocyte from toxic oxygen species have implications for improving the outcome of in vitro fertilization-embryo transfer procedures… Melatonin reduces oxidative damage in the placenta and may improve hemodynamics and nutrient transfer at the placental-uterine interface. The use of melatonin to treat preeclampsia should also be considered.”

"Good quality evidence has emerged … shown that melatonin can help reduce chronic pelvic pain in women with endometriosis potentially through its effects on brain-derived neurotrophic factor and beneficial effects on sleep quality … and as a method of reducing oxidative stress and improving dyspnoea in patients with chronic obstructive pulmonary disease… Melatonin shows promise as an adjunctive therapy in the treatment of infertility. Its unique anti-oxidative characteristics and safety profile make it an ideal potential adjuvant therapy to be further investigated in well designed double blind randomised placebo-controlled trials.”

""When participants had taken personal responsibility for their own well-being during their birth journey, they enhanced the possibility of experiencing birth satisfaction. However, despite having taken personal responsibility for her own well-being, when a mother felt she was excluded from taking part in the decision making process, her sense of birth satisfaction was compromised... birth satisfaction is dependent on a number of inter-related factors which work together to enhance a mother’s perception of her birth process as a satisfying event"

"A brain region called the hypothalamus is smaller among women who use birth control pills, compared with non-users, a new study finds."

"To be vibrant, healthy women we can no longer be chained to the technology and drugs designed decades ago at a time when the hormonal functions of women were not understood. Women are amazing rhythmic creatures and require the beautiful dance of their hormones to be healthy. No woman should have a baby she doesn’t want. But knowingly putting synthetic hormones that disrupt the endocrine system into her body, destroying that rhythm and destroying fertility by removing hormones and replacing them with toxins, is simply not a reasonable option"

"... 5 percent of women tested had a gene called CYP3A7*1C that is usually active in fetuses and then switched off before birth. But some women with this gene continue to make the CYP3A7 enzyme into adulthood... "That enzyme breaks down the hormones in birth control and may put women at a higher risk of pregnancy while using contraceptives, especially lower dose methods"

"With habit changes and herbal supplements, Karchmer says, she is typically able to help women get at least 80 percent of the way towards their “ideal” period"

"As more couples worldwide face infertility problems and seek access to assisted reproduction technologies to conceive, it is essential for them to receive counselling on the importance of dietary influences and of adopting a healthy lifestyle"

"...with the “pro-fertility diet,” the more compliant a patient was, the better the result. But researchers did not see the same relationship when they evaluated women with different levels of compliance with the Mediterranean diet and their assisted reproductive technology outcomes..."

"...therapeutic power of mindfulness meditation in the context of infertility distress. It serves to integrate the evidence on the effectiveness of mindfulness-based psychological interventions to improve the emotional well-being and biological outcomes in Infertility... thus lead to reduced psychological distress and enhanced conception rates in infertility."

“...there is a well-characterized association between high intake of folic acid, polyunsaturated fats, and plant-based foods on fertility outcomes… Given the positive effect of a healthy diet on fertility outcomes… clinicians should provide counseling to improve dietary behaviors among patients”

“… cervical mucus secretions can be used as a good predictor of impending fertility… cervical mucus monitoring can become a very useful ­approach for women with unexplained subfertility… may help in offering a more patient-friendly approach within infertility centres and probably will also reduce ART-related costs for subfertile couples”

“Studies have shown an association between oral contraceptive use and risk of [chron’s disease] and menopausal hormone therapy and risk of [ulcerative colitis]… oral estrogen has been shown to modify intestinal permeability, a critical step in the pathophysiology of inflammatory bowel disease… Recent data have linked modification in the gut microbiome to endogenous levels of androgens, which are also known to be altered with exogenous hormone use and influence the development of autoimmune diseases”

“…key nutrient depletions concern folic acid, vitamins B2, B6, B12, vitamin C and E and the minerals magnesium, selenium and zinc”.

“… estimates of the prevalence of current infertility ranged from 11.5%... to 15.7%… regardless of the definition, the prevalence of current infertility has increased since the last time it was measured in Canada… factors such as obesity, smoking, alcohol use and sexually transmitted infections (STIs) have been shown to adversely affect female [fertility]… detrimental changes in these factors over time may be related to the observed increase in the prevalence of current infertility”

“Fertility charting of vaginal discharge… [to] identify the occurrence of ovulation clinically and also identify a longer window of fertility than urinary luteinizing hormone kits… may lead to higher rates of conception… likely to reduce time to conception for many couples, and also to reduce unnecessary intervention and cost.”

“Expectant mothers matched with a doula had better birth outcomes than did mothers who gave birth without involvement of a doula… doula-assisted mothers were four times less likely to have a LBW baby, two times less likely to experience a birth complication involving themselves or their baby, and significantly more likely to initiate breastfeeding... Nearly all (90.4%) of the adult mothers assisted by a doula chose to initiate breastfeeding"

"...oral contraceptives have found themselves on lists of lifestyle drugs, along with antidepressants and treatments for erectile dysfunction, smoking addiction, obesity, wrinkles, and male pattern balding... lawsuits represent women's dissatisfaction with existing methods of contraception... suggests that birth control might have something in common with another “feminine technology”... women make the best of the limited array of contraceptives and choose the one that is least unsatisfactory. Pharmaceutical companies have been content with this status quo, offering women small lifestyle add-ons to basically the same old oral contraceptives, seeking to maximize profits and minimize losses rather than to develop true innovations in birth control. Therefore, for the past 50 years, the Pill has retained the dubious honor of being the least unsatisfactory choice in contraception for American women."

"... among healthy women trying to conceive, nearly all pregnancies can be attributed to intercourse during a six-day period ending on the day of ovulation."

“… Higher pretreatment adherence to the pro-fertility diet was associated with an increased probability of live birth among women undergoing assisted reproductive technologies”

“Mind/body–based interventions have been shown to be an effective stress-management approach for the treatment of numerous physical and psychologic condition… cognitive behavior therapy, relaxation training, negative health behavior modification, and social support components… participation [in mind/body group program] was associated with increased pregnancy rates.”

“… fifty-one percent of women using hormonal birth control reported adverse effects... health providers often recommend breaks when women complain of contraceptive adverse effects “with no discussion about what else could be used in the interim”… doctors tend to default to prescribing oral contraceptives or other hormonal contraception, “but they do a poor job of acknowledging and hearing young women who say they don’t want to do that.”… family doctors are still the top source of contraceptive information, but only 54.2% [of women] consider them trustworthy"

"Doula support is highly valued by women who receive it… despite not necessarily receiving a direct benefit in pain reduction, women in this study liked doula support, wished it for a fellow patient… understanding the potential benefits and limitations of doula care is important for providers considering incorporating this service into their practice setting"

"In a nationwide prospective cohort study of more than 1 million women living in Denmark, an increased risk for first use of an antidepressant and first diagnosis of depression was found among users of different types of hormonal contraception, with the highest rates among adolescents... Use of hormonal contraception, especially among adolescents, was associated with subsequent use of antidepressants and a first diagnosis of depression, suggesting depression as a potential adverse effect of hormonal contraceptive use."