This is my favourite Chapter.
This gave me goosebumps and as I've read all his other chapters I know this means a lot to him. I'll get back to posting my own blog posts after this shameless promotion of his Podcasts but this is worth a listen.
My husband is up to Chapter 3. On his new Youtube Channel. He has also started to show his other works on his webpage https://www.midwifeart.com . Please observe this is the amended video correcting the reported sound error. Enjoy.
I'm just going to put this here for anyone who is vaguely interested. 2 for now 18 in the pipeline, apparently then a regular update. My Midwife's Beard
There is no need to add anymore than what is said from this incredible person. On notice indeed!
A review of more than 60 studies and 20 million births has found that caesarean birth is linked to a higher risk of autism spectrum disorder and attention-deficit hyperactivity disorder in kids. The international review, which includes Australian studies, shows kids have 33 per cent higher odds of developing autism spectrum disorder and 17 per cent higher odds of developing ADHD if they are born by c-section. Whether the c-section delivery was elective or emergency made almost no difference to the odds of developing these disorders. The researchers say understanding why this link might occur will be important given the increase in C-section rates.
Research link HERE:
Reaction and consideration.
The findings of this large study are significant, interesting and require consideration. However as with all research it requires scrutiny and with much research further study and investigation to clarify the findings implications.
Autism has had an association with Pre-term birth, and LSCS (Lower Segment Caesarean Section) is associated more commonly with pre-term birth to avoid physical complication or stresses upon the baby.
This is one factor that can compounded by uncorrected over view studies.
The 63 papers that contribute the body of evidence of which this association has been drawn has little reference to whether adjusted corrections have been made or considered in reference to the conclusion results. That is not to underplay the findings, they are significant and of interest but dictate clarification and further assessment.
Assoc. Prof. Jason Howitt of Swinburne University identifies concerns that some of the studies had high rates of autism not consistent with the general population and suggests heavy bias as it is " not consistent with worldwide rates of autism of between 1-3% of all birth." In some studies included in this research the rates were between 10-70%.
Professor Jeffrey Keelan acknowledges the significance of the study but that the researchers have been unable to adequately adjust for many factors that may link outcome with birthing method. He reiterates that further evaluation and research is need to clarify the findings.
Dr Alex Polyakov is a Senior Lecturer in the Department of Obstetrics and Gynaecology at The University of Melbourne and a Consultant Obstetrician, Gynaecologist and Fertility Specialist
"It is a meta-analysis which combined data from 61 studies that included more than 20 million deliveries. The authors reported a statistically significant association between caesarean delivery and autism spectrum disorders as well as ADHD. Other psychiatric disorders did not demonstrate a statistically significant association with the mode of delivery. The methods employed in meta-analysis have been criticised recently. This criticism is usually centred on the fact that a number of unrelated studies, which employed a variety of methodologies, populations and statistical analysis techniques are combined to produce a point estimate of risk. The legitimacy of such data manipulation must be questioned and its results are usually of doubtful exactitude. This can easily be demonstrated if one was to examine two largest individual studies included in the autism spectrum disorders (ADH) and ADHC meta-analysis.
A study by Curran et al was conducted in Sweden between 1982 and 2011 and used ICD-9 and ICD-10 to define ADH and examined 2,697314 deliveries, 28,290 children were diagnosed with ADH. This translates to a prevalence of ADH of 1.05% in this population. This is the largest study in this meta-analysis. The second-largest study was by Yip et al and was conducted in Norway and Finland between 1984 and 2004. It used ICD-8, 9 and 10 to define ADH and included 1,052,397 deliveries with 1,303 children being diagnosed with ADH. In this study, which is the second-largest included in this meta-analysis, the prevalence of ADH was 0.12%, approximately 10 times less than reported by Curran et al. This demonstrates the pitfalls of combining radically different studies to try to arrive at a meaningful conclusion.
The above exercise can be repeated with the ADHD portion of the article. If the two largest studies included are examined, the prevalence of ADHD in one was 2.77%, while in the second-largest sample it was 0.2%, again a tenfold difference.
What can be concluded from these discrepancies in the prevalence of the two diagnoses? Firstly, even if the final results are accepted, it is almost impossible to assess their clinical significance. A 20% increase in risk has radically different meanings, depending on the prevalence of a particular outcome. For example, a 20% jump from a baseline of 3%, will translate into 3.6%, probably a clinically significant increase, that would warrant an intervention to prevent it. On the other hand, the same 20% increase, if applied to the baseline rate of 0.2%, will result in 0.24% prevalence, which may not be as clinically troublesome and may not warrant an intervention.
Secondly, one must question the wisdom of combining such divergent studies and expecting an accurate and unbiased estimation of risk. The old saying from computer science: 'garbage in, garbage out' seems to apply, as poor quality input will invariably produce sub-optimal output.
Overall, it must be stated that both caesarean section and vaginal delivery have risks for mothers and babies. These risks are not the same and there is no consensus as to which mode of delivery is better overall. The study adds another possible risk to indiscriminate utilisation of caesarean section as the preferred mode of delivery, but it must be balanced against recognised risks of alternative delivery strategies."
Emeritus Professor Alastair MacLennan AO (head of Australian Collaborative Cerebral Palsy Research group and University of Adelaide) also identifies a cautionary overview.
"Although an interesting and controversial topic the many methodological weaknesses of this study make any conclusion very unreliable.
Firstly no realistic physiological mechanism for the weak association of autism and ADHD with mode of delivery is offered.
The studies analysed were very different (heterogeneous) and all were observational studies that do not allow for a wide variety of potential biases.
As a general rule for outcomes in observational studies to be plausibly significant the Odds Ratio (times difference) should be more than 2 and the confidence intervals should not cross one. In this study, the ASD odds ratio was only 1.33 and ADHD was only 1.17.
For all the other outcomes examined the confidence intervals crossed one meaning that there was no statistical significance."
In summary, it is a large study with an interesting and well-performed metaanalysis of neurodevelopment outcomes on an impressively large number of deliveries (over 20 million) from over 60 studies performed across 19 different countries. The central findings are that caesarean section deliveries are associated with a 33% increase in risk of autism spectrum disorder (ASD) and a 17% increase in attention-deficit/hyperactivity disorder (ADHD).
The issue is: can a casual connection and link be drawn based on the evidence? Further research is required.
Is it ok to masturbate during pregnancy?
It is generally perceived that masturbating during pregnancy is safe, in some instances it can provide health benefits, such as lowering stress and promoting blood flow.Women experience different effects on their libido whilst pregnant, their hormones have a large effect on this.
Women often wonder whether masturbating while pregnant is safe or if there are any risks. The good news is that, in most cases, it is totally safe. Dr Petrina Duncan welcomes consultation in regard to your own personal contextual consideration in this regard.
Masturbation is safe during low-risk pregnancies.In most low-risk pregnancies, masturbation is a perfectly safe way to relieve stress and manage an elevated libido. Consultation with Dr Petrina or your chosen health professional is advised. Sex toys can be utilised as long as hygeine is maintained and all toys are clean.
Wash all toys with soap and water to prevent bacteria from entering the vagina. Hands should also be clean and nails trimmed to prevent any risk of cuts or lacerations.
Are there benefits?
Masturbation, including during pregnancy, can be good for the body. Some women even report stronger or more intense orgasms while pregnant.
Some benefits of masturbation during pregnancy include:
Are there side effects?Later on in pregnancy, a woman may notice increased Braxton-Hicks contractions following an orgasm. These contractions, though sometimes uncomfortable, are nothing to worry about. There are other cramping sensations that can be associated with the post orgasmic state but these should remain mild. If they raise any concern, you should always consider contacting Dr. Petrina or your chosen health provider
Are there any risks?
There are no risks associated with masturbation for a woman having a low-risk pregnancy who has no complications or other medical issues.
When preterm labor is a risk, however, vaginal penetration — or even having an orgasm — can trigger labor. In these cases, the doctor may recommend avoiding intercourse or orgasms to lower the chances of premature delivery.
As identified above without appropriate consideration there are potential risks of infection from grazes and cuts caused by long nails.
When to avoid masturbating during pregnancy
This advise may be that a woman avoids having orgasms altogether or only refrain from vaginal penetration, for example.
The Uterine muscle contracts during orgasm. In some situations, this can trigger early labor, premature delivery, or other serious complications.
If vaginal penetration is to be avoided, masturbation or mutual masturbation with a partner can be a good alternative. However if an orgasm is contra-indicated and has been advised against then one should avoid masturbation and all other sexual activity.
If the water has broken or if there is any vaginal bleeding, refrain from masturbation and other sexual activity. Always consult your chosen health professional.
Some sexual activity is not safe during pregnancy and as with most things, whilst pregnant consultation with your chosen health professional is advised.
All content is strictly informational and should not be considered medical advice.
Two Years of Kindred. Time has flown and it has been a magnificent 2years of welcoming many people into our family as New mothers, mothers to be and mothers of mothers. Thank you to everyone within Kindred and all those that I have seen as their doctor or supported with their own personal needs. It truly is a pleasure and I look forward to many years of committed resolve to provide the best Obstetric and Gynaecological care there is. So Proud.
Before anyone says anything I know the anniversary is in February but I am just using this time to reflect, and I have been sooooooooo busy, so many babies.
For those of you that have not been watching or even been aware, there is a revolution in womens football happening. The womens world cup 2019 has been an amazing spectacle of athletic prowess and artistry. It is now at the semi final stage.
The rise of womens football is a story of realisation, belief and commitment. It is a story of empowerment and breaking constricting perceptions.
Watch this Optus advert promoting the empowerment of our sisters and daughters and be inspired...
I am not a huge football fan but I enjoy watching the games both my husband and son watch. Die hard LEEDS United fans and I have shared some time watching previous world cups with them.
But it is this world cup, where the world is listening and open to the power of womens sport.
The worlds game has recorded record audiences, over 1billion tickets sold, tv audiences inc average viewers per match of France av.10.106 million, Brazil 22 Million, Italy 7million, USA up to 40 million and England V's Norway broke the record at 7.6million viewers watching at home in England! I include the last one as my husband is religiously cheering on the 3 Lionesses (England). Viewing figures in Australia have also been the highest they ever have been and sponsors have flooded in to take advantage of the epiphany, for some, that womens football has truely arrived!
There are the detractors, the nay sayers and general dismissive individuals with their blinkered perspectives, my son was told by a peer he must be "gay" when he glowing reported some of the excellent football he had witnessed. A befuddling slur being a pubescent boy watching women play extremely athletic sport is surely the opposite, but he rises above it and sees it for what it is, ignorance. My husband defends the game online faced with short sited followers of the male game that can't open to see another beautiful facet of the sport they profess to love. But, more and more it is embraced by the football masses as another facet of this enticing game. Watch if you will the passionate display of energy, fans and players of the recent France v's USA game to see magnificence.
Why am I writing about this, because it reflects broader perceptions of women in society. I have the pleasure and honour of supporting women at all stages of their womanliness, be it reproductive or restoratively, and I never ceased to be amazed at the courage, strength and commitment of the women I meet. Perhaps I am reflecting a hope that instead of rhetoric the world is open to equality, no more, no less, equality! Free from pre-conceptual prejudice based on gender, sexuality, age, ethnicity or belief.
I am basking in my husbands undiminished support of the game he watches, blind to the gender just basking in the delights of watching football as he shouts on England with our son and daughters by his side. England play the USA on Wednesday morning at 5am and then on to the final. Whatever the score, whichever team hoists the cup aloft. Football, choice, men and women have won! Equal pay, equal rights
Petrina Duncan, Obstetrician, Gynaecologist, and mother. Writes about events, news issues and health issues.