When I first entered the world of natural birth I was educated to believe body weight had no effect on maternal or infant outcomes.  The organization I trained with was equally adamant that gestational weight gain was a useless measure that predicted nothing. I believed them. I made this belief a part of my life and looked the other way when I was obese for the first time in my life after my second pregnancy.  I spread this belief to other mothers, believing I was protecting them from fat shaming, from a non-evidence based health system, from the poorly researched advice they would get from otherRead More →

Progress with research is slow, and I am beginning to accept that. I don’t even mean the time it takes for research to be adopted into practice.  I’m talking about the work of creating and running a study all the way through publication of the results. Ideas come fast. Ideas have multiple possibilities.  But when the hard work of turning the idea into a legitimate study begins, pieces don’t always come together well. And sometimes they just come together slowly. Like the last 18 months…during which I began several projects that didn’t seem to be moving anywhere fast – and a dissertation that needs toRead More →

Earlier this week, the Lancet published international estimates of stillbirth rates. The conclusion of the authors was that progress in reducing stillbirth is slow. This is especially true  in my home country of the United States where stillbirth is now more prevalent than infant death. I don’t want to minimize the reality of the numbers; but I do want to acknowledge the importance of actually calculating these numbers.  Why? Because the deaths must be counted before action is taken.  It happened this way with neonatal mortality — it was ignored because there was an assumption that you couldn’t really count it.  Some brave advocates refused to acceptRead More →

The problem with epidemiological associations is the wide variety of things which may be driving them.  For example, a new study  reports an association between hospital geographic location and the variation in primary cesarean delivery rates in the United States. This phenomena is not limited to the United States, a study published in the European Journal of Public Health reports evidence of local drivers of cesarean rates. How much do all these factors matter?  In the cesarean study, almost 40% of the variation in adjusted relative risk for primary cesarean — in plain terms, these factors mattered quite a bit. The question is, what are these local drivers?Read More →

No one really believes the Friedman Curve represents timing of cervical dilation anymore.   Modern researchers have used more sophisticated techniques to identify problems with the Friedman Curve, generally about the slope of the line which represents the speed or progress of dilation. What remains from the Friedman Curve is the idea that labor has a line that can represent the normal process of dilation. This line becomes the basis of judgement of normality of labor. In some places the labor progress is charted in a partograph to allow visual comparison of the progress to the line. Decisions to intervene are made based on deviation fromRead More →

When your job is basically to write, you have to let other people read what you write. This is the worst, and best, part of writing.  This week I had to submit my draft dissertation proposal to two professors and the entire grant mock review committee. I have feedback from the two professors, and I have to admit I’m really happy with the comments.  I think this speaks to the benefit of working through to a third version with three members of my committee before sharing the draft. Those of you not in the academic community may wonder why so many eyes are helpful forRead More →

A study published in the June edition of Acta obstetricia et gynecologica Scandinavica explored fear of childbirth through maternal surveys.  While the study question was about the effect of counseling for fear of childbirth, several interesting things are revealed in the descriptive statistics (the part of the study where the researchers tell you about the individuals in the study). The authors report this counseling was generally from midwives either with or without specialized training in counseling, or from an obstetrician, and the counseling is never really described as an intervention.  For that reason we won’t dwell too much on the effects of the counseling. Out of 936 womenRead More →

Here is an opportunity for you to participate in research that helps us understand what it is like to become a mother.  Researchers at the University of Michigan are investigating the pregnancy-related experiences that are unique to sexual minorities to help minimize the effect of these stressors on prenatal and postnatal outcomes. If you are a lesbian couple, aged 18-45 and expecting your first child, they want to talk to you.  Here is a flier that provides general information: Flyer (pdf) And a few more specifics if it helps you decide: For this study, we are recruiting lesbian couples ages 18 to 45 who are expecting their first child. IfRead More →

I’ve spent the last five years learning how to interpret research, I know it isn’t easy.  I didn’t always know this.  I used to think I could read the conclusions of a paper, check out a few things and either incorporate it or ignore it.  The problem was, just like all humans, my trust in a paper was more related to how closely it resembled what I already believed than anything within the design of the study. Now when I read a paper I go through a long process of making decisions; What exactly is the research question? What theory does this study build from?Read More →