Ornament

The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

Ornament

Stress and Early Miscarriage

Practice Variation in Cesarean Rates: Not Due to Maternal Complications
This brief but well-referenced post analyzes cesarean rates relative to differences in maternal diagnoses or pregnancy complexity. On average, the likelihood of cesarean delivery for an individual woman varied between 19 and 48 percent across hospitals.”

Birth attendants often claim that their high cesarean rate is due to their clientele - that they provide care for a lot of high-risk clients.  This analysis shows that:

    Among lower risk women, likelihood of cesarean delivery varied between 8 and 32 percent across hospitals.
    Among higher risk women, likelihood of cesarean delivery varied between 56 and 92 percent across hospitals.
    Hospital variability did not decrease after adjusting for patient diagnoses, socio-demographics, and hospital characteristics.

This shows that practice variation in cesarean rates is real, substantive, and not just a reflection of the mother’s risk level.

Tips for Choosing a Care Provider - great overview! from Henci Goer


**** These advertisements help pay for the access to and maintenance of these web pages. ****
If you or someone you know is having a problem with alcohol during pregnancy, Rehab-international.org may have the answers you are looking
for.

**** The content may or may not meet the usual standards for these web pages. ****




Fox News Network June 3, 1997
NEW YORK: Women who log many hours at the office during the first trimester of pregnancy may have a greater risk of miscarriage compared with women who work fewer hours, a new study in lawyers suggests.

And stress may be the culprit: The more hours a woman worked, the more likely she was to report feeling stressed, although there was no direct connection between stress level and miscarriage, according to a report in the Journal of Occupational and Environmental Medicine.

"Working more than 45 hours per week on the job was a strong predictor of stress and was associated with a three-fold higher rate of miscarriage, even after taking into account other factors such as age, smoking, alcohol intake, and previous miscarriage," said lead study author Dr. Marc B. Schenker of the University of California-Davis School of Medicine in Sacramento.

Women who reported drinking seven or more alcoholic drinks a week in the first trimester had five times the risk of miscarriage.

The survey included 584 female attorneys, and compared those who worked more than 45 hours a week, about 42% of women, to lawyers who worked less than 35 hours a week, about 10% of those surveyed.

Women who were partners or associates in a law firm were more likely to report stress, as were those in criminal law and litigation. Several other factors could contribute to a stressful work environment, including "the existence of political intrigue and 'backbiting', lack of opportunity for advancement, advancement not determined by quality of work, and lack of respect by superiors," the authors wrote. Sexual harassment on the job was also widely reported in a survey conducted by the American Bar Association in 1990, the authors noted.

The results need to be confirmed by future studies. If female lawyers who suffered a miscarriage were more likely to respond to the survey, the results could be misleading. About 75 percent of the female lawyers surveyed responded to the questionnaire. The new study also relied on a woman's ability to recall events that happened sometimes months or years earlier, a method that is susceptible to errors.

However, the findings are not surprising, said Dr. Paul Rosch, president of the American Institute of Stress in Yonkers, New York.

"There are a lot of studies out that show that stress during pregnancy raises the risk of complications," he said. "There's certainly nothing new about the fact that job stress is the leading source of stress for American adults, and lawyers are particularly high on the list. And a lot of reasons for that might specifically apply to women."

However, the perception of stress is highly personal, meaning that not all people who work dozens of hours a week necessarily feel stress, said Rosch, who is also a clinical professor of medicine and psychiatry at the New York Medical College.

"For some women who enjoy it, they would feel more stressed by arbitrarily going home when they know they have work to do, so like everything else about stress there is nothing you can say that is generic," he said. "But if you certainly think the job is getting to you, and you want to have a healthy child, it's something to think about."



This Web page is referenced from another page containing related information about Miscarriage

 




SEARCH gentlebirth.org

Main Index Page of the Midwife Archives

Main page of gentlebirth.org         Mirror site

Please e-mail feedback about errors of fact, spelling, grammar or semantics. Thank you.

Permission to link to this page is hereby granted.
About the Midwife Archives / Midwife Archives Disclaimer