(Press-News.org) A McMaster University-led analysis published in the BMJ on Oct. 19, exposes high rates of injuries with forceps and vacuum delivery in Canada that have been documented for over a decade without efforts to address them.
The paper, titled Maternal and neonatal trauma during forceps and vacuum delivery must not be overlooked, was authored by perinatal epidemiologists, obstetricians, urogynecologists, community advocates and patient partners, and calls for increased recognition, transparency and action to prevent these injuries.
As part of the analysis, researchers present data from the Organisation for Economic Co-operation and Development that show that since 2010, Canada has had the highest rates of maternal trauma during forceps and vacuum deliveries when compared with other high-income countries.
The most recent data from 2019 shows Canada with the highest rate at 16.3 per cent, followed by Denmark at 12.7 per cent and the United States at 11.1 per cent.
The paper’s lead author, Giulia Muraca, an assistant professor in the Departments of Obstetrics and Gynecology and Health Research Methods, Evidence, and Impact at McMaster University explains that while benchmarking against other countries is informative, the key facts are about how this is affecting Canadians.
“More than 35,000 infants are born each year in Canada with the use of these instruments and maternal injuries are occurring at an alarming frequency. We are not doing a good enough job sharing information about these risks with pregnant people or putting enough effort into reducing them.”
Maternal trauma describes a group of injuries to the pelvis and surrounding organs that occur during childbirth, such as severe perineal and cervical lacerations. These injuries have several short- and long-term consequences, such as pelvic pain, sexual problems, and anal incontinence. One in four people sustain these injuries following forceps deliveries (25.3 per cent) and one in eight with vacuum deliveries (13.2 per cent).
“We’re calling for a national response to recognize the frequency and severity of these injuries in Canada. We have neglected to address them for far too long, and we are urging the maternity care community to make a commitment to reducing them,’” says Muraca. Similar national initiatives to reduce maternal trauma have been underway in other countries, such as the United Kingdom and Australia.
As part of the analysis, researchers worked with patients who have experienced the trauma caused by forceps and vacuum deliveries firsthand. One of those patients is Laura Ralph, who suffered a pelvic floor injury during her son’s delivery due to the use of forceps.
“I remember a cesarean delivery being discussed, but I don’t recall whether one was offered to me. I was also completely uninformed of the risks of cesarean versus forceps delivery,” Ralph said.
“I often think of that conversation about cesarean delivery and wish someone had taken a few minutes to explain the pros and cons of each potential outcome with me.”
Ralph has long-term complications as a result of her delivery. She had to use a pessary – a device inserted into the birth canal to provide support after pelvic prolapse and feared having more children because of the trauma she endured.
In the analysis, several potential reasons for these high rates of injuries are discussed, such as policies in Canada regarding labour interventions and challenges with training. However, the researchers caution against reflexive recommendations to increase training.
“If we expect these injuries to decrease by simply investing in the existing training paradigms, we run the risk of harming even more people and families, and further stigmatizing people with these injuries,” says study co-author Roxana Geoffrion, an associate professor of Obstetrics and Gynaecology at the University of British Columbia. “Efforts to change the culture around these injuries need to take precedence, including improving informed consent practices, and engendering a culture in which these injuries are acknowledged as severe, avoidable complications.”
The researchers hope the analysis will spur a national conversation about these injuries and the impacts they can have on birthing parents.
"During labour, it is often difficult to make informed split-second decisions surrounding different modes of delivery,” adds Geoffrion, whose clinical and academic practice is devoted to patients with pelvic floor disorders following childbirth trauma. “Through this research, we hope to encourage more thorough conversations between patients and their maternity care providers to establish informed consent for various modes of delivery during pregnancy and well before labour begins."
-30-
END
Toronto, ON — New research from the University of Toronto has revealed the mental health toll of the COVID-19 pandemic on older adults with peptic ulcer disease (PUD), a painful condition in which gastric sores develop in the lining of the stomach or upper portion of the small intestine.
The researchers examined a subsample of older adults from the Canadian Longitudinal Study on Aging, a national dataset of older Canadians. The sample consisted of 1,140 older adults with PUD, of whom 689 had a pre-pandemic history of depression and 451 had no history of depression. By using longitudinal data, the researchers were ...
Key takeaways:
Eating more than one weekly serving of red meat may raise type 2 diabetes risk.
Replacing red meat with plant-based protein sources, such as nuts and legumes, may reduce risk of type 2 diabetes.
Embargoed for release: Thursday, October 19, 4:00 AM ET
Boston, MA — People who eat just two servings of red meat per week may have an increased risk of developing type 2 diabetes compared to people who eat fewer servings, and the risk increases with greater consumption, according to a new study led by researchers from Harvard T.H. ...
Grouping English learners together in classrooms, a longstanding practice in schools, has no impact—positive or negative—on reading development for elementary school students, shows a new study by a team of literacy education researchers.
“When I taught middle school 20 years ago, I noticed that my English learner students were separated from their native English-speaking peers all day long,” says NYU Steinhardt associate professor Michael Kieffer, the study’s lead author. “Data show that this practice continues in many places today, ...
Arlington, Va. — October 19, 2023 — A new report published today in the American Journal of Infection Control (AJIC) demonstrates that implementing a dedicated team of nurses to assist with central line insertions can reduce patients’ risk of developing bloodstream infections due to those central lines. In this report, infection preventionists at UNC Health found that having this dedicated team reduced the proportion of central line-associated bloodstream infections occurring within ...
Scientists have discovered the deepest known evidence of coral reef bleaching, more than 90 metres below the surface of the Indian Ocean.
The damage – attributed to a 30% rise in sea temperatures caused by the Indian Ocean dipole – harmed up to 80% of the reefs in certain parts of the seabed, at depths previously thought to be resilient to ocean warming.
However, scientists say it serves as a stark warning of the harm caused in our ocean by rising ocean temperatures, and also of the hidden damage being caused throughout the natural world as a result of climate change.
The findings, highlighted in a study published ...
Of all the mammals, bats have one of the poorest fossil records, with palaeontologists estimating that about 80 per cent of it is missing.
This has made it difficult to pinpoint exactly when they first began to fly, or began roosting in caves, or developed their unique way of ‘seeing’ their surroundings in the dark using sound – called echolocation.
But a near-perfectly preserved bat’s skull discovered by French palaeontologists in a cave that dates back about 50 million years has shed new light on what we thought we knew about this ancient, ...
Many aquifers in California and around the world are being drained of their groundwater because of the combined impacts of excess pumping, shifts in land use, and climate change. However, a new study by scientists at UC Santa Cruz and UC Berkeley, published on Oct. 18 in Nature Water, may offer a solution. It describes the development and operation of a novel incentive program that uses water rebates to pay for some of the costs of getting stormwater runoff into the ground. The program is called recharge net metering (ReNeM).
Although ...
In vitro fertilization (IVF) is a time-intensive and often stress-inducing fertility procedure. Yet how does that stress impact its success? Investigators at Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, assessed the effects of anxiety and depression in men on fertility and IVF outcomes. Their findings reveal no correlation between anxiety, regardless of antidepressant use, on IVF outcomes or live birth rate. Results are published in Human Reproduction.
“Our findings indicate that despite past concerns over antidepressant medication’s ...
Niigata, Japan - A new Japanese ecological study revealed that prefecture-specific participation rates for Specific Health Checkups (SHC participation rates) had significant negative effects on prefecture-specific standardized incidence rates (SIRs) of treated ESKD and prefecture-specific prevalence of chronic kidney disease (CKD). The findings support the importance of increasing SHC participation rates at the population level and encouraging people to undergo regular health checkups.
"Japan has one of the highest incidence and ...
A 2000-year-old practice by Chinese herbalists – examining the human tongue for signs of disease – is now being embraced by computer scientists using machine learning and artificial intelligence.
Tongue diagnostic systems are fast gaining traction due to an increase in remote health monitoring worldwide, and a study by Iraqi and Australian researchers provides more evidence of the increasing accuracy of this technology to detect disease.
Engineers from Middle Technical University (MTU) in Baghdad and the University of South Australia (UniSA) used a USB web camera and computer to capture tongue ...
