Artichoke vs Brussels Sprouts – Which is Healthier?

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Our Verdict

When comparing artichoke to Brussels sprouts, we picked the sprouts.

Why?

Finally, a vegetable that beats artichoke—after it previously beat heart-of-palm, asparagus, and even cabbage! It was still close though, which is impressive for artichoke, considering what a nutritional powerhouse Brussels sprouts are:

In terms of macros, the only meaningful difference is that artichoke has slightly more carbs and fiber, so artichoke gets the most marginal of nominal wins in this category.

In the category of vitamins, however, artichoke has more of vitamins B3, B9, and choline, while Brussels sprouts have more of vitamins A, B1, B2, B6, C, E, and K, giving sprouts the clear victory here, especially with much higher margins of difference (e.g. 58x more vitamin A, as well as 7x more vitamin C, and 10x more vitamin K).

When it comes to minerals, artichoke has more copper, magnesium, phosphorus, and zinc, while Brussels sprouts have more iron, manganese, potassium, and selenium, resulting in a 4:4 tie, and the small margins of difference are mostly comparable, with the exception that sprouts have 8x more selenium. So, Brussels sprouts win this category very marginally on that tie-breaker.

Adding up the sections we see that macros and minerals gave a small win each to artichoke and sprouts respectively, while the vitamins category was an overwhelming win for sprouts, so—with this deciding factor in mind—sprouts win the day today.

Want to learn more?

You might like to read:

Sprout Your Seeds, Grains, Beans, Etc

Enjoy!

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Recommended

  • Shredded Wheat vs Organic Crunch – Which is Healthier?
  • Grain Brain – by Dr. David Perlmutter
    Grain Brain offers a compelling case against wheat, carbs, and sugar, backed by science. A must-read for those concerned about their brain health.

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  • Why STIs Are On The Rise In Older Adults

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Three Little Words

    Sexually Transmitted Infections (STIs) are often thought of as something that predominantly plagues younger people… The truth, however, is different:

    ❝Rising divorce rates, forgoing condoms as there is no risk of pregnancy, the availability of drugs for sexual dysfunction, the large number of older adults living together in retirement communities, and the increased use of dating apps are likely to have contributed to the growing incidence of STIs in the over-50s.

    These data likely underestimate the true extent of the problem as limited access to sexual health services for the over 50s, and trying to avoid the stigma and embarrassment both on the part of older people and healthcare professionals, is leading to this age group not seeking help for STIs.❞

    ~ Dr. Justyna Kowalska

    Read more: Managing The Rise In STIs Among Older Adults

    That said, there is a gender gap when it comes to the increased risk, for example:

    ❝A retrospective study from the USA involving 420,790 couples aged 67 to 99 years, found that widowhood was associated with an increased risk of STIs in older men, but not women❞

    ~ US Dept of Health & Human Services

    Source: CDC: | Sexually Transmitted Disease Surveillance

    Is abstinence the best preventative, then?

    It is inarguably the most effective, but not necessarily the best for everyone.

    This is because for most adults, a healthy sex life is an important part of overall wellbeing.

    See also: Mythbusting The Big O

    Even in this case there is a gender gap in:

    • the level of importance placed on frequency of sexual interactions
    • what act(s) of sexuality are held to be most important:

    ❝Among sexually active men, frequent (≥2 times a month) sexual intercourse (P < .001) and frequent kissing, petting, or fondling (P < .001) were associated with greater enjoyment of life.

    Among sexually active women, frequent kissing, petting, or fondling was also associated with greater enjoyment of life (P < .001), but there was no significant association with frequent intercourse (P = .101).

    Concerns about one’s sex life and problems with sexual function were strongly associated with lower levels of enjoyment of life in men and to a lesser extent in women.❞

    ~ Dr. Lee Smith et al.

    Source: Sexual Activity is Associated with Greater Enjoyment of Life in Older Adults

    If you have the time to go into it much more deeply, this paper from the Journal of Gerontology is much more comprehensive, looking also at related lifestyle factors, religious/political backgrounds, views on monogamy or non-monogamy (of various kinds), hormonal considerations, the impact of dementia or other long-term disabilities that may affect things, widowhood, and many other elements:

    The National Social Life, Health, and Aging Project: An Introduction

    What’s the best preventative, then?

    Regular health screening for yourself and your partner(s) is an important key to preventative health when it comes to STIs.

    You can Google search for a local STI clinic, and worry not, they are invariably discreet and are well-used to everybody coming in. They’re just glad you’re being responsible about things. It’s also not their job to judge your sexual activities, even if it’s something you might have reason to wish to be secretive about, try to be honest there.

    Secondly, most of the usual advice about safe sex still goes, even when there’s no risk of pregnancy. For example, if there’s at least one penis involved, then condoms remain the #1 barrier to all manner of potential infections (we know, almost nobody likes condoms, but sometimes the truth isn’t what we want to hear).

    Lastly, if there’s at least one vagina involved, then please for the love of all that is holey, do not put anything there that could cause a yeast infection.

    What can cause a yeast infection? Pretty much anything with sugar, which includes but is not limited to:

    • Most kinds of food that Cosmo-style “liven things up in the bedroom” advice columns might suggest using (including fruit, honey, chocolate sauce, whipped cream, etc)
    • Hands that are not clean (watch out for bacteria too)
    • A mouth that has recently been eating or drinking anything with sugar in it, and that includes many kinds of alcohol, as well as milk or hot drinks that had milk in

    Yeast infections are not nearly so serious as the STIs the other measures are there to avoid, but they’re not fun either, so some sensible policies in that regard are always good!

    On a related note, see also: How To Avoid UTIs

    Recap on the single most important part of this article:

    At all ages, it remains a good health practice—unless one is absolutely celibate—to regularly get oneself and one’s partner(s) checked for STIs.

    Take care!

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  • The Vagus Nerve’s Power for Weight Loss

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Arun Dhir is a university lecturer, a gastrointestinal surgeon, an author, and a yoga and meditation instructor, and he has this to say:

    Gut feelings

    The vagus nerve is the 10th cranial nerve, also known as “vagus” (“the wanderer”), because it travels from the brain to many other body parts, including the ears, throat, heart, respiratory system, gut, pancreas, liver, and reproductive system. It’s no surprise then, that it plays a key role in brain-gut communication and metabolism regulation.

    The vagus nerve is part of the parasympathetic nervous system, responsible for rest, digestion, and counteracting the stress response. Most signals through the vagus nerve travel from the gut to the brain, though there is communication in both directions.

    You may be beginning to see how this works and its implications for weight management: the vagus nerve senses metabolites from the liver, pancreas, and small intestine, and regulates insulin production by stimulating beta cells in the pancreas, which is important for avoiding/managing insulin resistance and metabolic syndrome in general.

    Dr. Dhir cites a study in which vagus nerve stimulation (originally used for treating epilepsy and depression) was shown to cause unintentional weight loss (6-11%) in patients, revealing a link to weight management. Of course, that is quite a specific sample, so more research is needed to say for sure, but because the principle is very sound and the mechanism of action is clear, it’s not being viewed as a controversial conclusion.

    As for how get these benefits, here are seven ways:

    1. Cold water on the face: submerge your face in cold water in the morning while holding water in your mouth, or cover your face with a cold wet washcloth (while holding your breath please; no need to waterboard yourself!), which activates the “mammalian dive response” in which your body activates the parasympathetic nervous system in order to remain calm and thus survive for longer underwater
    2. Alternate hot and cold showers: switch between hot and cold water during showers for 10-second intervals; this creates eustress and activates the process of hormesis, improving your overall stress management and reducing any chronic stress response you may otherwise have going on
    3. Humming and gargling: the vibrations in the throat stimulate the nearby vagus nerve
    4. Deep breathing (pranayama): yoga breathing exercises, especially combined with somatic exercises such as the sun salutation, can stimulate the vagus nerve
    5. Intermittent fasting: helps recalibrate the metabolism and indirectly improves vagus nerve function
    6. Massage and acupressure: stimulates lymphatic channels and the vagus nerve
    7. Long walks in nature (“forest bathing”): helps trigger relaxation in general

    For more on all of this, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    The Vagus Nerve (And How You Can Make Use Of It)

    Take care!

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  • Optimism Seriously Increases Longevity!

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    Always look on the bright side for life

    ❝I’m not a pessimist; I’m a realist!❞

    ~ every pessimist ever

    To believe self-reports, the world is divided between optimists and realists. But how does your outlook measure up, really?

    Below, we’ve included a link to a test, and like most free online tests, this is offered “as-is” with the usual caveats about not being a clinical diagnostic tool, this one actually has a fair amount of scientific weight behind it:

    ❝Empirical testing has indicated the validity of the Optimism Pessimism Instrument as published in the scientific journal Current Psychology: Research and Reviews.

    The IDRlabs Optimism/Pessimism Test (IDR-OPT) was developed by IDRlabs. The IDR-OPT is based on the Optimism/Pessimism Instrument (OPI) developed by Dr. William Dember, Dr. Stephanie Martin, Dr. Mary Hummer, Dr. Steven Howe, and Dr. Richard Melton, at the University of Cincinnati.❞

    Take This Short (1–2 mins) Test

    How did you score? And what could you do to improve on that score?

    We said before that we’d do a main feature on this sometime, and today’s the day! Fits with the theme of Easter too, as for those who observe, this is a time for a celebration of hope, new beginnings, and life stepping out of the shadows.

    On which note, before we go any further, let’s look at a very big “why” of optimism…

    There have been many studies done regards optimism and health, and they generally come to the same conclusion: optimism is simply good for the health.

    Here’s an example. It’s a longitudinal study, and it followed 121,700 women (what a sample size!) for eight years. It controlled for all kinds of other lifestyle factors (especially smoking, drinking, diet, and exercise habits, as well as pre-existing medical conditions), so this wasn’t a case of “people who are healthy are more optimistic as a result. And, in the researchers’ own words…

    ❝We found strong and statistically significant associations of increasing levels of optimism with decreasing risks of mortality, including mortality due each major cause of death, such as cancer, heart disease, stroke, respiratory disease, and infection.

    Importantly, findings were maintained after close control for potential confounding factors, including sociodemographic characteristics and depression❞

    Read: Optimism and Cause-Specific Mortality: A Prospective Cohort Study

    So that’s the why. Now for the how…

    Positive thinking is not what you think it is

    A lot of people think of “think positive thoughts” as a very wishy-washy platitude, but positive thinking isn’t about ignoring what’s wrong, or burying every negative emotion.

    Rather, it is taking advantage of the basic CBT, DBT, and, for that matter, NLP principles:

    • Our feelings are driven by our thoughts
    • Our thoughts can be changed by how we frame things

    This is a lot like the idea that “there’s not such thing as bad weather; only the wrong clothes”. Clearly written by someone who’s never been in a hurricane, but by and large, the principle stands true.

    For example…

    • Most problems can be reframed as opportunities
    • Replace “I have to…” with “I get to…”
    • Will the task be arduous? It’ll be all the better looking back on it.
    • Did you fail abjectly? Be proud that you lived true to your values anyway.

    A lot of this is about focusing on what you can control. If you live your life by your values (first figure out what they are, if you haven’t already), then that will become a reassuring thing that you can always count on, no matter what.

    Practice positive self-talk (eliminate the negative)

    We often learn, usually as children, to be self deprecatory so as to not appear immodest. While modesty certainly has its place, we don’t have to trash ourselves to do that!

    There are various approaches to this, for example:

    • Replacing a self-criticism (whether it was true or not) with a neutral or positive statement that you know is true. “I suck at xyz” is just putting yourself down, “Xyz is a challenge for me” asks the question, how will you rise to it?
    • Replacing a self-criticism with irony. It doesn’t matter how dripping with sarcasm your inner voice is, the words will still be better. “Glamorous as ever!” after accidentally putting mascara in your eye. “So elegant and graceful!” after walking into furniture. And so on.

    Practice radical acceptance

    This evokes the “optimistic nihilism” approach to life. It’s perhaps not best in all scenarios, but if you’re consciously and rationally pretty sure something is going to be terrible (and/or know it’s completely outside of your control), acknowledging that possibility (or even, likelihood) cheerfully. Borrowing from the last tip, this can be done with as much irony as you find necessary. For example:

    Facing a surgery the recovery from which you know categorically will be very painful: with a big smile “Yep, I am going to be in a lot of pain, so that’s going to be fun!” (fun fact: psychological misery will not make the physical pain any less painful, so you might as well see the funny side) ← see link for additional benefits laughter can add to health-related quality of life)

    Plan for the future with love

    You know the whole “planting trees in whose shade you’ll never sit”, thing, but: actually for yourself too. Plan (and act!) now, out of love and compassion for your future self.

    Simple example: preparing (or semi-preparing, if appropriate) breakfast for yourself the night before, when you know in the morning you’ll be tired, hungry, and/or pressed for time. You’ll wake up, remember that you did that, and…

    Tip: at moments like that, take a moment to think “Thanks, past me”. (Or call yourself by your name, whatever works for you. For example I, your writer here, might say to myself “Thanks, past Nastja!”)

    This helps to build a habit of gratitude for your past self and love for your future self.

    This goes for little things like the above, but it also goes for things whereby there’s much longer-term delayed gratification, such as:

    • Healthy lifestyle changes (usually these see slow, cumulative progress)
    • Good financial strategies (usually these see slow, cumulative progress)
    • Long educational courses (usually these see slow, cumulative progress)

    Basically: pay it forward to your future self, and thank yourself later!

    Some quick ideas of systems and apps that go hard on the “long slow cumulative progress” approach that you can look back on with pride:

    • Noom—nutritional program with a psychology-based approach to help you attain and maintain your goals, long term
    • You Need A Budget—we’ve recommended it before and we’ll recommend it again. This is so good. If you click through, you can see a short explanation of what makes it so different to other budgeting apps.
    • Duolingo—the famously persistence-motivational language learning app

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Related Posts

  • Shredded Wheat vs Organic Crunch – Which is Healthier?
  • How To Heal Psoriasis Naturally

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Nutritionist Julia Davies explains the gut-skin connection (& how to use it to your advantage) in this video:

    Inside out

    Psoriasis is a chronic autoimmune skin condition, in which the skin renewal process accelerates from 28 days (normal) to 3–5 days, leading to red, scaly patches. It most commonly affects the outer joints (especially elbows & knees) but can appear anywhere, including the scalp and torso.

    Autoimmune diseases are often linked to gut barrier integrity issues, as leaky gut syndrome allows toxins/food particles to penetrate the gut lining, triggering an immune response, which means inflammation.

    Standard treatments often include topical or systemic immunosuppressants, such as steroids. Such medications suppress the immune response (and thus the symptoms) but they don’t address root causes.

    What to do about it, from the root

    As you might imagine, part of the key is a non-inflammatory (or ideally, anti-inflammatory) diet. This means starting by removing likely triggers; gluten sensitivity is common so that’s near the top of the list.

    At the very top of the list though is sugar*, which is not only pro-inflammatory but also feeds candida in the gut, which is a major driver of leaky gut, as the fungus puts its roots through your intestines (that’s as bad as it sounds).

    *as usual, sugar that comes with adequate fiber, such as whole fruit, is fine. Fruit juice, however, is not.

    It is likely to see early improvements within 6 weeks, and significant improvement (such as being mostly symptom-free) can take 6–8 months, so don’t give up if it’s day 3 and you’re not cured yet. This is a marathon not a sprint, and you’ll need to maintain things or the psoriasis may return.

    In the meantime, it is recommended to do all you reasonably can to help your gut to repair itself, which means a good amount of fiber, and occasional probiotics. Also, focusing on whole, nutrient-dense foods will of course reduce inflammation and improve energy—which can be a big deal, as psoriasis is often associated with fatigue, both because inflammation itself is exhausting (the body is very active, on a cellular level), and because a poor diet is not invigorating.

    Outside of diet, stress is often a trigger for flare-ups, so try to manage that too, of course.

    For more on all of this, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Of Brains & Breakouts: The Brain-Skin Doctor

    Take care!

    Don’t Forget…

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  • Your Brain On (And Off) Estrogen

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This is Dr. Lisa Mosconi. She’s a professor of Neuroscience in Neurology and Radiology, and is one of the 1% most influential scientists of the 21st century. That’s not a random number or an exaggeration; it has to do with citation metrics collated over 20 years:

    A standardized citation metrics author database annotated for scientific field

    What does she want us to know?

    Women’s brains age differently from men’s

    This is largely, of course, due to menopause, and as such is a generalization, but it’s a statistically safe generalization, because:

    • Most women go through menopause—and most women who don’t, avoid it by dying pre-menopause, so the aging also does not occur in those cases
    • Menopause is very rarely treated immediately—not least of all because menopause is diagnosed officially when it has been one year since one’s last period, so there’s almost always a year of “probably” first, and often numerous years, in the case of periods slowing down before stopping
    • Menopausal HRT is great, but doesn’t completely negate that menopause occurred—because of the delay in starting HRT, some damage can be done already and can take years to reverse.

    Medicated and unmedicated menopause proceed very differently from each other, and this fact has historically caused obfuscation of a lot of research into age-related neurodegeneration.

    For example, it is well-established that women get Alzheimer’s at nearly twice the rate than men do, and deteriorate more rapidly after onset, too.

    Superficially, one might conclude “estrogen is to blame” or maybe “the xx-chromosomal karyotype is to blame”.

    The opposite, however, is true with regard to estrogen—estrogen appears to be a protective factor in women’s neurological health, which is why increased neurodegeneration occurs when estrogen levels decline (for example, in menopause).

    For a full rundown on this, see:

    Alzheimer’s Sex Differences May Not Be What They Appear

    It’s not about the extra X

    Dr. Mosconi examines this in detail in her book “The XX Brain”. To summarize and oversimplify a little: the XX karyotype by itself makes no difference, or more accurately, the XY karyotype by itself makes no difference (because biologically speaking, female physiological attributes are more “default” than male ones; it is only 12,000ish* years of culture that has flipped the social script on this).

    *Why 12,000ish years? It’s because patriarchalism largely began with settled agriculture, for reasons that are fascinating but beyond the scope of this article, which is about health science, not archeology.

    The topic of “which is biologically default” is relevant, because the XY karyotype (usually) informs the body “ignore previous instructions about ovaries, and adjust slightly to make them into testes instead”, which in turn (usually) results in a testosterone-driven system instead of an estrogen-driven system. And that is what makes the difference to the brain.

    One way we can see that it’s about the hormones not the chromosomes, is in cases of androgen insensitivity syndrome, in which the natal “congratulations, it’s a girl” pronouncement may later be in conflict with the fact it turns out she had XY chromosomes all along, but the androgenic instructions never got delivered successfully, so she popped out with fairly typical female organs. And, relevantly for Dr. Mosconi, a typically female brain that will age in a typically female fashion, because it’s driven by estrogen, regardless of the Y-chromosome.

    The good news

    The good news from all of this is that while we can’t (with current science, anyway) do much about our chromosomes, we can do plenty about our hormones, and also, the results of changes in same.

    Remember, Dr. Mosconi is not an endocrinologist, nor a gynecologist, but a neurologist. As such, she makes the case for how a true interdisciplinary team for treating menopause should not confined to the narrow fields usually associated with “bikini medicine”, but should take into account that a lot of menopause-related changes are neurological in nature.

    We recently reviewed another book by Dr. Mosconi:

    The Menopause Brain – by Dr. Lisa Mosconi

    …and as we noted there, many sources will mention “brain fog” as a symptom of menopause, Dr. Mosconi can (and will) point to a shadowy patch on a brain scan and say “that’s the brain fog, there”.

    And so on, for other symptoms that are often dismissed as “all in your head”, as though that’s a perfectly acceptable place for problems to be.

    This is critical, because it’s treating real neurological things as the real things they are.

    Dr. Mosconi’s advice, beyond HRT

    Dr. Mosconi notes that brain health tends to dip during perimenopause but often recovers, showing the brain’s resilience to hormonal shifts. As such, all is not lost if for whatever reason, hormone replacement therapy isn’t a viable option for you.

    Estrogen plays a crucial role in brain energy, and women’s declining estrogen levels during menopause increase the need for antioxidants to protect brain health—something not often talked about.

    Specifically, Dr. Mosconi tells us, women need more antioxidants and have different metabolic responses to diets compared to men.*

    *Yes, even though men usually have negligible estrogen, because their body (and thus brain, being also part of their body) is running on testosterone instead, which is something that will only happen if either you are producing normal male amounts of testosterone (requires normal male testes) or you are taking normal male amounts of testosterone (requires big bottles of testosterone; this isn’t the kind of thing you can get from a low dose of testogel as sometimes prescribed as part of menopausal HRT to perk your metabolism up).

    Note: despite women being a slight majority on Earth, and despite an aging population in wealthy nations, meaning “a perimenopausal woman” is thus the statistically average person in, for example, the US, and despite the biological primacy of femaleness… Medicine still mostly looks to men as the “default person”, which in this case can result in seriously low-balled estimates of what antioxidants are needed.

    In terms of supplements, therefore, she recommends:

    • Antioxidants: key for brain health, especially in women. Rich sources include fruits (especially berries) and vegetables. Then there’s the world’s most-consumed antioxidant, which is…
    • Coffee: Italian-style espresso has the highest antioxidant power. Adding a bit of fat (e.g. oat milk) helps release caffeine more slowly, reducing jitters. Taking it alongside l-theanine also “flattens the curve” and thus improves its overall benefits.
    • Flavonoids: important for both men and women but particularly essential for women. Found in many fruits and vegetables.
    • Chocolate: dark chocolate is an excellent source of antioxidants and flavonoids!
    • Turmeric: a natural neuroprotectant with anti-inflammatory properties, best boosted by taking with black pepper, which improves absorption as well as having many great qualities of its own.
    • B Vitamins: B6, B9, and B12 are essential for anti-aging and brain health; deficiency in B6 is rare, while deficiency in B9 (folate) and especially B12 is very common later in life.
    • Vitamins C & E: important antioxidants, but caution is needed with fat-soluble vitamins to avoid toxicity.
    • Omega-3s: important for brain health; can be consumed in the diet, but supplements may be necessary.
    • Caution with zinc: zinc can support immunity and endocrine health (and thus, indirectly, brain health) but may be harmful in excess, particularly for brain health.
    • Probiotics & Prebiotics: beneficial for gut health, and in Dr. Mosconi’s opinion, hard to get sufficient amounts from diet alone.

    For more pointers, you might want to check out the MIND diet, that is to say, the “Mediterranean-DASH Intervention for Neurodegenerative Delay” upgrade to make the Mediterranean diet even brain-healthier than it is by default:

    Four Ways To Upgrade The Mediterranean Diet

    Want to know more from Dr. Mosconi?

    Here’s her TED talk:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Enjoy!

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  • Women want to see the same health provider during pregnancy, birth and beyond

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    Hazel Keedle, Western Sydney University and Hannah Dahlen, Western Sydney University

    In theory, pregnant women in Australia can choose the type of health provider they see during pregnancy, labour and after they give birth. But this is often dependent on where you live and how much you can afford in out-of-pocket costs.

    While standard public hospital care is the most common in Australia, accounting for 40.9% of births, the other main options are:

    • GP shared care, where the woman sees her GP for some appointments (15% of births)
    • midwifery continuity of care in the public system, often called midwifery group practice or caseload care, where the woman sees the same midwife of team of midwives (14%)
    • private obstetrician care (10.6%)
    • private midwifery care (1.9%).

    Given the choice, which model would women prefer?

    Our new research, published BMC Pregnancy and Childbirth, found women favoured seeing the same health provider throughout pregnancy, in labour and after they have their baby – whether that’s via midwifery group practice, a private midwife or a private obstetrician.

    Assessing strengths and limitations

    We surveyed 8,804 Australian women for the Birth Experience Study (BESt) and 2,909 provided additional comments about their model of maternity care. The respondents were representative of state and territory population breakdowns, however fewer respondents were First Nations or from culturally or linguistically diverse backgrounds.

    We analysed these comments in six categories – standard maternity care, high-risk maternity care, GP shared care, midwifery group practice, private obstetric care and private midwifery care – based on the perceived strengths and limitations for each model of care.

    Overall, we found models of care that were fragmented and didn’t provide continuity through the pregnancy, birth and postnatal period (standard care, high risk care and GP shared care) were more likely to be described negatively, with more comments about limitations than strengths.

    What women thought of standard maternity care in hospitals

    Women who experienced standard maternity care, where they saw many different health care providers, were disappointed about having to retell their story at every appointment and said they would have preferred continuity of midwifery care.

    Positive comments about this model of care were often about a midwife or doctor who went above and beyond and gave extra care within the constraints of a fragmented system.

    The model of care with the highest number of comments about limitations was high-risk maternity care. For women with pregnancy complications who have their baby in the public system, this means seeing different doctors on different days.

    Some respondents received conflicting advice from different doctors, and said the focus was on their complications instead of their pregnancy journey. One woman in high-risk care noted:

    The experience was very impersonal, their focus was my cervix, not preparing me for birth.

    Why women favoured continuity of care

    Overall, there were more positive comments about models of care that provided continuity of care: private midwifery care, private obstetric care and midwifery group practice in public hospitals.

    Women recognised the benefits of continuity and how this included informed decision-making and supported their choices.

    The model of care with the highest number of positive comments was care from a privately practising midwife. Women felt they received the “gold standard of maternity care” when they had this model. One woman described her care as:

    Extremely personable! Home visits were like having tea with a friend but very professional. Her knowledge and empathy made me feel safe and protected. She respected all of my decisions. She reminded me often that I didn’t need her help when it came to birthing my child, but she was there if I wanted it (or did need it).

    However, this is a private model of care and women need to pay for it. So there are barriers in accessing this model of care due to the cost and the small numbers working in Australia, particularly in regional, rural and remote areas, among other barriers.

    Women who had private obstetricians were also positive about their care, especially among women with medical or pregnancy complications – this type of care had the second-highest number of positive comments.

    This was followed by women who had continuity of care from midwives in the public system, which was described as respectful and supportive.

    However, one of the limitations about continuity models of care is when the woman doesn’t feel connected to her midwife or doctor. Some women who experienced this wished they had the opportunity to choose a different midwife or doctor.

    What about shared care with a GP?

    While shared care between the GP and hospital model of care is widely promoted in the public maternity care system as providing continuity, it had a similar number of negative comments to those who had fragmented standard hospital care.

    Considering there is strong evidence about the benefits of midwifery continuity of care, and this model of care appears to be most acceptable to women, it’s time to expand access so all Australian women can access continuity of care, regardless of their location or ability to pay.

    Hazel Keedle, Senior Lecturer of Midwifery, Western Sydney University and Hannah Dahlen, Professor of Midwifery, Associate Dean Research and HDR, Midwifery Discipline Leader, Western Sydney University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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