‘Free birthing’ and planned home births might sound similar but the risks are very different
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The death of premature twins in Byron Bay in an apparent “wild birth”, or free birth, last week has prompted fresh concerns about giving birth without a midwife or medical assistance.
This follows another case from Victoria this year, where a baby was born in a critical condition following a reported free birth.
It’s unclear how common free birthing is, as data is not collected, but there is some evidence free births increased during the COVID pandemic.
Planned home births also became more popular during the pandemic, as women preferred to stay away from hospitals and wanted their support people with them.
But while free births and home births might sound similar, they are a very different practice, with free births much riskier. So what’s the difference, and why might people opt for a free birth?
What are home births?
Planned home births involve care from midwives, who are registered experts in childbirth, in a woman’s home.
These registered midwives work privately, or are part of around 20 publicly funded home birth programs nationally that are attached to hospitals.
They provide care during the pregnancy, labour and birth, and in the first six weeks following the birth.
The research shows that for women with low risk pregnancies, planned home births attended by competent midwives (with links to a responsive mainstream maternity system) are safe.
Home births result in less intervention than hospital births and women perceive their experience more positively.
What are free births?
A free birth is when a woman chooses to have a baby, usually at home, without a registered health professional such as a midwife or doctor in attendance.
Different terms such as unassisted birth or wild pregnancy or birth are also used to refer to free birth.
The parents may hire an unregulated birth worker or doula to be a support at the birth but they do not have the training or medical equipment needed to manage emergencies.
Women may have limited or no health care antenatally, meaning risk factors such as twins and breech presentations (the baby coming bottom first) are not detected beforehand and given the right kind of specialist care.
Why do some people choose to free birth?
We have been studying the reasons women and their partners choose to free birth for more than a decade. We found a previous traumatic birth and/or feeling coerced into choices that are not what the woman wants were the main drivers for avoiding mainstream maternity care.
Australia’s childbirth intervention rates – for induction or augmentation of labour, episiotomy (cutting the tissue between the vaginal opening and the anus) and caesarean section – are comparatively high.
One in ten women report disrespectful or abusive care in childbirth and some decide to make different choices for future births.
Lack of options for a natural birth and birth choices such as home birth or birth centre birth also played a major role in women’s decision to free birth.
Publicly funded home birth programs have very strict criteria around who can be accepted into the program, excluding many women.
In other countries such as the United Kingdom, Netherlands and New Zealand, publicly funded home births are easier to access.
Ink Drop/Shutterstock
Only around 200 midwives provide private midwifery services for home births nationally. Private midwives are yet to obtain insurance for home births, which means they are risking their livelihoods if something goes wrong and they are sued.
The cost of a home birth with a private midwife is not covered by Medicare and only some health funds rebate some of the cost. This means women can be out of pocket A$6-8,000.
Access to home birth is an even greater issue in rural and remote Australia.
How to make mainstream care more inclusive
Many women feel constrained by their birth choices in Australia. After years of research and listening to thousands of women, it’s clear more can be done to reduce the desire to free birth.
As my co-authors and I outline in our book, Birthing Outside the System: The Canary in the Coal Mine, this can be achieved by:
- making respectful care a reality so women aren’t traumatised and alienated by maternity care and want to engage with it
- supporting midwifery care. Women are seeking more physiological and social ways of birthing, minimising birth interventions, and midwives are the experts in this space
- supporting women’s access to their chosen place of birth and model of care and not limiting choice with high out-of-pocket expenses
- providing more flexible, acceptable options for women experiencing risk factors during pregnancy and/or birth, such as having a previous caesarean birth, having twins or having a baby in breech position. Women experiencing these complications experience pressure to have a caesarean section
- getting the framework right with policies, guidelines, education, research, regulation and professional leadership.
Ensuring women’s rights and choices are informed and respected means they’re less likely to feel they’re left with no other option.
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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The How Not to Die Cookbook – by Dr. Michael Greger
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We’ve previously reviewed Dr. Greger’s “How Not To Die”, which is excellent and/but very science-dense.
This book is different, in that the science is referenced and explained throughout, but the focus is the recipes, and how to prepare delicious healthy food in accordance with the principles laid out in How Not To Die.
It also follows “Dr Greger’s Daily Dozen“, that is to say, the 12 specific things he advises we make sure to have every day, and thus helps us to include them in an easy, no-fuss fashion.
The recipes themselves are by Robin Robertson, and/but with plenty of notes by Dr Greger; they clearly collaborated closely in creating them.
The ingredients are all things one can find in any well-stocked supermarket, so unless you live in a food desert, you can make these things easily.
And yes, the foods are delicious too.
Bottom line: if you’re interested in cooking according to perhaps the most science-based dietary system out there, then this book is a top-tier choice.
Click here to check out The How Not To Die Cookbook, and live well!
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Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk?
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What’s The Deal With MSG?
There are a lot of popular beliefs about MSG. Is there a grain of truth, or should we take them with a grain of salt? We’ll leap straight into myth-busting:
MSG is high in salt
True (technically) False (practically)
- MSG is a salt (a monosodium salt of L-glutamic acid), but to call it “full of salt” in practical terms is like calling coffee “full of fruit”. (Coffee beans are botanically fruit)
- It does contain sodium, though which is what the S stands for!
- We talked previously about how MSG’s sodium content is much lower than that of (table) salt. Specifically, it’s about one third of that of sodium chloride (e.g. table salt).
MSG triggers gluten sensitivity
False!
Or at least, because this kind of absolute negative is hard to prove in science, what we can say categorically is: it does not contain gluten. We understand that the similar name can cause that confusion. However:
- Gluten is a protein, found in wheat (and thus wheat-based foods).
- Glutamate is an amino acid, found in protein-rich foods.
- If you’re thinking “but proteins are made from amino acids”, yes, they are, but the foundational amino acid of gluten is glutamine, not glutamate. Different bricks → different house!
The body can’t process MSG correctly
False!
The body has glutamate receptors throughout the gut and nervous system.
The body metabolizes glutamate from MSG just the same as from any other food that contains it naturally.
Read: Update on food safety of monosodium l-glutamate (MSG) ← evidence-based safety review
MSG causes “Chinese Restaurant Syndrome”
False!
Racism causes that. It finds its origins in what was originally intended as a satirical joke, that the papers picked up and ran with, giving it that name in the 1960s. As to why it grew and persisted, that has more to do with US politics (the US has been often at odds with China for a long time) and xenophobia (people distrust immigrants, such as those who opened restaurants), including nationalistic rhetoric associating immigrants with diseases.
Read: Xenophobia in America in the Age of Coronavirus and Beyond ← academic paper that gives quite a compact yet comprehensive overview
Research science, meanwhile, has not found any such correlation, in more than 40 years of looking.
PS: we realize this item in the list is very US-centric. Apologies to our non-US subscribers. We know that this belief isn’t so much of a thing outside the US—though it certainly can crop up elsewhere sometimes, too.
Are there any health risks associated with MSG, then?
Well, as noted, it does contain sodium, albeit much less than table salt. So… do go easy on it, all the same.
Aside from that, the LD50 (a way of measuring toxicity) of MSG is 15.8g/kg, so if for example you weigh 150lb (68 kg), don’t eat 2.2lb (a kilogram) of MSG.
There have been some studies on rats (or in one case, fruit flies) that found high doses of MSG could cause heart problems and/or promote obesity. However:
- this has not been observed to be the case in humans
- those doses were really high, ranging from 1g/kg to 8g/kg. So that’d be the equivalent of our 150lb person eating it by the cupful
- it was injected (as a solution) into the rats, not ingested by them
- so don’t let someone inject you with a cup of MSG!
Read: A review of the alleged health hazards of monosodium glutamate
Bottom line on MSG and health:
Enjoy in moderation, but enjoy if you wish! MSG is just the salt form of the amino acid glutamate, which is found naturally in many foods, including shrimp, seaweed, and tomatoes.
Scientists have spent more than 40 years trying to find health risks for MSG, and will probably keep trying (which is as science should be), but for now… Everything has either come up negative, or has been the result of injecting laboratory animals with megadoses.
If you’d like to try it in your cooking as a low-sodium way to bring out the flavor of your dishes, you can order it online. Cheapest in bulk, but try it and see if you like it first!
(I’ll be real with you… I have 5 kg in the pantry myself and use about half a teaspoon a day, cooking for two)
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How much does your phone’s blue light really delay your sleep? Relax, it’s just 2.7 minutes
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It’s one of the most pervasive messages about technology and sleep. We’re told bright, blue light from screens prevents us falling asleep easily. We’re told to avoid scrolling on our phones before bedtime or while in bed. We’re sold glasses to help filter out blue light. We put our phones on “night mode” to minimise exposure to blue light.
But what does the science actually tell us about the impact of bright, blue light and sleep? When our group of sleep experts from Sweden, Australia and Israel compared scientific studies that directly tested this, we found the overall impact was close to meaningless. Sleep was disrupted, on average, by less than three minutes.
We showed the message that blue light from screens stops you from falling asleep is essentially a myth, albeit a very convincing one.
Instead, we found a more nuanced picture about technology and sleep.
Mangostar/Shutterstock What we did
We gathered evidence from 73 independent studies with a total of 113,370 participants of all ages examining various factors that connect technology use and sleep.
We did indeed find a link between technology use and sleep, but not necessarily what you’d think.
We found that sometimes technology use can lead to poor sleep and sometimes poor sleep can lead to more technology use. In other words, the relationship between technology and sleep is complex and can go both ways.
How is technology supposed to harm sleep?
Technology is proposed to harm our sleep in a number of ways. But here’s what we found when we looked at the evidence:
- bright screen light – across 11 experimental studies, people who used a bright screen emitting blue light before bedtime fell asleep an average of only 2.7 minutes later. In some studies, people slept better after using a bright screen. When we were invited to write about this evidence further, we showed there is still no meaningful impact of bright screen light on other sleep characteristics including the total amount or quality of sleep
- arousal is a measure of whether people become more alert depending on what they’re doing on their device. Across seven studies, people who engaged in more alerting or “exciting” content (for example, video games) lost an average of only about 3.5 minutes of sleep compared to those who engaged in something less exciting (for example, TV). This tells us the content of technology alone doesn’t affect sleep as much as we think
- we found sleep disruption at night (for example, being awoken by text messages) and sleep displacement (using technology past the time that we could be sleeping) can lead to sleep loss. So while technology use was linked to less sleep in these instances, this was unrelated to being exposed to bright, blue light from screens before bedtime.
Which factors encourage more technology use?
Research we reviewed suggests people tend to use more technology at bedtime for two main reasons:
- to “fill the time” when they’re not yet sleepy. This is common for teenagers, who have a biological shift in their sleep patterns that leads to later sleep times, independent of technology use.
- to calm down negative emotions and thoughts at bedtime, for apparent stress reduction and to provide comfort.
There are also a few things that might make people more vulnerable to using technology late into the night and losing sleep.
We found people who are risk-takers or who lose track of time easily may turn off devices later and sacrifice sleep. Fear of missing out and social pressures can also encourage young people in particular to stay up later on technology.
What helps us use technology sensibly?
Last of all, we looked at protective factors, ones that can help people use technology more sensibly before bed.
The two main things we found that helped were self-control, which helps resist the short-term rewards of clicking and scrolling, and having a parent or loved one to help set bedtimes.
We found having a parent or loved one to help set bedtimes encourages sensible use of technology. fast-stock/Shutterstock Why do we blame blue light?
The blue light theory involves melatonin, a hormone that regulates sleep. During the day, we are exposed to bright, natural light that contains a high amount of blue light. This bright, blue light activates certain cells at the back of our eyes, which send signals to our brain that it’s time to be alert. But as light decreases at night, our brain starts to produce melatonin, making us feel sleepy.
It’s logical to think that artificial light from devices could interfere with the production of melatonin and so affect our sleep. But studies show it would require light levels of about 1,000-2,000 lux (a measure of the intensity of light) to have a significant impact.
Device screens emit only about 80-100 lux. At the other end of the scale, natural sunlight on a sunny day provides about 100,000 lux.
What’s the take-home message?
We know that bright light does affect sleep and alertness. However our research indicates the light from devices such as smartphones and laptops is nowhere near bright or blue enough to disrupt sleep.
There are many factors that can affect sleep, and bright, blue screen light likely isn’t one of them.
The take-home message is to understand your own sleep needs and how technology affects you. Maybe reading an e-book or scrolling on socials is fine for you, or maybe you’re too often putting the phone down way too late. Listen to your body and when you feel sleepy, turn off your device.
Chelsea Reynolds, Casual Academic/Clinical Educator and Clinical Psychologist, College of Education, Psychology and Social Work, Flinders University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Cottage Cheese vs Ricotta – Which is Healthier?
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Our Verdict
When comparing cottage cheese to ricotta, we picked the ricotta.
Why?
Cottage cheese is a famous health food, mostly for being a low-fat, low-carb, source of protein. And yet, ricotta beats it in most respects.
Looking at the macros first, cottage cheese has more carbs, while ricotta has more protein and fat. The fat profile is pretty much the same, and in both cases it’s two thirds saturated fat, which isn’t good in either case, but cottage cheese has less overall fat which means less saturated fat in total even if the percentage is the same. Because the difference in carbs and protein is not large, while ricotta has considerably more fat, we’ll call this category a win for cottage cheese.
In terms of vitamins, cottage cheese has more of vitamins B1, B5, and B12, while ricotta has more of vitamins A, B2, B3, B9, D, E, and K, so this one’s a win for ricotta.
In the category of minerals, cottage cheese has slightly more copper, while ricotta has much more calcium, iron, magnesium, manganese, potassium, selenium, and zinc. In particular, 2.5x more calcium, and 5x more iron! An easy and clear win for ricotta here.
Taking everything into account: yes, cottage cheese has less fat (and thus, in total, less saturated fat, although the percentage is the same), but that doesn’t make up for ricotta winning in pretty much every other respect. Still, enjoy either or both (in moderation!) if you be so inclined.
Want to learn more?
You might like to read:
Take care!
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Hardwiring Happiness – by Dr. Rick Hanson
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Publishers are very excitable about “the new science of…”, and it’s almost never actually a new science of. But what about in this case?
No, it isn’t. It’s the very well established science of! And that’s a good thing, because it means this book is able to draw on quite a lot of research and established understanding of how neuroplasticity works, to leverage that and provide useful guidance.
A particular strength of this book is that while it polarizes the idea that some people have “happy amygdalae” and some people have “sad amygdalae”, it acknowledges that it’s not just a fated disposition and is rather the result of the lives people have led… And then provides advice on upgrading from sad to happy, based on the assumption that the reader is quite possibly coming from a non-ideal starting point.
The bookdoes an excellent job of straddling neuroscience and psychology, which sounds like not much of a straddle (the two are surely very connected, after all, right?) but this does mean that we’re hearing about the chemical structure of DNA inside the nuclei of the neurons of the insula, not long after reading an extended gardening metaphor about growth, choices, and vulnerabilities.
Bottom line: if you’d like a guide to changing your brain for the better (happier) that’s not just “ask yourself: what if it goes well?” and similar CBTisms, then this is a fine book for you.
Click here to check out Hardwiring Happiness, and indeed hardwire happiness!
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When “Normal” Health Is Not What You Want
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝When going to sleep, I try to breathe through my nose (since everyone says that’s best). But when I wake I often find that I am breathing through my mouth. Is that normal, or should I have my nose checked out?❞
It is quite normal, but when it comes to health, “normal” does not always mean “optimal”.
- Good news: it is correctable!
- Bad news: it is correctable by what may be considered rather an extreme practice that comes with its own inconveniences and health risks.
Some people correct this by using medical tape to keep their mouth closed at night, ensuring nose-breathing. Advocates of this say that after using it for a while, nose-breathing in sleep will become automatic.
We know of no hard science to confirm this, and cannot even offer a personal anecdote on this one. Here are some pop-sci articles that do link to the (very few) studies that have been conducted:
- Mouth taping may be a trending sleep hack, but the science behind it is slim
- Mouth Taping for Sleep: Does it Work? And What are the Side Effects?
This writer’s personal approach is simply to do breathing exercises when going to sleep and first thing upon awakening, and settle for imperfection in this regard while asleep.
Meanwhile, take care!
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