What’s the difference between a home birth and a free birth?
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If you’re looking on social media for information and experiences of giving birth at home, you’ll find widely varied content.
On the one hand, you’ll find women who develop a relationship with their midwife over time and eventually have a “home birth” where they feel comfortable and safe.
Others choose to birth outside the medical system in a “free birth”. They might birth at home but feel compelled to forgo specialist skills and equipment.
While free births and home births sound similar, they come with very different potential risks.
What is a home birth?
Planned home births involve care from registered midwives. They care for women through the pregnancy, support them to give birth at home and continue this care for around six weeks following the birth.
Registered midwives either work privately or are employed by a hospital to provide home births.
Around 20 publicly funded home birth programs operate nationally for low-risk women who don’t live far from the hospital. Most set a maximum distance (time or kilometres) from the hospital so women can get there quickly if they need medical care or in an emergency.
Private midwives work for themselves and charge for care before, during and after a home birth. Women are able to get some money back from Medicare or through some private health funds.
Midwives are highly skilled and carry resuscitation equipment and medications to deal with emergencies, for instance, if the baby isn’t breathing or the mother is bleeding heavily.
What is a free birth?
When a woman chooses to have a free birth they make the decision to have a baby, usually at home, without a registered health professional such as a midwife or doctor in attendance. These are also called unassisted or wild births.
Those who plan a free birth may hire an unregulated birth worker or doula to support them at the birth. But they don’t have the training, regulation or medical equipment and skills needed to manage emergencies.
Women may have limited or no antenatal health care, so risk factors such as twins and breech presentations (the baby coming bottom first) aren’t detected beforehand and given the right kind of specialist care.
Free birth isn’t the same as when a baby comes too fast to make it to hospital. This is called being “born before arrival”.
How common are home births and free births?
In 2023, 97% of women give birth in hospital. Of these, three-quarters birthed in a public hospital; the rest went private.
A small proportion of women gave birth out of hospital, including in birth centres (1.5%), at home (0.7%), or in other settings (such as being before arrival at a hospital) (0.7%).
There was a slight increase in the number of home births in recent years, from 923 (0.3%) in 2019 to 2,081 (0.7%) in 2023.
It’s unclear how common free birth is, as data is not collected. But there is some evidence free births increased during the COVID pandemic and this trend has continued.
Are home births safe?
The research shows that for women with low-risk pregnancies, planned home births attended by competent midwives (with links to hospitals) are safe.
Private midwives are required to book a woman into the nearby hospital and share information with the hospital at the start of a pregnancy in case medical care is needed at any time.
Midwives across Australia follow national referral guidelines and safety and quality guidelines from the Nursing and Midwifery Board about when to consult or refer women for medical care. Around 12-35% of women who plan to give birth at home will be transferred to hospital. Some midwives can continue to care for women who need extra medical support in hospital.
Women with risk factors are recommended to not give birth at home as there is a greater chance of needing extra medical care for her or her baby. Risk factors include being pregnant with twins, having a baby in a breech position, or having high blood pressure.
For low-risk women and their babies, there is no difference in the risk of death between planned home and hospital births.
However, compared with hospital births, women who plan to give birth at home have a lower chance of having an episiotomy (a surgical cut to the perineum), a perineal tear, significant blood loss, or an infection. They are less likely to be induced, have a caesarean section, or have a forceps or vacuum delivery.
Women who have a home birth more often report positive experiences than in hospitals and tend to make the same choice for the next birth. A home birth can also be healing for women who have experienced a traumatic birth.
Why would a woman choose to have a free birth?
The main reason women choose to free birth is a previous traumatic birth or feeling coerced to make certain choices, such as being induced or having an episiotomy or caesarean section.
Sometimes, women can’t access a midwife to attend them at home. For others, the cost is prohibitive.
Others are motivated by a strong belief in their own capacity to give birth without professional support, with social media influencers impacting these decisions.
The risks of free birth are primarily are due to not having a trained midwife in attendance and the lack of skills to detect complications and transfer to a hospital, or to manage complications at home.
If you choose to birth at home, it’s important to have a registered midwife supporting you during labour to make this option as safe as possible.
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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Five Flavors & Five Benefits
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Five Flavors Of Good Health
Schisandra chinensis, henceforth Schisandra, is also called the “five flavor fruit”, for covering the culinary bases of sweet, salt, bitter, sour, and pungent.
It can be eaten as a fruit (small red berries), juiced from the fruit, or otherwise extracted into supplements (dried powder of the fruit being a common one).
It has long enjoyed usage in various traditional medicines, especially in China and Siberia.
So, what are its health claims, and how does the science stack up?
Menopause
Most of the studies are mouse studies, and we prefer studies on humans, so here’s a small (n=36) randomized clinical trial that concluded…
❝Schisandra chinensis can be a safe and effective complementary medicine for menopausal symptoms, especially for hot flushes, sweating, and heart palpitations❞
~ Dr. Joon Young Park & Dr. Kye Hyun Kim
Read more: A randomized, double-blind, placebo-controlled trial of Schisandra chinensis for menopausal symptoms
Antioxidant (and perhaps more)
Like many berries, it’s a good source of lignans offering antioxidant effects:
Antioxidant Effects of Schisandra chinensis Fruits and Their Active Constituents
Lignans usually have anticancer effects too (which is reasonably, given what is antioxidant is usually anticancer and anti-inflammatory as well, by the same mechanism) but those have not yet been studied in schisandra specifically.
Antihepatotoxicity
In other words, it’s good for your liver. At least, so animal studies tell us, because human studies haven’t been done yet for this one. The effect is largely due to its antioxidant properties, but it seems especially effective for the liver—which is not surprising, giving the liver’s regeneration mechanism.
Anyway, here’s a fascinating study that didn’t even need to use the fruit itself, just the pollen from the plant, it was that potent:
Athletics enhancer
While it’s not yet filling the shelves of sports nutrition stores, we found a small (n=45) study with healthy post-menopausal women who took either 1g of schisandra (experimental group) or 1g of starch (placebo group), measured quadriceps muscle strength and resting lactate levels over the course of a 12 week intervention period, and found:
❝Supplementation of Schisandra chinensis extract can help to improve quadriceps muscle strength as well as decrease lactate level at rest in adult women ❞
Anti-Alzheimers & Anti-Parkinsons
The studies for this are all in vitro, but that’s because it’s hard to find volunteers willing to have their brains sliced and looked at under a microscope while they’re still alive.
Nevertheless, the results are compelling, and it seems uncontroversial to say that schisandra, or specifically Schisandrin B, a compound it contains, has not only anti-inflammatory properties, but also neuroprotective properties, and specifically blocks the formation of excess amyloid-β peptides in the brain (which are critical for the formation of amyloid plaque, as found in the brains of Alzheimer’s patients):
Is it safe?
For most people, yes! Some caveats:
- As it can stimulate the uterus, it’s not recommended if you’re pregant.
- Taking more than the recommended amount can worsen symptoms of heartburn, GERD, ulcers, or other illnesses like that.
And as ever, do speak with our own doctor/pharmacist if unsure, as your circumstances may vary and we cannot cover all possibilities here.
Where can I get some?
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
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Cognitive Enhancement Without Drugs
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Cognitive Enhancement Without Drugs
This is Elizabeth Ricker. She’s a Harvard-and-MIT-trained neuroscientist and researcher, who now runs the “Citizen Science” DIY-neurohacking organization, NeuroEducate.
Sounds fun! What’s it about?
The philosophy that spurs on her research and practice can be summed up as follows:
❝I’m not going to leave my brain up to my doctor or [anyone else]… My brain is my own responsibility, and I’m going to do the best that I can to optimize it❞
Her goal is not just to optimize her own brain though; she wants to make the science accessible to everyone.
What’s this about Citizen Science?
“Citizen Science” is the idea that while there’s definitely an important role in society for career academics, science itself should be accessible to all. And, not just the conclusions, but the process too.
This can take the form of huge experiments, often facilitated these days by apps where we opt-in to allow our health metrics (for example) to be collated with many thousands of others, for science. It can also involve such things as we talked about recently, getting our own raw genetic data and “running the numbers” at home to get far more comprehensive and direct information than the genetic testing company would ever provide us.
For Ricker, her focus is on the neuroscience side of biohacking, thus, neurohacking.
I’m ready to hack my brain! Do I need a drill?
Happily not! Although… Bone drills for the skull are very convenient instruments that make it quite hard to go wrong even with minimal training. The drill bit has a little step/ledge partway down, which means you can only drill through the thickness of the skull itself, before the bone meeting the wider part of the bit stops you from accidentally drilling into the brain. Still, please don’t do this at home.
What you can do at home is a different kind of self-experimentation…
If you want to consider which things are genuinely resulting in cognitive enhancement and which things are not, you need to approach the matter like a scientist. That means going about it in an organized fashion, and recording results.
There are several ways cognitive enhancement can be measured, including:
- Learning and memory
- Executive function
- Emotional regulation
- Creative intelligence
Let’s look at each of them, and what can be done. We don’t have a lot of room here; we’re a newsletter not a book, but we’ll cover one of Ricker’s approaches for each:
Learning and memory
This one’s easy. We’re going to leverage neuroplasticity (neurons that fire together, wire together!) by simple practice, and introduce an extra element to go alongside your recall. Perhaps a scent, or a certain item of clothing. Tell yourself that clinical studies have shown that this will boost your recall. It’s true, but that’s not what’s important; what’s important is that you believe it, and bring the placebo effect to bear on your endeavors.
You can test your memory with word lists, generated randomly by AI, such as this one:
You’ll soon find your memory improving—but don’t take our word for it!
Executive function
Executive function is the aspect of your brain that tells the other parts how to work, when to work, and when to stop working. If you’ve ever spent 30 minutes thinking “I need to get up” but you were stuck in scrolling social media, that was executive dysfunction.
This can be trained using the Stroop Color and Word Test, which shows you words, specifically the names of colors, which will themselves be colored, but not necessarily in the color the word pertains to. So for example, you might be shown the word “red”, colored green. Your task is to declare either the color of the word only, ignoring the word itself, or the meaning of the word only, ignoring its appearance. It can be quite challenging, but you’ll get better quite quickly:
The Stroop Test: Online Version
Emotional Regulation
This is the ability to not blow up angrily at the person with whom you need to be diplomatic, or to refrain from laughing when you thought of something funny in a sombre situation.
It’s an important part of cognitive function, and success or failure can have quite far-reaching consequences in life. And, it can be trained too.
There’s no online widget for this one, but: when and if you’re in a position to safely* do so, think about something that normally triggers a strong unwanted emotional reaction. It doesn’t have to be something life-shattering, but just something that you feel in some way bad about. Hold this in your mind, sit with it, and practice mindfulness. The idea is to be able to hold the unpleasant idea in your mind, without becoming reactive to it, or escaping to more pleasant distractions. Build this up.
*if you perchance have PTSD, C-PTSD, or an emotional regulation disorder, you might want to talk this one through with a qualified professional first.
Creative Intelligence
Another important cognitive skill, and again, one that can be cultivated and grown.
The trick here is volume. A good, repeatable test is to think of a common object (e.g. a rock, a towel, a banana) and, within a time constraint (such as 15 minutes) list how many uses you can think of for that item.
Writer’s storytime: once upon a time, I was sorting through an inventory of medical equipment with a colleague, and suggested throwing out our old arterial clamps, as we had newer, better ones—in abundance. My colleague didn’t want to part with them, so I challenged him “Give me one use for these, something we could in some possible world use them for that the new clamps don’t do better, and we’ll keep them”. He said “Thumbscrews”, and I threw my hands up in defeat, saying “Fine!”, as he had technically fulfilled my condition.
What’s the hack to improve this one? Just more volume. Creativity, as it turns out, isn’t something we can expend—like a muscle, it grows the more we use it. And because the above test is repeatable (with different objects), you can track your progress.
And if you feel like using your grown creative muscle to write/paint/compose/etc your magnum opus, great! Or if you just want to apply it to the problem-solving of everyday life, also great!
In summary…
Our brain is a wonderful organ with many functions. Society expects us to lose these as we get older, but the simple, scientific truth is that we can not only maintain our cognitive function, but also enhance and grow it as we go.
Want to know more from today’s featured expert?
You might enjoy her book, “Smarter Tomorrow”, which we reviewed back in March
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Early exposure to air pollution could affect brain development and mental health later in life
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Exposure to air pollution in early life could have lasting effects on child development and mental health in adolescence, according to our recent study.
We integrated air pollution data with existing longitudinal data from the Christchurch Health and Development Study (CHDS). The CHDS has followed more than 1,200 children born in the city in 1977, with a strong focus on developmental and mental health outcomes.
Our aim was to examine how exposure to air pollution shapes development and mental health in later childhood and adolescence. We found an increased risk of attention problems, conduct issues, lower educational attainment and substance abuse in adolescence associated with higher exposure.
Existing evidence often focuses on adulthood. However, by tracking air pollution exposure from the prenatal period to the age of ten, and linking this data to subsequent cognitive and mental health outcomes, we were able to highlight the long-term consequences of growing up in polluted environments.
Air pollution is one of the leading environmental contributors to disease, especially respiratory and cardiovascular conditions. Children are especially vulnerable to air pollution because their brains and bodies are developing.
A growing body of evidence suggests air pollution could affect brain development, educational attainment and mental health, contributing to depression, anxiety and conduct or attention problems. Despite this, few studies have tracked long-term exposure to air pollution from early childhood.
Getty Images Patterns of exposure
We chose to conduct this research in Christchurch because the city is a historical air-pollution hotspot, with a documented history of measurements, and because of its long-running birth cohort study.
The CHDS collects detailed information on participants’ health, development, education and family backgrounds from prenatal into adulthood.
The city of Christchurch now enjoys much better air quality, but it was an air-pollution hotspot in the past. Flickr/Larry Koester, CC BY-SA For this study, we linked historical air-pollution data, measured as the concentration of black smoke from 1977 to 1987, to residential locations of birth cohort members. This allowed researchers to estimate each child’s annual exposure to air pollution during key developmental periods.
We found four distinct patterns of air-pollution exposure across childhood (see graph below):
- consistently low (these children had the lowest levels of air pollution throughout childhood)
- consistently high (this groups had the highest levels of air pollution from birth to the age of ten)
- elevated preschool (exposure peaked between ages three to six and then declined)
- high prenatal and postnatal (high exposure before and immediately after birth, but declining later).
We then examined whether children in the higher exposure groups were more likely to experience adverse impacts on cognition, educational achievement and mental health in later childhood and adolescence.
We adjusted for a range potential confounders such as socioeconomic status, neighbourhood disadvantage and parental characteristics.
We found children with elevated pre-school exposure had poorer educational attainment and a higher likelihood of conduct disorders and substance abuse problems. High prenatal and postnatal exposure was linked to a greater risk of attention problems as well as substance abuse in adolescence.
Children with persistently high air-pollution exposure were more likely to develop attention problems and had higher odds of substance abuse issues in adolescence.
Researchers identified four different trajectory patterns of exposure to air pollution from the prenatal period through to the age of ten. Author provided, CC BY-SA What these findings mean
The effects of air pollution on several outcomes were small at an individual level, but they could be highly important at a population level.
This is because even small shifts in cognitive and mental health outcomes, when applied to entire populations of children exposed to poor air quality, could have major consequences affecting future educational achievement, workforce productivity and public health burdens.
These findings support previous research suggesting air pollution could affect brain function by causing inflammation, oxidative stress and affecting neurodevelopmental pathways. Importantly, they reinforce the idea that certain developmental periods, such as the prenatal period and early childhood, may be especially sensitive to pollution exposure.
We need further research to confirm our findings but potential considerations include reducing children’s exposure to air pollution and improving urban air quality by cutting emissions from vehicles, industry and residential heating.
We should also promote cleaner energy sources to decrease exposure to harmful pollutants such as nitrogen dioxide and fine particulate matter. Providing better access to green spaces may mitigate the impact of air pollution.
To strengthen public health and policy measures, we need stricter air quality regulations, particularly around schools and childcare centres. We should also implement air-quality monitoring in urban areas to identify high-risk zones for children.
Better public information is crucial to minimise indoor and outdoor pollution exposure. This could include the use of air purifiers for indoor activies or limiting outdoor exposure during peak pollution periods.
Further research and action
Our study highlights the need for more research on air pollution’s effects on children’s mental health and cognition, particularly in different environmental and socioeconomic contexts.
Policymakers, educators and healthcare professionals must consider air pollution as a potential risk factor for developmental challenges, not just a physical health concern.
Air pollution may not be visible in the same way as poor housing or inaccessible healthcare, but its impact on child development could be important at a population level.
Given the rising prevalence of mental ill health in young people and adults, tackling air pollution could be an overlooked but essential public health strategy for protecting future generations.
Matthew Hobbs, Associate Professor and Transforming Lives Fellow in Spatial Data Science and Planetary Health, Sheffield Hallam University; Joseph Boden, Professor of Psychology, Director of the Christchurch Health and Development Study, University of Otago; Lianne Jane Woodward, Professor of Child Developmental Psychology, University of Canterbury, and Susie (Bingyu) Deng, Postdoctoral Research Associate in Health Sciences, University of Liverpool
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Flossing Without Flossing?
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Flossing Without Flossing?
You almost certainly brush your teeth. You might use mouthwash. A lot of people floss for three weeks at a time, often in January.
There are a lot of options for oral hygiene; variations of the above, and many alternatives too. This is a big topic, so rather than try to squeeze it all in one, this will be a several-part series.
The first part was: Toothpastes & Mouthwashes: Which Help And Which Harm?
How important is flossing?
Interdental cleaning is indeed pretty important, even though it may not have the heart health benefits that have been widely advertised:
However! The health of our gums is very important in and of itself, especially as we get older:
Flossing Is Associated with Improved Oral Health in Older Adults
But! It helps to avoid periodontal (e.g. gum) disease, not dental caries:
Flossing for the management of periodontal diseases and dental caries in adults
And! Most certainly it can help avoid a stack of other diseases:
Interdental Cleaning Is Associated with Decreased Oral Disease Prevalence
…so in short, if you’d like to have happy healthy teeth and gums, flossing is an important adjunct, and/but not a one-stop panacea.
Is it better to floss before or after brushing?
As you prefer. A team of scientists led by Dr. Claudia Silva studied this, and found that there was “no statistical difference between brush-floss and floss-brush”:
Flossing is tedious. How do we floss without flossing?
This is (mostly) about water-flossing! Which does for old-style floss what sonic toothbrushes to for old-style manual toothbrushes.
If you’re unfamiliar, it means using a device that basically power-washes your teeth, but with a very narrow high-pressure jet of water.
Do they work? Yes:
As for how it stacks up against traditional flossing, Liang et al. found:
❝In our previous single-outcome analysis, we concluded that interdental brushes and water jet devices rank highest for reducing gingival inflammation while toothpick and flossing rank last.
In this multioutcome Bayesian network meta-analysis with equal weight on gingival inflammation and bleeding-on-probing, the surface under the cumulative ranking curve was 0.87 for water jet devices and 0.85 for interdental brushes.
Water jet devices and interdental brushes remained the two best devices across different sets of weightings for the gingival inflammation and bleeding-on-probing. ❞
~ Journal of Evidence-Based Dental Practice
You may be wondering how safe it is if you have had dental work done, and, it appears to be quite safe, for example:
BDJ | Water-jet flossing: effect on composites
Want to try water-flossing?
Here are some examples on Amazon:
- Waterpik Complete Care 9.0 ← example of a top-end water-flossing device
- Philips Sonicare Power Flosser 3000 ← top-tier not-Waterpik-brand device
- INSMART Cordless Water Dental Flosser ← very low price and still average 4.5 star reviews, so in our opinion, a fine first choice
Bonus: if you haven’t tried interdental brushes, here’s an example for that
Enjoy!
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Eyes for Alzheimer’s Diagnosis: New?
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It’s Q&A Time!
This is the bit whereby each week, we respond to subscriber questions/requests/etc
Have something you’d like to ask us, or ask us to look into? Hit reply to any of our emails, or use the feedback widget at the bottom, and a Real Human™ will be glad to read it!
Q: As I am a retired nurse, I am always interested in new medical technology and new ways of diagnosing. I have recently heard of using the eyes to diagnose Alzheimer’s. When I did some research I didn’t find too much. I am thinking the information may be too new or I wasn’t on the right sites.
(this is in response to last week’s piece on lutein, eyes, and brain health)
We’d readily bet that the diagnostic criteria has to do with recording low levels of lutein in the eye (discernible by a visual examination of macular pigment optical density), and relying on the correlation between this and incidence of Alzheimer’s, but we’ve not seen it as a hard diagnostic tool as yet either—we’ll do some digging and let you know what we find! In the meantime, we note that the Journal of Alzheimer’s Disease (which may be of interest to you, if you’re not already subscribed) is onto this:
See also:
- Journal of Alzheimer’s Disease (mixture of free and paid content)
- Journal of Alzheimer’s Disease Reports (open access—all content is free)
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Superfood Soba Noodle Salad
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This Japanese dish is packed with nutrients and takes very little preparation time, involving only one cooked ingredient, and a healthy one at that!
You will need
- 8 oz dried soba noodles
- ½ bulb garlic, finely chopped
- 2 tbsp avocado oil
- 2 tsp soy sauce
- ¼ cucumber, cut into thin batons (don’t peel it first)
- ½ carrot, grated (don’t peel it first)
- 6 cherry tomatoes, halved (you wouldn’t peel these, right? Please don’t)
- ½ red onion, finely sliced (ok, this one you can peel first! Please do)
- 1 tbsp chia seeds
- 1 tsp crushed red chili flakes
- Garnish: fresh parsley, chopped
Method
(we suggest you read everything at least once before doing anything)
1) Cook the soba noodles (boil in water for 10 mins or until soft). Rinse with cold water (which lowers the glycemic index further, and also we want them cold anyway) and set aside.
2) Make the dressing by blending the garlic, avocado oil, and soy cauce. Set it aside.
3) Assemble the salad by thoroughly but gently mixing the noodles with the cucumber, carrot, tomatoes, and onion. Add the dressing, the chia seeds, and the chili flakes, and toss gently to combine.
4) Serve, adding the parsley garnish.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Rice vs Buckwheat – Which is Healthier? ← soba noodles are made from buckwheat, which by the way is also a good source of rutin, which can strengthen blood vessel walls against damage, reducing the risk of atheroma
- Cucumber Extract Beats Glucosamine & Chondroitin… At 1/135th Of The Dose?!
- Our Top 5 Spices: How Much Is Enough For Benefits?
- Chia: The Tiniest Seeds With The Most Value
Take care!
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