Podcasts about preterm

Understanding Unicornuate Uterus: What It Is, Prevalence, Risks, and a Positive Outlook A unicornuate uterus is a rare congenital condition where the uterus develops with only one half, or "horn," instead of the typical two-horned shape of a normal uterus. This happens during fetal development when one of the Müllerian ducts, which form the uterus, fails to develop fully. As a result, the uterus is smaller, has only one functioning fallopian tube, and may or may not have a rudimentary horn (a small, underdeveloped second horn). This condition falls under the category of Müllerian duct anomalies, which affect the female reproductive tract. For those diagnosed, understanding the condition, its implications, and the potential for a healthy pregnancy can provide reassurance and hope.   What Is a Unicornuate Uterus? The uterus typically forms as a pear-shaped organ with two symmetrical halves that fuse during fetal development. In a unicornuate uterus, only one half develops fully, creating a smaller-than-average uterine cavity. This anomaly can occur with or without a rudimentary horn, which may or may not be connected to the main uterine cavity. If a rudimentary horn is present, it might cause complications like pain if it accumulates menstrual blood, as it often lacks a connection to the cervix or vagina. The condition is often diagnosed during routine imaging, such as an ultrasound, MRI, or hysterosalpingogram (HSG), typically when a woman seeks medical advice for fertility issues, pelvic pain, or irregular menstruation. In some cases, it's discovered incidentally during pregnancy or unrelated medical evaluations.   How Prevalent Is It? Unicornuate uterus is one of the rarest Müllerian duct anomalies, occurring in approximately 0.1% to 0.4% of women in the general population. Among women with Müllerian anomalies, it accounts for about 2% to 13% of cases. The condition is congenital, meaning it's present at birth, but it often goes undiagnosed until adulthood because many women experience no symptoms. Its rarity can make it feel isolating for those diagnosed, but awareness and medical advancements have made it easier to manage and understand. Risks Associated with Unicornuate Uterus While many women with a unicornuate uterus lead healthy lives, the condition can pose challenges, particularly related to fertility and pregnancy. The smaller uterine cavity and reduced endometrial surface area can increase the risk of certain complications, though these are not inevitable. Below are some potential risks: Fertility Challenges: The smaller uterus and single fallopian tube may slightly reduce the chances of conception, especially if the rudimentary horn or other structural issues interfere with ovulation or implantation. However, many women with a unicornuate uterus conceive naturally without intervention. Miscarriage: The limited space in the uterine cavity can increase the risk of miscarriage, particularly in the first trimester. Studies suggest miscarriage rates may be higher (around 20-30%) compared to women with a typical uterus, though exact figures vary. Preterm Birth: The smaller uterus may not accommodate a growing fetus as easily, potentially leading to preterm labor or delivery before 37 weeks. Research indicates preterm birth rates in women with a unicornuate uterus range from 10-20%. Fetal Growth Restriction: The restricted uterine space can sometimes limit fetal growth, leading to low birth weight or intrauterine growth restriction (IUGR). Malpresentation: Babies in a unicornuate uterus may be more likely to position themselves in a breech or transverse position due to the confined space, which could complicate delivery. Cesarean Section: While not mandatory, a cesarean may be recommended in cases of malpresentation, preterm labor, or other complications. However, this is not a universal requirement. Other Complications: Women with a unicornuate uterus may have a higher risk of endometriosis or painful periods, especially if a non-communicating rudimentary horn is present. Kidney abnormalities are also associated with Müllerian anomalies, as the kidneys and reproductive tract develop simultaneously in the fetus. Despite these risks, it's critical to note that not every woman with a unicornuate uterus will experience these complications. With proper medical care, many achieve successful pregnancies and deliveries.   A Positive Outlook: Normal Vaginal Delivery Is Probable The diagnosis of a unicornuate uterus can feel daunting, but it's important to emphasize that a healthy, full-term pregnancy and a normal vaginal delivery are entirely possible. Advances in obstetrics and prenatal care have significantly improved outcomes for women with this condition. Here's why you can remain optimistic: Personalized Care: Working with an experienced obstetrician or maternal-fetal medicine specialist ensures close monitoring throughout pregnancy. Regular ultrasounds can track fetal growth, position, and amniotic fluid levels, allowing for timely interventions if needed. Not Doomed to Cesarean: While some women may need a cesarean due to specific complications, many with a unicornuate uterus deliver vaginally without issue. The decision depends on factors like fetal position, labor progression, and overall health, not the uterine anomaly alone. Full-Term Pregnancies Are Achievable: With careful monitoring, many women carry their pregnancies to term (37-40 weeks). Preterm birth is a risk, but it's not a certainty, and modern neonatal care can support babies born slightly early if needed. Healthy Babies: Countless women with a unicornuate uterus give birth to healthy, thriving babies. The condition does not inherently affect the baby's development or genetic health. Support and Advocacy: Connecting with others who have similar experiences, whether through online communities or support groups, can provide emotional strength and practical advice. Knowing you're not alone can make all the difference. A unicornuate uterus is a rare but manageable condition that requires awareness and, in some cases, specialized care. While there are risks to consider, they are not insurmountable, and many women with this anomaly experience successful pregnancies and vaginal deliveries without complications. With the right support, you can embrace your unique journey, knowing that a unicornuate uterus does not mean you're destined for preterm birth, cesarean delivery, or pregnancy complications. Instead, it's a testament to your resilience and the incredible capabilities of modern medicine to support you every step of the way.   Connect With Us: YouTube: Dive deeper into pregnancy tips and stories atyoutube.com/maternalresources . Instagram: Follow us for daily inspiration and updates at @maternalresources . Facebook: Join our community at facebook.com/IntegrativeOB Tiktok: NatureBack Doc on TikTok Grab Our Book! Check out The NatureBack Method for Birth—your guide to a empowered pregnancy and delivery. Shop now at naturebackbook.myshopify.com .    

Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from April 26-May 2, 2025.

How do we lower the amount of preterm or low weight births? Dongqing Wang, Assistant Professor in the Department of Global and Community Health at George Mason University's College of Public Health, examines one solution. Dongqing Wang is an Assistant Professor in the Department of Global and Community Health. Wang's research focuses on the nutritional […]

This Earth Sunday, we celebrate not God's gift of the earth to us, but God's gift to us of our interconnected relationship with the earth, God's wider, deeper, higher, and altogether “very good” creation of which we are a part. Our guest preacher will be The Rev. Dr. Chris Davies, one of the executive ministers of our Southern New England Conference of our United Church of Christ denominational family… and an avid beekeeper! She will share with us spiritual lessons for our current moment she's gleaned from caring for bees and the way bees care for each other.About our guest preacher:  The Rev. Dr. Chris Davies is a Celtic spiritualist, Christ-follower, organizer, queer femme, visionary, beekeeper, and liturgist.  An ordained minister in the United Church of Christ, she loves faith deeply, and is committed to finding ways to continue to bring the gospel into the world, past this generation and into those to follow.  Chris attended Smith College for her undergrad work and Andover Newton for both a Masters of Divinity and Doctor of Ministry, focusing on queering proclamation.  She is passionate about justice and Jesus, works as the Executive Minister of Programs and Initiatives in the Southern New England Conference of the UCC.  Chris serves on the foundation board of Preterm, an independent abortion Clinic in Cleveland, OH.Join us for worship Sundays @ 10am EDT, on-site & online via Zoom. Connect at www.NeedhamUCC.org—-The Congregational Church of Needham strives to be a justice-seeking, peace-making, LGBTQ+ affirming, radically inclusive congregation of the United Church of Christ in Needham, MA. www.NeedhamUCC.orgChurch is the practice.Love is the point.

Send us a textLung Recruitment Before Surfactant Administration in Extremely Preterm Neonates: 2-Year Follow-Up of a Randomized Clinical Trial.Gallini F, De Rose DU, Iuliano R, Romeo DM, Tana M, Paladini A, Fusco FP, Nobile S, Cota F, Tirone C, Aurilia C, Lio A, Esposito A, Costa S, D'Andrea V, Ventura ML, Carnielli V, Dani C, Mosca F, Fumagalli M, Scarpelli G, Giordano L, Fasolato V, Petrillo F, Betta P, Solinas A, Gitto E, Gargano G, Mescoli G, Martinelli S, Di Fabio S, Bernardo I, Tina LG, Staffler A, Stasi I, Mondello I, Scapillati E, Vedovato S, Maffei G, Bove A, Vitaliti M, Terrin G, Lago P, Gizzi C, Strozzi C, Villani PE, Berardi A, Cacace C, Bracaglia G, Pascucci E, Cools F, Pillow JJ, Polglase G, Pastorino R, van Kaam AH, Mercuri E, Orfeo L, Vento G; IN-REC-SUR-E Study Group; Malguzzi S, Rigotti C, Cecchi A, Nigro G, Costabile CD, Roma E, Sindico P, Venafra R, Mattia C, Conversano M, Ballardini E, Manganaro A, Balestri E, Gallo C, Catenazzi P, Astori MG, Maranella E, Grassia C, Maiolo K, Castellano D, Massenzi L, Chiodin E, Gallina MR, Consigli C, Sorrentino E, Bonato S, Mancini M, Perniola R, Giannuzzo S, Tranchina E, Cardilli V, Dito L, Regoli D, Tormena F, Battajon N, Arena R, Allais B, Guidotti I, Roversi F, Meli V, Tulino V, Casati A.JAMA Netw Open. 2024 Sep 3;7(9):e2435347. doi: 10.1001/jamanetworkopen.2024.35347.PMID: 39320892 Free PMC article. Clinical Trial.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textFunisitis increases the risk of death or cerebral palsy in extremely preterm infants.Jain VG, Parikh NA, Rysavy MA, Shukla VV, Saha S, Hintz S, Jobe A, Carlo WA, Ambalavanan N; Eunice Kennedy Shriver NICHD Neonatal Research Network.Am J Obstet Gynecol. 2025 As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Early Detection and Early Intervention - where are we now (and what does the future hold)?The last time we had Alicia on the pod, we spoke about the Cochrane Review she led titled “Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants” which was published in 2024. In this week's episode, we thought we'd ask Alicia about the state of early intervention right now and what the provision of therapy looks like within our current context of early detection and early intervention for children with cerebral palsy.There have been some rather significant developments in the early detection and early intervention space over the past 20 years. From the rapid technological advances to the value of co-design and involvement of people with lived experience, we now have some impressive evidence to guide our clinical pathways. However, what is very clear now is the vital importance of implementation. The industry has generated substantial knowledge that now needs to be implemented into practice with one particularly important aspect that we must include - family involvement and well-being. Alicia speaks ever so passionately about our role as therapists and I cannot help but to feel even more compelled to ensure that the family is at the centre of everything we do. It is exciting to know that we have the evidence now, so it's time to put it into practice and it can start in your very next session.https://findanexpert.unimelb.edu.au/profile/27041-alicia-spittle

Send us a textThis week we have a couple of great Local interviews! Ochsner Children's Hospital has been one of our anchoring sponsors for years now and for our fifth season, We have created a BRAND NEW SEGMENT called         "A Mother's Giving: & the Milk Bank of Louisiana with Dr. Harley Ginsberg."Dr. Ginsberg is board certified in both pediatrics and neonatal-perinatal medicine and has been on staff at Ochsner since 1987. He served as both the Section Head of neonatal medicine at Ochsner and the Medical Director of the neonatal intensive care unit (NICU) at Ochsner Baptist Medical Center from 1989 until 2021. Dr. Ginsberg managed the team at Ochsner that took care of babies during Hurricane Katrina. Currently he is Medical Director of the NICU at Ochsner Kenner Medical Center. Dr. Ginsberg is the Founder and Medical Director of Mothers Milk Bank of Louisiana at Ochsner Baptist and is a member of the Standards Committee for the Human Milk Banking Association of North America. He has written chapters for medical textbooks on neonatology and has published scientific medical in articles in the New England Journal of Medicine, Pediatrics, Journal of Perinatology and Clinics in Perinatology. Fully accredited by the Human Milk Banking Association of North America, Mothers' Milk Bank of Louisiana at Ochsner Baptist was Louisiana's first human milk bank and the 24th nonprofit milk bank in the United States. Preterm infants are at risk for a condition called necrotizing enterocolitis, which results in inflamed intestines, bacterial infection and damage to the colon and intestines. Without proper care, the infant may die.Pasteurized donor human milk helps offset these potential dangers. Unfortunately, some mothers of preterm infants cannot produce their own milk. That's where Mothers' Milk Bank of Louisiana steps in.As of August 2020, Louisiana provides Medicaid coverage for using pasteurized donor human milk in a hospital. In 2022, Louisiana legislators approved inpatient and outpatient coverage for pasteurized donor human milk. Listen as Dr. Ginsberg and I dive into the Milk bank of Louisiana and hear the powerful impacts it has on our community and state! Go to https://www.ochsner.org/services/mothers-milk-bank-at-ochsner-baptist to learn more or to make a donation today!______________________________________________________________________________________________Then later we welcome back DIRTY DOGS! The local documentary making big waves in our city yall. Not only did the documentary chronicle the heated monopoly on New Orleans' food cart licenses for the French Quarter. What WAS a half century monopoly was essentially ended by a group of passionate film makers that felt convicted to MAKE THINGS RIGHT.  I am so excited to welcome restauranteur and host Brad Bohannan and Cinematographer, Adrian Sosebee to talk about their HOLLYWOOD AWARD they just received in  Beverly Hills! Brad also talks to us about his latest venture with his inspirational wife, Jefferson Parrish Council Person, Arita Bohannan. Together and with a village behind them, they work to bring inclusive and autistic friendly playgrounds to neighborhoods and communities tThank you to our family of amazing sponsors! Ochsner Hospital for ChildrenWww.ochsner.orgRouses MarkersWww.rousesmarkets.comSandpiper VacationsWww..sandpipervacations.comCafe Du Monde www.shop.cafedumonde.com The Law Firm of Forrest Cressy & James Www.forrestcressyjames.comComfort Cases Www.comfortcases.orgNew Orleans Ice Cream CompanyWww.neworleansicecream.comERA TOP REALTY: Pamela BreauxAudubon Institute www.auduboninstitute.orgUrban South Brewery www.urbansouthbrewery.com

Send us a textShort Duration of Antenatal Corticosteroid Exposure and Outcomes in Extremely Preterm Infants.Chawla S, Wyckoff MH, Lakshminrusimha S, Rysavy MA, Patel RM, Chowdhury D, Das A, Greenberg RG, Natarajan G, Shankaran S, Bell EF, Ambalavanan N, Younge NE, Laptook AR, Pavlek LR, Backes CH, Van Meurs KP, Werner EF, Carlo WA; National Institute of Child Health and Human Development (NICHD) Neonatal Research Network (NRN).JAMA Netw Open. 2025 Feb 3;8(2):e2461312. doi: 10.1001/jamanetworkopen.2024.61312.PMID: 39982720 Free PMC article.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textWhole-Body Hypothermia for Neonatal Encephalopathy in Preterm Infants 33 to 35 Weeks' Gestation: A Randomized Clinical Trial.Faix RG, Laptook AR, Shankaran S, Eggleston B, Chowdhury D, Heyne RJ, Das A, Pedroza C, Tyson JE, Wusthoff C, Bonifacio SL, Sánchez PJ, Yoder BA, Laughon MM, Vasil DM, Van Meurs KP, Crawford MM, Higgins RD, Poindexter BB, Colaizy TT, Hamrick SEG, Chalak LF, Ohls RK, Hartley-McAndrew ME, Dysart K, D'Angio CT, Guillet R, Kicklighter SD, Carlo WA, Sokol GM, DeMauro SB, Hibbs AM, Cotten CM, Merhar SL, Bapat RV, Harmon HM, Sewell E, Winter S, Natarajan G, Mosquera R, Hintz SR, Maitre NL, Benninger KL, Peralta-Carcelen M, Hines AC, Duncan AF, Wilson-Costello DE, Trembath A, Malcolm WF, Walsh MC; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.JAMA Pediatr. 2025 Feb 24:e246613. doi: 10.1001/jamapediatrics.2024.6613. Online ahead of print.PMID: 39992674As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textEvaluating decision regret after extremely preterm birth.Belden L, Kaempf J, Mackley A, Kernan-Schloss F, Chen C, Sturtz W, Tomlinson MW, Guillen U.Arch Dis Child Fetal Neonatal Ed. 2025 Feb 21;110(2):191-199. doi: 10.1136/archdischild-2024-327287.PMID: 39164062As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textResponse to Inhaled Nitric Oxide and Mortality Among Very Preterm Neonates With Pulmonary Hypertension.Baczynski M, Weisz D, Thomas L, Fevrier S, Castaldo M, Soraisham A, Hyderi A, Agarushi R, Bhattacharya S, Lalitha R, Sidhu A, Abdul Wahab MG, Altit G, Hébert A, Louis D, Elsayed Y, Mitra S, Deshpande P, Kharrat A, Zhu F, Ting J, Yoon E, Shah PS, Jain A; Canadian Neonatal Network Investigators.JAMA Netw Open. 2025 Feb 3;8(2):e2458843. doi: 10.1001/jamanetworkopen.2024.58843.PMID: 39928335 Free PMC article.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

This week Bobbi Conner talks with MUSC's Dr. Christopher Goodier about reducing risk of pre-term birth.

On New York University Week:  Reducing the rising rate of preterm births is an important goal for the future. Laura Jelliffe-Pawlowski, professor of epidemiology and precision health at the Rory Meyers College of Nursing, looks into the data to find solutions. Dr. Laura Jelliffe-Pawlowski is a Professor of Epidemiology and Precision Health at NYU Rory […]

Today on the podcast, Radical Birth Keeper School graduate, Eveliina shares her three unique birth stories. At 30 weeks with her second child, Eveliina experienced bleeding and was coerced into an “emergency” c-section, leaving her with a painful vertical incision. The death of her daughter woke up Eveliina's inner mother lion. With Eveliina's third pregnancy, she had a wild pregnancy and freebirthed her beautiful healthy third daughter at home with her family in Finland.Follow Eveliina on Instagram @vapaasynnytyssuomi✨Doors to the Radical Birth Keeper School are OPEN! - The groundbreaking program for women embarking on the path of sovereign birth-work. https://www.freebirthsociety.com/radicalbirthkeeperschool✨ Matriarch Rising Festival tickets are now LIVE! Join us for our annual women's gathering -  https://www.matriarchrisingfestival.com/✨The FBS private membership community, “The Lighthouse” is the most epic space for conscious women! - Get on the waitlist for when doors open next! - https://www.freebirthsociety.com/membership✨Connect with Free Birth Society on Instagram at - https://www.instagram.com/freebirthsociety✨Check out our best-selling course, The Complete Guide to Freebirth - https://www.freebirthsocietycourses.com/cgtf✨ Join the waitlist for the MatriBirth Midwifery Institute - https://www.freebirthsociety.com/mmiwaitlist✨Get our FREE Freebirth starter kit here! - https://www.freebirthsociety.com/start-here✨Are you a sovereign birth professional? Get listed on the MatriBirth Directory here - https://Matribirthdirectory.com✨Join the MatriBirth Directory and connect with sovereign birth professionals near you! -  https://matribirthdirectory.com/✨ Get on the waitlist for REIGN ~ Emilee Saldaya's action-oriented coaching container that is guaranteed to elevate you into your next phase of life for 2025 - https://www.freebirthsociety.com/reign✨Donate to the podcast - https://www.paypal.com/donate/?hosted_button_id=2YJBSCNYXT52Y✨Subscribe to our Youtube channel - https://www.youtube.com/@FreeBirthSociety✨Learn about everything we do at  - https://www.freebirthsociety.com~~~~~This episode is brought to you by MASA Chips. MASA is part of a growing movement to bring back real food. The kind of food our grandparents ate before Big Food got involved. MASA chips are just three simple ingredients: organic corn, salt, and beef tallow. No seed oils, no fillers, no ultra-processed garbage.When you snack, snack on something real! Go to https://masachips.com/discount/FREEBIRTHSOCIETY and use code FREEBIRTHSOCIETY for 20% off your first order!~~~~~When you need guidance from someone you can truly trust, someone who aligns with your values on sovereignty and natural living, look no further than Dr. Jennifer Tice, ND - Naturopathic Pediatrician + Homeopathic Expert

Send us a textIn this episode, I had the pleasure of speaking with Dr Ilana Levene, who is now a Neonatology subspeciality trainee at Oxford, England. Ilana has done some fantastic work on exploring the important topic of human milk expression. She described her randomized control trial in using relaxing techniques to facilitate human milk expression in the NICU. She shared the challenges that she had in conducting her RCT. We also talked about RCTs with negative results and how negative results are also important in conducting research. Ilana has now created a website with printables for parents and staff in the NICU on human milk expression. This can be assessed for free here : http://www.hifn.org/printable . Ilana also shared her interest in perinatal equity and shared details on her project Spectrum which involves gathering photos of the lactating breast conditions/chest from people with a wide spectrum of skincolours. These will be provided as a free educational image library. Currently she is chairing a priority setting partnership for LGBTQIA+ perinatal care. As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Dr. Phillip Bennett, a co-director of the March of Dimes Prematurity Research Center at Imperial College London, discusses a historic randomized controlled trial (RCT) that will test a vaginal probiotic's ability to reduce preterm birth risk.

There is a lot doctors and scientists still don't fully understand about what includes labour, both pre and at term. But we do know that there are treatments that can reduce your chance of having a preterm birth, especially if you have had one in the past. Preterm birth can be especially traumatic for those living in remote communities which is why in our guests on today's podcast, Drs. Kirsten Duckitt and Jennifer Kask, developed a prevention of preterm birth pathway in Northern Vancouver Island that is spreading to other remote communities. They share with us a moving story of a pregnant individual from a remote community who had her baby in their hospital, and break down the definitions and rates of preterm birth, risks to mama and baby, and how they can be decreased. Listen to our podcast on Being a NICU parent! Taking you from anxious and overwhelmed to confident during your childbirth experience: Pregnancy to Parenthood Online Prenatal Masterclass. *This episode is a re-release. Original release date: November 3, 2021.

Send us a textDouble Jeopardy: A Distinct Mortality Pattern Among Preterm Infants with Congenital Heart Disease.Higgins BV, Levy PT, Ball MK, Kim M, Peyvandi S, Steurer MA.Pediatr Cardiol. 2025 Apr;46(4):939-946. doi: 10.1007/s00246-024-03519-4. Epub 2024 Jun 12.PMID: 38864860 Free PMC article.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textSimilarities and Differences in the Neurodevelopmental Outcome of Children with Congenital Heart Disease and Children Born Very Preterm at School Entry.Wehrle FM, Bartal T, Adams M, Bassler D, Hagmann CF, Kretschmar O, Natalucci G, Latal B.J Pediatr. 2022 Nov;250:29-37.e1. doi: 10.1016/j.jpeds.2022.05.047. Epub 2022 Jun 2.PMID: 35660491 Free article.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textParental and Medical Classification of Neurodevelopment in Children Born Preterm.Richter LL, Janvier A, Pearce R, Bourque CJ, Church PT, Luu TM, Synnes A.Pediatrics. 2025 Feb 1;155(2):e2024066148. doi: 10.1542/peds.2024-066148.PMID: 39786567As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

In this Complex Care Journal Club podcast episode, Ms. Pearce and Dr. Synnes discuss a series of patient-oriented research studies aimed at partnering with parents in reimagining meaningful outcomes for premature infants. They describe the inclusion of parents on the study team, recruitment of parent participants, lessons and challenges while conducting the study, messages for other researchers and parents, and the next steps from this work. SPEAKERS Rebecca Pearce, B. Ed, MSc Vice Principal Villa Maria High School Parent Partner CHU Sainte-Justine and Canadian Premature Babies Foundation‌ Anne Synnes, MDCM, MHSc Clinical Professor, Neonatologist University of British Columbia British Columbia's Women's Hospital and British Columbia's Children's Hospital Research Institute HOST Kilby Mann, MD Assistant Professor Pediatric Rehabilitation Medicine Children's Hospital Colorado DATE Initial publication date: February 10, 2025. ARTICLES REFERENCED Pearce R, Synnes A, Lam MM, Richter LL, Bacchini F, Jones M, Luu TM, Janvier A; PARENTS' VOICE NETWORK. Partnering With Parents to Change Measurement and Reporting of Preterm Birth Outcomes. Pediatrics. 2024 Nov 1;154(5):e2024067093. doi: 10.1542/peds.2024-067093. PMID: 39354888. Haslam MD, Lisonkova S, Creighton D, Church P, Yang J, Shah PS, Joseph KS, Synnes A; Canadian Neonatal Network and the Canadian Neonatal Follow-Up Network. Severe Neurodevelopmental Impairment in Neonates Born Preterm: Impact of Varying Definitions in a Canadian Cohort. J Pediatr. 2018 Jun;197:75-81.e4. doi: 10.1016/j.jpeds.2017.12.020. Epub 2018 Feb 3. PMID: 29398054. TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/p65m4p98gppf65mz3zhmm9g/February_Pearce_and_Synnes_ccjcp_final_revisions‌ Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Pearce R, Synnes A, Mann K. Focus on Abilities: Parent-Identified Outcomes of Preterm Infants. 2/2025. OPENPediatrics. Online Podcast: https://soundcloud.com/openpediatrics/focus-on-abilities-parent-identified-outcomes-of-preterm-infants

Welcome to ohmTown. The Non Sequitur News Show is held live via Twitch and Youtube every day. We, Mayor Watt and the AI that runs ohmTown, cover a selection of aggregated news articles and discuss them briefly with a perspective merging business, technology, and society. You can visit https://www.youtube.com/ohmtown for the complete history since 2022.Articles Discussed:Cats learn to associate faster than babies.https://www.ohmtown.com/groups/nonsequiturnews/f/d/cats-learn-to-associate-images-with-words-faster-than-babies/Microplastics in Preterm placenta.https://www.ohmtown.com/groups/technologytoday/f/d/the-hidden-threat-in-the-womb-microplastics-found-in-preterm-placentas/Recreating DeepSeeks OpenAI Killerhttps://www.ohmtown.com/groups/nonsequiturnews/f/d/team-says-theyve-recreated-deepseeks-openai-killer-for-literally-30/Nobody really knows AI, apparently.https://www.ohmtown.com/groups/nonsequiturnews/f/d/if-you-think-anyone-in-the-ai-industry-has-any-idea-what-theyre-doing-it-appears-that-deepseek-just-accidentally-leaked-its-users-chats/More snow in Hawaii than NYC.https://www.ohmtown.com/groups/nonsequiturnews/f/d/hawaii-could-get-more-snow-than-new-york-city-has-had-this-year/The Art of Firing People by EA.https://www.ohmtown.com/groups/mobble/f/d/ea-apparently-thinks-theres-an-art-to-firing-people/Summer Game Fest 2025https://www.ohmtown.com/groups/technologytoday/f/d/summer-game-fest-returns-to-the-youtube-theater-on-june-6/Something is Wiping out Sea Urchinshttps://www.ohmtown.com/groups/technologytoday/f/d/an-extremely-violent-global-pandemic-mysterious-disease-wipes-out-sea-urchins-worldwide/Driven to Prisonhttps://www.ohmtown.com/groups/mobble/f/d/2-jailed-for-posing-as-learner-drivers-to-sit-theory-test/Decode this Ancient Script

Breastfeeding twins can be challenging, especially when the babies are late preterm. What are some of the ways these babies behave differently? What should you know before attempting to tandem nurse? Plus, some great advice for managing triple feedings: breastfeeding, supplementation and pumping. Learn more about your ad choices. Visit megaphone.fm/adchoices

HeHe welcomes Zhenya Lindgardt, President and CEO of Sera Prognostics, to discuss the critical issue of preterm birth, its rising incidence in the U.S., and innovative solutions available today. Zhenya explains the definition and statistics of preterm birth, and introduces the Preterm test, a blood test that predicts the risk of preterm birth as early as 18 weeks of gestation. The conversation also covers the effectiveness of Sera Prognostics' intervention bundles, improvements in pregnancy care, and the importance of innovation in maternal health. Listeners will learn about the accessibility and process of the Preterm test and the overall goal of making this technology widely available to improve maternal and neonatal outcomes.   Understanding Preterm Birth Advancements in Preterm Birth Testing Interventions for High-Risk Pregnancies Clinical Trials and Results At-Home Testing and Accessibility Innovation in Maternal Health Guest Bio: Zhenya Lindgardt is an accomplished leader in healthcare innovation, currently serving as the President, CEO, and Board Director of Sera Prognostics, Inc. and CEO of The Commons Project Foundation. As the leader of Sera, Zhenya is revolutionizing the maternal and infant health space by addressing the preterm birth crisis with cutting-edge science. With a rich background including senior roles at Uber Technologies and a 19-year tenure at Boston Consulting Group, she has demonstrated expertise in driving growth and fostering innovation. Her contributions span multiple therapeutic areas and focus on leveraging data to improve patient outcomes and reduce healthcare costs. INSTAGRAM: Connect with HeHe on IG  Connect with HeHe on YouTube   https://www.facebook.com/serapregnancy https://www.instagram.com/serathepregnancycompany?igsh=NTc4MTIwNjQ2YQ== https://www.linkedin.com/company/sera-prognostics BIRTH EDUCATION: Join The Birth Lounge here for judgment-free childbirth education that prepares you for an informed birth and how to confidently navigate hospital policy to have a trauma-free labor experience!   Download The Birth Lounge App for birth & postpartum prep delivered straight to your phone!   LINKS MENTIONED: Websites: Sera | The Pregnancy Company PreTRM® Premature Birth Risk Blood Test from Sera March of Dimes Report Card CDC NYU article about racial disparities in pre-term birth rates What is causing the rise in pre-term birth?   Diagnostics: AVERT Trial Press Release: Sera PreTRM® Test Prevention Strategy Demonstrates 18% Reduction in Severe Neonatal Morbidity and Mortality in Newly Published AVERT Trial | Sera   AVERT Trial Data: https://www.mdpi.com/2075-4418/14/14/1462

Understanding Amniotic Fluid: What's Normal and What's Not Amniotic fluid is the protective liquid contained within the amniotic sac that surrounds a baby during pregnancy. This vital fluid plays a critical role in fetal development, providing cushioning, regulating temperature, and enabling the baby to move and grow within the uterus. It also facilitates the development of essential systems like the lungs, digestive tract, and musculoskeletal system. What Is Amniotic Fluid Made Of? Amniotic fluid begins to form around the 12th day of pregnancy and is initially composed of water from the mother. As the pregnancy progresses, it includes fetal urine, nutrients, hormones, and antibodies, creating a nutrient-rich environment for the growing baby. What's Normal? The amount of amniotic fluid changes throughout pregnancy, peaking around 34 weeks and then gradually decreasing. Here's what's considered normal: Volume: Typically, the amount of amniotic fluid ranges from 500 to 1,000 milliliters at term. Clear or Slightly Tinted Fluid: Normal amniotic fluid is clear or slightly yellow-tinted. Healthy Fetal Movement: Adequate fluid allows the baby to move freely, which promotes muscle and bone development. Doctors assess amniotic fluid levels using ultrasound and measure the Amniotic Fluid Index (AFI) or the Deepest Vertical Pocket (DVP) to ensure levels are within a healthy range. What's Not Normal? Abnormalities in amniotic fluid levels can indicate potential complications: Low Amniotic Fluid (Oligohydramnios): This condition occurs when fluid levels are too low and can lead to: Restricted fetal growth. Increased risk of umbilical cord compression. Complications during labor, such as reduced cushioning for the baby. Excess Amniotic Fluid (Polyhydramnios): Excess fluid can result from issues such as gestational diabetes, fetal anomalies, or infections. It may cause: Preterm labor. Difficulty breathing for the mother due to uterine overdistension. Increased risk of placental abruption or cord prolapse. Discolored Fluid: Green or Brown (Meconium-Stained Fluid): This indicates that the baby has passed its first stool in utero, which could signal fetal distress. Bloody Fluid: This may suggest complications like placental abruption or injury. Monitoring Amniotic Fluid Routine prenatal care includes monitoring amniotic fluid levels. If abnormalities are detected, your healthcare provider may recommend additional tests, interventions, or close monitoring to ensure the safety of both mother and baby.   Your feedback is essential to us! We would love to hear from you. Please consider leaving us a review on your podcast platform or sending us an email at info@maternalresources.org. Your input helps us tailor our content to better serve the needs of our listeners. For additional resources and information, be sure to visit our website at Maternal Resources: https://www.maternalresources.org/. You can also connect with us on our social channels to stay up-to-date with the latest news, episodes, and community engagement: Twitter: https://twitter.com/integrativeob YouTube: https://www.youtube.com/maternalresources Instagram: https://www.instagram.com/integrativeobgyn/ Facebook: https://www.facebook.com/IntegrativeOB Thank you for being part of our community, and until next time, let's continue to support, uplift, and celebrate the incredible journey of working moms and parenthood. Together, we can create a more equitable and nurturing world for all

Preterm infants, especially those born at periviability, are at inherent risk of a variety of short-term neonatal complications- depending on their gestational age- including sepsis, respiratory distress, IVH, and have an overall higher mortality compared to term born infants. Well known interventions are intended to reduce these complications; these include antenatal corticosteroids, magnesium sulfate for CNS protection, and antibiotics for latency in PPROM. This is an even bigger issue for those born in the periviable interval. That group is a unique population. But does mode of delivery matter? Cesarean delivery is currently not recommended before 25 weeks' gestation unless for maternal indications, even in the setting of malpresentation. We'll cover recently stated guideline in this episode. These recommendations are based on a lack of evidence of improved neonatal outcomes and survival following cesarean delivery and the maternal risks associated with cesarean delivery at this early gestational age. Plus, for non-vertex presenting fetuses, C-section has been reported to reduce risk of neonatal mortality, but what about vertex presenting preterm/periviable babies? In this episode, we will review the mode of delivery and neonatal outcomes in preterm birth with a special focus on those born in the periviable interval, like 22- and 23-weeks gestation. There's lots to cover here…so listen in for details.

Oscar-winning Michelle Yeoh's career has spanned four decades. Starting out as a martial arts actor, she became a key figure in the Hong Kong action scene. But it was her role in James Bond film Tomorrow Never Dies that catapulted her into Hollywood. She's since starred in many hits including Crouching Tiger, Hidden Dragon and the multi-Oscar winning movie - including for her own performance - Everything Everywhere all At Once. Now, she's in the film adaptation of the musical Wicked. She joined Nuala McGovern live in the studio to discuss it.We look back at a special programme, that came live from the Radio Theatre in Broadcasting House in London, looking at the support for children with Special Educational Needs and Disabilities – or SEND as it's often known in England. Nuala heard from guest panellists including Kellie Bright, an actress in EastEnders but also a mum to a child with SEND, Katie, who is 17 and says she was completely failed by the SEND system, and the Minister for School Standards, Catherine McKinnell.On 22 September 1994, the American TV show Friends premiered on NBC and the characters Monica, Rachel, Phoebe, Joey, Chandler and Ross became household names. To celebrate its 30th anniversary, Anita spoke to one of the show's writers and producers, Betsy Borns and the journalist Emma Loffhagen about why the show still resonates today.We hear from listener Siobhan Daniels. She wrote to us on Instagram: 'I would love you to talk about van life and an alternative way of living.' Siobhan is 65 years old and after selling her home and possessions has lived in her motorhome for the last five years. Preterm birth is the leading cause of neonatal deaths in the UK. Last month the House of Lords Preterm Birth Committee published a report calling on the government to do more to reduce the risks of babies being born prematurely and to improve the lives of those families who are affected. Anita discussed the proposed changes with Nadia Leake, who gave birth to twins eleven years ago at just 22 weeks and is the author of 'Surviving Prematurity,'Corinne Bailey Rae's latest album is a complete departure from her previous work. Black Rainbows is inspired by a trip to Stony Island Arts Bank, a Chicago-based archive of black art and culture. The record spans punk, rock, experimental jazz, electronica and more. She joined Anita for a very special performance live from the Woman's Hour Glastonbury picnic table back in the summer.Presenter: Anita Rani Producer: Annette Wells Editor: Emma Pearce

Is that your water breaking or did you just pee yourself (again?) At this stage of pregnancy, it's important to learn the signs of pre-term labor in case that baby wants to make an early appearance! Sarah chats symptoms to look out for and some tell-tale signs birth is near, PLUS baby's development, tips for the week, and a to-do list to help keep us all on track Want more from Sarah? Personal Instagram: @SarahMerrill_Hall Share some Laughs: @bigkidproblems Check out the NEW IG @bottleserviceBKP Shop Sarah's Pregnancy/ Postpartum Must Haves on Amazon Shop Bottle Service MERCH!  Big Thank You to our Episode Sponsors! MANSCAPED - Get 20% off + free shipping with the code bottleservice at Manscaped.com Green Chef - The #1 Meal Kit for Clean Eating. Go to greenchef.com/bottleservice50 and use code bottleservice50 for 50% off your first box plus 20% off your next two months! Learn more about your ad choices. Visit megaphone.fm/adchoices

Send us a textIn this episode, Ben and Daphna sit down with Dr. Dieter Wolke, professor of developmental psychology at the University of Warwick, to discuss life course outcomes for very preterm, very low birth weight infants. Dr. Wolke explores the concept of life tasks, emphasizing milestones like independence, social integration, and relationships. He highlights the long-term impacts of neonatal experiences, the role of overprotective parenting, and the need for individualized support across the life span. This insightful conversation challenges traditional labels and advocates for a nuanced approach to fostering well-being and resilience in preterm children.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textIn this episode, Ben and Daphna sit down with Dr. Cindy McEvoy, professor of pediatrics and director of neonatal research at Oregon Health & Science University, to discuss optimizing lung development in preterm infants. Dr. McEvoy shares insights from her research on the benefits of prolonged CPAP use in preterm infants, showing how it supports lung growth, improves alveolar volume, and enhances pulmonary function. She emphasizes the importance of education and proper CPAP application to maximize benefits while debunking myths about weaning protocols. This conversation highlights the potential of targeted respiratory strategies to improve long-term outcomes.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

In this heartfelt and eye-opening episode of the Empowering NICU Parents Podcast, host Nicole Nyberg dives deep into the profound and often unspoken challenges of prematurity. From the critical moments in the NICU to the lasting physical, emotional, and developmental impacts on children and their families, this episode sheds light on the full scope of the prematurity journey.Discover how preterm birth affects every organ system, why the NICU environment plays such a pivotal role, and how parents can navigate the long-term outcomes with knowledge and confidence. Nicole also shares her personal experience as a mom of a micropreemie, offering insight, support, and a reminder that no family is alone in this journey.Whether you're a NICU parent, healthcare provider, or someone wanting to better understand preterm birth and its impact, this episode is packed with essential information, actionable advice, and heartfelt encouragement. Tune in, be inspired, and join the movement to raise awareness and empower families navigating life beyond the NICU!Dr. Brown's Medical: https://www.drbrownsmedical.comOur NICU Roadmap: A Comprehensive NICU Journal: https://empoweringnicuparents.com/nicujournal/ NICU Mama Hats: https://empoweringnicuparents.com/hats/ NICU Milestone Cards: https://empoweringnicuparents.com/nicuproducts/ Newborn Holiday Cards: https://empoweringnicuparents.com/shop/ Empowering NICU Parents Show Notes: https://empoweringnicuparents.com/shownotes/ Episode 64 Show Notes: https://empoweringnicuparents.com/episode64 Empowering NICU Parents Instagram: https://www.instagram.com/empoweringnicuparents/ Empowering NICU Parents FB Group: https://www.facebook.com/groups/empoweringnicuparents Pinterest Page: https://pin.it/36MJjmH

In this episode, Dr. Jamie Lo welcomes Dr. Sarah Osmundson to discuss SMFM Consult #71, focusing on the management of previable and periviable preterm prelabor rupture of membranes (PPROM). Together, they delve into key considerations for patient counseling, the challenges of defining viability across different institutions and regions, and the maternal and neonatal outcomes linked to various management strategies. Dr. Osmundson highlights the critical role of informed consent, the need to align care with patient values, and opportunities to address gaps in research through collaborative efforts. This episode unpacks the complexities of managing PPROM and provides valuable insights for maternal-fetal medicine providers navigating these nuanced and sensitive conversations. Click here for the full episode transcript.  Additional Resources -         SMFM Consult Series #71 -         SMFM Clinical Webinar Series: Management of Previable and Periviable Preterm Prelabor Rupture of Membranes -         Maternal morbidity after preterm premature rupture of membranes at

In the United States, more than 400,000 babies are born prematurely each year, which is about 1 in 10 babies. Over the last several decades, multiple studies have shown a link between poor oral health and increased occurrence of preterm birth. Researchers have looked at various ways to improve dental health during pregnancy, including doing a “deep-teeth cleaning” (also called ‘scaling and planing'), which involves removing plaque and tarter on the teeth and below the gum line. However, despite improving periodontitis, deep teeth cleaning approaches have not proven to be effective in the prevention of preterm birth. But now new data has discovered an easy and inexpensive way to improve oral health and potentially reduce preterm births. This data was originally presented at the annual Pregnancy meeting at SMFM, but now it is a peer reviewed publication. In this episode, we will review how chewing xylitol gum has promising results for preterm birth reduction. Nonetheless, some important limitations must be reviewed. Listen In for details.

I'm pleased to welcome you to this podcast for a crucial topic in the care of preterm babies: the use of surfactant therapy guided by tests of their lung function. Practice is evolving in this area, and we're here to discuss the latest evidence. Three guests are joining me today, Greta Sibrecht and Franek Borys, authors of the October 2023 Cochrane review, and, later, Anna Lavizzari, lead investigator for one of the ongoing studies.

I'm pleased to welcome you to this podcast for a crucial topic in the care of preterm babies: the use of surfactant therapy guided by tests of their lung function. Practice is evolving in this area, and we're here to discuss the latest evidence. Three guests are joining me today, Greta Sibrecht and Franek Borys, authors of the October 2023 Cochrane review, and, later, Anna Lavizzari, lead investigator for one of the ongoing studies.

Dr. Sam Mesiano, an investigator at the March of Dimes Ohio Collaborative Prematurity Research Center, discusses the enzyme that leads to progesterone withdrawal and labor in cases of infection-related preterm birth - and how this enzyme discovery can be used to revive progesterone therapy to delay or stop preterm birth.

A new Woman's Hour series, Forgotten Children, explores the impact on families when one or both parents are sent to prison. Reporter Jo Morris hears from Kerry Wright, who was just 17 and living in Spain with her parents when British police arrived at their door and arrested both of them, from Nan (not her real name), whose daughter received a prison sentence, leaving Nan to care for her five grandchildren and to Emily (not her real name), whose husband was sentenced to prison for domestic abuse. Nuala McGovern also spoke to Sarah Burrows, founder of Children Heard and Seen, a charity supporting children and families with parents or partners serving prison sentences, and Lucy Baldwin who is a research fellow at Durham University and a criminal justice consultant.As a new musical adaptation of The Devil Wears Prada, with lyrics contributed by the American musician Shaina Taub and music by Elton John, hits London's West End, Anita Rani was joined by the show's leading ladies, Vanessa Williams, Georgie Buckland and Amy Di Bartolomeo to discuss the enduring appeal of this story.Nuala spoke to TV presenter and author Giovanna Fletcher from the Himalayas at the start of her trek to raise money and awareness for CoppaFeel! the breast cancer charity.Preterm birth is the leading cause of neonatal death in the UK. Today the House of Lords Preterm Birth Committee have published a report calling on the government to do more to reduce the risks of babies being born prematurely and to improve the lives of those families who are affected. Anita discusses proposed changes with Nadia Leake, who gave birth to twins eleven years ago at just 22 weeks and is the author of 'Surviving Prematurity,' Evelyn Forde was the first black female president of the Association of School and College Leaders, awarded an MBE for services to education, and named Times Educational Supplement Headteacher of the Year in 2020. In her book Herstory: A Leadership Manifesto, Evelyn shares her journey through the education system, her experiences of racism in her career, alongside the testimonies of other black leaders in the sector. With just 1% of headteachers in state schools in England from a black background, she joined Nuala to discuss why she thinks urgent action is needed to address the issue in education. A new musical – Mozart: Her Story - tells the story of Wolfgang Amadeus Mozart's sister Maria-Anna, who taught him how to play the piano. Nuala is joined by the lyricist, Tegan Summer, and actor, Gabrielle Brooks who gives a performance from the new show.Presenter: Anita Rani Producer: Annette Wells Editor: Rebecca Myatt

Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from November 9-15, 2024.

Preterm birth is the leading cause of neonatal death in the UK. Today the House of Lords Preterm Birth Committee have published a report calling on the government to do more to reduce the risks of babies being born prematurely and to improve the lives of those families who are affected. Anita Rani discusses proposed changes with Nadia Leake, who gave birth to twins eleven years ago at just 22 weeks and author of 'Surviving Prematurity,' Caroline Lee-Davey, CEO of the charity Bliss, which supports parents and families of premature or sick babies, and Baroness Laura Wyld, a member of the Preterm Birth Committee.A Georgian heiress and her husband are suing a property developer for over £36 million after buying a mansion and discovering a “moth infestation”… “of extreme proportions”. The couple describe killing up to 100 moths a day, watching them land on their children's toothbrushes, plates of food and cutlery. And they are now seeking damages including £50,000 for moth-shredded clothes. The property developer denies all claims. Well, it's that time of year where you may be getting your winter woollies out and we wondered what's the best way to deal with such an occurrence? Anita is joined by Harriet Walker, Fashion Editor at The Times, who has been having her own nightmare experience with moths.In the next instalment of Woman's Hour's week-long series Forgotten Children, which looks at the impact on families when one or both parents serve time in prison, reporter Jo Morris speaks to Emily (not her real name), whose husband was sentenced to prison for crimes he committed against her. Emily discovered that, not only did she have to face the stigma of her children's father being in prison, but as a single-parent she also struggled to access services to help her children cope with their father's imprisonment. As a new musical adaptation of The Devil Wears Prada, with lyrics contributed by the American musician Shaina Taub and music by Elton John, hits London's West End, Anita is joined by the show's leading ladies, Vanessa Williams, Georgie Buckland and Amy Di Bartolomeo to discuss the enduring appeal of this story. Presenter: Anita Rani Producer: Rebecca Myatt

Preterm birth is the greatest cause of neonatal mortality and morbidity, with infants born extremely preterm at highest risk. Author Brett J. Manley, PhD, the Royal Women's Hospital, Melbourne, Australia, discusses a new study of the effect of intratracheal corticosteroid administration on survival free of bronchopulmonary dysplasia in preterm infants, with JAMA Deputy Editor Tracy A. Lieu, MD, MPH. Related Content: Intratracheal Budesonide Mixed With Surfactant for Extremely Preterm Infants

I'm honored to share a replay of my guest appearance on Mary Coughlin's Care Outloud Podcast.Together, we dive deep into the personal and professional impact of my journey as a NICU parent after the premature birth of my son William at 23 weeks. We explore how that experience transformed my life, inspiring my dedication to family-centered care, trauma-informed care, and mental health support for NICU families.Throughout our heartfelt conversation, I also discuss my work as a Neonatal Nurse Practitioner and Clinical Product Specialist at AngelEye Health, as well as how I created Empowering NICU Parents to provide resources and support to families during their NICU journey.It was an incredible honor to join Mary, someone I have admired for so long. Mary's expertise in trauma-informed care, coupled with her compassion and wisdom, made this conversation truly special.Tune in to hear more about our shared passion for improving neonatal care and the importance of connection and support for NICU families.Dr. Brown's Medical: https://www.drbrownsmedical.comOur NICU Roadmap: A Comprehensive NICU Journal: https://empoweringnicuparents.com/nicujournal/ NICU Mama Hats: https://empoweringnicuparents.com/hats/ NICU Milestone Cards: https://empoweringnicuparents.com/nicuproducts/ Newborn Holiday Cards: https://empoweringnicuparents.com/shop/  Empowering NICU Parents Show Notes: https://empoweringnicuparents.com/shownotes/ Episode 63 Show Notes: https://empoweringnicuparents.com/episode63Empowering NICU Parents Instagram: https://www.instagram.com/empoweringnicuparents/ Empowering NICU Parents FB Group: https://www.facebook.com/groups/empoweringnicuparents Pinterest Page: https://pin.it/36MJjmH

Send us a textFetal haemoglobin and oxygen requirement in preterm infants: an observational study.Ulinder T, Hellström W, Gadsbøll C, Nilsson L, Gebka M, Robertz G, Bruschettini M, Hellstrom A, Ley D.Arch Dis Child Fetal Neonatal Ed. 2024 Sep 25:fetalneonatal-2024-327411. doi: 10.1136/archdischild-2024-327411. Online ahead of print.PMID: 39322316As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textTeleneonatal or routine resuscitation in extremely preterm infants: a randomized simulation trial.Gentle SJ, Trulove SG, Rockwell N, Rutledge C, Gaither S, Norwood C, Wallace E, Carlo WA, Tofil NM.Pediatr Res. 2024 Sep 28. doi: 10.1038/s41390-024-03545-1. Online ahead of print.PMID: 39341942As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Want to send us a message? Fan mail? Thoughts on the episode?In this episode, Katie takes Rachel behind the scenes for an in-depth exploration of donor milk—an intriguing topic that might just challenge everything you thought you knew about this practice.                                                    I have to caveat that some of the information in this episode is possibly going to get your knickers in a twist though – do we have any episode that don't?!We'll be discussing:  The history of milk banking  Are we seeing different health outcomes when using donor milk compared to a mother's own milk?Are there differences between donor and mothers milk that we should know aboutWhat about informal, unpasteurised, milk sharing? Is this also happening in the hospital settings as well? And have you ever heard the term “milk sibling” before? I'll also dive into whether we need to rethink our approach to milk when caring for vulnerable infants. Plus, Rachel asks me about the future of milk banking—where is this practice headed?LINKS:Evidence-Based Methods That Promote Human Milk Feeding of Preterm Infants Early postpartum pumping behaviorsSupplementation of Mother's Own Milk with Preterm Donor MilkMaternal production of milkProactive Lactation Care Economic benefits and costs of human milk feedingsThe institutional cost of acquiring 100 mL of human milkWant to listen to the new podcast 'The Feeding Couch'? Find it here or on all good podcast hosting platforms! Get 10% off Katie's Breastfeeding & Lactation: the fundamentals online course today with code POD10 at checkout. Support the show Please support the show via Patreon or BuyMeACoffee MERCH here! Music Joseph McDade Like this podcast? Leave us a review here Want more from Katie and Rachel? Katie's website Rachel's website DisclaimerThe information provided on this podcast does not, and is not intended to, constitute medical or legal advice; instead, all information available on this site are for general informational purposes only. The Midwives' Cauldron podcast reserves the right to supplement, change or delete any information at any time.The information and materials on the podcast is provided "as is"; no representations are made that the content is error-free. Whilst we have tried to ensure the accuracy and completeness of the information we do not warrant or guarantee the accurateness. The podcast accepts no liability for any loss or damage howsoever arising out of the use or reliance on the content.

Send us a textDon't wait, vaccinate: evaluation of routine vaccination administration and reactogenicity in preterm infants.Abdelmessih E, Desai PV, Tracy J, Papadopoulos J, Bashqoy F.J Perinatol. 2024 Sep 10. doi: 10.1038/s41372-024-02111-1. Online ahead of print.PMID: 39256613As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textPaediatric intensive care admissions of preterm children born

We have received so many messages and emails from you requesting more VBAMC stories and today, we are giving you just that. Susana joins us from Mexico sharing her VBAC story after five Cesareans!Each of Susana's Cesarean experiences was unique in their own way, but the dream of a vaginal birth never left her heart. When she found a supportive midwife and doctor during her VBA5C pregnancy, Susana knew this was her chance to finally achieve that goal. With her husband by her side encouraging and supporting her, Susana powerfully pushed her baby out. The hospital staff and community buzzed with shock and amazement over what she had achieved!“That moment was unlike any other moment in my life.”ACOG Article: Dr. Angelica GloverEvidence-Based Birth: The Evidence on VBACNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Women of Strength, this is the moment so many of you have been waiting for. We have a VBA5C so for anyone who doesn't know what that means, it is a VBAC after 5 Cesarean story for you today. This has been requested so much. We received emails in our personal email. We have gotten it on social media saying, “Please, can we get some stories that have VBAC after more than 3 Cesareans?” We know so many people out there don't know that this is an option or they know it's an option but they don't find the support or they can't find the support. They are few and far between but we have our friend Susana today who is going to be sharing her VBA5C story. Welcome, Susana. How are you?Susana: Hi. Thank you so much for inviting me. I'm so excited. Meagan: Oh my gosh. I am so excited. Yes. I am so excited and you are in Mexico, correct? Is that where your VBAC was? Susana: I'm sorry? Meagan: Was your VBAC in Mexico?Susana: Yeah, but it was a very, very hard way. I'm going to share what I did. First of all, I can't separate this way from my faith because I prayed so much for this and I trusted so much and also, I trusted so much in the process and in the body and those things But okay, I'm going to tell you what happened with me and why I had five C-sections. First of all, I got pregnant in 2009. My pregnancy went very healthily with no problems at all. I was 41+5 weeks and I had a doctor who was– well, he said he was for natural birth. I don't know how to say it. He was pro-birth. Meagan: Yeah, that he's pro. He's supportive. Susana: Supportive. Yeah, that's the word. But in reality, he was more C-section-supportive. While we were passing a very difficult part of our life because my father-in-law passed away exactly on my due date. We were very emotional and very sensitive. Labor wasn't starting so the doctor said, “No, baby is not engaged. You are only 3 centimeters. I can say that baby is not going to birth naturally. I say that it is better for you to go directly to the C-section.” I was disappointed because I was walking so much every day, but for the situation for my husband and all of the family, I accepted. We went to the C-section. I got pregnant again in 2010 8 months later and I was very excited to now get a VBAC. The doctor said he wasn't going to support me but in the end, I had a TOLAC, a trial. I was progressing well. I was 5 centimeters when I went to the hospital and the doctor was a little bit nervous because the C-section that I had before was one year and five months before so he was like, “You have to be fast because we have the risk of uterine rupture.” He started to make an impression on me and I was starting to be stressed. After 5 hours I think, he said, “Baby is not getting down. You are still at 5 and we are going to the C-section again.” I cried a lot and my husband said, “We tried and we can't do this anymore. It can be dangerous. Go to the C-section.” It was very traumatic because they put in the epidural and it only worked in half of my body. I started to scream, “No, please. No. I can feel everything.” They put the epidural in again. It was difficult. Then I got pregnant again in 2012 but I didn't fight anymore. I decided for a repeat C-section. The good part is that it was peaceful because I was accepting the situation. Everything went well. Then I got pregnant in 2013. Also, we were going to opt for a C-section because I didn't have any other chance but the doctor started saying, “No more babies. Four C-sections is a thing,” and things like that but my husband and I were talking about it and we thought that it wasn't an option for us to have– I don't remember the word. Tying the tubes. Meagan: Oh yeah, a tubal. Susana: Yes. The sterilization. So we went to a repeat C-section. It wasn't as smooth as the one before because my baby was 37.5 weeks so we had a little problem with maturity. Is that the word? She was very small. Meagan: She was technically preterm. Susana: Yeah. Preterm. She showed signs of preterm. She was whimpering and something like that. We had to go to the neurospecialist. Everything was going well and there was no problem at all, but we were careful for another pregnancy. We waited a lot and we got pregnant again in 2017. I spent the half of my pregnancy with the same doctor, but at half of the pregnancy when I was 20 weeks, some friend told me, “Oh, you know what? There is a mom in Brazil who had a VBAC after four C-sections.” I was like, “What?” I didn't know that existed. I started to inform myself and I found a supportive midwife but she said, “We aren't going to chance it to go to the hospital. We have to have the birth in your house.” We prepared everything for the home birth and the bad thing is that I was anxious at 39 weeks and had prodromal labor. I passed the due date. I was 41 and 42 and then 42.5 weeks so stress started to play a role here. I started labor but I passed three days in labor so that was really, really hard. I passed two days at 5 centimeters dilation. Then my midwife said, “I don't know what has happened. I think we can't wait anymore. You have to go to the hospital. Baby is good.” The heart rate was optimal but I didn't know what to do anymore. We went to the hospital. It was the only public hospital. Oh, the doctors were freaking out like, “What are you doing? Come on. You have to get the C-section 2 weeks before.” I suffered very, very much obstetric violence. It was very traumatic. Baby was very low. I was at 8 centimeters when I got to the hospital. I was begging for them to let me try and let me push but they said, “No. You are crazy. We have to go to the C-section right, right now.” When they pulled baby out, they broke the uterine artery and I lost a lot of blood. I was very weak and it was very painful. That was a disaster. We were like, “No more babies I think”, but by the grace of God, I got pregnant again in 2021. Sadly, I had a miscarriage on Christmas actually. It was very sad. But I don't know. That miscarriage let me know that my body works and that I would be able to have good contractions and my body was able to give birth. I prayed, “God, if you want, I want another baby.” In November of 2022, I got pregnant again and that time, I was totally strong to fight for another try to have a vaginal birth. My husband was totally against the trying. He was so scared. Also, I was a little bit scared, but I was trusting at that time. I was trusting so hard. I was praying so hard. I decided to not go to the doctor because I was so scared of the doctor. I was hesitant. I don't know why I didn't want to hear, “You are in danger. No. This is so dangerous. You can't try. You have to go directly at 38 weeks to the C-section and you have to have a blood transfusion and you are of advanced maternal age,” because I am 41 years old, but I don't know. I said, “I don't want that in my pregnancy.” Actually, I had a friend who had seven C-sections and then had four home births. She was telling me, “No. Trust God. You have to know when they talk from fear and when they talk from the truth.” I could tell that a lot of people were speaking to me from the fear they felt, not from the truth. I stayed with that doctor until 28 weeks. I found a doctor who wasn't judging me and who was open but he didn't have experience with VBAC after multiple C-sections so he said, “I can check you and support you but not in the birth. I can't do that. I have no experience.” Well, for me, it was like, “Oh, I'm at the beginning of the way.” Okay, so I kept praying and when I was 34 or 35 weeks in the pregnancy, I had a doula who gave me a contact of a midwife that she was supporting VBAC after three C-sections in a hospital with a doctor. I said, “Maybe there's a chance for me.” I contacted her. I talked to her and she was very optimistic. She said, “Yeah. Of course. I can support you. We can prepare a home birth. I can support you. I can be your attendant.” I don't know the word. Meagan: Maybe advocate? Susana: Not advocate. I mean, she was the one who received the baby. Meagan: Oh, like catching. Yeah, attending. Susana: Yeah, attending the birth. But my husband was like, “No, not a chance.” Because for my husband and also for me, it was very difficult and not secure. We were scared. We thought about what if something happened. That midwife told me, “I can speak with the doctor and maybe we can have a plan.” I said, “Okay.” I was 36 weeks so it could be difficult that he started to attend me in these late weeks. But I still had trust and confidence in God. I kept praying all of the time. One day, she called me and said, “Susana, good news. The doctor said yes. I told him all of the truths. I didn't hide anything and he said, ‘Okay. If you are with me, I can attend this birth. But I need to watch her in the next days.'” So we went to the doctor. The doctor was in another city 40 minutes to an hour away from here. My husband couldn't be with me so my parents went with me. My parents were so scared. Meagan: I bet. Meagan: They were very against trying. My husband wasn't completely confident about it. All of my environment was against the VBAC. When we went to the doctor, the doctor was so supportive and so humane and so good and so kind. He said, “We are going to try. We are going to make our best. We are a good team. The midwife and I work together very good and very successfully but I'm going to keep all of the team here if we need the C-section in the last moment.” We agreed on that. My parents were so relieved. We talked with my husband and he was relieved also but he also had doubts. But in the environment of a hospital and– oh, I don't know the word. The place where they make the C-section? Meagan: The operating room? Susana: Yeah, the operating room. In the side of the room, if everything was good, we trusted. He was supportive for the first time. He said, “Okay.” Two weeks passed after this visit and there was the moment when I started getting excited with things with labor. It was on the 11th of August last year in 2023 when I saw my mucus plug and the bloody show. I said, “Oh. I think things can be starting at any moment.” But in my last experience when I had the bloody show, it was two or three days before the labor really started. I patiently waited and the contractions started to be hardest but there was a half hour in between them. It was very manageable and still manageable. I passed the day with my normal activities. I had lunch with my parents and my five kids. I went to gymnastics class with my daughters and actually at night, we went to mass with friends and families that we know. A friend of ours invited us to dinner and I said, “No. I want to go home.” My husband was like, “What? You don't want to go anywhere.” My husband started to sense that something was wrong. We returned to home and contractions started to be closer and intense. I wrote to my midwife and she said, “Okay. You have to count how many contractions happen in one hour,” so I started counting and from 10:00 PM to 11:00 PM, I had nine contractions. I wrote her and she said, “Okay, you are starting. I'm going to go to your home.” By the way, she lives 2 hours from my city so she came to my place at 2:30 AM and checked me. I was only 3 centimeters and 60% effaced. She went and she said, “Oh, congratulations. You are a 3. We only have to wait 7 more.” She was so positive and so kind and so lovely. But for me, it was like, What? 3 centimeters. There's a long way to go. I was so disappointed and I started to have a crisis thinking, Okay. This is going to be three days of labor. It's starting to be unbearable. I don't know what I'm going to do. My husband told me, “You have to know that this is not going to be easy.” I was like, “Oh my god. What is going to happen?” I wrote a friend and she told me, “Maybe you were wrong. Maybe you are not in labor yet. Maybe it is prodromal labor so calm yourself and keep making your activities as normal.” I said, “Yeah, maybe that's true. Maybe I'm not in labor yet.” One of the things is that my contractions don't hurt in the uterus or in the belly. They hurt in the legs. Meagan: Oh. It radiates down. Susana: Exactly. I felt like it started in the hips and ran into the legs but I felt like– I don't know how to say– but a burning. Yeah. It was burning pain. It was very, very intense. My friend told me, “Put one leg on the chair and one leg on the floor and balance side to side while a contraction comes.” I made that and that was really, really helpful. I could have a contraction very easily that way. I was telling myself, “My pelvis can open. My baby can know how to birth. Everything is okay. God is with me,” and things like that. That affirmation worked very, very good because it calmed myself and that's how I passed the contractions all day long. Not the day, only the morning. My daughter, that morning, had a science fair so we decided it was at 8:00 AM so we went. It was the worst time for me having those contractions every seven minutes and very painful. All of the parents were like, “What is happening to her?” Meagan: That's amazing that you went. Susana: It was because I thought, I'm going to have three days in labor. My midwife had told me that when there's a labor after so many C-sections, there's a lot of times that it lasts three, four, or even five days so in my mind, that was my expectation. While I was at the science fair, I said to my husband, “Please take me home. Let's go home. I am in a lot of pain.” I called my midwife again and she came. She checked me and I was 6 centimeters so for me, I was like, “What? Whoa!” Yeah. She said, “We have to go to the hospital.” Oh, before that, we were planning to rent an AirBnB in the city which is Leon, Mexico to spend with all of the family those days that I was supposed to be in labor. So she said, “Forget about that plan. We will go directly to the hospital.” We called the doctor and the doctor said, “I need to check her with an ultrasound. You need to go to the office with me.” I thought it was useless, but we went to the office. It was the worst travel because I had contractions every 4 minutes and we were traveling in the van, but the good thing was that my midwife was making pressure on my hips and that released the pain. After 1 hour and 20 minutes, we arrived to the doctor. He checked me really fast and he said, “You are 6 centimeters.” Again, I was so disappointed because I thought, “Oh my god. One hour and I'm still a 6.” But my midwife told me, “No, I don't think so. I think you are maybe a 7 or an 8.”She is very wise. She had a lot of intuition. So we went to the hospital and it was 20 minutes away from the office. We arrived at the hospital at 12:35 PM. When we arrived at the hospital, he wanted to put me in an emergency room, but the doctor arrived immediately and told them, “No. Put her directly in a room because it was going to be a room birth.” I gave birth in a room, not in an operating room, but in a labor and delivery room. Meagan: They had you labor the rest of the way and give birth in the operating room?Susana: Yeah. In Mexico, all of the births happen in the operating room. Actually, it's not an operating room but it looks like it. It only has that stuff that they put the woman with the legs up. Yeah, I don't remember the name, sorry. Meagan: Like just the position? Susana: Yeah. Meagan: Okay, gotcha. Susana: So we went to the room. My midwife said, “Do you want to go to the shower?” I said, “Yeah, please.” I went to the shower. At that time, my water broke like a balloon because I felt something really big getting out. It was shocking and I was like, “What? Is that the placenta?” She said, “No, let me see what it is.” It was the amniotic sac almost complete. It was amazing because my midwife told me, “I've never seen something like this.” It was amazing. After that, the contractions felt very different with no pain and I started to feel to push. It was very different for me and very scary because I never felt something like that. Meagan: Right. Susana: My midwife told me, “You're going to birth now. You have to choose your position.” I stayed on my knees on the floor with the arms on the bed and started to push my baby out. I can say I didn't feel any pain in this moment. I only felt the pressure. I think I had the reflex, the fetal ejection reflex.Meagan: Yeah, mhmm. It's like where the baby just comes out. Susana: Yeah, because I wasn't pushing and my body was pushing. It was an amazing feeling but also, I was scared because I didn't know how to do that. My husband was praying with me and he was very supportive and very loving in that moment. That moment was awesome. I know God was there. I knew all my prayers were answered in this precious moment. I only let my body make its worth. I felt incapable of pushing a baby out. That was an amazing feeling. I don't know how to say it. It's like you are here but you are not. Meagan: Yeah. It's surreal. It's really– when you realize you're in that moment of pushing your baby out and I can't even imagine after five Cesareans, just that moment of, Wait, is this really happening? Susana: Exactly. It was like a dream. My husband was telling me, “Yes. You are so strong. You are telling me the truth. The miracle is done. Come on love. You can do it. You are so close.” I can't remember exactly but I think it was four or five pushes and baby was out. Baby had two wraps of the cord. Meagan: Double nuchal cord, okay. Susana: Yes. Then the body was out and it was a relieving feeling. It was magical. Everything was done. Every pain, every pressure, and every fear was gone. I felt that very warm and wet body in my arms. It was a magical moment like, I can't believe this is happening. Praise to God. I was crying. That moment was unlike any other moment in my life. Meagan: I can't even imagine. Wow. So was everyone very pleased and shocked? That's not a normal thing. For VBAC after one and two, it's like, okay. After three, providers are like, “I don't really know. Risks do go up so we are nervous about this,” so after five, how was your community around you?Susana: Yeah. They were very shocked. Actually, the hospital didn't allow VBAC after multiple C-sections, but the doctor said because in the lobby, they asked, “How many pregnancies and how many births? All those were natural births?” The doctor said, “Yeah.” Everything was happening very fast. After the baby was born, everyone was screaming, “Vaginal birth after five C-sections here!” The nurses and the doctor and the people in the lobby said, “What?! It's a miracle.” Everybody was so happy. Everybody was shocked. I don't know. It was amazing. Meagan: I'm sure they had a lot of feelings. I'm sure they were so happy for you and so shocked and even probably still questioning, “Wait, really did that just happen?” Because even we as a mom pushing in that moment, I think it's very much for the providers too, “Wait, is this happening?”Susana: Yeah, actually the doctors said the medical community was pretty– I don't know the word but they were saying, “What did you do? You didn't do another C-section? What's wrong with you?” They didn't do the episiotomy and I didn't tear at all. Meagan: Amazing. Susana: What else? He said, “It was a perfect birth.” Nothing went wrong. Nothing. So for him, for my doctor, he was very proud. He was not scared of sharing the evidence or the support and my case. Meagan: Right. He wasn't scared of sharing that he was supportive of you doing that. Susana: Exactly. He put on social media what we did. A lot of people were like, “What?” But he told me, “I only supported you because of your midwife because she is amazing. She is very wise. She has a lot of intuition. She had a good eye to know when it can happen and when not. Meagan: Yeah. Susana: She is awesome. Meagan: I wonder if they work together often now. Susana: Not too often because she usually goes to home births but when a couple wants a hospital or a VBAC, she works with him. Meagan: Oh my gosh. That's awesome that they can work together and it really truly makes it possible for those who want to. We know that not everybody will and we know that the risk is not acceptable for others. Susana: Right. Right, exactly. Meagan: Something that I love on ACOG, there is a website that is called acog.org so the American College of Obstetricians and Gynecologists so it's more here in the U.S. but there is a provider called Dr. Angelica Glover. She wrote an article on VBAC and one of the things that I enjoyed about her article was the very end. It says, “One size does not fit all. If you are pregnant and have a previous Cesarean birth, talk through all of these questions with your OB/GYN. Weigh the risks and benefits of each birth option like you would with any important healthcare decision.” I love that. Just like you would with any healthcare decision. It says, “Think of this as an ongoing conversation with your OB that starts early in pregnancy and evolves over time. Your feelings may change and your risk factors could change too. There is no one-size-fits-all answer when it comes to choosing between trying for a VBAC or a repeat Cesarean birth. What matters is that you are comfortable with your decision and you feel supported through your pregnancy and birth.” I love that because really in the end, VBAC after three, four, five, or whatever may not be comfortable for someone else but it may be for someone like you. Then the biggest factor is finding the support and we know that can be really hard so I love hearing that you had two providers who were on board with you, trusted you, and trusted the process. I do love that your midwife talked to you about how it can take time and you made it to 8 centimeters before right? Your body had done it. It just still needed time. It has gone through a lot and there was scar tissue and all of the things. It can take time, but you were allowed that time. You were allowed that time. They trusted you and they trusted themselves even. I am just so happy for you and I appreciate you sharing your story because it is one of those things that is really desired. A lot of people don't know it's an option then they find out and they are like, Wait, is this really possible?Yes, it is so it's really nice to hear a story here and there as they come along to show that yes. Women of Strength, it is possible. Are there risks? Yes. There are risks. Are they more than VBAC after one or two Cesareans? Yeah and honestly, we don't even know the exact evidence on specifically VBAC after five Cesareans because they are not studied and they are not happening. Susana: No, they are not but I can say that I read a lot. I found very good information from the Royal College of Gynecology and Obstetrics in the United Kingdom and it said that as a provider, you have to let the mom share if they want to try or do the repeat C-section, but always the vaginal birth is less risky than a repeat C-section especially after too many C-sections. Meagan: We do know that there are increased risks with repeat Cesareans as well. We know that is also very much a thing so we want to make sure that we are taking into consideration that as well because we've got issues where uterine rupture actually can also happen in a repeat Cesarean and that risk can be there. Bleeding and hysterectomy, there are risks that are sometimes actually higher for a Cesarean than a vaginal birth. It's just important to know all of the risks. I think sometimes we hyper-focus on the risk of VBAC instead of going through and looking at things. Evidence-Based Birth has such an amazing article and I think it was actually even a podcast episode on VBAC. She talked about how there are a ton of studies within here. She goes through the maternal outcomes here. Susana: That's awesome. Meagan: Yeah. It shows the maternal outcomes and the newborn outcomes. It says, “Maternal adverse events or bad outcomes were more frequent among women who had a C-section birth after Cesarean,” meaning they attempted a VBAC but it ended up in a Cesarean compared to those who had a VBAC. That's another risk. We have Cesarean risks. We have VBAC risks and then we have where we are going for a VBAC and it goes into a Cesarean. There is also risk there. We really need to just pause and stop and look at everything. I mean, literally, everything before we make a decision. There are so many times like with your first birth, there was so much going on. You had such an unfortunate event happening with the loss of your loved one and a provider was saying, “Oh, you're only at 3 centimeters and 60% effaced so this is probably not going to happen,” when in reality, that vaginal birth probably very much would have happened but we just didn't know. We didn't know. Susana: Yeah, totally. Yeah. Meagan: It's so hard because there are so many times where we hear these things from a provider. Me too. I did too. I was like, okay. We trust them and we don't want to not trust our provider but at the same time, we want to make sure that we do get informed. I'm so proud of you for along the way getting informed and learning about your options and I'm so happy for you that you were able to have your vaginal birth. Susana: Yeah, thank you. Thank you so much. I can say at least here, I think younger OB/GYNs are more open to support VBAC than the older OB/GYNs. I don't know how it is in the United States, but here, I think that is happening. Meagan: Yeah. I think it takes us all continuing to advocate for ourselves to have these providers stop and change their point of view because I believe that so many times, even if the evidence is there, there are so many times that it takes seeing it to believe it. You can look at a piece of paper and look at the evidence and you can see that, but at the same time, you're like, Okay, yeah. Sure. That probably can't happen, even though it's right there on the form, but seeing it really can change a lot of people's perspectives and just opinions. I think that is what you probably did to that entire hospital. Like you said, “Vaginal birth after five Cesareans in here!” Yeah. They were all blown away and you really did. You changed their perspective. Susana: Yeah. I am so happy to help another woman, to inspire, to read, to find information, real information. Don't let the doctors scare you. There is risk in all of pregnancy. It can be risky. Life is risky. Meagan: Life is risky. You're not wrong there. There is risk everywhere. It's just important to know the risk and then decide if that risk is acceptable to you. If that risk is acceptable to you, then great. Go for it. If not, that's okay. Susana: It is worth every moment and every pain. Everything, it was worth it. Meagan: Yeah. Well, I'm so happy for you. Congrats again and thank you for being with us today and sharing a VBAC after five Cesareans story. Susana: Oh, thank you so much. I'm so happy and I hope that a lot of women hear this podcast and are inspired themselves. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Send us a textEffects of a live versus heat-inactivated probiotic Bifidobacterium spp in preterm infants: a randomised clinical trial.Athalye-Jape G, Esvaran M, Patole S, Nathan EA, Doherty DA, Sim E, Chandrasekaran L, Kok C, Schuster S, Conway P.Arch Dis Child Fetal Neonatal Ed. 2024 Aug 17:fetalneonatal-2023-326667. doi: 10.1136/archdischild-2023-326667. As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textRetrospective study of preterm infants exposed to inhaled nitric oxide in Kaiser Permanente Southern California: morbidity, mortality and follow-up.Bhatt DR, Braun D, Dizon RA, Shi JM, Weerasinghe S, Sabio A, Reddy S, Lee HC, Ramanathan R, Lakshminrusimha S.J Perinatol. 2024 Jul 18. doi: 10.1038/s41372-024-02051-w. Online ahead of print.PMID: 39025953As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!