Holocaust literature gives exhaustive attention to direct means of exterminating Jews, by using gas chambers, torture, starvation, disease, and intolerable conditions in ghettos and camps, and by the ...Einsatzgruppen. In some circles, the term “Holocaust” has become the ultimate description of horror or horrific events. The Nazi medical experiments and practices are an example of these. Nazi medical science played a central and crucial role in creating and implementing practices designed to achieve a “Master Race.” Doctors interfered with the most intimate and previously sacrosanct aspects of life in these medical experiments – reproductive function and behavior – in addition to implementing eugenic sterilizations, euthanasia, and extermination programs. Manipulating reproductive life – as a less direct method of achieving the genocide of Jews – has been less acknowledged. The Nazis prevented those regarded as not meeting idealized Nazi racial standards – and particularly Jewish women – from having sex or bearing children through legal, social, psychological and biological means, as well as by murder. In contrast, they promoted reproductive life to achieve the antithesis of genocide – the mass promotion of life – among those deemed sufficiently “Aryan.” Implementing measures to prevent birth is a core feature of the UN Convention on the Prevention and Punishment of Genocide. As with many other aspects of the Holocaust, science and scientists were inveigled into providing legitimacy for Nazi actions. The medical profession was no exception and was integrally involved in the manipulation of birth to implement the Holocaust.
Abstract Objective The Canadian Perinatal Surveillance System (CPSS) of the Public Health Agency of Canada (PHAC) routinely monitors national perinatal health indicators using available ...administrative databases and population health surveys. Women’s perceptions and assessments of their perinatal experiences are not captured by these data sources. The Maternity Experiences Survey (MES) addresses some of these knowledge gaps, and was designed to examine experiences, practices, perceptions and knowledge during pregnancy, birth and the early postpartum months among women giving birth in Canada. Methods A randomly selected sample of 8542 women, stratified primarily by province and territory, was drawn from the May 2006 Canadian Census. Birth mothers living with their infants at the time of interview were invited to participate in a computer assisted telephone interview conducted by Statistics Canada on behalf of the PHAC. Interviews took approximately 45 minutes and were completed when infants were between five and 10 months old (between 9 and 14 months in the territories). Completed responses were obtained from 6421 women (78%). Results Most women reported being satisfied with the care they received. The findings suggested a higher use of selected interventions in pregnancy, labour and birth than is recommended by current evidence and a lower adherence to several best practices related to family-centred issues and the World Health Organization / United Nations Children’s Fund “Baby Friendly Hospital Initiative.” Conclusion Assessing women’s perceptions of their perinatal care provides a valuable supplement to traditional perinatal surveillance tools. The MES will allow for women’s views to be considered in relation to current maternity care policies and practices in Canada.
BACKGROUND: Despite the current World Health Organization recommendation that infants be exclusively breastfed for 6 mo, this practice remains unusual in both developed and developing countries. ...OBJECTIVE: The objective was to compare health and development outcomes at age 6.5 y in children who were exclusively breastfed for 3 mo (EBF3) or for 6 mo (EBF6); in the EBF3 group, the children continued partial breastfeeding for greater-than-or-equal6 mo. DESIGN: This was a prospective cohort study nested within a large, cluster-randomized trial of a breastfeeding promotion intervention in the Republic of Belarus. Outcomes compared at 6.5 y included anthropometric measurements, systolic and diastolic blood pressure, intelligence quotient, teachers' ratings of academic performance, parent- and teacher-rated behavior, atopic symptoms, allergen skin-prick tests, and dental caries. All statistical analyses were adjusted for cluster- and individual-level covariates and for clustering of outcomes within the clinics at which the children were examined. RESULTS: The 2427 EBF3 and 524 EBF6 children who were followed up represented 84.7% and 89.4%, respectively, of those followed for the first year of life. The only significant differences observed between the 2 groups were in mean body mass index, triceps skinfold thickness, and hip circumference, all of which were higher in the EBF6 group. CONCLUSIONS: We observed no demonstrable beneficial or adverse long-term effects on child health of exclusive breastfeeding for 6 mo. Higher adiposity measures in the EBF6 group probably reflect reverse causality rather than a causal effect of prolonged exclusive breastfeeding. Established benefits appear to be limited to the period of exclusive breastfeeding.
Abstract Objective To compare the maternity experiences of immigrant women (recent, ≤ 5 years in Canada; non-recent > 5 years) with those of Canadian-born women. Methods This study was based on data ...from the Canadian Maternity Experiences Survey of the Public Health Agency of Canada. A stratified random sample of 6421 women was drawn from a sampling frame based on the 2006 Canadian Census of Population. Weighted proportions were calculated using survey sample weights Multivariable logistic regression was used to estimate odds ratios comparing recent immigrant women with Canadian-born women and non-recent immigrant women with Canadian-born women, adjusting for education, income, parity, and maternal age. Results The sample comprised 7.5% recent immigrants, 16.3% non-recent immigrants, and 76.2% Canadian-born women. Immigrant women reported experiencing less physical abuse and stress, and they were less likely to smoke or consume alcohol during pregnancy, than Canadian women; however, they were more likely to report high levels of postpartum depression symptoms and were less likely to have access to social support, to take folic acid before and during pregnancy, to rate their own and their infant’s health as optimal, and to place their infants on their backs for sleeping Recent and non-recent immigrant women also had different experiences, suggesting that duration of residence in Canada plays a role in immigrant women’s maternity experiences. Conclusion These findings can assist clinicians and policy-makers to understand the disparities that exist between immigrant and non-immigrant women in order to address the needs of immigrant women more effectively.
Available evidence suggests that prolonged and exclusive breastfeeding is associated with lower infant weight and length by 6 to 12 months of age. This evidence, however, is based on observational ...studies, which are unable to separate the effects of feeding mode per se from selection bias, reverse causality, and the confounding effects of maternal attitudinal factors.
A cluster-randomized trial in the Republic of Belarus of a breastfeeding promotion intervention modeled on the World Health Organization (WHO)/UNICEF Baby-Friendly Hospital Initiative versus control (then current) infant feeding practices. Healthy, full-term, singleton breastfed infants (n = 17 046) weighing > or =2500 g were enrolled soon after birth and followed up at 1, 2, 3, 6, 9, and 12 months old for measurements of weight, length, and head circumference. Data were analyzed according to intention-to-treat, while accounting for within-cluster correlation. To assess the potential for bias in observational studies of breastfeeding, we also analyzed our data as if we had conducted an observational study by ignoring treatment, combining the 2 randomized groups, and comparing 1378 infants weaned in the first month and those breastfed for the full 12 months of follow-up with either > or =3 months (n = 1271) or > or =6 months (n = 251) of exclusive breastfeeding.
Infants from the experimental sites were significantly more likely to be breastfed (to any degree) at 3, 6, 9, and 12 months and were far more likely to be exclusively breastfed at 3 months (43.3% vs 6.4%). Mean birth weight was nearly identical in the 2 groups (3448 g, experimental; 3446 g, control). Mean weight was significantly higher in the experimental group by 1 month of age (4341 vs 4280 g). The difference increased through 3 months (6153 g vs 6047 g), declined slowly thereafter, and disappeared by 12 months (10564 g vs 10571 g). Analysis by z scores confirmed that infants in both groups gained more weight than the WHO/Centers for Disease Control and Prevention reference, with no evidence of undernutrition in the control group. Length followed a similar pattern. In the observational analyses, infants weaned in the first month were slightly lighter and shorter at birth and their weight-for-age and length-for-age z scores declined by 1 month, but they caught up to both experimental and the other observational groups by 6 months and were heavier and longer by 12 months. Among infants in the 2 prolonged and exclusive breastfeeding groups, weight-for-age z scores fell slightly between 3 and 12 months; length-for-age fell below the reference by 6 months with catch-up to the reference by 12 months. Head circumference showed no significant differences at any age between the 2 trial groups or among the observational groups.
Our data, the first in humans based on a randomized experiment, suggest that prolonged and exclusive breastfeeding may actually accelerate weight and length gain in the first few months, with no detectable deficit by 12 months old. These results add support to current WHO and UNICEF feeding recommendations. Our observational analysis showing faster weight and length gains with early weaning and slower gains with prolonged and exclusive breastfeeding may reflect unmeasured confounding differences or a true biological effect of formula feeding.
Breastfeeding unfriendly in Canada? Chalmers, Beverley
CMAJ. Canadian Medical Association journal,
2013-Mar-19, 2013-03-19, 20130319, Letnik:
185, Številka:
5
Journal Article
Recenzirano
Odprti dostop
The Canadian Maternity Experiences Survey found that although at least 90% of Canadian women intended to start, and started, breastfeeding, 21% added liquids other than breastmilk within 1 week of ...delivery and 25.2% within 2 weeks, which suggests that hospital breastfeeding support practices are failing about a quarter of all breastfeeding women.4 Calculations based on 372 724 births in 2007 indicated that 335 452 women started breastfeeding, thereby expressing their desire to breastfeed, and 84 534 gave up exclusive breastfeeding within 1-2 weeks of giving birth.6 Similarly, a 2009 survey of all Ontario births during a 1-year period found that only 61.6% of mothers were exclusively breastfeeding at discharge from hospital.7 The Canadian Maternity Experiences Survey clearly showed that few of the in-hospital breastfeeding sup - portive practices recommended by the Baby- Friendly Hospital Initiative as necessary to support breastfeeding were being appropriately im plemented by hospitals in Canada.4 For in - stance, only 26.6% of women put their baby to the breast for the first time during the most optimal period (30 min to 2 h) after birth; 28.1% of mothers whose babies were not admitted to a neonatal intensive care unit or special care unit held their babies within 5 minutes of birth; 31.1% of mothers held their babies skin-to-skin on first contact; 35.8% of mothers were offered or given free formula; 35.0% of women whose babies were not admitted to a neonatal intensive care unit or special care unit had rooming-in for the recommended 23-24 hours per day; 50.2% of mothers did not follow the recommended demand-feeding schedule; and 44.4% of babies were given a pacifier within the first week of life.4 These figures suggest that hospital practices (and therefore training of health care workers) probably contribute more to breastfeeding failure than social determinants of health, which are unlikely to have changed or influenced these inhospital practices. Inadequate support is given to mothers who have had cesarean deliveries. We downplay the breastfeeding challenges faced by the 27.8% of women in Canada who give birth by cesarean delivery.6 Although the rates of breastfeeding initiation among mothers who have had cesarean and vaginal deliveries do not differ, mothers who have had cesarean deliveries have less optimal mother-infant contact after birth and lower rates of continued breastfeeding.10 They are more likely to be given free formula samples, use pacifiers and not feed their babies on demand, factors that reduce success in breastfeeding10 and are indicative of inappropriate breastfeeding support.
Abstract Objective The Maternity Experiences Survey (MES) is an initiative of the Canadian Perinatal Surveillance System. Its primary objective is to provide representative, pan-Canadian data on ...women’s experiences during pregnancy, birth, and the early postpartum period. Methods The development of the survey involved input from a multidisciplinary study group, an extensive consultation process and two pilot studies. The MES population consisted of birth mothers 15 years of age and over who had a singleton live birth in Canada during a three-month period preceding the 2006 Canadian Census of Population and who lived with their infants at the time of data collection. Experiences of teenage, immigrant, First Nations, Inuit, and Métis mothers were of particular interest. The sample was drawn from the 2006 Canadian Census. A 45-minute interview was conducted at five to 14 months post partum, primarily by telephone by female professional Statistics Canada interviewers. Results A response rate of 78% was achieved, corresponding to 6421 women who were weighted to represent an estimated 76 508 women. The cooperation rate was 92% and the refusal rate was 1.0%. Item non-response was low, and few data errors were identified. The final MES sample was judged to be representative of the corresponding Census population for all characteristics investigated. Conclusion The MES marks an important milestone in the availability of information on maternity experiences in Canada. For the first time, it is possible to provide high quality data at national, provincial, and territorial levels on a wide spectrum of maternity experiences as reported by women.
In the midst of the turmoil that has followed the disintegration of the Soviet Union in 1989, medical systems in Eastern Europe have begun to undergo massive transformation. For maternity care this ...has meant an opening up to the influx of information regarding prevailing obstetrical practice in North America and Western Europe.
How is change in childbirth effected? What can we learn from the transformations that are taking place in Eastern Europe? What sources of authoritative knowledge in health care are regarded highly in this region? How are these changing? Should representatives from the West seek to influence this process
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