The Rooted Womb

“First they came for VBAC, and I did not speak out, because mine was not a VBAC. Then they came for twin birth, and I did not speak out, because mine was not a twin birth. Then they came for breech birth, and I did not speak out, because mine was not a breech birth. Then they came for home birth, and I did not speak out, because mine was not a home birth. Then they came for my birth, and there was no one left to speak for me.” — drstu

I recently heard this poem on Dr Stu’s podcast and I cannot say how much it resonated with me.

When I had my babies I thought birth was pretty normal. Low intervention, nothing dramatic. As I moved into midwifery I began to see that this felt like the minority, not the majority.

After I had my third quickly at home, something snapped in me that was irreversible. The absolute realisation of what normal birth can be. Soon after I went back to work I couldn’t contain myself any longer. I felt I had to fight for this, to share the good news of normal physiological birth, to protect women and give them real options.

This poem hit so hard because it is so easy not to fight for things when they don’t affect us directly. Whether you had a great experience or a hard one, this is a reminder that it is always worth standing up for the things that matter 💥

Stuart James Fischbein,MD

📸 Beautiful Til

Sustained breastfeeding associations with brain structure and cognition from late childhood to early adolescence

"Abstract
Background: While breastfeeding benefits early child neurocognition, its influences into adolescence, a period of intense brain remodeling and heightened mental health risk, remain unclear.

Methods: Breastfeeding and neurocognitive longitudinal associations were explored over a two-year period in the Adolescent Brain Cognitive Development (ABCD) Study® (nbaseline = 5098, ages 9-10, 49% female; nfollow-up = 3810, ages 11-12, 48% female). Breastfeeding duration was reported as never breastfed (15.8%), 1-6 months (34.6%), 7-12 months (26.4%), and >12 months (23.1%). MRI-derived estimates of cortical thickness, surface area, and cortical myelin were calculated across 148 brain regions alongside fluid cognition measures. Linear mixed-effects models tested the influence of breastfeeding duration and its interaction with age on neurocognitive outcomes. Significant cortical thickness and surface area associations were explored for cortical myelin differences. Parallel mediation analyses examined whether cortical features mediated the breastfeeding-fluid cognition relationship.

Results: Breastfeeding duration was positively associated with cortical thickness (31 regions), surface area (45 regions), and fluid cognition (all p values < 0.05), and with greater cortical myelin in four regions and increases by follow-up in 12 regions (all p values < 0.05). Surface area mediated the breastfeeding-fluid cognition link (β = 0.008, CIboot95% = 0.005, 0.012).

Conclusions: These findings emphasize the importance of extending breastfeeding practices for optimal adolescent neurocognition.

Impact: Does breastfeeding influence neurocognition during early adolescence, and does it impact neurocognitive development at this stage? In this longitudinal study, breastfeeding demonstrated dose-dependent, lasting positive influences on neurocognition that remained stable over a 2-year period spanning late childhood to early adolescence. Specifically, individuals who were breastfed longer showed increased cortical thickness, surface area, cortical myelin, and fluid cognition, predictors of positive outcomes in later life, including physical and mental health. Our findings highlight the importance of breastfeeding and support its extended practice for optimal neurodevelopment and potential late-life benefits."
https://pubmed.ncbi.nlm.nih.gov/40382469/

Putting an End to the Global Slaughter of Women Bleeding to Death Regular everyday events are rarely newsworthy. The media typically induces emotional reactions through constant reports of deaths related to emerging diseases, accidents, murders, human conflicts, and natural disasters. There is a widespread tendency to ignore the amplitude of chronic problems. Few....

“Over the years I have come to the conclusion that postpartum haemorrhages are almost always related to inappropriate interference. Postpartum haemorrhage would be extremely rare if a small number of simple rules were understood and observed. “
I will add that the narrative of hemorrhage is so overused when true hemorrhaging is extremely rare in physiological birth, like Odent names—-
“There is a widespread tendency to ignore the amplitude of chronic problems. Few people realize that bleeding is the single most common cause of maternal deaths worldwide.

These deaths are to a great extent -preventable-. Most of them will be avoided on the day when we have rediscovered the basic needs of women in labour and of newborn babies.”

Putting an End to the Global Slaughter of Women Bleeding to Death Regular everyday events are rarely newsworthy. The media typically induces emotional reactions through constant reports of deaths related to emerging diseases, accidents, murders, human conflicts, and natural disasters. There is a widespread tendency to ignore the amplitude of chronic problems. Few....

🚨 New Study: increasing breastfeeding rates to 90% could save 72,300 noncommunicable disease deaths globally per year.

✨️ Formula feeding does carry risks, which is why breastfeeding on a population level is a public health concern. Individual benefit vs risk is different for each mother baby dyad.

This study also found increasing breastfeeding to 90% could prevent 10 million cases of diabetes across the lifespan of the cohort.

Of the delayed NCDSs, most delayed deaths were from ischaemic heart disease (43%) and stroke (33%), with cancer accounting for 18%.

Study authors interpreted the data to mean: Scaling up exclusive breastfeeding coverage could lead to benefits in reducing NCDs, complementing its established benefits for child mortality and early childhood development.

Essentially, this study added to the importance of breastfeeding on a global population level. Breastfeeding absolutely saves lives.

This study, published in the Lancet, focused on low and middle income countries. What does this mean for people in wealthier countries? Breastfeeding benefits still exist wherever you live and reduce the risk of developing cancer, diabetes, etc. However, in a wealthier country, you may have access to additional preventative measures and care, and access to medical care if you become sick.

Wherever you live, breastfeeding is the biological norm following a pregnancy

At the population level, breastfeeding reduces risk and has significant benefit.

As parents, we make decisions on individual levels.

For simple math, let's say on a population level the risk of allergies is 15 in 100 in not breastfeeding infants but in breastfeeding infants it's 5 in 100. Breastfeeding does not mean there's a 0% chance of allergies and not breastfeeding doesn't mean a 100% chance of allergies. Simply, when we look at large groups, more formula fed infants have allergies compared to breastfed infants.

All this said, breastfeeding is not easy. Low rates are often associated with lack of support, early return to work, birth complications, etc.

What support did you wish you had?