Thank you for the Feedback!

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I was walking up the path from my daily trip to feed and water the animals, and stopped to check the mail. To my surprise and joy, I found a lovely family photo card in the mailbox! It was a heartfelt thank you from a recent client:

Thank you for the amazing service you have provided our family. Josie is our 3rd baby and I have never felt so amazing after a birth! I feel so emotionally balanced and happy – it’s almost hard to believe!! I battled postpartum depression after my first two babies – but there are no signs at all this time!!! Thank you for helping to keep us healthy and happy!

Hugs!

The Taylors

What a wonderful surprise to find in the mailbox! We always encourage anyone who has tried this service to speak about their experience. The more we talk about and share our experiences, the more common encapsulation will become! Please feel free to share your experience below, or contact us privately.
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2010 Columbus Dispatch article on Placentas…quotes from Amy Wakeling and Kelsie Meyers

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Great article in the local Dispatch!  Hadn’t seen this one before.  It talks about the practice of Placenta Encapsulation being rare.  I guess it was even back in 2010.  It also mentions that most of the hospitals here in Columbus have a standard procedure for moms who want to take the placenta home.

Good to see local midwife, Amy (Wakeling) Knisley mentioned in the article.  And local Placenta Encapsulator, Kelsie Meyers is also quoted quite a bit.

“The practice, known as placentophagy, is rare in the United States but happens often enough that some people are making a profession out of dehydrating placentas, grinding them up and putting them in capsules.

And hospitals, including those in Columbus, have drafted policies on placenta release in response to requests from women who want them both for medicinal and cultural reasons. In some cultures, the placenta is customarily buried.

Research on the purported benefits of placenta is scarce, but women who have taken placenta capsules say they ease postpartum depression, increase milk production and improve energy.”

http://www.dispatch.com/content/stories/local/2010/10/08/placenta-nutrients-might-aid-new-moms.html

There’s some great info there.  If anyone is interested in this service here in Central Ohio, feel free to email me at    birthingbeautifully@hotmail.com373756_278018708897769_1776250333_n

Film Review: Birth Story: Ina May Gaskin & the Farm Midwives

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A couple weeks ago there was a disturbance in the force.  It seems that all births in central Ohio stopped to allow a congregation of midwives, student midwives, and doulas.  They packed the Studio 35 theater on Indianola Ave to the gills from what I am told.  If I can convince my wife, there may be a personal review forthcoming.  But for now she said it was a great film and you will have to satisfy your curiosity with this report from http://www.hollywoodreporter.com/review/birth-story-ina-may-gaskin-412793

Telling the commune’s story alongside that of this midwife practice, Lamm and Wigmore find satisfied customers both young and old; frequently, interviews are intercut with decades-old video footage of the subject in the middle of labor. We watch breach deliveries and other challenging cases, and see various ways — like having young children present — in which the group has tried to change perceptions of childbirth as something to be dreaded.

Trailer:

This is a short snipit to wet your appetite.  You can read more about it at the link.  And you can also get a hold of the documentary here:

http://birthstorymovie.com/

Placental Corticotropin-Releasing Hormone (CRH) and Post-Partum Depression; N.I.H. 1998

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Dr. Chrousos is quoted in an article in Discover from 1995 on the PlacentaBenefits.info website. He is speaking about this hormone and the stress relieving effects it has on pregnant mothers.  How it is produced in the hypothalamus and the placenta.  And that the placental production stops after birth, creating a disruption until the hypothalamus rebalances the system a few weeks after birth.  Until recently I had not been able to find this source article.

Here’s a few clips from the Annals of Internal Medicine in 1998 which mentioned the National Institute of Health (NIH) study he and others doctors conducted. It’s quite instructive! For example, I had no idea that Post-Partum Blues (mild transient depression) was so common as to occur in 60% to 70% of women.  I had learned through previous research that full Post-Partum Depression occurs in 10%.

Interactions between the Hypothalamic-Pituitary-Adrenal Axis and the Female Reproductive System: Clinical Implications

George P. Chrousos, MD; David J. Torpy, MB, BS; and Philip W. Gold, MD

Ann Intern Med. 1998;129:229-240.

“The clinical implications of placental CRH extend beyond pregnancy, labor, and delivery (76, 77) (Figures 5 and 6). The postpartum period is characterized by an increased incidence of psychiatric and autoimmune manifestations. Indeed, the “post-partum blues,” a mild form of transient depression, occurs in 60% to 70% of women; full-blown post-partum depression affects about 10%; and very severe postpartum psychosis affects about 1 in 1000.

We hypothesized that the postpartum period might be associated with low hypothalamic CRH secretion, which would predispose patients to atypical depression and autoimmune phenomena. We prospectively studied 17 pregnant women who were healthy and had no personal or family history of depression (77). Psychometric testing was done serially beginning with the 20th week of pregnancy and continuing up to a year postpartum. We did ovine CRH stimulation tests at 3, 6, and 12 weeks postpartum. Nine women had normal affect throughout, but 7 developed postpartum blues and 1 developed full-fledged postpartum depression. Plasma levels of ACTH before and after ovine CRH showed little response at 3 weeks, a better but still suppressed response at 6 weeks, and an almost normal response at 12 weeks. Cortisol levels remained in the upper normal range throughout, mostly be- cause plasma cortisol-binding globulin levels were about twice the normal level at 3 weeks, and it took about 3 months or longer for them to decrease to within the normal range. When we separated the women at 3, 6, and 12 weeks into those with the blues or depression and those without a mood disorder, the former had marked suppression of the ACTH response to ovine CRH compared with the latter. Thus, whereas the overall data showed a transient suppression of hypothalamic CRH secretion in the postpartum period, women with the blues or depression had a more severe suppression that lasted longer.

In the postpartum state, the major source of CRH and estrogen, the placenta, is no longer present, whereas the hypothalamic CRH neuron is probably suppressed as a result of previous exposure to high levels of Cortisol for more than 3 months and because of concurrent estrogen deficiency.”

Conclusion: “Placental CRH drives the pituitary-adrenal axis to produce high Cortisol secretion during the latter part of pregnancy. Withdrawal of placental CRH after delivery provokes a secondary hypothalamic CRH deficiency with varying consequences for mood disorders and autoimmune phenomena.

Several lines of evidence suggest that the lethargy, fatigue, hypersomnia, and hyperphagia of atypical depression are associated with hyposecretion of CRH (3). This hyposecretion may contribute to a significant increase in the incidence of allergic and autoimmune phenomena in this form of depression and in its two homolog transient states, the postpartum blues or depression and the postcure state of patients with the Cushing syndrome (48, 77, 79).”

Pregnancy Hormone Chart

Source: http://integrativehealthconnection.com/wp-content/uploads/2011/11/Interactions-between-the-Hypothalamic-Pituitary-Adrenal-Axis-and-the-Female-Reproductive-System-Clinical-Implications.pdf

There is also a Journal of Clinical Endocrinology & Metabolism article from 1996 which cites this NIH study as well:

http://jcem.endojournals.org/content/81/5/1912.abstract

Placenta Supplements Scientific Research

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Enhancement of opioid-mediated analgesia: A solution to the enigma of placentophagia

Mark B. Kristal

Source: Neuroscience & Biobehavioral Reviews Volume 15, Issue 3, Autumn 1991, Pages 425–435

Department of Psychology, State University of New York at Buffalo, Buffalo, NY 14260, USA

Two major consequences of placentophagia, the ingestion of afterbirth materials that occurs usually during mammalian parturition, have been uncovered in the past several years. The first is that increased contact, associated with ingesting placenta and amniotic fluid from the surface of the young, causes an accelerated onset of maternal behavior toward those young. The second, which probably has importance for a broader range of mammalian taxa than the first, is that ingestion of afterbirth materials produces enhancement of ongoing opioid-mediated analgesia. The active substance in placenta and amniotic fluid has been named POEF, for Placental Opioid-Enhancing Factor. Recent research on both consequences is summarized, with particular attention to POEF, the generalizability of the enhancement phenomenon, its locus and mode of action, and its significance for new approaches to the management of pain and addiction.

http://www.sciencedirect.com/science/article/pii/S0149763405800351

Baby blues – postpartum depression attributed to low levels of corticotropin-releasing hormone after placenta is gone 

Many new mothers feel depressed for weeks after giving birth. Physicians have vaguely attributed this malaise to exhaustion and to the demands of motherhood. But a group of researchers at the National Institutes of Health has found evidence for a more specific cause of postpartum blues. New mothers, the researchers say, have lower than normal levels of a stress-fighting hormone that earlier studies have found helps combat depression.
When we are under stress, a part of the brain called the hypothalamus secretes corticotropin-releasing hormone, or CRH. Its secretion triggers a cascade of hormones that ultimately increases the amount of another hormone – called cortisol – in the blood. Cortisol raises blood sugar levels and maintains normal blood pressure, which helps us perform well under stress. Normally the amount of cortisol in the bloodstream is directly related to the amount of CRH released from the hypothalamus. That’s not the case in pregnant women.
During the last trimester of pregnancy, the placenta secretes a lot of CRH. The rise is so dramatic that CRH levels in the maternal bloodstream increase threefold. “We can only speculate,” says George Chrousos, the endocrinologist who led the NIH study, “but we think it helps women go through the stress of pregnancy, labor, and delivery.”
But what happens after birth, when the placenta is gone? Chrousos and his colleagues monitored CRH levels in 17, women from the last trimester to a year after they gave birth. All the women had low levels of CRH – as low as seen in some forms of depression – in the six weeks following birth. The seven women with the lowest levels felt depressed.
Chrousos suspects that CRH levels are temporarily low in new mothers because CRH from the placenta disrupts the feedback system that regulates normal production of the hormone. During pregnancy, when CRH levels are high in the bloodstream, the hypothalamus releases less CRH. After birth, however, when this supplementary source of CRH is gone, it takes a while for the hypothalamus to get the signal that it needs to start making more CRH.
“This finding gives reassurance to people that postpartum depression is a transient phenomenon,” says Chrousos. “It also suggests that there is a biological cause.”
COPYRIGHT 1995 Discover
COPYRIGHT 2004 Gale Group

Interactions between the Hypothalamic-Pituitary-Adrenal Axis and the Female Reproductive System: Clinical Implications

George P. Chrousos, MD; David J. Torpy, MB, BS; and Philip W. Gold, MD

Ann Intern Med. 1998;129:229-240.

“The clinical implications of placental CRH extend beyond pregnancy, labor, and delivery (76, 77) (Figures 5 and 6). The postpartum period is characterized by an increased incidence of psychiatric and autoimmune manifestations. Indeed, the “post-partum blues,” a mild form of transient depression, occurs in 60% to 70% of women; full-blown post-partum depression affects about 10%; and very severe postpartum psychosis affects about 1 in 1000.

We hypothesized that the postpartum period might be associated with low hypothalamic CRH secretion, which would predispose patients to atypical depression and autoimmune phenomena. We prospectively studied 17 pregnant women who were healthy and had no personal or family history of depression (77). Psychometric testing was done serially beginning with the 20th week of pregnancy and continuing up to a year postpartum. We did ovine CRH stimulation tests at 3, 6, and 12 weeks postpartum. Nine women had normal affect throughout, but 7 developed postpartum blues and 1 developed full-fledged postpartum depression. Plasma levels of ACTH before and after ovine CRH showed little response at 3 weeks, a better but still suppressed response at 6 weeks, and an almost normal response at 12 weeks. Cortisol levels remained in the upper normal range throughout, mostly be- cause plasma cortisol-binding globulin levels were about twice the normal level at 3 weeks, and it took about 3 months or longer for them to decrease to within the normal range. When we separated the women at 3, 6, and 12 weeks into those with the blues or depression and those without a mood disorder, the former had marked suppression of the ACTH response to ovine CRH compared with the latter. Thus, whereas the overall data showed a transient suppression of hypothalamic CRH secretion in the postpartum period, women with the blues or depression had a more severe suppression that lasted longer.

In the postpartum state, the major source of CRH and estrogen, the placenta, is no longer present, whereas the hypothalamic CRH neuron is probably suppressed as a result of previous exposure to high levels of Cortisol for more than 3 months and because of concurrent estrogen deficiency.”

Conclusion: “Placental CRH drives the pituitary-adrenal axis to produce high Cortisol secretion during the latter part of pregnancy. Withdrawal of placental CRH after delivery provokes a secondary hypothalamic CRH deficiency with varying consequences for mood disorders and autoimmune phenomena.

Several lines of evidence suggest that the lethargy, fatigue, hypersomnia, and hyperphagia of atypical depression are associated with hyposecretion of CRH (3). This hyposecretion may contribute to a significant increase in the incidence of allergic and autoimmune phenomena in this form of depression and in its two homolog transient states, the postpartum blues or depression and the postcure state of patients with the Cushing syndrome (48, 77, 79).”

http://integrativehealthconnection.com/wp-content/uploads/2011/11/Interactions-between-the-Hypothalamic-Pituitary-Adrenal-Axis-and-the-Female-Reproductive-System-Clinical-Implications.pdf

Have we forgotten the significance of postpartum iron deficiency?

Bodnar LM, Cogswell ME, McDonald T.

Source: Am J Obstet Gynecol. 2005 Jul;193(1):36-44.

Magee Women’s Research Institute and Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, PA 15261, USA. bodnar@edc.pitt.edu

The postpartum period is conventionally thought to be the time of lowest iron deficiency risk because iron status is expected to improve dramatically after delivery. Nonetheless, recent studies have reported a high prevalence of postpartum iron deficiency and anemia among ethnically diverse low-income populations in the United States. In light of the recent emergence of this problem in the medical literature, we discuss updated findings on postpartum iron deficiency, including its prevalence, functional consequences, risk factors, and recommended primary and secondary prevention strategies. The productivity and cognitive gains made possible by improving iron nutriture support intervention. We therefore conclude that postpartum iron deficiency warrants greater attention and higher quality care.

http://www.ncbi.nlm.nih.gov/pubmed/16021056

Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial.

Verdon F, Burnand B, Stubi CL, Bonard C, Graff M, Michaud A, Bischoff T, de Vevey M, Studer JP, Herzig L, Chapuis C, Tissot J, Pécoud A, Favrat B.

Source: BMJ. 2003 May 24;326(7399):1124.

General Practice Unit, University of Lausanne, rue du Bugnon 44, 1011 Lausanne, Switzerland.

OBJECTIVE: To determine the subjective response to iron therapy in non-anaemic women with unexplained fatigue.

DESIGN: Double blind randomised placebo controlled trial.

SETTING: Academic primary care centre and eight general practices in western Switzerland.

PARTICIPANTS: 144 women aged 18 to 55, assigned to either oral ferrous sulphate (80 mg/day of elemental iron daily; n=75) or placebo (n=69) for four weeks.

RESULTS: 136 (94%) women completed the study. Most had a low serum ferritin concentration; <or= 20 microg/l in 69 (51%) women. Mean age, haemoglobin concentration, serum ferritin concentration, level of fatigue, depression, and anxiety were similar in both groups at baseline. Both groups were also similar for compliance and dropout rates. The level of fatigue after one month decreased by -1.82/6.37 points (29%) in the irongroup compared with -0.85/6.46 points (13%) in the placebo group (difference 0.95 points, 95% confidence interval 0.32 to 1.62; P=0.004). Subgroups analysis showed that only women with ferritin concentrations <or= 50 microg/l improved with oral supplementation.

CONCLUSION: Non-anaemic women with unexplained fatigue may benefit from iron supplementation. The effect may be restricted to women with low or borderline serum ferritin concentrations.

http://www.ncbi.nlm.nih.gov/pubmed?term=verdon%20iron%20supplementation

The impact of fatigue on the development of postpartum depression.

Corwin EJ, Brownstead J, Barton N, Heckard S, Morin K.

Source: J Obstet Gynecol Neonatal Nurs. 2005 Sep-Oct;34(5):577-86.

College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH 43210, USA. corwin.56@osu.edu

Previous research suggests early postpartum fatigue (PPF) plays a significant role in the development of postpartum depression (PPD). Predicting risk for PPD via early identification of PPF may provide opportunity for intervention.

Conclusions: Fatigue by Day 14 postpartum was the most predictive variable for symptoms of PPD on Day 28 in this population.

http://www.ncbi.nlm.nih.gov/pubmed/16227513

Maternal iron deficiency anemia affects postpartum emotions and cognition.

Beard JL, Hendricks MK, Perez EM, Murray-Kolb LE, Berg A, Vernon-Feagans L, Irlam J, Isaacs W, Sive A, Tomlinson M.

Source: J Nutr. 2005 Feb;135(2):267-72.

Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA 16802, USA. jbeard@psu.edu

The aim of this study was to determine whether iron deficiency anemia (IDA) in mothers alters their maternal cognitive and behavioral performance, the mother-infant interaction, and the infant’s development. This article focuses on the relation between IDA and cognition as well as behavioral affect in the young mothers. This prospective, randomized, controlled, intervention trial was conducted in South Africa among 3 groups of mothers: nonanemic controls and anemic mothers receiving either placebo (10 microg folate and 25 mg vitamin C) or daily iron (125 mg FeS0(4), 10 microg folate, 25 mg vitamin C). Mothers of full-term normal birth weight babies were followed from 10 wk to 9 mo postpartum (n = 81). Maternal hematologic and iron status, socioeconomic, cognitive, and emotional status, mother-infant interaction, and the development of the infants were assessed at 10 wk and 9 mo postpartum. Behavioral and cognitive variables at baseline did not differ between iron-deficient anemic mothers and nonanemic mothers. However, iron treatment resulted in a 25% improvement (P < 0.05) in previously iron-deficient mothers’ depression and stress scales as well as in the Raven’s Progressive Matrices test. Anemic mothers administered placebo did not improve in behavioral measures. Multivariate analysis showed a strong association between iron status variables (hemoglobin, mean corpuscular volume, and transferrin saturation) and cognitive variables (Digit Symbol) as well as behavioral variables (anxiety, stress, depression). This study demonstrates that there is a strong relation between iron status and depression, stress, and cognitive functioning in poor African mothers during the postpartum period.

http://www.ncbi.nlm.nih.gov/pubmed/15671224

Effects of placentophagy on serum prolactin and progesterone concentrations in rats after parturition or superovulation.

Blank MS, Friesen HG.

J Reprod Fertil. 1980 Nov;60(2):273-8.

In rats that were allowed to eat the placentae after parturition concentrations of serum prolactin were elevated on Day 1 but concentrations of serum progesterone were depressed on Days 6 and 8 post partum when compared to those of rats prevented from eating the placentae. In rats treated with PMSG to induce superovulation serum prolactin and progesterone values were significantly (P < 0.05) elevated on Days 3 and 5 respectively, after being fed 2 g rat placenta/day for 2 days. However, feeding each rat 4 g placenta/day significantly (P < 0.02) lowered serum progesterone on Day 5. Oestrogen injections or bovine or human placenta in the diet had no effect. The organic phase of a petroleum ether extract of rat placenta (2 g-equivalents/day) lowered peripheral concentrations of progesterone on Day 5, but other extracts were ineffective. We conclude that the rat placenta contains orally-active substance(s) which modify blood levels of pituitary and ovarian hormones.

Placenta for Pain Relief:
Placenta ingestion by rats enhances y- and n-opioid antinociception, but suppresses A-opioid antinociception
Jean M. DiPirro*, Mark B. Kristal

Behavioral Neuroscience Program, Department of Psychology, University at Buffalo, Buffalo, NY 14260, USA. dipirrjm@buffalostate.edu 2004

Ingestion of placenta or amniotic fluid produces a dramatic enhancement of centrally mediated opioid antinociception in the rat. The present experiments investigated the role of each opioid receptor type (A, y, n) in the antinociception-modulating effects of Placental Opioid-Enhancing Factor (POEF—presumably the active substance). Antinociception was measured on a 52 jC hotplate in adult, female rats after they ingested placenta or control substance (1.0 g) and after they received an intracerebroventricular injection of a y-specific ([D-Pen2,D-Pen5]enkephalin (DPDPE); 0, 30, 50, 62, or 70 nmol), A-specific ([D-Ala2,N-MePhe4,Gly5-ol]enkephalin (DAMGO); 0, 0.21, 0.29, or 0.39 nmol), or n-specific (U-62066; spiradoline; 0, 100, 150, or 200 nmol) opioid receptor agonist. The results showed that ingestion of placenta potentiated y- and n-opioid antinociception, but attenuated A-opioid antinociception. This finding of POEF action as both opioid receptor-specific and complex provides an important basis for understanding the intrinsic pain-suppression mechanisms that are activated during parturition and modified by placentophagia, and important information for the possible use of POEF as an adjunct to opioids in pain management.
http://www.ncbi.nlm.nih.gov/pubmed?term=placenta%20pain%20dipirro%20kristal

Placentophagia: A Biobehavioral Enigma

KRISTAL, M. B. NEUROSCI. BIOBEHAV. REV. 4(2) 141-150, 1980.

Although ingestion of the afterbirth during delivery is a reliable component of parturitional behavior of mothers in most mammalian species, we know almost nothing of the direct causes or consequences of the act. Traditional explanations of placentophagia, such as general or specific hunger, are discussed and evaluated in light of recent experimental results. Next, research is reviewed which has attempted to distinguish between placentophagia as a maternal behavior and placentophagia as an ingestive behavior. Finally, consequences of the behavior, which may also be viewed as ultimate causes in an evolutionary sense, are considered, such as the possibility of beneficial effects on maternal behavior or reproductive competence, on protection against predators, and on immunological protection afforded either the mother or the young.

http://api.ning.com/files/EfX4**M*LKKhLNZJzSwl7XAdrLgSECTTufJGGhny1N*hdJIIIKz09lI9kEKSt1ajFFxp54pDIaCuW6oyRBzsyrU1cPm7QEDt/Kristal_biobehavioral.pdf

Placenta increases milk supply

Soykova-Pachnerova E, et. al.(1954). Gynaecologia 138(6):617-627.

An attempt was made to increase milk secretion in mothers by administration of dried placenta per os. Of 210 controlled cases only 29 (13.8%) gave negative results; 181 women (86.2%) reacted positively to the treatment, 117 (55.7%) with good and 64 (30.5%) with very good results. It could be shown by similar experiments with a beef preparation that the effective substance in placenta is not protein. Nor does the lyofilised placenta act as a biogenic stimulator so that the good results of placenta administration cannot be explained as a form of tissue therapy per os. The question of a hormonal influence remains open. So far it could be shown that progesterone is probably not active in increasing lactation after administration of dried placenta.

This method of treating hypogalactia seems worth noting since the placenta preparation is easily obtained, has not so far been utilized and in our experience is successful in the majority of women.

http://mommyfeelgood.files.wordpress.com/2010/10/placenta_lactagogon1.pdf

Home birth shows woman at her most powerful

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Home birth shows woman at her most powerful

11:01 PM, Oct. 28, 2011
Written by
Chrissie Williams

As a child of the ’80s the word feminism always brought to mind for me images of a working woman.

I envisioned her a man-hating, career-oriented vixen who would stop at nothing to be CEO of some multibillion-dollar corporation.

And so imagine my surprise when instead of this iconic empowered woman with the corner office, the reality of feminist ideals were personified while attending a planned home birth.

I was there to document her experience on video — a birth attended only by two midwives, two doulas, her husband and me.

I left not troubled but in awe of the power of choice and the authority found when women join one another in collective action instead of whispering rumors or judgments with turned backs.

(continued at link)

Home Birth Summit: What were the Outcomes?

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http://www.homebirthsummit.org/summit-outcomes.html

What Were the Outcomes of the Home Birth Summit?

The following statements reflect the areas of consensus that were achieved by the individuals who participated in the Home Birth Consensus Summit at Airlie Center in Warrenton, Virginia from October 20-22, 2011. These statements do not represent the position of any organization or institution affiliated with those individuals.

In creating these statements relating to maternity care and birth place in the United States, we acknowledge the complexity inherent in each topic of concern, as well as some disagreement about how to best achieve or demonstrate these principles. While all agreed that there is great value and need for further work in these areas, action plans that flow from these principles may be carried out by individuals or in newly formed, multi-stakeholder work groups according to their own, or shared, values and priorities.

Summary statements such as these can be interpreted differently by different readers. Therefore, although there was both unanimity and consensus about the topics addressed, there was not necessarily unanimity as to all of the specific words chosen to create the statements. For example, words such as “autonomy”, “independence”, and “collaboration” may have different implications for practitioners, policy makers, and consumers.

These common ground principles are intended to provide a foundation for continued dialogue and collaboration across sectors, as we work together towards a common goal of improving maternal and newborn care for families choosing home birth.

(9 statements continued at link)