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Consumer Reports: Back to Basics for Safer Childbirth

When it’s time to bring a new baby into the world, there’s a lot to be said for letting nature take the lead. The normal, hormone-driven changes in the body that naturally occur during delivery can optimize infant health and encourage the easy establishment and continuation of breastfeeding and mother-baby attachment. Childbirth without technical intervention can succeed in leading to a good outcome for mother and child, according to a new report. (Take our maternity-care quiz to test your knowledge.)

“Evidence-Based Maternity Care: What It Is and What It Can Achieve,” co-authored by Carol Sakala and Maureen P. Corry of the nonprofit Childbirth Connection analyzed hundreds of the most recent studies and systematic reviews of maternity care. The 70-page report was issued collaboratively by Childbirth Connection, the Reforming States Group (a voluntary association of state-level health policymakers), and Milbank Memorial Fund, and released on Oct. 8, 2008.

The report found that, in the U.S., too many healthy women with low-risk pregnancies are being routinely subjected to high-tech or invasive interventions that should be reserved for higher-risk pregnancies. Such measures include:

Inducing labor. The percentage of women whose labor was induced more than doubled between 1990 and 2005

Use of epidural painkillers, which might cause adverse effects, including rapid fetal heart rate and poor performance on newborn assessment tests
Delivery by Caesarean section, which is estimated to account for one-third of all U.S births in 2008, will far exceed the World Health Organization’s recommended national rate of 5 to 10 percent
Electronic fetal monitoring, unnecessarily adding to delivery costs
Rupturing membranes (”breaking the waters”), intending to hasten onset of labor

Episiotomy, which is often unnecessary

In fact, the current style of maternity care is so procedure-intensive that 6 of the 15 most common hospital procedures used in the entire U.S. are related to childbirth. Although most childbearing women in this country are healthy and at low risk for childbirth complications, national surveys reveal that essentially all women who give
birth in U.S. hospitals have high rates of use of complex interventions, with risks of adverse effects.

The reasons for this overuse might have more to do with profit and liability issues than with optimal care, the report points out. Hospitals and care providers can increase their insurance reimbursements by administering costly high-tech interventions rather than just watching, waiting, and shepherding the natural process of childbirth.

Convenience for health care workers and patients might be another factor. Naturally occurring labor is not limited to typical working hours. Evidence also shows that a disproportionate amount of tech-driven interventions like Caesarean sections occur during weekday “business hours,” rather than at night, on weekends, or on holidays.


Many practices that have been proven effective and do little to no harm are underused in today’s maternity care for healthy low-risk women. They include:

Prenatal vitamins
Use of midwife or family physician
Continuous presence of a companion for the mother during labor
Upright and side-lying positions during labor and delivery, which are associated with less severe pain than lying down on one’s back
Vaginal birth (VBAC) for most women who have had a previous Caesarean section
Early mother-baby skin-to-skin contact
The study suggests that those and other low-cost, beneficial practices are not routinely practiced for several reasons, including limited scope for economic gain, lack of national standards to measure providers’ performance, and a medical tradition that doesn’t prioritize the measurement of adverse effects, or take them into account.

3 Responses to ““Back to Basics for Safer Childbirth” Consumer Reports Article”

February 24th, 2009 at 11:09 pm edit
Isis says:
Thanks for posting this its about time the rest of the media caught up to this.

February 26th, 2009 at 9:39 am edit
rachel moses says:
it is so great to see this issue of mistreatment of birth being addressed in the mainstream media. having had 2 home births myself, i am totally horrified disgusted by the invasive abusive treatment i see most of the women around me receiving at their hospital births. lets get this straightened out ladies! walking through the doors of a hospital as a pregnant woman put you/baby way too much danger. drugged up moms and newborns and 30+% c-section rate? come on, this is just not acceptable. Also in serious question ought to be all this “scanning” of babies in the womb; just 30 years ago x-rays were supposdly safe and we now know of course taht they are not. How about the pathetically low (1%) of babies who are breastfed to the World Health Organzation’s reccommended TWO FULL YEARS. And further, what is up with all this machine milking women to bottle feed babies with? its disgusting, and even the La Leche league organization seems to accept it as an equivalent when it clearly is NOT. It negates all of the importance of the MOTHER being with the baby. What no one is talking about either are the far reaching effects. lets hear more about these issues!

February 27th, 2009 at 1:22 am edit
Kate Quick says:
Machine milking women to bottle feed babies? Well, if women who want to breastfeed don’t hook themselves up to machines, they have three options. 1)Take their babies to work with them, which most employers won’t allow and which probably isn’t that feasible once babies can crawl, at least not without a playpen, which is a whole different argument. 2) Take a much much longer maternity leave than any employer I’ve ever heard of will pay for or even grant unpaid. 3) Stay at home with her babes. It all comes down to economics and misplaced priorities. The same is true of maternity care…economics and mislplaced priorities. It’s time to reprioritize. Let’s put moms and babes first, for a change. Longer maternity leaves for working women, respect for midwives and women who use them, and a little more anger at the mistreatment of women birthing in a hospital setting. Oh yeah, and a little more faith in our bodies’ ability to give birth!

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Comment Wall


You need to be a member of Pregnancy to add comments!

Comment by Cherylyn on September 6, 2009 at 8:09pm
Tons of good nutrition, fresh foods, lots of fluids. It's tough. I had a hard time getting enough to keep my milk going after I got pregnant. I wasn't able to breastfeed through the pregnancy because it ultimately dried up and my little girl wasn't willing to suckle when there was no milk. I was constantly hungry and couldn't seem to eat enough in the first trimester. I even drank mother's milk tea, and it still wasn't enough. I know of lots of women who have breastfed throughout pregnancy and them tandem nursed. I would love to know their secrets!
Comment by Bonnie P on September 6, 2009 at 7:58pm
Laura, how did the appointment go?
Does anyone know if you're pregnant and breastfeeding at the same time should you be taking 2 prenatal vitamins a day? I wouldn't have even thought about it, but my husband asked.
Comment by Laura Morales on September 3, 2009 at 2:14pm
Just found out I'm preggo on Sunday. This will be my 1st planned natural birth( had baby #2 natural but not on purpose) I told my mom that I was going natural and she said "Why? Just call me when it's over". Have my 1st midwife appt. tomorrow, hope we click and everything goes well.
Comment by Ricki Lake & Abby Epstein on August 3, 2009 at 2:57pm
We are looking for video footage and photos for our follow up film. If you are willing to share your birth videos, click HERE for more details. Thanks!
Comment by Amy Dingler on July 11, 2009 at 4:47pm
I posted a blog about our trip to Lake Lure, North Carolina. I am also doing another giveaway on my blog! Its an autographed copy of a children's book written by David Klett - "Rachel And The Wizard Of Lake Lure" Enter for your chance to win!
Comment by Amy Dingler on July 2, 2009 at 12:10pm
Check out my blog!! I am hosting free giveaways! My first giveaway is over $150 in coupons. Enter for your chance to win!!!!!! Please become a follower and subscribe to my updates. If you subscribe you will be sent an email when new giveaways begins. There is also some links to other great giveaways running right now. Check them out!!! All you need to do is leave a comment on the blog to enter!
Comment by Empowered Mommy on June 13, 2009 at 10:13pm
I'm a mom of 3 under 3 and I recently launched an online advocacy group for expectant moms, Join for Free for a chance to win a Target Gift Card. Thanks! :)
Comment by Carol Yeh-Garner on May 31, 2009 at 10:18am
Anyone interested in natural birth and using HypnoBirthing, be inspired by reading my blog at There is a birth story of an OB & his wife. They had an amazing HypnoBirth!
Comment by Coralissa on May 30, 2009 at 3:07pm
Hello group! I just wanted to share that I had my baby May 20th. I almost had the perfect but had to transfer. Here is a link to my birth story.
Comment by Cherylyn on May 13, 2009 at 1:06pm
This is a major event including the screening of three amazing childbirth films: Orgasmic Birth, The Business of Being Born, and Pregnant in America, and the producer of Orgasmic Birth will be at the screening as well!

Date: June 13, 2009
Location: Towne Cinema Theaters in American Fork, UT
Cost: $25
What: Screening of Orgasmic Birth, Pregnant in America, The Business of Being Born, Special Guest Speaker, Debra Pascali-Bonaro
Email: if you have questions

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