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Consumer Reports: Back to Basics for Safer Childbirth

http://www.consumerreports.org/health/medical-conditions-treatments/pregnancy-childbirth/maternity-care/overview/maternity-care.htm

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.
OVERUSE OF HIGH-TECH MEASURES

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.

UNDERUSE OF HIGH-TOUCH, NONINVASIVE MEASURES

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!

Discussion Forum

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Comment by Meredith Paige Browning Lovell on July 6, 2010 at 4:03pm
Semen does contain prostaglandins but those are more for softening and ripening the cervix. The reason nipple stimulation and an orgasm help is the both release the oxytocin, your body's natural hormone, which is similar to pitocin but WAY better.
Comment by Mandy Gibbs on July 6, 2010 at 2:35pm
I thought it was the semen, which contains prostaglandins, that stimulates contractions?
Comment by Meredith Paige Browning Lovell on July 6, 2010 at 1:32pm
If sex is too painful try just receiving, the oxytocin that stimulates labor is released during an orgasm.
Comment by Mandy Gibbs on July 6, 2010 at 11:20am
Yeah...I wouldn't mind the sex other than it hurts like a bitch afterwards and then if it doesn't send me into to labor my crotch will just hurt for days!! But we are going to try it...if we can get a certain 3 year old to go to bed on time!!
Comment by Tarrah Carmon on July 6, 2010 at 10:18am
SEX! and lots of it! also nipple stimulation...... :) have a fun week! lol
Comment by Mandy Gibbs on July 6, 2010 at 9:59am
haha...would be nice Brittany but I highly doubt it!!
Comment by Brittany Tubb on July 6, 2010 at 8:25am
well hopefully cleaning the bathroom will send u into labor this week! :))
Comment by Mandy Gibbs on July 6, 2010 at 8:04am
No Ziggy...and I am really glad because my midwife was out of town this weekend and she'll be out of town next weekend...so if he comes early it needs to be during the week! I got so much stuff done this weekend it's not even funny...my house is spotless...except the bathroom and that is getting tackled tonight!! I have my next appointment tomorrow so we will see where I am at...I thought all the cleaning would send me into labor...but no such luck. I kept getting some cramps but nothing too bad or exciting!
Comment by naomi on July 6, 2010 at 5:43am
tarrah you are so funny lol. Its not that hard sweetie stop putting so much thought into it she doesn't have to have a bow in her hair all the time and just get white socks. Believe me after a while whenyour sleep deprived with two kids you'll justb e putting on whatever outfit you see andnot worrying aboutthe other stuff. I never put bows in my daughters hair or that much tought into what she wore all her stuff was cute so no matter what I picked out it was cute.
Comment by Tarrah Carmon on July 5, 2010 at 7:14pm
i have a feeling this is going to be WAY harder than a boy lol not only does the outfit have to match but also the socks shoes and a bow! good gosh ill spend all day just picking out stuff to wear! oh well she will be beautiful no matter what!
 

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