Widely circulated among maternal health advocates this week, “10 Procedures to Think Twice About During Your Pregnancy” from Consumer Reports reminds pregnant women that, among other things, they are consumers. Usually a consumer check-list includes the many features you want, but when it comes to quality maternity care in the U.S. today, less is sometimes more.
In the developing world, childbirth can be dangerous due to lack of medications and procedures. But here, problems can stem from too much intervention. According to Consumer Reports, “Despite a health-care system that outspends those in the rest of the world, infants and mothers fare worse in the U.S. than in many other industrialized nations.”
One reason is the general health of our population. But another, “appears to be a health-care system that has developed into a highly profitable labor-and-delivery machine, operating according to its own timetable rather than the less predictable schedule of mothers and babies. Childbirth is the leading reason for hospital admission, and the system is set up to make the most of the opportunity. Keeping things chugging along are technological interventions that can be lifesaving in some situations but also interfere with healthy, natural processes and increase risk when used inappropriately.”
Here’s their list of 10 over-used procedures. Please note: All of these procedures can be valuable or even life-saving when medically necessary. This list is about overzealous usage under circumstances where intervention is not required.
1. A C-section with a low-risk first birth
2. An automatic second C-section
3. An elective early delivery
4. Inducing labor without a medical reason
5. Ultrasounds after 24 weeks
6. Continuous electronic fetal monitoring
7. Early epidurals
8. Routinely rupturing the amniotic membranes
9. Routine episiotomies
10. Sending your newborn to the nursery
Read the article for full, nuanced explanations of each bullet point (and charts! and graphs!) and then send it to all your pregnant friends. It’s a practical, evidence-based approach to what can be a very confusing system to navigate.
The article also gives expectant moms some ideas about what they can do including: consider a midwife, try turning a breech baby, stay home during early labor, be patient, get labor support, listen to yourself and touch your newborn.
They include a state-by-state guide to hospitals statistics for birth practices. Some of my childbirth education students are shocked to learn that the hospital they’ve chosen for their “natural birth” has a 43% c-section rate. Your care-provider’s statistics and philosophy of practice has more of an impact on how your birth will be handled than the hospital stats but it can be useful to see what the norm is where you’re delivering. Ask your care-provider how many c-sections she or he performs; how many episiotomies; what’s the induction policy. Feeling secure that your care-provider is looking out for your best interests is crucial in childbirth for reasons to do not just with the physical well-being of you and your baby but your emotional health as well.
Source: Consumer Reports.
Photo: Chris and Jenni/Flickr