Earlier this month a new report came out showing a more natural approach to childbirth can optimize infant health. The report, “Evidence-Based Maternity Care: What It Is and What It Can Achieve”, is co-authored by Carol Sakala and Maureen P. Corry and issued collaboratively by Childbirth Connection, the Reforming States Group, and Milbank Memorial Fund.

The report (PDF) says that “although most childbearing women and newborns in the United States are healthy and at low risk for complications, national surveys reveal essentially all women who give birth in U.S. hospitals experience high rates of interventions with risks of adverse affects.”

The report was picked up by a few news organizations and Consumer Reports even wrote an article about it. The report found that many maternity practices are overused on healthy women with low-risk pregnancies, thus introducing risk of harm with little or no medical benefit at all. Such practices 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

The study also highlights several safe and effective practices that are underused for healthy low-risk pregnant women:

  • Use of midwife or family physician
  • Prenatal vitamins
  • Ginger for nausea and vomiting in pregnancy
  • Continuous labor support
  • 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 Cesarean section
  • Measures to relieve pain, bring comfort, and/or promote progress during labor (such as acupuncture and hypnosis)
  • Delayed and spontaneous pushing
  • Delayed cord clamping
  • Early mother-baby skin-to-skin contact
  • Breastfeeding and interventions to promote its initiation and duration

As a natural childbirth advocate myself I am happy to see this article published and picked up by some news organizations. Any way the facts can be made available to childbearing women is a good thing, in my opinion. Women should have all the facts so they make informed decisions about their childbirth. It’s also the same reason I loved the documentary The Business of Being Born; information about maternity care and birth choices is starting to come out to the general public a bit more often.

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