Wednesday, March 25, 2009

Consumer Reports Quiz on Childbirth Interventions

Go and take the Consumer Reports Quiz about childbirth interventions and perceptions. As they state on their website:
Despite growing evidence of harm, many obstetricians and maternity hospitals still overuse high-tech procedures that can mean poorer outcomes for baby and Mom.
Most hospital birth these days come with all kinds of high-tech interventions. The vast majority of women giving birth in the hospital now have the following interventions (and the rate for fat women is even higher):
  • chemical induction of labor (or augmentation of contractions after labor begins)
  • continuous electronic monitoring
  • breaking the mother's waters artificially
  • an epidural and/or IV pain meds
Many are also subjected to:

  • forceps or vacuum extraction
  • an episiotomy (cutting the vaginal opening wider)
  • a cesarean section
Yet how often are these interventions really questioned? Most women just accept that this is the way birth is done these days.........but is widespread use of these interventions really beneficial? Or does it cause more harm than good?

The quiz really debunks their routine use and points out possible risks and side effects women may not be aware of.

Some Sample Questions

Here are a couple of my favorite questions from the quiz. They really speak to the two biggest steps towards cesareans that women make when pregnant......they see an OB instead of a midwife for their care, and they get talked into (or ask for!) induction of labor.

[If you want to lower your chances for a cesarean, that's two places to start right there....first, hire a midwife for your care instead of an OB, and second, don't induce labor unless there is a truly compelling medical reason, well-supported by research.]
True or False? An obstetrician will deliver better maternity care, overall, than a midwife or family doctor.

False. Studies show that the 8 percent to 9 percent of U.S. women who use midwives and the 6 to 7 percent who choose family physicians generally experienced just-as-good results as those who go to obstetricians.

Those who used midwives also ended up with fewer technological interventions. For example, women who received midwifery care were less likely to experience induced labor, have their water broken for them, episiotomies, pain medications, intravenous fluids, and electronic fetal monitoring, and were more likely to give birth vaginally with no vacuum extraction or forceps, than similar women receiving medical care.

Note that an obstetric specialist is best for the small proportion of women with serious health concerns.
[My note: That doesn't mean fat women; it means women with serious concerns like heart conditions, pre-existing diabetes, some autoimmune conditions, certain pregnancy complications, etc.]
True or False? Induced labor increases the likelihood of Caesarean section in first-time mothers.

True. The cervix may not be ready for labor. Other effects of induced labor include an increased likelihood of an epidural, an assisted delivery with vacuum extraction or forceps, and extreme bleeding postpartum.

I was also happy to see a question in there about VBACs! Yay!

True or False? Once you’ve had a C-section, it’s best to do it again.

False. Studies show that, as the number of a woman’s previous C-sections increased, so did the likelihood of harmful conditions, including: trouble getting pregnant again, problems delivering the placenta (placenta accreta), longer hospital stays, intensive-care (ICU) admission, hysterectomy, and blood transfusion.

Click on the link to read their entire report, called "Back to basics for safer childbirth: Too many doctors and hospitals are overusing high-tech procedures." It's short but very good. I'll just end with a couple of pithy quotes:

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.

...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.
Can I hear an AMEN!!??!! So refreshing to hear this from a mainstream media resource!!


Anonymous said...

it's been a while since I aced a pop quiz! Thanks for posting on such an important topic.

Anonymous said...

I'm not nit picking but just had to say, I have a heart defect and I went with a midwife with my second. The difference was amazing.

The OB group (with my first) thought my (very mild) heart defect was a big deal. Sent me to a cardiologist (who gave me a full workup to be safe but then TOLD ME my defect wasn't an issue in pregnancy/delivery). And then the OB pushed antibiotics during delivery because of my heart defect. Despite me talking to another OB in the practice and being told I wouldn't need them (apparently the OBs in the SAME PRACTICE couldn't agree).

Other things bugged me about my (admittedly easy) delivery so I went with a midwife the second time.

I told her the name of my heart defect and she said oh yeah, that doesn't affect pregnancy. LOL! The midwife knew more about my defect than the OBs did. So much for the idea people have that they are not as well trained.

Just to say that if you do have medical issues that you think mean you need an OB, it's still worth running it by a midwife to see what they say. Even heart defects ;-)

Or being "old". Like my 36 year old sister who is going to a midwife because OB's thinks she is "old" to have her first so is at risk but the midwife laughed and said a lot of her clients are in their 40's and it's not an issue.