Sometimes we focus so much on the pregnancy and birth, that we forget about what happens after the baby is born! As with other aspects of pregnancy and birth, it's important to remember that most of these routine interventions have their place....but only when indicated. There isn't much evidence that supports their routine use in ALL babies as is "standard of care" in most US hospitals. You can examine the evidence for yourself and see if you would like these interventions to be a part of your baby's first few hours or days. You might want to add newborn procedure preferences to your birth plan, and I also recommend having a person with you at your birth who is clear on what you want and don't want done to your baby. It's easy for the new mother to get caught up in the moment when meeting her new baby, and rightly so! But she may not notice some of these procedures taking place, because they are sometimes very quick!
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In Part 1 we looked at the evidence against some common pregnancy interventions, and in Part 2 we examined common practices during labor, including continuous fetal monitoring and cervical checks. There are two more interventions that the evidence strongly recommends against, yet they are, in my experience, recommended or nearly forced on a majority of women who are birthing in the hospital. However, that doesn't mean that you can't examine the evidence and make your own decision about if you would like them to be a part of your care. In Part 1 we looked at some routine procedures that you might reconsider (routine ultrasound and cervical exams, for example) that, although common, have been repeatedly proven to be either unreliable, or possibly even harmful to your or your baby. You can find Part 1 here. Next in the trilogy are some interventions that are so commonplace in the management of labor and birth, that many parents don't even realize that they have the option to decline them! Many of them are "standard of practice", despite never being proven useful or applicable to ALL or even MOST women. One study looked at practice recommendations and the evidence behind them, and found “Among the obstetrics recommendations, level A evidence (defined as "good and consistent scientific evidence") was noted for 24.6% of the diagnostic recommendations." (bolded type mine). Did you get that? Less than 1/3 of obstetric practice recommendations are based on good and consistent scientific evidence. I decided during my first pregnancy that I had to take responsibility for researching some of these practices myself, and I'm sharing some of my findings here. Please also keep in mind that this research generally replies to physiological birth; labor that does not include drugs to induce or augment labor, or epidural pain relief. These interventions increase the risk of fetal distress, and necessitate other interventions. You still have some options in your care, but you may not be able to safely decline some of these procedures. Without further ado, Part 2. |
Author- Sara
I look at birth from the perspective that our bodies are wonderfully made, and if we really believe that and work with the birth process and nourish our bodies properly, they will function optimally, most of the time! Archives
November 2019
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