Don’t make a birth plan, it’s pointless, because birth is completely unpredictable.
If I had a pound for every time I’ve heard a woman being given this crappy nugget of pseudo-wisdom, I’d be rich enough to start my own luxury birth centre in St Lucia.
It’s fabulously convenient to tell women this, actually, because not only does it totally discourage them from researching their birth options, making a plan and thus becoming one of those ‘tricky customers’ in the birth room who knows what she wants and isn’t afraid to ask.
But also, once birth is over, if the birth was difficult or even downright unpleasant, you can ask her, “Did you make a birth plan?”, and if she says yes you can shake your head and say, “Oh dear”, in a way that basically implies, “I told you so”, and bingo, the whole sorry mess is her fault and everyone else is off the hook.
Actually, making a birth plan is one of the very best moves a pregnant woman can make.
Dr. Stuart Fischbein chuckled when he read the title of the press release: “Women with a fear of childbirth endure a longer labor.”
The release was promoting a study published this week in BJOG: An International Journal of Obstetrics and Gynecology. Researchers at Akershus University Hospital in Norway found women who feared giving birth were in labor for 1 hour and 32 minutes longer, on average, than those who had no fear.
“I’m glad there’s now evidence to say that,” Fischbein said, “but it’s obvious.”
For those of us who aren’t OB/GYNs, it may seem more like a cruel joke. Women who are afraid of the pain and the possible medical complications associated with giving birth have to suffer through it longer?
The American College of Obstetricians and Gynecologists has released new guidelines encouraging OB-GYNs and other birth practitioners to re-examine the necessity of various interventions that may not necessarily benefit low-risk moms.
The new committee opinion does not signal a dramatic shift in best practices for managing uncomplicated labors, but it is a clear acknowledgement from ACOG that technological interventions can often times interfere with a natural process rather than help it along.
“This committee opinion is the first one, to my knowledge, that specifically addresses low-risk patients,” author Dr. Jeffrey L. Ecker, chief of the Obstetrics and Gynecology department at Massachusetts General Hospital told The Huffington Post. “It says, very clearly, that there are some times when watchful waiting is appropriate. Just because we have the technology, doesn’t mean it has to be used in every patient.”
Many doctors and hospitals already embrace measures to limit intervention when appropriate, he said. But for others, this will likely shift the standard care.
(click link at top to continue reading on huffingtonpost.com)
10 procedures to think twice about during your pregnancy
Despite a healthcare 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. Infants in this country are more than twice as likely to die before their first birthday as those in Japan and Finland. And America now ranks behind 59 other countries in preventing mothers from dying during childbirth and is one of only eight countries in the world, along with Afghanistan and El Salvador, whose maternal mortality rate is rising.
Why? Partly because mothers in the U.S. tend to be less healthy than in the past, “which contributes to a higher-risk pregnancy,” says Diane Ashton, M.D., deputy medical director of the March of Dimes.
But another key reason may be that medical expediency appears to be taking a priority over the best outcomes. The U.S. healthcare system has developed into a labor-and-delivery machine, often operating according to its own timetable rather than the less predictable schedule of mothers and babies. 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.
(click link at the top to read on Consumerreports.org)
When I read the January 11thNew York Times Well blog, titled When A Big Baby Isn’t So Big, I looked back on my career as a labor nurse and thought, “Yep – happens all the time.” Predictions for a “too big baby” were among the most common reasons I heard from women admitted to my labor unit for induction of labor or scheduled cesarean sections. In most cases, once the baby was delivered, either vaginally or surgically, they weren’t all that big after all.
The New York Times blog is centered around a recent study based on Childbirth Connection’s national survey of 1,960 new mothers, called Listening to Mothers III. The survey indicates that four out of five mothers who were warned they might have large babies gave birth to infants who were not large, and weighed less than 8 pounds 13 ounces (which defines macrosomia – a larger than average baby). These mothers were almost twice as likely to have interventions like medical induction of labor or attempt to self-induce labor, presumably so their baby wouldn’t get too big to deliver vaginally. They were also nearly twice as likely to have planned C-sections, though as the blog mentions, researchers say that increase fell just short of being statistically meaningful.
(click link to read the blog on the Every Mother Counts website)