Choosing Wisely for Women

If you’ve been following us on Twitter this week, you will have picked up on a trend: Many of the Choosing Wisely topics address things that women commonly experience in the health care system: overused Pap tests and ovarian ultrasound exams, for instance.

Of particular concern among procedures is the needlessly high rate of early childbirth. We’ve asked Dr. Jose Luis Mosquera, a Consumer Reports medical adviser, to elaborate on this one. Here are his comments:

Childbirth statistics in the United States show far too many women are taking serious health risks by deciding to deliver their baby early out of convenience for themselves or their doctors. Scheduling a birth for convenience prior to 39 weeks has increased dramatically in our country and has resulted in fewer full-term births.  The number of babies born at 37 or 38 weeks via C-section or early induction of labor doubled between 1990 and 2007.

This early intervention carries increased risks to both mother and baby.  Babies born earlier than 39 weeks are more likely to suffer from multiple medical issues, and in some cases infant death. Brains and lungs are still developing at 37-38 weeks, so early delivery can mean breathing and feeding difficulties, higher risk of cerebral palsy and the need for intensive unit care for issues like severe jaundice. It also increases the possibility of post partum depression.

Sometimes inducing labor or having a C-section is entirely appropriate. Water breaking and labor not starting, being a week or more past the due date, or malposition of the baby are all common examples that may require intervention.

In most cases, a natural childbirth is entirely possible and clearly the safest and healthiest way for mother and baby. When compared to induced labor, natural childbirth is not only safer, but also quicker and less stressful. There is less need to require IV lines, monitors strapped to your body, or having medical equipment surrounding you in a sterile hospital environment.

Instead your labor can begin at home, where you are in control. Here are three key suggestions:

  1. Get support during your labor from a family member or friend. This continued support results in shorter labor and requires less medical help.
  2. Listen to your mind and body with trust in finding ways to cope with labor. Whether it’s walking, rocking, or showering, you should trust your instincts. When it’s time to push, you should do so in the way that feels right to you instead of being told when to push.
  3. Cuddle your newborn right away. When the baby is placed naked on their mother’s chest right after birth, these babies are more likely to breast feed longer and better than those taken away to be cleaned, measured and dressed.

When it comes to childbirth, Mother Nature is often the best doctor you should listen to.

 

 

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