Today I begin the series "10 Simple Truths About Birth". You can respond on Facebook, or directly on my blog at www.childbirthtoday.blogspot.com.
Truth #2: US maternity care does not practice evidence based care.
The US Maternity Health Care system does, in fact, not practice evidence based care. A close look at the statistical data on maternal morbidity and mortality/infant morbidity and mortality shows a very bleak picture of our outcomes based on an interventive based care plan. In fact, in their new initiative, Childbirth Connection states that “the largely healthy and low-risk population of childbearing women and newborns experiences 6 of the 10 most common hospital procedures. One out of three babies is born via cesarean section, the most common operating room procedure in the United States. Best evidence supports more judicious, restrictive use of maternity care procedures, and suggests that overuse is contributing to significant excess harm and costs.´
There is obviously a disparity between evidence based care and the care practices in the US. But, as Childbirth Connection also asks, how can you make a change if you don’t know what you are aiming for?” Exactly!
The scope of change will never happen with birth professionals standing at the hospital doors, banging, and yelling “You must change because we say so and because it is right”. As stated in another “Truth”, hospitals are indeed companies or businesses wanting to make a profit. Change will not happen necessarily because the literature says that is the thing to do….especially if “what we’ve always done” is working….mirroring the old adage: If it ain’t broke don’t fix it.
It is broken. Research is beginning to come to the surface about our broken system. A report issued by the California Pregnancy-Related and Pregnancy Associated Mortality Review shows that deaths from pregnancy-related causes, usually occurring at the time of birth, have risen dramatically in the U.S., in spite of the increased use of technology and the increase in cesarean section rates. In fact, the study that was released on April 26, 2011 stated that the increase in cesarean sections were a major contributor to the increase in deaths from pregnancy-related causes.
But again, what does evidence based maternity care look like? What is staffing, what services? Is there a comprehensive childbirth education program and if so, what do those classes look like, certification? What about a hospital based doula program? Again, the Childbirth Connection asks for an essential package to answer these questions and many more.
I especially like Childbirth Connection’s call for a revival and broaden reach of childbirth education through expanded models and innovative teaching modalities.
This in turn, will foster and promote a true cultural shift in attitudes toward childbearing.