Tuesday, June 05, 2012

Addressing the Giant Pink Elephant in Our Room

The giant pink elephant?  Yes, you know the one that everyone addresses on Facebook and Twitter and blogs about?  We all "talk" about evidence-based care, yet precious few of us "do" anything about it.

A historic consensus statement was made today (6/5/12), by ACNM, MANA and NACPM which gives maternity care providers, policymakers and women a succinct summary of the evidence for the benefits of normal physiologic birth.  I highly encourage you to read the entire document!

The eight page document, titled Supporting Healthy and Normal Physiologic Childbirth, A Consensus Statement by ACNM, MANA, and NACPM, provides a definition of physiologic birth and the factors that interfere with physiologic birth ~ including but not limited to induction/augmentation of labor, time constraints on labor by policies and staffing, food and fluid deprivation, medications, immediate cord clamping and more.

With 64 references to solidify the evidence-based nature of this consensus, this document also identifies the delicate hormonal orchestration of physiologic birth, so often ignored in US maternity care.  Focusing on improvement of outcomes, the document lists the factors that influence the ability of women to give birth without intervention: for women, factors include a myriad of education including autonomy and self-determination through increased knowledge of the process with fully informed decision making.  Conversely, the document also lists factors from the clinician point of view that contributes to women birthing without intervention: education and competence in caring for women choosing physiologic birth, shared decision making and working within an infrastructure that supports physiologic birth.  Included also are suggestions for the birthing setting and environment that not surprisingly mirror the Lamaze Healthy Care Practices.

Together with the Blueprint for transforming maternity care by Childbirth Connection and the Lamaze Push for Your Baby: Push for the Safest, Healthiest Birth Possible, we have no reason not to move forward in this effort.  However, the giant pink elephant in the room is the fact that not all of us can work together toward a common goal.  Perhaps we need to take a deep breath, and begin anew.  Territorialism, and outright gnawing on each other cannot bring us together in the spirit inwhich the ACNM, MANA, and NACPM have done.  As we all need to do, they have embraced their differences and worked toward a common goal - one that seeks to define physiologic birth and show the way in which it can be achieved for the betterment of maternity care and the health and well-being of women and our next generation.  If we all worked together as the midwives have shown us, what we could accomplish! We could truly change the world.

The only obstacle in our way now is ourselves.

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