Patients assume doctors know what is best, and they often do. They train and study for years to practice medicine, and OBs then train specifically in obstetrics to make sure they know everything they need to before branching out on their own.
Knowing what is best and doing what is best are different, however, and that means there are practices that doctors know are bad that they continue to perform anyway. This is obvious when we look at maternal morbidity rates in developed countries, as well as increases in surgical births. All the knowledge that doctors have isn't saving their patients from suffering.
That's why it's important for moms to be informed. Knowing what practices are evidence-based and when to refuse to cave to a doctor are essential when a woman is pregnant and getting ready to give birth. Doctors will often just stick to the course they always have, even if the practices they are using have been proven to cause harm or put a woman in danger.
Though researchers are coming out with new guidelines in many areas related to pregnancy and childbirth so that unnecessary acts won't take place, many doctors have still been slow to implement new practices. Old habits are hard to break, but women who demand better care have a better chance of being accommodated. An excellent litmus test when choosing a doctor is to ask which practices they perform that are not generally beneficial to women and their babies. If the doctor is married to old, dangerous ideas, find a new one.
Who hasn't seen a movie where the female protagonist knows how far along she is because a doctor or nurse continually enters the room, checks her cervix, and then screams, "7 centimeters!". This is so common that it's not often even questioned. However, checking the cervix is not an innocuous practice, and it also doesn't predict much of anything about when a woman will deliver.
Every time someone does a cervical check, there's a chance of bacteria entering the body. Sure, doctors wear gloves that shouldn't tear, but that doesn't mean they never do. A woman can also enter the hospital dilated to a four, but she may still be at a four hours later. That doesn't mean something is wrong, but knowing she's not dilating on the doctor's schedule often puts pressures on mom and gives the doctor a reason to push her into unnecessary interventions.
An occasional check during labor is warranted, but it's definitely okay to refuse the checks leading up to the due date and to ask for minimal checks during delivery.
14Getting The Party Started
Inducing labor before or right after the due date is so common that most women choose their children's birthdays. Doctors often make it clear from the beginning that mom will be induced, and women take for granted that induction is safe.
This has been proven wrong in certain situations, and new rules were put into place to make sure women weren't being induced too early. Because babies' lungs develop at the end of the pregnancy, children can be born too early and need intensive care simply because of unnecessary inductions. This has led researchers to recommend that doctors don't induce before the 39 week mark.
Even then, induction usually isn't necessary, and it won't work unless mom's body is already ready to go. Medical inductions come with risks, such as stronger contractions, fetal distress, and an eventual C-section if the induction doesn't work. When possible, waiting it out can be a better option.
13No Do Overs
The old saying once a C-section, always a C-section is still true in many OB offices. Vaginal births after C-sections(VBACs) are less common because doctors refuse to perform them. That means a woman who has to have a C-section with her first child will be forced to have more if she wants to have more kids.
The risks of problems go up every time a woman has a surgical birth. Forcing her into more or making her limit how many children she has is unfair since VBACs are safe and wonderful options for most women.
Doctors cite the slight increase in uterine rupture when a VBAC is performed. However, they don't compare this less than one percent risk with the higher risks of infection, blood loss, and death related to multiple C-sections.
It is still possible to find OBs and midwives who allow VBACs, but mom will have to search. If she know she is a good candidate, she should keep looking until she finds someone who will accommodate her.
12Estimated Weight Obsession
Sonograms and measurements are good tools to use to estimate how far along mom is. However, these tools aren't perfect and they can give information that is false. Unfortunately, some doctors base major decisions, like when mom should birth, on faulty data.
Doctors are fond of forcing women into inductions and interventions by using the weight of a baby they haven't yet met. They will take a measurement, make assumptions, and then tell mom her baby is too big to stay in the womb any longer, even if the due date hasn't even rolled around.
The position of the baby during a sonogram and many other factors affect the accuracy of the weight measurement. Women report their doctors' estimates being two to three pounds off, meaning they were induced because the baby was thought to be too big when he was actually just a normal size. Inductions can lead to further interventions that then may land mom a C-section, all because a doctor decided to move forward based on fiction, not fact.
11Every Little Heartbeat
It's easy to be told that constant fetal heart rate monitoring is good for us. It sounds good, right? The baby is constantly monitored throughout labor, and that should make it safer. However, that's not actually how it works.
Even though mom is tethered to a fetal heart rate monitor the entire labor, the baby's heart rate print out is only viewed occasionally. There are also plenty of downsides to the monitors, including longer labors and quicker, unnecessary interventions.
A baby's heart rate will fluctuate during labor. Most of those fluctuations are fine and not a sign of any major issues, but doctors use even the slightest change to defend C-sections and forcep or vacuum assisted deliveries.
It's also not great for a woman to be stuck on her back throughout labor. Women who can walk tend to have shorter labors. That's why intermittent fetal heart rate monitoring makes mores sense.
Women who know they are going into labor would do well to eat some food before checking into the hospital. Once they are in the hospital, everything but ice chips will likely disappear.
An antiquated belief that said women were at high risk for aspiration during labor means that most women are famished while trying to give birth. Labor is work, and the body needs fuel to make it happen. It's even been proven that women who have light snacks during labor may be better off since their bodies won't be in emotional or physical distress from not eating.
Even with the evidence that supports light snacks during labor, many doctors still choose to withhold food from their patients. Mom needs to find a doctor who is willing to let her eat during labor so she doesn't have to perform one of the hardest physical feats of her life on an empty stomach.
9Don't Make A Move
Walking during labor is good. Movement can help the baby drop into the birth canal, and it may also help women manage pain and shorten labor. That's why it's a shame that many doctors tether mom to the bed and keep her immobilized.
An IV is usually placed in mom's arm the minute she enters the hospital, though the benefits of pumping mom full of fluids are under question. Once a doctor hooks mom up to the IV, she is usually stuck in the bed or very near it. Add in fetal heart rate monitoring, and doctors effectively immobilize women early in labor.
Even if a woman chooses to have an epidural, a move that will keep her from walking because she can't feel her legs, she should be given the option to move around until she absolutely wants the pain medication. Even a bit of movement early in labor can offer mom benefits.
8Keep It All Medical
Regular medical practices have their place, but many doctors scoff at women receiving help from anyone outside of the medical community. Though the benefits of natural care practitioners have been studied and proven, many doctors won't recommend their patients to them.
Chiropractors and acupuncturists can make pregnancy easier and more comfortable for mom, but there are doctors who actively discourage patients from seeing them. Chiropractors have been known to perform manipulations that help breech babies flip to the right position, and acupuncturist can help labor get started if mom is overdue.
Fear or a lack of understanding as to how natural care practitioners work makes many doctors discourage their patients from being under their care. Unfortunately, mom and the baby are the ones who miss out on the benefits of having both natural and medical options working for them. That's one reason moms need to do research on their own and seek out the care they need.
7Any Drug Will Do
Doctors use drugs for purposes they weren't intended for often, but that doesn't make it a good practice. Take, for instance, a drug that is used regularly to induce labor and ripen the cervix. Cytotec, also known as Misoprostol, is placed in the vagina or given to mom orally. Despite how common the use of this medication is to start labor, most people don't know that it has only been tested to treat ulcers.
Midwives and others in the medical community have long warned that using a drug that has not been approved for the purpose it's being used for is dangerous, and most moms would likely agree if they knew this was happening. However, they generally aren't informed of the situation or the risks that come along with using Cytotec.
Women can refuse to take Cytotec or refuse to have it put on their vaginas, and they don't have to explain why. Since any drug used for the wrong purpose can be dangerous, women can simply inform their doctors that they won't take it and leave it at that.
6The Counting Game
Believe it or not, women can push without being told when to do it. They can even push without having a nurse or doctor count to ten, demanding they start and stop at a certain time.
Women's bodies are pretty good at taking signals and following cues, and that's why moms in labor don't need anyone telling them when pushing needs to take place. In fact, being told when to start and stop pushing can mess up mom's natural inclination to follow her body, and this could disrupt labor.
Doctors and nurses can definitely encourage mom through the pushing phase, but they don't need to tell her how to do it and when to stop. Simply telling her to listen to her body and to push to comfort is sound advice. The rest is just medical professionals trying to control a situation that they can't.
5On The Mark...
Women who birth in hospitals can expect to be on the clock the minute they show up in labor. Doctors have a bad habit of timing moms and demanding that their bodies follow a pattern, entering each phase of labor within a certain amount of time. Forget the fact that all women are different and their bodies don't all perform the same. That's not a consideration for many medical professionals.
Recent research and recommendations say that it's best to let women labor longer, even in the pushing phase, without intervening or threatening them with C-sections. It turns out that our bodies work like they are supposed to in most cases, and many women just need time to labor, not deadlines.
When a baby is legitimately in distress or when obstructed labor occurs, it makes sense to use interventions or C-sections. Outside of emergency circumstances, women should just be given space and time, and the doctor should relinquish his sense of control to let this happen.
4The Hard Way
Gentle C-sections are all the rage right now, mostly because they offer women who have to have surgery options that regular C-sections don't. Mom can watch a gentle C-section, and she isn't separated from her baby during the procedure. She may be allowed to breastfeed immediately, and every measure is taken to make the surgery better for her and her little one.
With all of the benefits, it's strange that many doctors refuse to perform gentle C-sections. They take slightly longer because the baby is pulled from mom's body slowly so he can receive the benefits of having his lungs gently squeezed on the way out. There is slightly more planning involved, but women who have gentle C-sections can attest to the benefits. Doctors still often refuse.
Because there is more planning and gentle C-sections are a new practice, doctors often refuse for their own convenience or because they want to save time. Both are lousy reasons, but that doesn't keep doctors from giving them.
3Shots For Lifestyle Choices
Vaccines are controversial to talk about, with each person taking a side and refusing to see any logic from the group that disagrees with them. The problem with this approach is that there are both benefits and dangers related to vaccines, and it would be easier to deal with if everyone could discuss the topic openly.
Doctors pushed the hepatitis B vaccine on newborns for years, and some still do. The problem is that hepatitis B is not a childhood illness, and the chance of a newborn catching it if mom doesn't have it are minimal.
There are plenty of risks with this shot, and a baby's underdeveloped immune system may not be able to handle it at birth. France actually investigated makers of the vaccine because they were not transparent about the risks.
Doctors often push vaccines without questioning when they are appropriate for kids. They simply follow the schedule regardless of the risks, and this leads to issues for children and their parents.
Separating mom and the baby after birth is a bad idea, but doctors don't often work to make sure it doesn't happen. While it is sometimes unavoidable, such as if mom or the baby need medical care, there are many times that doctors can carry out anything they need to do while mom and the baby are together instead of separating them.
Separating mom and baby early on may lead to problems with breastfeeding and attachment, and it causes both of them unnecessary stress. Baby friendly hospitals are working to change the norm, which is taking the baby to the nursery while mom is left alone, but doctors can do a lot to remedy this problem, regardless of what kind of hospital mom delivers at.
Doctors sometimes don't view their jobs as encompassing taking care of mom and baby's emotional well-being, but they should. It matters what those moments after birth are like for the new family, and it doesn't take much for doctors to make them easier.
Cutting the umbilical cord is usually something we see dads do right after birth, the doctor handing him scissors so he can detach the baby from mom. The problem is that waiting until the cord isn't pulsing is the best way to go, and many doctors don't recommend that method.
Allowing the baby to get all possible cord blood can help them avoid problems with anemia and give them a head start on good health. Waiting is easy, and it doesn't take long for the cord to stop pulsing. However, many doctors are ready to be finished with one birth so they can run to the next, so they don't offer mom the option of waiting for the cord to be cut.
It's perfectly acceptable to ask the doctor to slow down and let the cord finish pulsing. There's no reason to get scissor happy and deprive the baby of blood he or she can use.
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