3.04.2008

Stats, Studies, and Soapboxes

In response to a slew of emails I have been receiving off blog, I am writing a post in regards to maternal-safe practices, why I do what I do, and am I REALLY anti-doctor/anti-medicine as some of you believe.

We in the independent childbirth field attempt to give honest, evidence-based information to the women and families that seek our expertise. We do this by staying abreast of the most current medical journals, Cochrane reviews, studies, findings, practices, protocols and policies of U.S.-based medical establishments, and the ACOG.

With that in mind, we will not hesitate to acknowledge that there is a great amount of evidence to show that our current methods of obstetrical care might not be serving women in their best interests all of the time. Unfortunately, most obstetrical practices, protocols, and stances are in place to protect the medical provider from litigation, not to protect the woman's best interests, health of mom, or baby.

I, like most doulas and childbirth educators, are not anti-doctor or anti-hospital - we are not even anti-intervention... We wholeheartedly HOPE, every time we pick up a medical journal or read the most current ACOG policies, that we will find the Obstetrical field is beginning to practice evidence-based medicine (EBM). Unfortunately, more often than naught, we don't see this.

The evidence in obstetrical research news supports a less interventive approach than what I currently see in the settings in my local hospitals as being statistically the safest option for both mothers and babies with normal pregnancies.

Pushed reviews some of the reasons why some medical studies can give unbalanced results, and why it is important to weigh the source and methodology of Obstetrical studies. For this reason, Cochrane reviews are one of the best sources of balanced medical research and information. Below, you will find some of the information that I often pass on to clients when they request EBM:

Neonatal Mortality Rate (rate of death in the first 28 days of life, per 1000 live births):

The United States ranks behind Iceland, Singapore, Japan, the Czech Republic, Finland, Monaco, Norway, San Marino, Slovenia, Sweden, Belgium, Cyprus, France, Spain, Andorra, Austria, Denmark, Germany, Greece, Israel, Italy, Luxembourg, the Netherlands, Portugal, Switzerland, Austria, Canada, Malta, New Zealand, the United Kingdom, and Belarus. We are number 31.

Maternal Mortality Rate (rate of death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy, per 100,000 live births):

  1. Ireland - 4
  2. Finland - 5
  3. Spain - 5
  4. Austria - 5
  5. Italy - 5
  6. Canada - 5
  7. Australia - 6
  8. Denmark - 7
  9. Switzerland - 7
  10. New Zealand - 7
  11. Qatar - 7
  12. Sweden - 8
  13. Portugal - 8
  14. Czech Republic - 9
  15. Germany - 9
  16. The former state union of Serbia and Montenegro - 10
  17. Japan - 10
  18. Norway - 10
  19. Belgium - 10
  20. Greece - 10
  21. Slovakia - 10
  22. Croatia - 10
  23. Poland - 10
  24. United Kingdom - 11
  25. Hungary - 11
  26. Kuwait - 12
  27. Israel - 13
  28. The former Yugoslaw Republic of Macedonia - 13
  29. United States of America - 14
These numbers are taken from CDC reports.

Bottom line, we have MAJOR room for improvement.

As a doula and childbirth educator, my number one role is advocacy. It is not telling a woman what she should do, what she will do, or making choices for her. It is not speaking to her medical team on her behalf, but equipping her with the information necessary to make the best, most informed choices so that she can make these choices for herself. One birth at a time, we strive to make births SAFER through encouraging EBM and informed decision making.

BTW, if you have a question or concern that you would like me to respond to, feel free to click on my profile and email me from that link. I WILL respond.

3 comments:

hbacmama said...

From the somewhat religious person.
AMEN!
So linking this after I get my oldest from school... !

kris said...

very well written;)

Jacob, Vanessa, Rudy, Andy, and Mickey said...

People always make the biggest uproar, when the truth is being said. I am grateful for your blog it has been one of my links for sometime and though not much of a commentor more of a reader.....enjoy your passion and diligence towards this purpose.
Thankyou!!!

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