The American College of Obstetricians and Gynecologists (ACOG) just released new guidelines that may benefit low-risk pregnancies.
The ACOG recently published new guidelines urging health care providers to reconsider unnecessary medical interventions for low-risk mothers. Many interventions could pose unwarranted risks to both Mother and Baby.
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WHAT IS A LOW-RISK PREGNANCY?
A low-risk pregnancy is when a mother has no pre-existing medical conditions, is not having multiples, and is within a healthy weight/age range. The mother and baby are deemed healthy, and there does not appear to be risks involving labor.
Some conditions and circumstances can arise in any pregnancy that can shift it from being a low-risk pregnancy to a high-risk pregnancy.
WHAT IS A MEDICAL INTERVENTION?
Medical intervention is “the act or fact or a means of interfering with the outcome or course especially of a condition or process (as to prevent harm or improve functioning),” according to Webster’s Dictionary.
In today’s society, these procedures seem to be used in unnecessary situations. The ACOG has brought to light that maybe less is best. Allowing a mother to let her body lead her through this natural process may be less invasive and pose less of a risk.
MEDICAL INTERVENTIONS THAT ARE COMMONLY USED
Epidurals are often used as a pain reliever during the birthing process. It can pose many risks to Mom and Baby. This medication can lengthen labor and leave Mom at more of a risk for a perineal tear. The use of an epidural may also increase the chances of an instrumental delivery which could present complications.
Due to Baby having a lowered immune system it will take the drug longer to be expelled from his system. While effective as pain management, low-risk pregnancies could benefit by avoiding this intervention.
Pitocin is a synthetic oxytocin that is used to induce or speed up labor. This is a drug that is administered through an IV. Using this method is sometimes medically necessary. The frequency that this drug is used in low-risk pregnancies is questionable. The risks to mom could include seizures, fainting, and dangerously high blood pressure.
A Canadian study suggests that using this method is twice as likely to end in a C-section birth as opposed to allowing the mother to go into “Spontaneous labor.”
3. Electronic Fetal Monitoring
There are three types of monitors: the external unit, a telemetry unit, and an internal unit. The external unit typically uses two belts and straps around the mother. The telemetry unit, unlike the external unit, allows the mother to move around while being monitored. The internal unit is attached directly to the unborn baby to monitor him more accurately.
Continuous monitoring has not been shown to improve outcomes for women experiencing low-risk pregnancies.
This method is used to start labor. At times, these procedures can be beneficial and necessary. There are four methods of induction commonly used. The first method is when the healthcare provider uses her finger to separate the cervix from around the baby’s head. The second method is to rupture the membranes with a sterile hook. The third way to insert prostaglandin gel or a balloon-like catheter to ripen the cervix. The fourth method is to use Pitocin.
Unless there is a clear medical reason to use induction, it is better to let nature take its course.
5. Directed Pushing
Directed pushing is when a mother is asked by the health care provider to hold her breath for a ten count. Then she is instructed to push throughout the contraction regardless of her natural urge to push.
This can be uncomfortable for a laboring mother. Women should follow their natural urge to push; their bodies were made to labor.
An episiotomy is a surgical cut to the perineum and muscle beneath it. This can shorten the pushing stage of labor by five to fifteen minutes. It can cause prolonged pain, after the birth, and possible infection for Mom.
This is a procedure that should only be used for medical reasons. The routine use of this method does not benefit Baby or Mom.
7. Cesarean Section
This is an incision in the abdomen that cuts through the uterus to remove the baby. The risk to Mom could be an infection of the uterus, wound, urinary tract, or even death. Babies could experience an increased level of respiratory compromise, slower neurological responses after birth, and a lowered immune system.
Many low-risk moms have elective c-sections. This method should only be used if deemed medically necessary.
LESS MAY BE BEST WITH LOW-RISK PREGNANCIES
Less unnecessary interventions may be less invasive on both mother and baby. The ACOG says that fewer interventions may equal better care. It is uncertain that the interventions help low-risk laboring mothers. Mothers, however, may benefit from better emotional support. Many factors can affect labor. The setting smells, and even people present can make an impact on the birthing woman.
Many of the interventions are physically and mentally uncomfortable for a laboring mother. “Anything that disturbs a laboring woman’s sense of safety and privacy will disrupt the birth process,” states Susan Buckley, MD.
Hospital births are relatively new considering humans have been around for quite some time.
As a species, we have thrived while birthing without medical help for many centuries.
Home births may be a positive option for moms that do not want their health care provider to perform nonessential interventions. Home births may be safe, if not safer, than a hospital for low-risk pregnancies.
Birthing at home would allow the low-risk mother to be more in control of her labor experience. This can be very helpful and instrumental in her having a safe delivery.
Labor is a marvelous and scary time for most moms. Medical interventions are useful when needed they can be detrimental when not. They could have adverse effects and disrupt the natural birthing process as opposed to helping it.
Mothers experiencing low-risk pregnancies should explore all of their options as medical interventions can sometimes cause more harm than good.
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