As established in my previous article, 4 questionable practices in the history of obstetrics, evidence clearly shows that controlled childbirths in hospitals don’t render healthier babies and mothers as an outcome. The fact that developed countries with a considerable percentage of home births, assisted by midwives, have better maternity mortality and infant mortality rates certainly supports this statement.
In obstetrics, as in many other medical professions, it is very likely that the fear of lawsuits and the need to control the outcome of childbirths has rendered a world of unnecessary and potentially dangerous interventions during labor. These are some of the most common interventions found today:
1) Pitocin
Pitocin is meant to replace the natural hormone oxytocin. Under certain circumstances, Pitocin can be a lifesaving intervention. However, studies do not support any medical reason to use it routinely, and they do, on the other hand, show that women who are induced artificially with Pitocin are twice as likely to be intervened by a C-section than those who decide to wait for their bodies to start labor naturally. 1. Additionally, obstetricians regularly recommend inducing labor at 41 weeks of pregnancy if labor has not started under the pretense that there is an increased risk of stillbirths and deaths. Evidence simply does not support this claim to be true as more stillbirths actually happen during weeks 37, 38 and 39 of pregnancy. Because it is administered continuously through an IV, contractions derived from Pitocin are longer, closer together and feel stronger than a laboring woman’s natural contractions. This can cause considerable stress to the baby and a deprivation of oxygen and blood, which leads to abnormal fetal heart rate patterns and fetal distress. The package insert also lists the following side effects: fetal heart abnormalities, low APGAR scores, neonatal jaundice, neonatal retinal hemorrhage, permanent central nervous system or brain damage and fetal death. For women, it can cause complications too, such as an increased risk of postpartum hemorrhage after birth. It also disrupts the natural hormonal balance of labor, which probably accounts for the reduced rate of breastfeeding mothers after induction via Pitocin.
2) Epidural
The epidural is a local anesthetic usually derived from cocaine, which is injected into the space around the tough coverings that protect the spinal cord. It then, is able to block the nerve signals from the sensory and motor nerves, thus providing fast acting short-term pain relief.
Even though they are considered safe, epidurals have a significant negative effect on birth as they interfere with hormones that are produced during labor. They inhibit the production of beta-endorphins, which are vital for women to shift consciousness (regarded by laboring women as traveling to a different planet). Epidurals also reduce oxytocin production, which explains why they tend to slow down the process of labor considerably (epidural labors tend to last an average of 3 or 4 hours longer). They also reduce the oxytocin peak that occurs at the precise time of birth since the woman’s lower receptors are numbed. This helps explain why there is an increased use of forceps in births where epidurals are used. They have also been shown to inhibit catecholamine (CA) production, which can slow down or stop labor in the early stages.
3) Fetal Monitoring
Fetal monitoring of the baby’s heart rate carries no direct health risks to the mother or baby. However, its use is associated with a significant increase in the rates of cesarean section, assisted vaginal delivery and lower Apgar scores. 2. Prior to the introduction of fetal monitors, C-sections in the US were approximately 4%. After its introduction, cesarean rates quickly climbed to 15% by the end of the 1970s. The current US cesarean rates are 33%. Besides this, other than a reduction in the incidence of neonatal seizures, there are no short or long term benefits of routine continuous electronic fetal monitoring. 3.
4) Ultrasound
Ultrasounds can be a helpful tool to help identify potential problems throughout the pregnancy for specific women with specific conditions (for example, suspected twins or suspected placenta previa). However, ultrasounds have become a regular practice in obstetrics, becoming yet another uncontrolled experiment on the most fragile populations of the world: pregnant women and their babies. In 2010, the Cochrane Collaboration reviewed evidence on routine prenatal ultrasounds (RPUs) and arrived at the conclusion that there is no evidence that supports its regular use in particular for low-risk pregnancies. 4. In fact, a randomized clinical trial done on over 15,000 women points to the fact that prenatal ultrasound does not improve birth outcomes. 5. This might be why the American College of Obstetricians and Gynecologists only recommends ultrasounds for very specific cases instead of the whole female population.
Depending on the ultrasound machine and the way ultrasound is done, heat coming from the device can lead to heating of sensory organs incased in bones. Additionally, cavitation (or the formation of empty spaces) can occur in tissues that have significant pockets of gas (for example, lungs or intestines) after birth. The ultrasound wave causes a mechanical shearing force at the cell surface of babies. This appears to have adverse effects in both prenatal and postnatal development. 6.
While evidence is not conclusive, it does seem to point to the fact that ultrasounds may be causing harm, with no benefit whatsoever for healthy pregnancies.
Now that we’ve gone over some of the most common interventions found in modern obstetrics, how was your childbirth? And how do you feel about these interventions? Is it time to go back to learning how nature does its job and work with it rather than against it?
Sources:
1. Routine induction of labor at 41 weeks gestation: nonsensus consensus
6. Quantification of risk from fetal exposure to diagnostic ultrasound.
Suggested further reading and research:
Buckley S. Gentle Birth, Gentle Mothering. Celestial Arts, 2009
