Thursday, July 8, 2010

Evidence-Based Medicine

Even before we became pregnant, we looked into pregnancy and birth.  I've spent countless hours looking at real research surrounding birth, and Trevor spoke (on a professional level) with OBGYN's while he was in clinicals for Labor & Delivery.  We have listened to other's opinions surrounding pregnancy and birth, mainly, those who came to the same conclusions we have.  One of my favorite blogs on the topic is Stand and Deliver.  I agree with alot of what Rixa has to say (but not all, of course).  Her most recent post got me thinking.

Every parent has to decide what is best for their family.  What I don't understand is how people can just go along with what "professionals" say without looking into it themselves, and then try to force their beliefs onto others.  Many of these "professionals" don't practice Evidence-Based Medicine.  They practice what I like to call Routine-Procedure-Based Medicine.  They do this because somewhere along the line, a patient needed the procedure and it wasn't done.  A policy was made to ensure that this wouldn't happen again, and it stuck.  No one considered the side effects this now routine procedure would have on those patients who don't need it.

I realize that these professionals are very busy and don't have time to pour over all the research.  I also realize that research is a never ending process, and the more technological advances we have the more the conclusions that came from that evidence can change, and we can even find new evidence.  I even realize that change is a slow process!

The first book on birth I read was on the Bradly Method titled "Husband Coached Childbirth."  It was originally written to advocate for fathers being in the delivery room at the time of their child's birth instead of pacing the halls of the waiting room.  It also talks about how animals give birth and how we should try to replicate that...that Natural Childbirth has the best outcomes for all involved.  It may Talk the Talk, but it does not Walk the Walk.  It is laden with Routine-Procedures...Interventions of natural childbirth.  Interventions that are sooooo routine and so accepted their not even considered interventions.

I am no longer shocked by the numbers of people who think birth is an emergency, and is dangerous, and is the "worst pain of your life," and needs to be managed by a doctor.  I am beginning to become amused by the number of people who want to be "Kept in the dark" regarding birth and pregnancy.  I've had numerous people tell me, upon hearing our pregnancy and birth preparation and plans, that it was so much easier when they had babies... they didn't have to do anything, the doctor just told them what to do.  How can they have so much trust in a doctor to keep them and their baby healthy... someone they see once a month, and have zero trust in their body to grow a perfectly healthy baby?  Women have grown babies and given birth since the beginning, then all of a sudden we have technology and doctors and medications available and they MUST be used!  I find it hard to believe that God, as Awesome as He is, would design us incapable of growing and birthing healthy babies.  I think it is much more likely our interference with His plans for us that renders (some of) us incapable of growing and birthing healthy babies.

This Technology, Medication and information the Doctors have are gifts from Him, and have their place.  However, because doctors don't do the research, and don't have time to review the research, they practice Routine-Procedure Based Medicine entirely too much.  Especially in birth.  Birth is not an emergency (there are some things than can become an emergency, but birth in itself is not an emergency), it is not inherently dangerous (driving a car is more dangerous), it is not "the worst pain of your life" (this is the media and general stigma surrounding birth - rent the movie "Orgasmic Childbirth" if you don't believe me), and it does not need to be managed (did Eve deliver her babies in a hospital with a doctor telling her what to do?  I THINK NOT!  Also, in other countries - Britain for one - you do not go to the hospital to give birth, babies are born at home).

I will not subject myself or my baby to Routine-Procedure-Based Medicine just because that is the view of our culture.  We will not have a managed birth.  We will not go to the hospital unless there is an emergency.  We will not be induced leading to an epidural leading to difficulties in breast feeding and infection needing treated with antibiotics which leads to allergies in the baby which leads to feeding formula which leads to more allergies and food intolerance.  I will not have a c-section if there are more than 12 hours between the water breaking and birth - this is necessary in a hospital because of risk of infection (my opinion - but a land fill probably has less antibiotic-resistant strains of germs).  There will be no cervical checks to give me permission to push - again the germ thing, and I will push if and when I feel the need to assist my body.  I will not be hooked up to an IV to keep me hydrated so I don't eat or dring anything in case of c-section.  I will not be forced to lay on my back to give birth - which leads to tearing or an episiotomy and often a "stuck" baby requiring removal by forceps, suction and even c-section.  The umbilical cord will not be cut or handled until it has stopped pulsing on its own - early cord cutting cause Rh sensitization in mothers if the baby and mother don't have the same blood factor, which leads to a managed pregnancy for the next baby, which leads to a multitude of other interventions.  It also deprives the baby of its own blood which leads to an anemic infant and stresses its body in more ways than I care to list right now.  She will not be suctioned, baby is capable of clearing her own passages given that the cord is not cut early.  The baby will not be given painful stimuli to make her cry (many babies born in water don't cry and it does not effect their apgars).  There will be no cord traction or uterine massage which can lead to turning the uterus inside out, partial release of the uterus, hemorrhage and maternal death.  The placenta will come out when it is ready.  There will be no Vitamin K injection - causes problems in getting a blood sample to check for the PKU test, nor will she be vaccinated for Hepatitis B - her body cannot process the other stuff in the vaccine and she is not at risk at this time in her life.

After we've had a chance to get to know our baby a little, get some food in all of us, bathe and get everything picked up, and rest a little, we will call our parents to come celebrate with some Birth Day Ice Cream Cake.  :) 

This is what is best for our family.  To those of you who roll your eyes at me and give me speeches on what is best for my baby, you add humor to my day.  You did what was best for your family given the information you had at that time.  Do not tell me what is best for my family using the information you had at the time you decided what was best for your family.  I'm choosing not to be stuck in the past, to live in the present, and have faith in the future.


  1. I loved this post!!! I wish I could parrot this word for word whenever I get crap about not following the main stream. So glad that I'm not the only "crazy" pregnant lady out there:)

  2. Good for you! This was a nicely informative post, i don't know much about home births so it was nice to learn a little from your research. I'd love to chat with you about it a bit more in detail. :-)
    Will it be just the two of you guys? Or will you have someone there to help trevor out? :-)


  3. Just the two of us! If I have to go to the hospital, we have a friend who will come sit with the baby until the grandparents get here.