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Assume as a given
that no one in the obstetrical profession is purposefully making
childbirth hard for women. Medicalized childbirth is well intentioned.
However, interventionist obstetrics does not properly acknowledge
the normal biology of spontaneous childbearing nor meet the practical
needs of healthy women and their babies.
Problem:
The uncritical acceptance of an
unscientific premise
-- surgical obstetrics for normal childbirth in
healthy women with normal pregnancies
Solution:
A science-based care maternity based
on physiological management -- safe, cost-effective and
mother-baby-father friendly.
This would result in a single,
evidence-based standard for all healthy women used by all maternity care
providers -- family practice physicians, obstetricians, and professional
midwives.
Physiological:
…"..in accord with, or characteristic of, the normal functioning of a
living organism”
(Stedman’s Medical
Dictionary definition of “physiological” – 1995)
The
scientific basis for physiological management of pregnancy and
normal childbirth is supported by a consensus
of the scientific literature.
Physiological management is actually protective for both mothers
and babies, reducing the episiotomy / operative delivery rate (and
associated complications), from approximately 72% to
approximately 5% with an identical, or even slightly
improved perinatal mortality rate.
It is efficacious -- that is, both safe and cost effective.
"In the first
place, do no harm..." ~
bringing the Hippocratic Oath into the 21st Century
In order to
bring
science-based maternity care to all childbearing women, we must
bring an
end to "flat
earth obstetrics".
True mastery in normal
childbirth services means bringing about a good outcome without
introducing any unnecessary harm. Our present system of obstetrics
for normal childbirth does not do well in this regard. The scientific
literature -- vital statistics records, textbooks and published research
-- all make it clear that routine obstetrical interventions and
conducting normal birth as a surgical procedure are more dangerous
for healthy women than the use of normal or 'physiological' principles.
For the last century, an
unscientific form of Interventionist obstetrics has dominated maternity
care in the United States, to the detriment of childbearing women and
the taxpaying public. In spite of spending
more money that any
other country in the world, the United States is 30th in maternal
mortality and 22nd in perinatal mortality. The five countries with the
best outcomes spend only a fraction of the money we do.
They all have national maternity care policies that depend on
physiological management.
Over the last hundred
years organized medicine has purposefully dismantled the infrastructure
for providing physiologically-based maternity care and replaced it with
interventionist obstetrics. Medical and surgical procedures
originally intended to treat life-threatening complications
are routinely used on healthy women with normal pregnancies,
without having been proven safe or more effective than physiological
management. This unregulated medical experiment introduces artificial
risk and serious complications. In the last three decades the
medicalization of childbirth has expanded exponentially. Institutional
memory of "normal" childbirth is now absent for obstetricians, the
nursing profession and medical educators.
Defensive medicine rules the
day. This creates an
asymmetrical burden of risk that falls unfairly on
the childbearing woman, in which
the mother is exposed to the actual pain and potential harm of medical
and surgical interventions in order to reduce the risk of litigation
for the obstetrician.
Premature and/or artificial termination of normal pregnancy through
induction of labor, surgical incisions, instruments or cesarean section
has become the statistical norm. Childbirth for healthy women in 21st
century America is typically accompanied by the routine use of
continuous electronic monitoring (93%),
inducing or speeding up labor with artificial hormones (63%), epidural
anesthesia (63%), episiotomy, instrumental delivery and/or cesarean
surgery (72%).
Obstetrical medicine rejects out
of hand the "social" model of childbirth used world-wide to the great
advantage of childbearing families. While publicly promoting itself as
virtuous beyond compare, the obstetrical profession is frequently
disrespectful and dismissive of the concerns of childbearing women and
their families. It does not provide truly informed consent and resorts
to threats of legal force if parents do not quickly comply with
obstetrical advice for risky medical and surgical interventions that
frequently turn out to be unwarranted.
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Table of
Contents ~ links to major documents // Position Papers
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