Practices of the OB Community

Here are some common interventions that have become dangerously routine of which I hope to give awareness to the unknowing and prevent unsafe and unnecessary procedures. This list is not limited to the five I’ve shared, but I hope it will open eyes and reveal the many misconceptions of what is deemed safe in the medical community.

  • Electronic Fetal Monitoring (EFM) also known as the non-stress test (NST) which measures both the fetal heart rate and the uterine contractions at the same time was invented by Orvan Hess and Edward Hon. It was introduced to make a reduction in cerebral palsy which has essentially been proven to have made no progress (the rates have remained the same for the past 30+ years). The EFM became universally used in the US and it has been linked to dependence on the machine that has led to increased misdiagnoses of fetal distress and increased (and likely unnecessary) cesarean deliveries.
  • Epidural Analgesia is administered to block the transmission of signals through nerves in or near the spinal cord and was generally given to those who were experiencing longer labors. It decreases pain and sensation in several parts of the body. In 2000 a study concluded that the administration of the epidural reduced the chances of having a vaginal delivery without additional interventions (forceps, episiotomy, etc.) from 71.4% to 37.8%. Only 35% of women receiving the epidural in a study done in 2001 had a normal birth without instrument assisted delivery. The epidural also interferes with release of endogenous (“arising from within”) oxytocin (Greek, “quick birth”) when used. A six week follow up of newborn infants in the U.K. found that bupivacaine, administered in the form of an epidural block, adversely altered brain function in a significant number of newborn infants throughout the six week testing period. A subsequent evaluation in the U.S. found essentially the same results.
  • Rupture of the membranes (ROM) surrounding the baby and amniotic fluid (otherwise known as the “breaking of the waters”) generally occurs prior to the birth of the baby, but may stay intact until even after the baby has been delivered. The performance of Amniotomy (artificial rupture of the membranes) before or during labor is intended to induce or accelerate labor. The procedure increases the incidence of abnormal fetal heart rate patterns, the risks of infection, while also increasing the cesarean rate by 20%. Valerie El Halta, a prominent home birth midwife, suggests one reason why early amniotomy may not benefit slowly progressing labors and late may have unpredictable effects: “if the baby is posterior, that is, facing the mother’s belly instead of her back, labor often progresses slowly until the baby turns into the anterior position. With membrane rupture, the head may surge downward into the pelvis and get stuck. As for permitting closer monitoring for suspected fetal distress, releasing the amniotic fluid adds to the baby’s stress by exposing the umbilical cord to compression during contractions. In addition, one potential cause of fetal distress is that the umbilical cord has slipped between the head and the cervix. Rupturing membranes could then cause prolapse, converting a concerning situation into an emergency.”
  • Oxytocin is a natural hormone produced by a woman’s body that causes uterine contractions. Pitocin is the synthetic form of oxytocin. Pitocin as well as all other drugs used in obstetric care have not been proven safe for the baby exposed to such drug in utero. None of the pharmaceutical manufacturers of those drugs approved by the FDA for use in obstetrics has carried out periodic neurological examinations of children exposed to their drug products in utero. The FDA has not required companies to provide such data. Virtually all drugs administered to women, including pitocin, rapidly filter across placental membranes and enter the blood, brain, and other major organs of the baby within minutes whether during pregnancy, labor, or birth. Always read “Indications” of any medication and if, for example, the words “obstetrics”, “pregnancy”, “labor”, “delivery”, or “lactation” are NOT mentioned in the INDICATIONS section of the package insert, the FDA has NOT approved the drug for use under those conditions.
  • Lithotomy (flat-on-back) or C-position (resting on tailbone with body curled in the shape of a C) are the most used birth positions in hospitals. They are solely used for the purpose of convenience for the doctors. Not only are these positions the least comfortable to labor in, they actually hinder the laboring process. It results in reducing the pelvic outlet up to 30% smaller and puts greater pressure on the perineum (which can thus lead to tearing, episiotomy, forceps delivery, or vacuum extraction). It also can decrease the fetal heart rate and other types of distress leading continuous or internal fetal monitoring, increased risk of shoulder dystocia, problems with presentation, or a prolonged pushing phase. There is no need for a woman’s legs to be held back and can in fact lead to putting lots of unnecessary stress on the perineum which in turn could lead to tearing.

The increase of information by these methods will not necessarily lead to better clinical outcomes. In fact, the evidence suggests otherwise.

Some additional resources I found helpful:
Is Homebirth for You? 6 Myths About Childbirth Exposed
Birth Misconceptions: Myth and Fact
Is Midwifery Safe?
Comparing Home Birth to Hospital and Birth Center Birth

The information in this blog, although written by me was obtained by several different sites online and I unfortunately did not cite the information. Please be aware that these are not my ideas but obtained from sources that may or may not have been copyrighted. Thanks and God bless!

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6 thoughts on “Practices of the OB Community

  1. I LOVED this information! I had a blog saved titled “Labor Truths” in hopes of getting around to finding this information; thank you for doing me an unknown favor!! 🙂 I do have a question in case you came across it while doing your research; are there any negatives or positives to an episiotomy? I have had numerous women tell me to have it done when I go through labor, but I wonder if the reason they needed it was because they were on their backs or curled up in C-position, thereby tightening the perineum. Any information you have is appreciated!!

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  2. It’s probably strange, but tearing is the number one thing that scares me about labor. I’m going to assume that the contractions happening are going to overpower the pain of a tear?? It makes me queasy to think of it…it really is scary to me.

    Interestingly enough, I was instructed in a dance class on the negatives to labor on ones back. As dancers, we were told by an instructor, “You know how your body works, and you also know how gravity works. Do the math.” The woman who said this had her first child just under a year ago and, while going to a hospital to deliver, she was heavily demanding in her labor choices. One of those choices was to not lay on her back.

    Thank you for the information!!

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  3. I’m so glad that you needed/wanted this information. I’ve been learning so much this past year and especially this past pregnancy while in preparation for a homebirth and alternative methods.

    Oftentimes episiotomy is encouraged by doctors for a couple of reasons that have no evidence to support (to prevent a jagged tear and/or to make room for baby to come through the vaginal opening). A straight cut is not better than a jagged one as an episiotomy can create more severe, larger tears than would occur naturally had they not been done. Evidence shows that the jagged tear will heal faster, because it tears along the natural grain of your skin and muscle fibers. Some women experience third and fourth degree tears during their second labor due to their first episiotomy tearing open.

    It’s also important to note that if in the rare case the episiotomy doesn’t lead to a deeper tear, it is easier to sew up than a jagged tear.

    To help prevent a tear, forced pushing should be avoided as should the positions mentioned in this entry be used for labor/delivery. Perineal massage can encourage the skin to stretch prior to baby’s delivery. Different positions that open up the pelvis and allow gravity to do its work as well as allowing your body to do the pushing with the contractions will be all that is truly necessary.

    Hope this helps and feel free to ask more questions if you have them and I’ll help you find the answers!

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  4. I’ve never experienced a tear, but I’ve heard that some women didn’t even know they tore when it occurred. There is a natural hormone released during labor that distracts us from a lot of our surroundings during labor.

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  5. Just wanted to pop in and say that I am loving this conversation. A Fruitful Vine, isn’t it amazing how many procedures we considered “normal” before and now find to be not only unnecessary, but actually dangerous?!!! It’s crazy! Cutting the cord immediately after birth, suctioning the baby’s mouth and nose, forced delivery of the placenta, immediate weighing and washing of the baby, vitamin K shots, that gunk that they smear all over poor baby’s eyes so that they can’t even see their own mommy, “purple” pushing, laying on your back during labor and delivery, monitors and IVs, breaking of the water and pain management drugs…the list goes ON AND ON!!! I am so excited about my next delivery and I am thrilled to be learning these vital childbirth truths so that my experience this time around can be what God intended.

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  6. I know A Lady in Training! You’ve inspired me to write another blog addressing the things you mentioned that I haven’t already (granted I can find the information). Why this stuff isn’t mainstream information is beyond me.

    Praise God for revealing these things to us! I pray more people will be made aware and experience the beauty that pregnancy, labor and delivery were created as!

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