scholarly journals Healthy Birth Practice #4: Avoid Interventions Unless They Are Medically Necessary

2014 ◽  
Vol 23 (4) ◽  
pp. 198-206 ◽  
Author(s):  
Judith A. Lothian
Keyword(s):  
Fetal Monitoring ◽  
The United States ◽  
Care Practice ◽  
Evidence Based ◽  
Intravenous Fluids ◽  
Normal Birth ◽  
Electronic Fetal Monitoring ◽  
Increase Risk ◽  
Care Practices ◽  
Continuous Electronic Fetal Monitoring

Maternity care in the United States is intervention intensive. The routine use of intravenous fluids, restrictions on eating and drinking, continuous electronic fetal monitoring, epidural analgesia, and augmentation of labor characterize most U.S. births. The use of episiotomy is far from restrictive. These interventions disturb the normal physiology of labor and birth and restrict women’s ability to cope with labor. The result is a cascade of interventions that increase risk, including the risk of cesarean surgery, for women and babies. This article is an updated evidence-based review of the “Lamaze International Care Practices That Promote Normal Birth, Care Practice #4: No Routine Interventions,” published in The Journal of Perinatal Education, 16(3), 2007.

scholarly journals Healthy Birth Practice #4: Avoid Interventions Unless They Are Medically Necessary

2019 ◽  
Vol 28 (2) ◽  
pp. 94-103
Author(s):  
Judith A. Lothian
Keyword(s):  
United States ◽  
Epidural Analgesia ◽  
Maternity Care ◽  
Fetal Monitoring ◽  
The United States ◽  
Unintended Consequences ◽  
Intravenous Fluids ◽  
Electronic Fetal Monitoring ◽  
Increase Risk ◽  
Continuous Electronic Fetal Monitoring

Maternity care in the United States continues to be intervention intensive. The routine use of intravenous fluids, restrictions on eating and drinking, continuous electronic fetal monitoring, epidural analgesia, and augmentation of labor characterize most U.S. births. The use of episiotomy has decreased but is still higher than it should be. These interventions disturb the normal physiology of labor and birth and restrict women's ability to cope with labor. The result is a cascade of interventions that increase risk, including the risk of cesarean surgery, for women and babies. This paper describes the use and effect of routine interventions on the physiologic process of labor and birth and identifies the unintended consequences resulting from the routine use of these interventions in labor and birth.

scholarly journals Healthy Birth Practice #1: Let Labor Begin on Its Own

2014 ◽  
Vol 23 (4) ◽  
pp. 178-187 ◽  
Author(s):  
Debby Amis
Keyword(s):  
United States ◽  
The United States ◽  
Labor Induction ◽  
Professional Organizations ◽  
Care Practice ◽  
Evidence Based ◽  
Normal Birth ◽  
Care Practices

As cesarean rates have climbed to almost one-third of all births in the United States, current research and professional organizations have identified letting labor begin on its own as one of the most important strategies for reducing the primary cesarean rate. At least equally important, letting labor begin on its own supports normal physiology, prevents iatrogenic prematurity, and prevents the cascade of interventions caused by labor induction. This article is an updated evidence-based review of the “Lamaze International Care Practices That Promote Normal Birth, Care Practice #1: Let Labor Begin on Its Own,” published in The Journal of Perinatal Education, 16(3), 2007.

scholarly journals Healthy Birth Practice #5: Avoid Giving Birth on Your Back and Follow Your Body’s Urge to Push

2014 ◽  
Vol 23 (4) ◽  
pp. 207-210 ◽  
Author(s):  
Joyce T. DiFranco ◽  
Marilyn Curl
Keyword(s):  
United States ◽  
Supine Position ◽  
The United States ◽  
Care Practice ◽  
Evidence Based ◽  
Birth Experience ◽  
Normal Birth ◽  
Care Practices

Women in the United States are still giving birth in the supine position and are restricted in how long they can push and encouraged to push forcefully by their caregivers. Research does not support these activities. There is discussion about current research and suggestions on how to improve the quality of the birth experience. This article is an updated evidence-based review of the “Lamaze International Care Practices That Promote Normal Birth, Care Practice #5: Spontaneous Pushing in Upright or Gravity-Neutral Positions,” published in The Journal of Perinatal Education, 16(3), 2007.

scholarly journals Healthy Birth Practice #2: Walk, Move Around, and Change Positions Throughout Labor

2014 ◽  
Vol 23 (4) ◽  
pp. 188-193 ◽  
Author(s):  
Michele Ondeck
Keyword(s):  
United States ◽  
Severe Pain ◽  
Obstetric Care ◽  
The United States ◽  
Care Practice ◽  
Evidence Based ◽  
Freedom Of Movement ◽  
Normal Birth ◽  
Childbirth Experience ◽  
Care Practices

In the United States, obstetric care is intervention intensive, resulting in 1 in 3 women undergoing cesarean surgery wherein mobility is treated as an intervention rather than supporting the natural physiologic process for optimal birth. Women who use upright positions and are mobile during labor have shorter labors, receive less intervention, report less severe pain, and describe more satisfaction with their childbirth experience than women in recumbent positions. This article is an updated evidence-based review of the “Lamaze International Care Practices That Promote Normal Birth, Care Practice #2: Freedom of Movement Throughout Labor,” published in The Journal of Perinatal Education, 16(3), 2007.

scholarly journals Healthy Birth Practice #6: Keep Mother and Baby Together— It’s Best for Mother, Baby, and Breastfeeding

2014 ◽  
Vol 23 (4) ◽  
pp. 211-217 ◽  
Author(s):  
Jeannette T. Crenshaw
Keyword(s):  
Child Outcomes ◽  
Feeding Preference ◽  
Skin Care ◽  
Care Practice ◽  
Evidence Based ◽  
Normal Birth ◽  
The Hours ◽  
Care Practices ◽  
The Moment ◽  
Skin To Skin

Mothers and babies have a physiologic need to be together at the moment of birth and during the hours and days that follow. Keeping mothers and babies together is a safe and healthy birth practice. Evidence supports immediate, uninterrupted skin-to-skin care after vaginal birth and during and after cesarean surgery for all stable mothers and babies, regardless of feeding preference. Unlimited opportunities for skin-to-skin care and breastfeeding promote optimal maternal and child outcomes. This article is an updated evidence-based review of the “Lamaze International Care Practices That Promote Normal Birth, Care Practice #6: No Separation of Mother and Baby, With Unlimited Opportunities for Breastfeeding,” published in The Journal of Perinatal Education, 16(3), 2007.

scholarly journals Healthy Birth Practice #3: Bring a Loved One, Friend, or Doula for Continuous Support

2014 ◽  
Vol 23 (4) ◽  
pp. 194-197 ◽  
Author(s):  
Jeanne Green ◽  
Barbara A. Hotelling
Keyword(s):  
Cultural Barriers ◽  
Care Practice ◽  
Evidence Based ◽  
Loved One ◽  
Labor Support ◽  
Normal Birth ◽  
Continuous Support ◽  
Care Practices

All women should be allowed and encouraged to bring a loved one, friend, or doula to their birth without financial or cultural barriers. Continuous labor support offers benefits to mothers and their babies with no known harm. This article is an updated evidence-based review of the “Lamaze International Care Practices that Promote Normal Birth, Care Practice #3: Continuous Labor Support,” published in The Journal of Perinatal Education, 16(3), 2007.

scholarly journals Continuous Electronic Fetal Monitoring during Labor: A Critique and a Reply to Contemporary Proponents

2018 ◽  
Vol 04 (01) ◽  
pp. e23-e28 ◽  
Author(s):  
Thomas Sartwelle ◽  
James Johnston
Keyword(s):  
Scientific Evidence ◽  
Fetal Monitoring ◽  
Standard Of Care ◽  
Developed Countries ◽  
Evidence Based ◽  
Current State ◽  
Electronic Fetal Monitoring ◽  
The Developed Countries ◽  
State Of Affairs ◽  
Continuous Electronic Fetal Monitoring

AbstractA half century after continuous electronic fetal monitoring (EFM) became the omnipresent standard of care for the vast majority of labors in the developed countries, and the cornerstone for cerebral palsy litigation, EFM advocates still do not have any scientific evidence justifying EFM use in most labors or courtrooms. Yet, these EFM proponents continue rationalizing the procedure with a rhetorical fog of meaningless words, misleading statistics, archaic concepts, and a complete disregard for medical ethics. This article illustrates the current state of affairs by providing an evidence-based review penetrating the rhetorical fog of a prototypical EFM advocate.

Electronic fetal monitoring in the twenty-first century: Language, logic and Lewis Carroll

2020 ◽  
pp. 147775092097180
Author(s):  
Thomas P Sartwelle ◽  
James C Johnston ◽  
Berna Arda ◽  
Mehila Zebenigus
Keyword(s):  
Medical Literature ◽  
Medical Profession ◽  
Scientific Research ◽  
Fetal Monitoring ◽  
First Century ◽  
Lewis Carroll ◽  
Evidence Based ◽  
Electronic Fetal Monitoring ◽  
Complete Failure ◽  
Twenty First Century

The Alice Books, full of illogical thoughts, words, and contradictions, were unrivaled entertainment until the publication of the medical literature promoting electronic fetal monitoring (EFM) for every pregnancy. The modern-day EFM advocates acknowledge EFM’s decades long failure but simultaneously recommend EFM use for lawsuit protection and because the profession has used EFM for every pregnancy for fifty years, therefore, it must be efficacious. These self-indulgent, illogical rationalizations ignore the half century of evidence-based scientific research proving that EFM is a complete failure as well as ignoring the fact that continued EFM use violates the fundamental principles of modern bioethics. This blind advocacy perpetuates four pernicious EFM harms occurring to mothers, babies, and the medical profession itself. This article sets out these four EFM harms with the goal of abolishing the misguided, illogical, contradictory, arguments used by the twenty-first century EFM Lewis Carroll mimics.

scholarly journals Evidence-based Standardized Care Plans for Use Internationally to Improve Home Care Practice and Population Health

2011 ◽  
Vol 02 (03) ◽  
pp. 373-384 ◽  
Author(s):  
D.J. Foster ◽  
T. Gomez ◽  
J.K. Poulsen ◽  
J. Mast ◽  
B.L. Westra ◽  
...  
Keyword(s):  
Home Care ◽  
Population Health ◽  
The United States ◽  
Care Practice ◽  
Evidence Based ◽  
Care Plans ◽  
Public Comment ◽  
Omaha System ◽  
On Line ◽  
Standardized Care

Summary Objectives: To develop evidence-based standardized care plans (EB-SCP) for use internationally to improve home care practice and population health. Methods: A clinical-expert and scholarly method consisting of clinical experts recruitment, identification of health concerns, literature reviews, development of EB-SCPs using the Omaha System, a public comment period, revisions and consensus. Results: Clinical experts from Canada, the Netherlands, New Zealand, and the United States participated in the project, together with University of Minnesota School of Nursing graduate students and faculty researchers. Twelve Omaha System problems were selected by the participating agencies as a basic home care assessment that should be used for all elderly and disabled patients. Interventions based on the literature and clinical expertise were compiled into EB-SCPs, and reviewed by the group. The EB-SCPs were revised and posted on-line for public comment; revised again, then approved in a public meeting by the participants. The EB-SCPs are posted on-line for international dissemination. Conclusions: Home care EB-SCPs were successfully developed and published on-line. They provide a shared standard for use in practice and future home care research. This process is an exemplar for development of evidence-based practice standards to be used for assessment and documentation to support global population health and research.

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