Giving Birth in a Hospital? Think Hard.

It has long been known by physicians, nurses and mothers alike that obstetrics is practiced a far stretch away from an evidence-based standpoint.

Starting way back in North America when midwives attended most births in the home while physicians pined away in their offices, trying to think up new ways to attract customers, er, patients, physicians thought they had a clue about birth. Or rather, how they could improve birth. It isn't obstetrics that improved birth, to be honest it would be hard stretched to say that the office of obstetrics has caused a great deal of problems. General knowledge of anatomy and physiology, the advancements of hygene, and understanding of infection are what have really increased safety. Let's look at what obstetrics has done...

• As much as 100% episiotomy rates at certain times during the last century, and even when it was proven to cause harm or at least not improved outcomes in almost every situation, the rates are shockingly high, as much as 50% or more in some practices.
• EFM (electric fetal monitoring) has not only became common in all hospital L&Ds, it is still used today as standard of care despite it's causing highly interventive outcomes (like cesarean section). Even more frustrating, continuous EFM is known to cause complications in labouring mothers because of lack of maternal mobility which is a key aspect in a well-progressing labour.
• Anyone who knows me knows I am appauled by the skyrocketing caesarean rate. Over 8% places unnecessary risks to the mother specifically and the baby inadvertently (prematurity and cuts from the scalpel to name only two). Just ask the WHO counsel who recommended a rate of no higher than 10-15%. They know the numbers should be lower but US supporters knew they could not sell such a low number to obstetricians "back home" so they settled on the higher average. Incomprehensible that physicians would knowingly risk patients lives to protect their own liability insurance and their personal time (heaven forbid they lower their patient load and reduce their income!). Equally incomprehensible is the number of hospitals and insurance companies who have contributed to this outrage.
• Breech babies born by cesarean instead of vaginally based on one flawed study... knowingly so the minute it was published. Last week a new study refutes the Hannah breech trials and stands behind the safety of vaginal breech birth, yet we have scores of delivering physicians who don't know the basics of leopold maneuvers (relying instead on ultrasound results) nevermind how to catch a frank or footling breech.
  
• Speaking of ultrasound, how can so many things be tested on our unborn without adequate testing like this all-too-common screening tool? No long-term and precious few short-term studies have ever been done on the effacity of ultrasound screening.
• Which then brings me to the sheer number of drugs that are "safe" for mothers until proven otherwise. I will not even start counting the number of drugs resulting in birth defects, stillbirth and more that have been used on pregnant women without adequate testing. Just recently we have the new "stop smoking patch" that has been found to cause birth defects and metronidazole causing the very preterm risks it was preported to fix.
• Oh, and let us not forget the biggest one, the safety of birth in hospitals. The huge homebirth study published last year in the not only shows the safety of homebirth, it shows the huge risks of hospital birth by contrast. Heck, just last week a young healthy mother gave birth and lost all four of her limbs because of the bacteria she recieved from the hospital she chose to give birth in. Terrifying to me.