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A question of necessity

The debate going on in Ireland about sweeping and stretching the cervix to avoid induction, and the necessity of doing vaginal examinations offers a wake up call about the many procedures that are done to women (and babies) during pregnancy that are really just habit. Sure, some people have tried to justify the habit by doing research (long after the habit has become established practice) but this avoids the findamental question of why we are performing these invasive procedures in the first place.

One basic question, asked whenever a procedure or treatment is suggested, may help to stop some of these ubiquitous routines:

IS THIS REALLY NECESSARY ?

Once time is taken for consideration, often the answer will be “No, not really”. Almost all inductions (except the 5 - 6% of babies with a real medical need), almost all episiotomies (except for the less than 5% of babies who need a rapid birth at the end of second stage), the majority of vaginal examinations, all the routine CGT traces on admission to hospital, all the artificial rupture of membranes, all the “push, push, push” instructions in second stage and the routine oxytocics for third stage would cease. Many more “management strategies” would also be reduced.

What a difference this would make for labouring women! Sure, some women might feel anxious if they are not subjected to all this interference because they associate it with “good care”. However, if their midwife said, cheerfully and firmly, that these routines were not necessary and could be harmful, women will quickly accept this, and discover the benefits of a more physiological labour.

If this question was then extended to the drugs routinely given to women in labour (pethidine, nitrous oxide, epidurals) we would have a revolution in our labour wards and healthier babies to boot. Women would discover their own innate power and midwives could practise their skills in a satisfying and enriching way.

It seems so simple....... I must be dreaming!

Posted by andrea at January 28, 2006 07:32 AM