Relay-Version: version B 2.10 5/3/83; site utzoo.UUCP Posting-Version: version B 2.10.2 9/5/84; site aecom.UUCP Path: utzoo!decvax!mcnc!philabs!aecom!werner From: werner@aecom.UUCP (Craig Werner) Newsgroups: net.med,net.women Subject: Birth Techniques (and their misconceptions) Message-ID: <1784@aecom.UUCP> Date: Sun, 7-Jul-85 20:40:18 EDT Article-I.D.: aecom.1784 Posted: Sun Jul 7 20:40:18 1985 Date-Received: Tue, 9-Jul-85 15:02:08 EDT Distribution: na Organization: Albert Einstein Coll. of Med., NY Lines: 75 Xref: pepe net.med:573 net.women:2851 In a recent request for topics, I got two requests related to childbirth, so the article summarized below caught my eye: From Parade Magazine, July 7, 1985, pp. 12-13. "Are Today's Birth Techniques Neccessary: What Doctor's Don't Tell You." by Diana Korte. [I thought the title needlessly incediary, but the content is reasonable.] Some common misunderstandings: 1. Shaving reduces infection. Studies do not back this up, and some indicate (not only for childbirth but for all surgery) that it may increase infection by irritating the skin. 2. An enema during labor eases the baby through the birth canal by stimulating the uterus to contract; it also reduces the chance of fecal contamination. In 1982, a British study found none of these claims to be true, and concluded "such rectal assaults on women in labor should be discouraged." [Among all things listed , this is the one practice I had never heard of] 3. All women should be hooked up to IV feeding during labor. The argument for this is that if a complication occurs during delivery (i.e. shock), putting an IV in then would be more difficult. It is routine in many hospitals. Others (more reasonably) only do it for women at high risk. 4. Women belong in bed during labor. Wrong. The supine (lying on back) position lowers maternal blood oressure, and may decrease blood supply to the Uterus, and hence Fetus. It also decreases the strength of contractions and slows labor. Also lying down, the mother has to work against gravity. Better would be standing with support, sitting, kneeling, or lying on the side. 5. An Episiotomy hastens labor and healing. It may also prevent later bladder problems. Actually, there is no evidence it shortens labor, or reduces severe tearing. It quotes, "Women who have episiotomies have a higher percentage of deep tears in the vagina." [The last statistic can be misleading, since women at risk for tearing are more likely to have an Episiotomy. Also, the surgeon who taught us anatomy remarked in lecture that the true reason for doing it is not to eliminate tearing, but rather to deflect it away from where it would do the most damage.] 6. Electronic fetal monitors accurately chart the fetus's heart rate during labor, resulting in better outcomes for babies. They do provide more information that a stethoscope, but it has not been proved that this neccessarily translates into a better outcome. It does result in a higher Ceasarian rate - since more information translates into more things to worry about on the part of the delivery team. 7. The amniotomy is a simple, efficient way to start or speed up labor. At best, it speeds labor by half an hour, which is negligible. This is offset by the loss of the Amniotic Fluid as a shock absorber for the baby's head. A better way to speed up labor would be simply have the woman stand up or walk around, assuming a normal birth. 8. A Ceasarian Delivery is often lifesaving. This IS true. The problem, however, is that Ceasarians are often performed when minor, not major, problems occur during birth. One reason is the fear of malpractice suits. [Obsetricians in NY currently must pay over $100,000/yr in malpractice insurance premiums.] [Except for those passages in square brackets, none of the above article represents my opinion. I just post what passes my way.] -- Craig Werner !philabs!aecom!werner "The world is just a straight man for you sometimes"