What I find so preposterous about MANA's position is that they «demand» scientific, evidence based precision
for obstetric interventions, but their stated ethical position is that birth is a mystery and death and bad outcomes have to be accepted in the process of «letting go» and «healing».
C. L. Roberts et al., «Rates
for Obstetric Intervention Among Private and Public Patients in Australia: Population Based Descriptive Study,» Br Med J 321, no. 7254 (2000): 137 — 141.
Not exact matches
Advise low ‑ risk nulliparous women that planning to give birth in a midwifery ‑ led unit (freestanding or alongside) is particularly suitable
for them because the rate of
interventions is lower and the outcome
for the baby is no different compared with an
obstetric unit.
1.1.2 Explain to both multiparous and nulliparous women that they may choose any birth setting (home, freestanding midwifery unit, alongside midwifery unit or
obstetric unit), and support them in their choice of setting wherever they choose to give birth: Advise low ‑ risk multiparous women that planning to give birth at home or in a midwifery ‑ led unit (freestanding or alongside) is particularly suitable
for them because the rate of
interventions is lower and the outcome
for the baby is no different compared with an
obstetric unit.
The neonatal outcomes
for women giving birth centre or a labour ward were comparable although the levels of
intervention were higher in the labour ward groups despite similarities in demographic and
obstetric predictors.
No woman needed
obstetric intervention in the first hour after admission and no baby required intubation at birth; three babies, however, were admitted to special care (one after caesarean delivery and two
for prematurity).
If you have developed some reliable predictive tool
for unmanifested complications that are averted by an
intervention, then please share it because the
obstetric community would desperately love to use it.
Since the early 1990s, government policy on maternity care in England has moved towards policies designed to give women with straightforward pregnancies a choice of settings
for birth.1 2 In this context, freestanding midwifery units, midwifery units located in the same building or on the same site as an
obstetric unit (hereafter referred to as alongside midwifery units), and home birth services have increasingly become relevant to the configuration of maternity services under consideration in England.3 The relative benefits and risks of birth in these alternative settings have been widely debated in recent years.4 5 6 7 8 9 10 Lower rates of
obstetric interventions and other positive maternal outcomes have been consistently found in planned births at home and in midwifery units, but clear conclusions regarding perinatal outcome have been lacking.
The midwife - led continuity model of care includes: continuity of care; monitoring the physical, psychological, spiritual and social well being of the woman and family throughout the childbearing cycle; providing the woman with individualised education, counselling and antenatal care; attendance during labour, birth and the immediate postpartum period by a known midwife; ongoing support during the postnatal period; minimising unnecessary technological
interventions; and identifying, referring and co-ordinating care
for women who require
obstetric or other specialist attention.
The move to in - hospital
obstetric care, which occurred gradually in the last century, added
interventions that generally made birth safer
for high - risk women but more difficult
for many low - risk mothers.
This strategy requires responsive health systems that are equipped with lifesaving commodities and staffed with health workers who can deliver high - quality and timely skilled care, including emergency
obstetric care and
interventions for small and ill newborn babies.
The authors also continued to say that hospitals should create a welcoming and comfortable birthing environment, as well as address unnecessary
obstetric interventions, both of which are often a primary motivation
for planned homebirth.
The control of excess weight, especially through lifestyle
interventions, should be mandatory not only
for improving reproductive and
obstetric outcomes, but also
for reducing costs derived from the greater consumption of drugs in IVF, failed treatments, maternal and neonatal complications, and metabolic and non-metabolic diseases in the offspring.»
For women who are likely to give birth easily, being in a major
obstetric unit may result in
interventions that make their birth less straightforward.
«We found compelling evidence
for impact of several
interventions on preventing stillbirths, especially emergency
obstetric care; screening and treatment
for maternal infections such as syphilis, and prevention and treatment of malaria,» said Gary Darmstadt, MD, MS, co-author and co-editor of the study and former director of the Johns Hopkins Bloomberg School of Public Health's International Center
for Advancing Neonatal Health.
Stunting is a known risk factor
for obstetric complications such as obstructed labor and the need
for skilled
intervention during delivery, leading to injury or death
for mothers and their newborns.