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CONSUMER REPORTS: Back to Basics For Safer Childbirth

Too many obstetricians and hospitals use potentially harmful high-tech or invasive procedures, new study finds

YONKERS, N.Y., Oct. 8 /PRNewswire-USNewswire/ -- According to Consumer Reports, many obstetricians and maternity hospitals overuse high-tech procedures that can result in poor results for newborns and their mothers. CR urges parents to test their knowledge of maternity care by taking a quiz available at CR's website,

A new report by the nonprofit Childbirth Connection published for the first time today on CR's Web site says when it's time to bring a new baby into the world, there's a lot to be said for letting nature take the lead. It finds that maternity care in the United States today is characterized by too many unnecessary and invasive procedures and not enough high-touch, low-tech measures that can optimize infant health. Lower tech measures can also encourage the establishment of successful breastfeeding and better mother-baby attachment.

The Childbirth Connection study analyzed hundreds of the most recent studies and systematic reviews of maternity care. It notes that the current style of maternity care is so procedure-intensive that six of the 15 most common hospital procedures in the entire U.S. are related to childbirth. Although most childbearing women in this country are healthy and at low risk for childbirth complications, national surveys reveal that essentially all women who give birth in U.S. hospitals have high rates of complex interventions, with risks of adverse effects.

To read the Childbirth Connection study or take the maternity quiz, please go to

Quiz: Maternity care, beware

Despite growing evidence of harm, many obstetricians and maternity hospitals still overuse high-tech procedures that can mean poorer outcomes for baby and Mom. Test your knowledge with our quiz below, and then learn more in our report (

True or false

An obstetrician will deliver better maternity care, overall, than a midwife or family doctor.

False. Studies show that the 8 percent to 9 percent of U.S. women who use midwives and the 6 to 7 percent who choose family physicians generally experienced just-as-good results as those who go to obstetricians. Those who used midwives also ended up with fewer technological interventions. For example, women who received midwifery care were less likely to experience induced labor, have their water broken for them, episiotomies, pain medications, intravenous fluids, and electronic fetal monitoring, and were more likely to give birth vaginally with no vacuum extraction or forceps, than similar women receiving medical care. Note that an obstetric specialist is best for the small proportion of women with serious health concerns.

Induced labor can halt fetal development.

True. The vital organs (including the brain and lungs) continue to develop beyond the 37th week of gestation. There is also a five-fold increase in the brain's white-matter volume between 35 and 41 weeks after conception. Inducing labor (with synthetic oxytocin, for example) might stop this growth if the fetus is not fully developed. Between 1990 and 2005, the number of women whose labor was induced more than doubled.

Due-date estimates can be off by up to two weeks.

True. This inaccuracy can lead to a baby being delivered by induction or Caesarean section up to two weeks earlier than its estimated due-date, cutting off important weeks of fetal development.

"Breaking the waters" helps hasten labor.

False. There is no evidence to support the fact that this common practice (about 47% of women) shortens labor, increases maternal satisfaction, or improves outcomes for newborns.

Induced labor increases the likelihood of Caesarean section in first-time mothers.

True. The cervix might not be ready for labor. Other effects of induced labor include an increased likelihood of an epidural, an assisted delivery with vacuum extraction or forceps, and extreme bleeding postpartum.

Once you've had a C-section, it's best to do it again.

False. Studies show that, as the number of a woman's previous C-sections increased, so did the likelihood of harmful conditions, including: trouble getting pregnant again, problems delivering the placenta (placenta accreta), longer hospital stays, intensive-care (ICU) admission, hysterectomy, and blood transfusion.

Labor itself can benefit a newborn's immunity.

True. When babies do not experience labor (if the mother has a C-section before entering into labor, for example), they fail to benefit from changes that help to clear fluid from their lungs. That clearance can protect against serious breathing problems outside the womb. Passage through the vagina might also increase the likelihood that the newborn's intestines will be colonized with "good" bacteria after the sterile womb environment.

Epidural anesthesia is a low-risk way to make labor easier.

False. Many women welcome the pain relief, but might not be well-informed about the increased risk of its side-effects, including lack of mobility, sedation, fever, longer pushing, and serious perineal tears.

Epidural anesthesia presents risks to newborns.

True. Babies whose mothers received epidurals during labor are at risk for rapid heart rate, hyperbilirubinemia (the presence of and excess of bilirubin in the blood), need for antibiotics, and poorer performance on newborn assessment tests.

Episiotomies reduce the risk of perineal tearing.

False. Evidence shows that routine use of episiotomy offers no benefits but rather increases women's risk of experiencing perineal injury, stitches, pain and tenderness, leaking stool or gas, and pain during sexual intercourse. Yet in 2005, 25 percent of women with vaginal births continued to experience this intervention. Episiotomy is one of several obstetric practices adopted into common usage before being adequately studied.

10 Drugs in OTC Medicines Pregnant Women Should Avoid

Drug Found in CR Recommendation Possible Alternative

Aspirin Excedrin 1st, 2nd, 3rd Tylenol

Migraine trimester: (Acetaminophen)

Not recommended

Bismuth Kaopectate; 1st, 2nd trimester: Imodium

Subsalicylate Pepto Bismol Use with caution (Loperamide)

3rd trimester:

Not recommended

Brompheniramine Dimetapp Cold 1st, 2nd trimester: Claritin

and Fever; Use with caution (Loratadine);

Dimetapp 3rd trimester: Zantac

Elixir Not recommended (Ranitidine)

Caffeine Excedrin 1st, 2nd. 3rd None

Aspirin-Free; trimester:

Excedrin Use with caution

Quicktabs CR Recommends:

Do not exceed 200

milligrams per day

to reduce risk of


Castor Oil -- 1st, 2nd. 3rd None


Do not take --

unacceptable risk

Chlorpheniramine Chlor- 1st, 2nd trimester: Claritin

Trimeton; Use with caution (Loratadine);

Combination 3rd trimester: Zantac

products: Not recommended (Ranitidine)


Cold and


Actifed Cold

And Sinus;


Plus Cold


Dristan Cold;

Sinutab Sinus




Sudafed Cold

and Allergy;

TheraFlu Flu

And Cold



Cold and







Tylenol Cold



Ibuprofen Advil, Motrin 1st, 2nd trimester: Tylenol

Use with caution (Acetaminophen)

3rd trimester:

Not recommended

Naproxen Aleve 1st, 2nd trimester: Tylenol

Use with caution (Acetaminophen)

3rd trimester:

Not recommended

Nicotine All 1st, 2nd, 3rd None

cigarettes; trimester:

Nicorette Not recommended

gum; Nicoderm


Pseudoephedrine Actifed Cold 1st trimester: Nondrug

and Sinus, Not recommended alternatives: Drink

Sudafed Nasal 2nd, 3rd trimester: plenty of fluids,

Decongestant, Use with caution consider using

Triaminic AM steam to relieve

Decongestant congestion, avoid

irritants like

tobacco smoke

SOURCE Consumer Reports
Copyright©2008 PR Newswire.
All rights reserved

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