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Abby's Magazine - Volume 5 Issue 4 | Page 41 What should be used, as lifesaving techniques, applied rou nely, have become dangerous interven ons for mom and baby. Yet we are told this is what we are supposed to do for the sake and safety of our babies. Because we are good moms, and trust the medical establishment to be looking out for our best interests and ac ng on the basis of scien fic evidence, we acquiesce – some mes against our be er judgment, and some mes only to discover later that we were bamboozled into the agenda of the profit-driven behemoth called the health care system. Otetric Evidence Is Reliable Only 30% of the me Are obstetrics prac ces reliable? Well, the 99% episiotomy rates have declined drama cally in the wake of ACOG admi ng that what they previously professed to be necessary was actually harmful. At the same me, rates of most other birth interven ons from induc ons to vacuum extrac ons have escalated. We are just now seeing a leveling off of the preterm birth rate in the US. Un l recently, induc ons and scheduled cesareans have been a leading culprit in the high incidence of preterm births in the US. The costs of the high rates of preterm babies to individuals and society has been so overwhelming that mandated changes in hospital policies now prohibit cesarean sec ons prior to 39 weeks of pregnancy unless absolutely medically necessary for mother or baby. Again, what was previously deemed safe by ACOG has been recognized to be harmful. Do we have a theme here? Indeed, a report by ACOG itself acknowledged that only about 30% of the obstetrics prac ces in the US are based on reliable medical evidence. Thirty percent have poor evidence, and the rest, well, "mezza, mezza," as my grandmother would have said. Let's take the external fetal monitor, for example. Used ubiquitously in US hospitals, this annoying machine with its two ght belly belts, one to measure the amplitude of contrac ons, the other to measure baby's heart beat during labor, not only keeps laboring moms virtually tethered to the hospital bed, it drama cally increases the rates of unnecessary cesareans, without improving any meaningful outcomes for mom or baby. This is well documented in the annals of the obstetrics and family medicine professions, yet its use persists. Why? It's one of a limited number of forms of evidence that can protect obstetricians and hospitals in the event of a lawsuit. Now that I am a physician many women ask me if I would s ll have my babies at home. My answer is unequivocally: "Absolutely." While you might say, "Well that's easy for you to say since you're long past your childbearing years" and don't have to make that choice, the proof is in the pudding in that I was the midwife to my granddaughter, born at home, to my public health specialist son and pediatrician daughter-in-law – a er I'd already become an MD! While I had in no way suggested, encouraged, or even broached the topic of home birth with my Harvard-trained daughter-in-law, who by the way, also has an MPH from Harvard. Her own experiences, during the course of prenatal care, led her to approach me. She'd concluded that home birth would be the safest op on for her and her baby. ere are Some Terrific Docs But… Now don't get me wrong, there are a lot of terrific doctors doing a spectacular job a ending births in hospitals. In fact, growing numbers (though s ll not the majority) of OBs are women who would like to see birth prac ces be democra zed and evidence-based. And many women do experience empowered, beau ful, natural births in the hospital. It's just a bit of a roule e, happening against the odds that fewer than 60% of women will even birth vaginally if in the hospital. The problem does not lie solely or even primarily with individual doctors. Hospital risk management teams, insurers, and legal commi ees ul mately determine how your doctor is allowed to prac ce. And a lot of it comes down to preven ng li ga on against doctors and hospitals – and has absolutely nothing to do with your best interest. Residency training ins lls the prac ce of "defensive medicine" early on. Many obstetricians exit residency not knowing what a truly natural birth even looks like, and have come to believe that birth is a dangerous event that must be contained and controlled. I have even heard some obstetrics' residents describe women who choose to birth at home as irresponsible, and even luna cs. On the other hand, growing numbers of obstetricians have become so disenchanted with and stressed by the medico-