The ACOG Publishes New Birth Recommendations

21 April 2017
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According to the American College of Obstetricians and Gynecologists, “widely accepted, currently-used labor and birth interventions are not necessarily the safest care for women and babies.”

You read that right.

In February (2017), the ACOG released a new committee opinion that common labor and birth interventions should not be used on low-risk pregnancies. If you are currently pregnant and fall into this low-risk category, it is of utmost importance that you educate yourself on these recommendations. It typically takes the medical field years to come up-to-date and follow through reliably.

The ACOG recommends that low-risk pregnant women seek individualized care as opposed to common obstetrics practices. These doctors are trained and capable of handling more intricate pregnancies and are quick to intervene when it is not necessary.

The committee also recommends the following:

Stay home until “active” labor

This is around 6 cm dilated but can be witnessed as a shift in the labor. The mother moves into a more serious role and contractions become stronger and more frequent. Waiting until this time helps prevent an unneeded c-section and other birth interventions (such as pitocin). During this time (and before), a warm bath may help with the pain, as well as relaxation and support.

Keep track of the baby’s heartbeat with a hand-held device.

Skip the constant fetal monitoring, as research has not proven it to be safe for baby. It is also quite cumbersome and interfering with the natural process of labor. By using a doppler (fetal stethoscope),  the risk of having a c-section drops drastically, as does the chance of needing forceps or vacuum to aid baby in being born.

Obtain continuous, one-to-one support from a labor companion such as a doula.

Hiring a doula or preparing your partner through a partner-based coaching childbirth class (such as the Bradley Method), reduces the chance of receiving a c-section, accepting pain medication, and

This shortens labor and reduces the likelihood of cesarean birth, use of pain medications, and increases the probability of a positive birth experience.

Drink clear liquids during labor.

Not eating or drinking in labor at the hospital is an outdated practice that can potentially spiral labor into interventions. Using an IV does not support the woman’s body in labor to move as needed. It is now recommended to drink plenty of clear liquid and the committee is currently still researching eating as needed while laboring.  I can assure you that eating helps keep energy levels where they need to be, and food should be consumed if wanted.

Avoid a procedure to break the membranes (bag of waters).

Having your water broken does not shorten labor or prevent a c-section. It is an intervention and should be left to break when the body forces it to. If it does not break before baby enters the world, it is perfectly safe and healthy to be born “in the caul.”

Use upright positions and/or move about during labor.

Work with gravity during labor. Laying on your back is the opposite of productive. This increases the intensity of contractions and stretches the length of the labor. Choosing to be upright, moving around will shorten labor time and reduce the chance of having a c-section.

Try various drug-free pain relief methods.

Instead of planning to ‘take the drugs’ once labor begins, understand that a drug-free birth has no adverse effects and includes many benefits for both mother and baby. There are too many techniques to list to handle labor without drug interventions, but some include:

  • Water
  • Movement
  • Relaxation
  • Breathing Techniques
  • Meditation

Use position of comfort and choice when pushing and giving birth.

As previously stated, lying on the back fights gravity, increases pain, and lengthens labor. This can be said for the second stage – or pushing, as well. There are several positions in which help baby move through the birth canal easier, and even aid in preventing tearing. Hands and knees, squatting (shorten birth canal by over 10%!), side-lying, or whatever is comfortable for the mother – that is the best position to push.

Rest and await the urge to push after full dilation.

Couples assume that 10cm means PUSH! The ACOG now recommends waiting to push until the body begins pushing on its own. There is a natural timeframe that the body creates after reaching maximum dilation. This time allows for rest and energy rebuild to effectively aid the body in birthing the baby.

Push according to one’s own urges and preferences.

Gone are the days with pushing for a count of 10 or bearing down and hold the breath to push as hard as possible. These tactics have been shown to cause possible harm and are no longer recommended. Allowing the woman’s body to be its own guide is now understood to be the best way to birth.

Following these recommendations can aid in achieving the birth a mother desires, one with little to no intervention. This is the absolute healthiest way for a baby to enter the world.

While pregnant, utilizing a knowledgeable chiropractor can also provide many benefits for mother and baby. I believe that opening your mind to alternative care and exploring additional birth team members can help make the journey of pregnancy and birth a more positive experience.

Reference:

http://www.nationalpartnership.org/research-library/maternal-health/professional-recommendations-to-limit-labor-and-birth-interventions.pdf

http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Approaches-to-Limit-Intervention-During-Labor-and-Birth

http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Delayed-Umbilical-Cord-Clamping-After-Birth