The problem with "great ideas"

        They are not used wisely.   I thought of this when at the last birth I attended as a doula, the OB says, “You have fallen off the ‘curve’ of typical labor progression. ”  Referring to the bell curve of the length of typical stages of birth, developed by Emanual Friedman.  He is horrified on how that information is used today.  “We found an average.  People think the average is what women should fall upon.  That is clearly not true but rather a broad range of normality beyond which a potential abnormality may or may not exist.  These abnormalities are not in themselves justification for forceps or cesarean…  It doesn’t’ mean she’s doing so badly that you have to do something terrible to her. That is being abused.”  (From the book Birth by Tina Cassidy, as seen in my review below)

              Now in this particular case the mom was exhausted and really wanted a cesarean.  The OB said, “Baby is fine and you are fine, so we can wait, but there is no guarantee you will continue to progress, or you will have the energy to push the baby out”   Mom chose cesarean and as she was SO tired, I don’t think she could have pushed the baby out if she was at 10cm at that moment, she feels good with her choice.  BUT, misuse of a “great idea”. 

              Another “great idea” was Electronic Fetal Monitoring, which was supposed to help during birth, to monitor the baby and determine if their was problems.  This was in replacement of the care provider or nurse listening to the baby’s heartbeat on their own.  Today nurses don’t even have to be in the room with a birthing mother, instead they are at a desk outside their room, watching monitors of many women.  This has only made women feel more isolated and alone during their births.   The machine is the center of attention instead of the moms or even the babies (though it is monitoring the baby, the machine is where the focus is)  

           Today intermittent fetal monitoring is standard in hospitals, where they monitor the baby for 15 minutes out of the hour.  This has been shown to be as effective as continuous monitoring in predicting problems.  Sadly because of litigation many hospitals now require continuous fetal monitoring.  So begins the cascade of interventions, where mom is strapped to a machine and unable to move. 

         How does one of the creators of Electronic Fetal Monitors feel about this great idea?   Well, it is another misused “tool” of the obstetrics world, leading to the increase in cesareans with no improvement of baby outcome.  Read an article about him in the Wall Street Journal here.