Harvard: Midwife Solution

Harvard Magazine states that an estimated 85% of pregnant women reach full term without complications in the U.S. which is an oft quoted statistic. This article is a thoughtful exploration of the “unnec-cesarean” issue and includes interviews with Certified Nurse-Midwives (CNMs) on how midwives are part of the solution.

Harvard notes 33% of babies in the U.S. in 2012 were born by C-section. Women being overweight, as well as the tendency of women in the U.S. to give birth at an older age, have contributed to high rates of C-sections.

Obstetricians may face liability issues if they do not intervene surgically, according to Michelle Mello, Professor of Law and Public Health at Harvard. However, many C-sections in the U.S. are medically unnecessary, despite the obstetrician’s exaggerated perceptions of liability and sometimes the patient’s exaggerated perception of risk, says Jeffrey Ecker, MD, Professor of Obstetrics & Gynecology at Massachusetts General Hospital.

Minimizing the first unnec-cesarean, avoiding unnecessary induction of labor, avoiding unnecessary continuous electronic fetal monitoring of the heart rate during labor, and avoiding epidural anesthesia unless you need it, as well as understanding the common risks associated with epidurals are important to lowering the rate of C-sections. C-sections pose greater risks to the mother and newborn than do vaginal births.

Certified Nurse-Midwives at hospitals think of birth as a normal and natural process, emphasize prenatal care, allow longer labor, and encourage vaginal births in women at low risk.1 Ana Langer, MD, Pediatrician, Professor of Public Health, and Coordinator of the Dean’s Special Initiative in Women and Health at Harvard Medical School, states that, “A balance needs to be reached that will allow women to have normal deliveries with as little intervention as possible, and at the same time, will be ready to address any unexpected emergencies.”

References

Lake, Nell. Labor, interrupted. (2012, May.) Harvard Magazine. Retrieved from http://harvardmagazine.com/2012/11/labor-interrupted