Anyone who knows me personally knows that I am a research geek. I thrive on keeping up with the news, especially anything that pertains to health care. The internet is my personal heaven on earth for all that is going on in the world. I can subscribe to what seems like a hundred different news feeds all in one place. I really about fell off my chair last week when all of my social media sites started to blow up with shares about the joint statement that was released by the American College of Gynecologist (ACOG) and the Society for Maternal -Fetal Medicine entitled Safe Prevention of the Primary Cesarean Delivery (full article). See Science & Sensibility for a great synopsis of the article.
I hate to say I told ya’ so but I’m going to say it…Seems like Midwives have been saying this exact sort of thing for years!
This document should have been titled The Midwife Solution-Prevention of the Primary Cesarean Section!!!
One of the things ACOG mentions in their position statement is that the Friedman curve should not be utilized any longer and that the Consortium on Safe Labor Data (study 2002-2006) be used in assessing length of labor. The Consortium basically says that normal labors are longer than previously described by Friedman, a conclusion found by Leah Albers, CNM in her studies dating back to 1996. Glad to see some more validation and hope that they put the statement into action.
Another point that I found interesting is that this statement found that labor support by doulas has been shown to be beneficial and is probably under-utilized. Funny the report makes no mention recommending care by Midwives, even though the Cochrane data base and a 2012 US systematic review published in Women’s Health Issues found that midwifery led care was safe, satisfying and should be offered to all low risk woman. See the American College of Nurse Midwives press release here. ACOG has another position statement which states that their members should work collaboratively with CNMs, but nowhere is that statement referenced in this one. Are they getting a little territorial?
At the end of the day in our practice, it really doesn’t matter what ACOG’s position is on this matter. Because you see, we (Midwives in general and our practice specifically) do not have a problem with cesarean sections. What I come back to is that I feel very fortunate to be a part of a profession that takes excellent care of women and babies. I also feel very fortunate to have a great group of back up physicians who practice evidenced- based medicine, who do not rush to cesarean sections if mom and baby are doing well (their cesarean rate is well below the national average). We collaborate with each other. We realize that each of our professions have something unique to bring to the table and that by working together, we improve the health of women more so than by working alone. This makes me happy!!!!!