With time information evolves. This happens with everything. It happens in all professions.
Working in maternal-infant health we are mandated to remain current and accept changes.
This is one of the only ways to care for clients/patients appropriately.
However this is not always the case. Archaic protocols often take precedence. In my experience the most inconsistent information and support protocols belong to:
Birth Doula Support
We need to recognize one of the best ways to achieve a vaginal birth and positive experience overall is with a birth doula present.
This information is evidence-based. It was published in the American College of Obstetricians and Gynaecologists (ACOG) Obstetric Care Consensus, Safe Prevention of the Primary Cesarean Delivery, published in March 2014 (reaffirmed 2016).
The document very clearly states "Published data indicate[s] that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula. ..Given that there are no associated measurable harms, this resource is probably underutilized." Read more here.
The use of gravity and spontaneous (vs. directed) pushing is best for healthy mothers and babies.
However many women are still being told when and for how long to push. There is no research to support the routine use of directed pushing. In fact, some researchers suggest it may cause harm to mother and/or baby. Read more here.
Maternity care providers should discourage supine (flat on back) positions and encourage gravity positive/neutral positions like squatting, semi-sitting, standing, and upright-kneeling positions. With an epidural a side-lying or semi-sitting position is ideal.
Erythromycin Eye Ointment (for baby)
The routine use of erythromycin is no longer recommended. The outdated protocol regarding the prophylactic eye ointment for babies was kiboshed by the Canadian Pediatric Society, Infectious Disease and Immunization Committee, in March 2015.
Their position statement clearly states "Neonatal ocular prophylaxis with erythromycin, the only agent currently available in Canada for this purpose, may no longer be useful and, therefore, should not be routinely recommended." Read more here.
It is topics like the above that need to be discussed with your care provider prior to birth and written into your birth plan/preferences. Healthcare providers, need to know what best care practices are important to your family! If you need assistance creating your birth plan please feel free to connect with our team. We love hearing from you!
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