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Advice to pregnant women: Not so fast

Advice to pregnant women: Not so fast

Don’t rush things. That’s the bottom-line advice to expectant mothers from the American College of Obstetricians and Gynecologists and the American Academy of Family Practitioners. Asked to identify five tests or procedures that were overdone, both organizations agreed on the same top two: a planned early delivery and inducing labor without a strong medical reason.

Not coincidentally, those two procedures also top Consumer Reports’ article What to Reject When You’re Expecting, which outlines 10 medical procedures women should think twice about during their pregnancy.

Over the past couple of decades it’s become increasingly common to manipulate the childbirth process to better suit the schedules of families, doctors, and hospital staff. Of course, sometimes it is medically necessary to deliver a baby before a woman goes into labor on her own. But recent research reveals that circumventing Mother Nature’s timetable just for the sake of convenience increases risk for both moms and babies.

For example, babies intentionally delivered even a week or two early without a medical reason are more likely to have problems breathing and feeding and to have severe jaundice or cerebral palsy. And even after a woman reaches the 39-week mark that is considered full term, inducing labor before her body is ready increases the chance that she’ll need other medical help, such as a Cesarean delivery, or C-section. Both practices make it more likely that an infant will need intensive care after birth.

Despite the evidence, many hospitals have been slow to change convenience-based practices. The more cynical among us might point to perverse financial incentives as one reason why. Fewer procedures and admissions to neonatal intensive care translates to fewer profits for many health care providers, who are often paid more for doing more.
That’s why the Choosing Wisely campaign, which encourages providers to adhere to evidence-based standards is so important. And why families need to inform themselves so that they can work with their providers to make the healthiest choices.

See a complete description of the Choosing Wisely campaign and a list of the reports Consumer Reports has produced so far with more than a dozen different medical societies.

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