First Do No Harm: Interventions During Childbirth

Abstract

Although medical and technological advances in maternity care have drastically reduced maternal and infant mortality, these interventions have become commonplace if not routine. Used appropriately, they can be life-saving procedures. Routine use, without valid indications, can transform childbirth from a normal physiologic process and family life event into a medical or surgical procedure. Every intervention presents the possibility of untoward effects and additional risks that engender the need for more interventions with their own inherent risks. Unintended consequences to intrapartum interventions make it imperative that nurse educators work with other professionals to promote natural childbirth processes and advocate for policies that focus on ensuring informed consent and alternative choices. Interdisciplinary collaboration can ensure that intrapartum caregivers "first do no harm."The Journal of Perinatal Education, 22(2),[83][84][85][86][87][88][89][90][91][92] http://dx

Perception of be Cared in Childbirth at the Light of the WHO Model

“…This is in accordance with the traditional model of assistance, in which basic care after admission to the institution includes being given a bed, meaning a space for her to occupy [17].…”

“…The vast majority of women did not feed during PD, in accordance with the traditional practice of banning / restraining of food, although more recently is offered ice or candy to suck and clear liquids at very small intake s [17,19]. Food restriction is originated by the knowledge of Mendelson spread in the 1940s [19,20].…”

“…Labor requires an effort of 295 Kcal on average [21] and current belief is that it is the woman who can best judge the need to ingest [20]. This is a way to prevent dehydration, ketosis or hyponatremia [17].…”

The effect of medical and operative birth interventions on child health outcomes in the first 28 days and up to 5 years of age: A linked data population‐based cohort study

“…These results support the “Too little too late, too much too soon debate” in maternal care, in which Miller et al40 argued that unnecessary use of nonevidence‐based interventions can be harmful for healthy women and infants, as much as a lack of lifesaving interventions is damaging for those that need them. Our results should make consumers and maternal health care professionals aware of the potential harm that birth interventions may have in the longer term, encouraging a “precautionary principle” approach that weighs the possible benefits of the intervention against its potential detrimental effects for each mother and child 41. The aim should always be to provide the right amount of care at the right time in the right way to childbearing women, with a clear assessment of the potential consequences of just‐in‐case interventions 40…”

Knowledge, attitude and preferences of pregnant women towards mode of delivery in a tertiary care center

“…However improper use of these interventions without scientific and legal reasons has converted a normal delivery to surgical and medical phenomenon. 1 An increasing rate of births by cesarean section is an issue of concern in many countries. Despite the recommendations by WHO that no region in the world is justified to have a cesarean section rate greater than 10-15%, it is the most common obstetrical operation worldwide.…”