Our midwife Marianne, just posted a link to how the current practice of Obstetrics has such little base on scientific evidence .. This is something we have known for a while!
The fact that Cytotec or Misoprostol is used widely by OB-GYNs to induce labor, even after the manufacturer and FDA explicitly say that they are not intended for use in pregnant women at full term, goes to prove that there is no basis in science for this particular guideline ..as for many others! Dr. Marsden Wagner calls it “vigilante obstetrics” – Usually drugs have to be proven safe before they are put into use; here, the OBs are saying that they will use it until it is proven unsafe to use!! Well, several years of unchecked use of this drug, has shown increased rates of fetal distress, increased C-sections, increased rates of uterine rupture (and thereby many unnecessary hysterectomies), and increased rates of maternal and fetal deaths. But, it is convenient – so its use continues unchecked!! Here, in India, where there is no clinical guideline use in most hospitals, we see so many, many, many labors induced with this drug which is NOT approved
- by the FDA
- by the pharmaceutical company that makes it
- by reliable and valid scientific evidence (Cochrane database)
- by the drug regulatory agency of any other industrialized country
- and by the British Royal College of Obstetricians and Gynecologists!
And, as Dr. Wagner points out in his book (Born in the USA – How a broken maternity care system must be fixed to put women and children first), the Cochrane Group (www.cochrane.org) has given the field of Obstetrics research an award called the “Wooden Spoon” which symbolizes its unique place as the medical specialty with the poorest quality of research and least evidence-based practice. Little wonder – out of 458 practices which are used in obstetrics, 260 of them are “unsupported by evidence” or “harmful practices”!
And, so it goes on .. the above example is only one of the many non-evidence based practices we see used during pregnancy, labor and “delivery” in today’s hospitals. It is now left to the parents -to-be to research, question and ensure that they get the best evidence-based care.