Digital Book Discontinued Birth Choices v1.1 | Page 7

Minimizing Risk
There are risks involved with many things in life; for example, when you drive your car, you risk being
injured in an accident. But, there are strategies that help keep that risk as low as possible. Obeying
traffic laws, staying alert, and wearing your seat belt all help reduce accidents and injuries. In birth,
there are also risks, but as with driving a car, there are things you and your birth team can do to
influence your risk.
Appropriate Use of Medical Interventions
We are fortunate to have access to many life-saving medical advancements, but just because we can use a
tool does not mean we always should. For example, wearing a helmet while driving a car provides an added
element of protection, but may also hamper your ability to see and make an accident more likely. Therefore, only
those who are at a higher risk (motorcycle riders, race car drivers, etc.) usually choose to wear them. Medical
interventions (tools, technology and medications) are used in most births today, but they carry risks and when
used inappropriately, can cause harm. Using an evidence-based approach to interventions can help improve
outcomes as well as satisfaction. This approach considers:
1. the preferences and goals of the individual (parents).
2. the most recent research and best approach for the situation.*
3. the experience and judgement of the care provider.
Current research and birth outcomes in the United States suggest that the overuse of interventions on a
widespread scale is causing harm. As a result, there has been increasing emphasis within the medical community
to make changes. To help lower intervention rates, improve outcomes and increase health and satisfaction, these
strategies are recommended by the American College of Obstetricians and Gynecologists (ACOG):**
• Sharing decision-making between women and
care providers.
• Using intermittent fetal monitoring in labor,
instead of continuous, for low-risk women.
• Encouraging movement and position changes
and keeping women off their backs in labor.
• Using alternative options to cesarean sections
whenever possible, including patience for a long
or slow labor or trying to help reposition a baby
in an unfavorable position.
• Continuous support, not involving medical
care but rather physical support (comfort
measures, etc.) as well as mental, emotional,
and informational support (encouragement,
explaining procedures, offering choices, etc.).
*Researching new technology or medications during
pregnancy, labor and birth is difficult because of
the potential for harm. In addition, it takes an
average of 17 years for new research findings to be
implemented in practice.
**Full statements are available at acog.org, titled “Safe
Prevention of the Primary Cesarean Delivery” (March
2014) and “Approaches to Limit Intervention During
Labor and Birth” (February 2019).
Step 1: Understand the Context
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