Healthcare system is fantastic these days. Doctors and nurses are able to carry out procedures that were impossible in the past. They ensure the well-being of their patients, they save lives, and they do everything to keep us safe and sound.
However, sometimes it appears that they try too hard. They offer us screenings we don’t actually need and conduct procedures that are completely unnecessary. It happens especially frequently with pregnant women, who are offered so many tests and exams that they might even start feeling like a pincushion at times.
To avoid it, we should know what to agree to and what to reject during pregnancy. We also need to remember that it’s better for women with healthy, uncomplicated pregnancies to avoid some procedures and interventions because they can do more harm than good. For instance, a pelvic exam can lead to a rupture of membranes and labor induction; genetic testing can give a false positive result that turns into too much stress, and an epidural can make the labor longer and lead to a C-section.
So read on, because we’ve found 20 of the things we can choose to opt out of during pregnancy, labor, and afterward (unless we have medical reasons to go for them).
20. PELVIC EXAM LATE IN PREGNANCY
In the United States and in some other countries, pelvic exams are offered routinely in pregnancy. Caregivers usually say that this procedure helps to see if there’re any changes in the cervix – whether it’s dilating, thinning or ripening, and what position it has.
Although this information seems to be useful in late pregnancy, pelvic exams actually aren’t that accurate and they don’t tell you what’s about to happen. For example, during an exam your cervix can be high and closed, but later the same day labor might start. Or it can be slightly dilated, but you won’t get into labor until two weeks later. Besides, during the exam the doctor can sweep your membranes, thus inducing labor, which you probably don’t want to happen.
19. ONCE A C-SECTION, ALWAYS A C-SECTION
Many specialists claim that once a woman had a C-section, she’s “destined” to get it with all subsequent deliveries she’s about to have. It means that if your first baby was delivered through C-section, you can’t give birth naturally to your second one.
But, despite this common opinion, VBAC (which stands for “vaginal birth after C-section”) is actually safer than you think. As per Belly Belly, natural birth is almost always better than C-section, because the latter is usually associated with more risks both for the mother and her baby.
But if you consider going for VBAC, keep in mind that it can problematic due to another reason – the lack of specialists and hospitals who will be willing to try it.
18. ROUTINE EPISIOTOMIES
An episiotomy is a surgical cut made just before delivery to increase the opening and facilitate the baby’s coming out. In rare cases (mostly, due to fetal distress), it’s necessary to perform this procedure to speed up the delivery process.
But, according to Consumer Report, more often routine episiotomies do more harm than good. For instance, a 2009 study that involved over 5 thousand women revealed that this procedure is associated with such problems as increased damage to the woman’s perineal area and a lengthier healing period.
So think twice before letting your ob/gyn do an episiotomy and consider all the risks involved.
17. GENETIC TESTING
Usually, a woman is offered genetic testing that will show whether the baby has certain genetic issues. Some moms want to do it, and it’s totally fine. But if you don’t want this test, because you’re going to accept your little one, even if they’re born with some flaws, you have every right to refuse.
Besides, keep in mind that the results of genetic testing aren’t as accurate as most moms-to-be think they are. The test can come positive, say that your baby has an issue and totally freak you out, but then your tot will be born just fine. Yes, sometimes it happens.
You don’t really need that kind of stress in pregnancy, do you?
16. AND SOME OTHER (NOT SO ACCURATE) TESTS
At some point in your pregnancy, it might seem to you that you have to do a series of endless tests and screenings. While some of them are necessary, there are those which you don’t really need.
Let’s take Nuchal Translucency Screening, for example. It’s done in two steps to reveal whether the baby is at risk of Down syndrome. First, you are usually tested between weeks 9 and 12 to measure the number of certain hormones in your body. And then, in weeks 11-14, you make an ultrasound. But the thing is, about 1 in 20 women will get a positive result, which can actually be false.
Some other not-so-accurate pregnancy tests you can reject are Chorionic Villus Sampling and Amniocentesis.
15. EXTRA ULTRASOUNDS
You don’t really need an ultrasound after the 24th week, unless your care provider wants to track a certain condition in your baby. If you only want to do it to determine your fetus’ size or the due date, keep in mind that, as per National Women’s Health Network, the procedure’s “margin of error increases significantly as the pregnancy progresses.”
According to a 2009 review of eight trials that involved over 27 thousand women, ultrasound after 24 weeks didn’t “provide any additional information leading to better outcomes” for moms-to-be and their babies. Besides, according to some studies, the procedure is even linked to a slightly increased C-section rate.
14. TAKING PRENATAL VITAMINS
Most practitioners recommend pregnant women to take prenatal vitamins, but it’s actually up to you to decide whether you’re going to do it. In fact, there’re many reasons why you might think of refusing. Vitamins can be expensive and they may have the additives you should better avoid during pregnancy.
Sure enough, if your nutrition is healthy and well-balanced, it’s likely to be sufficient for the healthy development of your baby. Natural sources of all vitamins and nutrients you need are always better than artificial supplements.
So agree to take prenatal vitamins only if you feel like your nutrition doesn’t meet the needs or if you have any health issues.
13. FREQUENT ROUTINE VISITS
If you ask your ob/gyn, they will probably tell you that you should get routine check-ups late in pregnancy. If you have a complicated pregnancy, you have to listen to them and visit your specialist on a regular basis. But if you feel fine (except for the normal pregnancy-related issues), you don’t really need to do it that often.
Obviously, it doesn’t mean that you shouldn’t visit your ob/gyn at all while you’re pregnant. You definitely should, but don’t do it too frequently. After all, you’ll have little energy, especially late in pregnancy due to your huge belly and all inconveniences related to it, and you won’t want to spend too much time on driving to the hospital every other day.
12. HOSPITAL DELIVERY
Over 98% of pregnant women in the United States choose to deliver their baby in the hospital and it’s clear why. Hospital birth is safer because if any risk occurs you’ll always have a team of specialists around you, who will be able to help you. But if you’ve had an absolutely healthy pregnancy and you’re sure that you’ll face no risk, you’re free to choose home birth.
At home, you’ll deliver your baby in a familiar setting and have more control over the experience. You’ll also need the services of a professional doula, who will make sure that everything goes well. But, in case of an emergency, you should always be ready to be transferred to the hospital.
11. GIVING BIRTH IN THE HOSPITAL BED
If you think that lying down on a hospital bed with your legs spread apart is the only possible labor position, you’re wrong. Yes, it’s traditional, but it’s far from being the only one.
According to What to Expect, you can choose any other comfortable position for labor, if you want to. You can be standing, rocking on a chair, squatting, sitting, kneeling over a bed, using a birthing ball, standing on all fours, or lying on your side. In fact, most of these positions are better than the traditional one, because they help use the force of gravity and push your baby out.
So unless there’s a reason you have to stay in the bed, choose any labor position that makes you more comfortable.
10. EPIDURAL (YES, YOU CAN ACTUALLY DO WITHOUT IT)
Many women think that epidural is a must because they don’t want to feel pain during labor. But they should also know that pain relief isn’t the only consequence of the shot. In some cases, women with an epidural can take up to 2.5 hours longer to go through the second stage of labor, compared to those who didn’t get the shot. It increases the risk of further issues, such as the doctor’s decision to speed up labor or do a C-section.
Besides, when offering pain relief, few specialists warn the woman that when it wears off she’s going to face some unpleasant issues, such as headache and difficulty walking.
9. ARTIFICIAL LABOR INDUCTION
Labor induction is usually recommended when either mom’s or baby’s health comes at risk in case pregnancy continues. But unless you have this kind of risk or any other medical reasons for labor induction (such as going beyond 42 weeks pregnant), it’s better to refuse from the procedure.
It’s been found that medically unnecessary labor induction has more risks than benefits. Depending on the method used to induce labor, these risks can vary from fetal distress to increased interventions and C-section. Besides, a 2011 study determined that babies born from induced labor were 64% more likely to get to the NICU after delivery.
8. ELECTIVE EARLY DELIVERY
As per National Women’s Health Network, in the last two decades, it’s become more common to artificially induce labor before the full term of pregnancy (which is considered to be 39-40 weeks). Between the years 1990 and 2007, births before the 38th week increased by 45%, while full-term deliveries dropped by 26%.
But, since there are numerous benefits to giving birth to a full-term baby, it’s highly recommended to reject elective early delivery, unless it’s required due to certain medical reasons. In this case, such risks and complications as feeding problems, jaundice, and cognitive issues can be avoided in babies, and postpartum depression – in moms.
7. EMERGENCY C-SECTION IN NON-EMERGENCY CASES
In certain cases, C-section is absolutely necessary (or at least highly advisable). But more often than not, uncomplicated natural birth is safer than surgical delivery. After all, C-section is a major surgery that carries a lot of risks and can lead to complications. The most common of them are pain at the incision site, bowel obstruction, and infection. Besides, C-section requires a longer healing period than natural delivery and it can have a larger emotional toll on a woman.
To ensure that you won’t have a C-section in a non-emergency case during labor, choose a caregiver and a hospital that support natural birth and have the rate of C-section lower than 24%.
6. STRIPPING THE BAG OF WATERS
The stripping of the bag of waters (or membranes) is done with the help of a small crochet hook-like instrument that’s inserted into the woman’s nether regions and through her partially dilated cervix. The bag of waters is stripped to release the hormones that will encourage labor and speed up the process. It’s also considered to help the baby move down a bit and put pressure on the cervix.
Although rupturing membranes is a good idea in some situations, you should also know about the potential risks of this procedure, like cord prolapse (slipping of the cord before the baby), infection, malposition of the baby, fetal distress, and even increased pain during labor.
5. REPEATED CERVICAL CHECKS
While you’re in labor in a hospital setting, it’s likely that you’ll have a nurse coming to see you every now and then and check your cervix to see how the labor is progressing.
Although this procedure can help you learn what your cervix is doing at the moment, it can in no way predict what’s going to happen next and how quickly it’s going to dilate. What’s more, cervical checks entail the risk of infections and further interventions. In the meantime, a professional nurse can actually predict how the labor is progressing by simply looking at you and analyzing your contractions.
So it’s up to you to have one cervical exam on admission and none after that, or opt for no checks at all.
4. CONTINUOUS FETAL MONITORING DURING LABOR
Having continuous fetal monitoring means being hooked up to a monitor to record the baby’s heartbeat in the entire duration of labor. It’s actually highly recommended to use fetal monitoring in certain cases. Among them is the mom having an epidural, getting an oxytocin shot, or attempting VBAC. But, despite its benefits, this monitor restricts the woman’s movements and carries the risks of further interventions.
In most cases, it’s enough to have periodic monitoring of the baby by using an electronic monitor, a handheld ultrasound device or special stethoscope. It will be as effective as the continuous one in reducing the risks of certain negative outcomes in the baby.
3. IMMEDIATE CORD CLAMPING
In most hospitals, the umbilical cord will be clamped immediately after birth. However, if you don’t want it to be done so quickly, you can talk about it with your care provider beforehand and add it as a request into your birth plan.
“Why would I want to do it?” you might ask. We have a good answer backed up by the World Health Organization that recommends delaying the cord clamping to at least 1 minute after birth. In an ideal case, the cord should remain intact for whole 5 minutes, so that the newborn can get all the necessary cord fluids, as well as oxygen and stem cells that pass through the cord.
2. SENDING A NEWBORN TO THE NURSERY RIGHT AWAY
In some situations, it’s essential to send the baby to a nursery or NICU immediately after birth. It can be required in case of premature delivery or certain health issues. Otherwise, it’s always better to let the new mom spend some time with her baby, breastfeed them for the first time, and have the first bonding session.
In fact, these days the World Health Organization and the United Nations Children’s Fund require hospitals to allow mothers and babies to stay together to be certified as Baby-Friendly by the Baby-Friendly Hospital Initiative. So ensure that your hospital is a member of the initiative and you won’t have any problem with spending some after-birth time with your newborn.
1. THE SO-CALLED THIRD STAGE MANAGEMENT
The third stage begins once your baby is born and your placenta and membranes expel from the wall of your uterus. At this stage, to help the placenta come out more quickly, a few procedures might be done that are commonly called third stage management. You can be given an injection of oxytocin to increase the strength of contractions and force your uterus to push the placenta out. Then the cord will be clamped immediately to use its traction and remove the placenta.
These procedures have their benefits, as well as their risks. Talk to your care provider to consider if third stage management will be beneficial in your situation and see whether you should agree on it.