Once you discover the ‘good news’, the first thing you would typically do is to visit a gynecologist of repute or one who you trust. Surely, but also consider the fact that pregnancy is one of nature’s most beautiful processes of creating life and childbirth, especially does not always needs medical intervention. So you definitely must make informed choices when you do.
In an effort to reduce potentially harmful medical interventions in pregnancy and childbirth, the American college of Obstetrics and Gynaecology (ACOG) recently came up with a CHOOSE WISELY list of questions. You could consider asking them to your gynecologist/ care provider as well:
The majority of pregnant women in India have more than the recommended two sonographies, in some cases 12 or more. The American Institute of Ultrasound in Medicine discourages the non-medical use of ultrasound. Two Ultrasounds are recommended in pregnancy, if a mother is not sure about the date of her last period or the date of conception a first trimester ultrasound can be done to confirm the due date, the second ultrasound is at 18 weeks to confirm normal anatomy. Ultrasounds in the last trimester, unless there is a specific condition, are not recommended after 24 weeks. Although some practitioners use ultrasounds after this point to estimate fetal size or due date, the margin of error increases as the pregnancy progresses and the procedure doesn’t provide any additional information leading to better outcomes for either mother or baby, according to a 2009 review of eight trials involving 27,024 women. In fact, the practice was linked to a slightly higher C-section rate.
Labor can be induced with synthetic oxytocin, artificial rupture of membranes or prostaglandin inserted into the vagina. ACOG states that ideally, labor should start on its own initiative whenever possible. Natural oxytocin is released into your blood stream as labor progresses, your own oxytocin provides lifelong health benefits to you and your baby. Synthetic oxytocin is very different from natural oxytocin and these differences can cause problems to you and your baby, including reduced blood flow, more painful labor requiring more pain medication, overstimulation of the uterus, hemorrhage, uterus rupture, the baby’s heart rate can become abnormal and may need resuscitation leading to spending time in the ICU, increased chances of needing a Caesarean-Sections are a few. There should be a valid reason for interfering with the natural process. WHO states that induction of labour should be reserved for specific medical indications, including toxemia, high blood pressure or if you are past 42 weeks gestation.
ACOG states - bed rest or activity restriction has been commonly recommended for a variety of conditions in pregnancy including multiple gestation, intrauterine growth restriction, preterm labor, premature rupture of membranes, vaginal bleeding and hypertensive disorders in pregnancy. However, information-to-date does not show an improvement in birth outcome with the use of bed rest or activity restriction, but does show an increase in loss of muscle conditioning and higher chances of thromboembolic disease.
If you want a natural birth there are three options, birthing in one of India’s two birth centres, a home birth, or spending time finding a doctor who is experienced and confident to support natural birth.
Some doctors prefer to prescribe many unnecessary tests, medications, and vitamins during pregnancy, others are cautious and only prescribe when a true need arises. Many doctors view pregnancy and birth as a medical condition and insist on bedrest and medical management, a few see pregnancy and birth as a healthy life event and encourage exercise, support the normal processes and inspire confidence. Many doctors in India consider gestation to be 38 weeks and induce or perform a caesarean section for all mothers by 38 weeks. Other care providers consider gestation to be 42 weeks and wait for labor to start normally.
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