Sunday, January 20, 2013

Where's the Evidence?

Home birth advocates often argue that OBs don't use evidence-based care in their practice.

So I have a question... where's the evidence that shows the safety and/or effectiveness of the following common home birth practices:

- herbs used to induce labor

- essential oils to induce or augment labor

- castor oil to induce or augment labor

- breech deliveries attempted outside of a hospital

- twin deliveries attempted outside of a hospital (or higher order multiples)

- treating GBS with garlic

- treating GBS with Hibiclens

- VBACs attempted without use of electronic fetal monitoring

I'm throwing this blog post together quickly so I'm sure I'm missing some.... help me out here.

If there is evidence to support any of these, I would love to read them so please add in the comments!


The following were added in the comments by "excpmstudent" (thank you for sharing!):

-evidence to support use of homeopathy for anything

-evidence to support use of herbs for postpartum hemorrhage

-evidence to support use of *no medications* to treat postpartum hemorrhage

-evidence to support maternal supplementation with Vitamin K to prevent newborn hemorrhagic disease in the breastfed newborn. 

-evidence that midwives have the ability discern variability of fetal heart tones with the exclusive use of auscultation. 

-evidence that if no vaginal checks are done, it's safe to keep a woman home and not in labor after her water breaks for days or a week or longer.

-evidence to support prolonged 2nd stage. (I'm talking 6-24 hours OR LONGER. I wish I was joking with this one.)

-evidence to support expectant management of prolonged 3rd stage of labor. (Again, for HOURS. For some midwives, the sky's the limit on waiting for a placenta to come out)


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