Birth Matters Virginia Sponsors National Video Contest
By Christine Cupaiuolo — March 19, 2009
Birth Matters Virginia, an organization that works to promote an evidence-based model of maternity care, is hosting a contest intended to educate women about their choices and options during pregnancy and childbirth.
The organization is inviting mothers, fathers, filmmakers, film students, birth advocates, and others to create a 4- to 7-minute educational video about birth. First prize is $1,000.
For rules and entry information, visit http://www.birthmattersva.org/videocontest.html. Updates are also available on Facebook. The deadline is Mother’s Day — May 10.
The judges will be Ricki Lake and Abby Epstein, makers of documentary “The Business of Being Born,” and Sarah Buckley, an OBGYN and author of “Gentle Birth, Gentle Mothering.”
Why does the reality of everyday, routine care for birthing women diverge so radically from best-evidence practice? It’s probably the money. The routine use of continuous electronic fetal monitoring is a fine example, because fetal monitoring for every woman all the time is not best-evidence care, but once a hospital owns a fetal monitor for every L&D room, it becomes “hospital policy” to do just that: monitor every woman all the time. The monitors are little cash-producing machines that crank out the profits along with those paper strips. The CDC just published the latest data on the c-section rate in the U.S., and alarmingly, it has risen steadily since 1996 to twice the rate recommended by the World Health Org, and there is undisputed evidence that continuous EFM has a direct effect on the increasing cesarean rate. Here’s a quote from the 2005 Practice Bulletin #70 of the American College of Obstetricians and Gynecologists: “Despite its widespread use there is controversy about the efficacy of EFM. Moreover, there is evidence that the use of EFM increases the rate of cesarean and operative vaginal deliveries. Given that the available data do not clearly support the use of EFM over intermittant ausculation, either option is acceptable in a patient without complications” (Obstetrics and Gynecology, Intrapartum Fetal Heart-Rate Monitoring, 106 (6), 1463-1561). No OB tells a patient that it’s just fine to have someone listen to her baby’s heart rate every half-hour or that she can request, and even insist on intermittant monitoring so that she’s not confined to bed or to the limited movement that the short monitor leads require. Nor are mothers told that if they stay connected to the EFM all through labor, they will have a greater chance of winding up with a cesarean. Why would ACOG even recommend EFM as an “acceptable option” when its “efficacy” is in question and evidence shows that “option” increases the c-section rate?
The evidence for the effect of EFM on the rate of cesareans has been around since the ’80s, and in December of 1987, the Lancet published a review of eight prior PRCTs (prospective randomly controlled trials), and reiterated the conclusions of all of those studies: the ONLY statistically significant constant effect of continuous EFM was to raise the rate of c-section. The studies showed no beneficial effect on fetal health or fetal outcomes. NONE. But there was that pesky effect on mothers…more c-sections. If the effect of a procedure is neither neutral nor beneficial, if it has indeed been shown to have risk, i.e., to lead to increased, and by implication, unnecessary c-section, how can the use of EFM on every woman, every day in this country have any ethical justification, and why is no one sounding the alarm? It’s probably the money.
(Take a look at the Coalition for Improving Maternity Services (CIMS) press release about the new c-section rates under “Press Room” at http://www.thebirthsurvey.com, and take the survey to share your birth experiences and add to transparency in maternity care.)
Jackie, you should make a video for the contest!
I thank you for the encouragement. I’d love to do a video…I’m a Lamaze educator, a doula and a lactation consultant, and often ask mothers I support to tell their birth stories, or nursing stories on video. I show these short videos to classes and private clients; they’re uniquely useful tools because the stories are real and immediate…no sappy music, no production values…just the mom, the baby and me and my little 5-year old JVC video camera. Alas, I’ve no time between now and the deadline to plan and execute. Maybe next time, should this contest become a successful and ongoing forum. But tell everyone you know who’s had a baby in the last three years to take The Birth Survey. It’s a “consumer’s report” for maternity care…the more mothers who put their birth info at the one end, the more parents-to-be can find info about local providers and facilities at the other end. http://www.thebirthsurvey.com