Science-oriented support for natural birth?

L0L0

Even though I can see that Dr. Amy has a very strong, slanted agenda, her "Hurt by Homebirth" website scares the crap out of me.  I'm into natural birth because I think epidurals and a lot of other interventions lead to worse outcomes for the baby and the mother, not because the birth experience trumps the baby's health (although having a fulfilling birth experience is also a high priority for me). 

 

I am having trouble finding hard data that compares homebirth, midwife, OB, C-section, etc. outcomes with each other.  Everything is just so politicized!  What's a good science-oriented source of information I could turn to? For example, I would love to understand more about "fetal distress" as shown in the fetal heart monitor as a justification for c-section. I know that constant fetal heart monitoring drastically increases the rate of c-sections, but does intermittent fetal heart monitoring result in highter rates of stillbirth, cerebral palsy, or any other negative outcomes? For the record, I'm planning a drug-free hospital birth with a CNM. Thanks.

pepomntpat

The ACOG recommends only intermittent fetal monitoring, so no, it is not associated with poor outcomes..

I personally liked Henci Goer's book The Thinking Woman's Guide to a Better Birth which explains the pros and cons of most interventions.

The ACOG doesn't support home birth, but their guidelines are more scientifically based and a reputable source whose recommendations are often not followed. 

tokenhoser

pepomntpat:

I personally liked Henci Goer's book The Thinking Woman's Guide to a Better Birth which explains the pros and cons of most interventions.

That is a great book - very research focused.

I would also read up on what the ACOG recommends - things like eating during labour, intermittent monitoring that still aren't common practice everywhere.

iris427

A good way to find objective information is go straight to the source--look for studies from peer-reviewed scientific journals.  If you go to Google Scholar or PubMed, you can do a search for whatever interests you and see what kind of research has been done. 

Kitttkattt

There are a lot links to scientific studies on dr amys website. Anything except large quality peer reviewed studies are just opinions.

flyer23

Actually, there was a recent study that found that most of ACOG's clinical guidelines aren't science-based, either. I can't find a link to the original study, but this post describes it: https://pushformidwives.org/2011/08/15/acog-study/

A big "problem" in finding science-based evidence about natural birth is that the hallmark of science-based evidence is a double-blind experiment, where participants are randomly assigned to one of two groups (treatment or placebo), and neither the participants nor the doctors know which group they're in. In the case of obstetrics, in most cases, it's either impossible or unethical to do that type of experiment. For example, there is no way to do a double blind experiment comparing intermittent to constant fetal monitoring, because it's quite obvious to everyone involved which group a woman is in.

You can definitely find scientific studies on birth-related stuff, but they aren't as wholeheartedly supportive of natural birth as you might think. I've seen studies showing that epidurals aren't correlated with a higher risk of c-sections, that inductions have just as good outcomes as non-induced labors, etc.

Ultimately, statistics are useful for giving background, but you have to make your own decisions based on your own situation.