Session: Who's Left to Catch the Baby?


Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

3375.0: Monday, December 12, 2005: 4:30 PM-6:00 PM

Oral

Who's Left to Catch the Baby?

Over the last two decades, maternity care practitioners have benefited from an international research collaboration based in Britain called the Cochrane Collaboration. The Cochrane Collaboration had laid to rest some obstetric myths, including whether or not several procedures done for decades are really of any worth (eg episiotomies, routine electronic fetal monitoring) Unfortunately, rather that adopting the spirit of the Cochrane Collaboration, there seems to be an increased trend in North America towards utilizing single new studies in isolation. Numerous articles in the media and health care literature point to a crisis in obstetrical care, which is particularly salient in rural areas. Obstetricians are in short supply, many family doctors are not practicing obstetrics for both personal and professional reasons, and the modest increase of midwives in some areas is not enough to make up the shortfall. In an effort to increase the access to prenatal care among low-income pregnant women, the March of Dimes has initiated the Healthy Beginnings Campaign in Oklahoma. Episiotomy, incision of the perineum at the time of vaginal childbirth, is a common surgical procedure experienced by women. Based on national hospital discharge data for 1999, just over 35 percent of women who gave birth vaginally had an episiotomy performed. Despite several decades of research the use of episiotomy is heavily driven by individual provider preference rather than variation in the physiology of vaginal birth. This session will examine access to care issues, the March of Dimes, Healthy Beginnings Campaign, and epidemiologic evidence on VBAC safety and episiotomy.

Learning Objectives: To describe the basic aspects of weight of evidence and its role in making decisions in women's care. 2)Articulate short and long term outcomes of routine VS restrictive episiotomy. 3)Recognize the various perspectives on the human resources crises in maternity care from the providers to the recipients. 4)Discuss the impact on increasing access to maternity care.

Organizer(s):

Barbara A. Levin, MD, MPH
Carol Nelson, CPM, LM
Cecilia Wachdorf, CNM, PhD

Presider(s):

Charles S. Mahan, MD

Moderator(s):

Charles S. Mahan, MD

4:30 PM

Welcoming Remarks

4:35 PM

Increasing access to health care for pregnant women through the Healthy Beginnings Campaign