Ms Evidence Based

Ms Evidence-Based is a stickler for facts.

She’s not going to make her birth choices based on what she’s read in the latest celebrity magazine.  Oh no!  She wants it backed up by cold, hard science.

Now, before we go any further, we’re all agreed that Ms Evidence-Based is fictional, and that there’s a lot of evidence about and that she might not have read all of it (a bit like the blogpost author), yes?  And that nobody will be basing any life or medical decisions on some random post off the internet?  Good?  Lovely.  Let’s continue…

Ms Evidence-Based’s story

Ms Evidence-Based is 26, as that’s the age most people would recommend as the ‘best’ for giving birth.

It’s her second baby, and she doesn’t have any other medical conditions or ‘risk’ factors.

Ms Evidence-Based decides to give birth at home.  This is because as it’s her second child, the Birthplace study says she can expect the best outcome for her and the baby’s health by avoiding hospital.

She has a Midwife with her, as having a skilled attendant helps to mitigate against maternal and infant death.

Ms Evidence-Based has antenatal health check-ups.

She uses a birth pool for some of her labour, as immersion in warm water will reduce the likelihood of her requesting to transfer to hospital to have an epidural (she wants to avoid an epidural as having this intervention will increase her chances of an instrumental delivery).

As well as her husband and Midwife, Ms Evidence-Based has hired a Doula, as continuous, emotional support from a non-family member improves her likelihood of having a birth without interventions.

It will also make her labour shorter!

Ms Evidence-Based requests that once the baby is born, the baby’s cord is not clamped so that as much blood as possible can pass between the placenta and the baby.

Once baby ‘Samantha’ has arrived, Ms Evidence-Based breastfeeds her.  She’s in frequent contact with breastfeeding support groups as she knows that regular support (especially face-to-face) will increase her chances of being able to feed for longer.

She continues to have her Doula visit for a few weeks post-natally, as feeling supported may reduce her risk of developing Post Natal Depression.

And the Doula can bring chocolate.  Which is just good.

References and further geekery (not all academic):

Age to give birth (based on popularity of recommendation, rather than health outcomes)

Home birth for ‘low-risk’ second-time mother and baby – Birthplace in England study and BMJ summary of its findings

Epidurals increase likelihood of instrumental delivery – Cochrane summary

Skilled attendant and healthcare effect on birth outcomes – Cochrane summary

Waterbirth reduces need for epidural – Cochrane summary

Continuous emotional support in labour (and beyond) – Evidence Based Birth’s summary; Doula UK reference page; Klaus, M. Kennell, J. and Klaus, P.  (2012).  The Doula Book.  Boston: De Capo Press.

Delayed cord clamping

Breastfeeding – WHO recommendations

Breastfeeding – regular support increases likelihood of a mother and baby continuing to breastfeed

Chocolate and Oxytocin – Netdoctor

For doing your own research:

Evidence Based Birth – website which summaries findings on a number of birth-related topics

Cochrane Collaboration – reviews of medical research across different genres, including pregnancy and maternity

Google Scholar

This article was published on the 31st May, 2013.

Magnifying glass: denverjeffrey.

Did you find looking at medical evidence useful in pregnancy?  Or is it a distraction?  Please let me know in the comments below.