The American College of Obstetricians and Gynecologists (ACOG) is the overseeing body for most of maternity care here in the USA, and this spring brought about a few new updates (and re-emphasizing some old ones as well). As an educated birth services customer, you should know some of the professional guidelines that currently stand for expectant mothers. These new additions are on the heels of recent changes a couple of years ago that encourage birth professionals to be more patient with the length of labor and pushing, all to help reduce our country’s too-high cesarean rates. So here they are
1. No elective, non-medically indicated inductions of labor or cesarean deliveries before 39 weeks.
This change is largely due to efforts form the March of Dimes, which has tried very hard to stop the arrival of pre-term babies simply by letting them gestate longer. With the current accuracy of early ultrasounds, it is rarely necessary to induce before 39 weeks, except in the case of certain medical conditions. As a side note, research shows that a suspected large baby is NOT a medically indicated reason for induction or cesarean delivery
2. No elective, non-medically indicated inductions of labor or cesarean deliveries between 39 weeks and 41 weeks unless the cervix is deemed favorable.
Again, we know that the research shows that it is best to let labor begin on its own, and an unfavorable cervix (one not ready for labor) is not very likely to open up, even with a medical induction. Unless there are medical issues present, it is best to let that baby grow a little bit longer! And again, a suspected large baby is NOT a medically indicated reason for induction or cesarean delivery.
3. No prenatal ultrasounds for non-medical purposes, for example, solely for keepsake videos and pictures.
This recommendation has come about largely due to a booming business of for-profit 4-D ultrasound centers, which promise glimpses of your baby to come. However, the research of long-term results from ultrasound use is still in its infancy (it has been a common prenatal practice for less than a generation), and the risks are still not fully known. Though ultrasounds for viability and anatomy analysis are considered safe, extra ultrasounds “just for fun” should be avoided.
4. No routine activity restriction or bed rest during pregnancy for any indication.
The research has been behind this recommendation for a while now, and it is great that ACOG has finally caught on. Even with some of the common risks of movement, research shows that bed rest during pregnancy has no statistically significant benefits, and may even increase risks in some areas. If your care provider suggests bed rest for an indication, this is a good time to ask questions and understand what the research says about your particular health risk and bed rest.
So that’s it. What new recommendation are you most excited about?