Wednesday, June 06, 2007


Evidence based practice is what I strive for. As I read Sage Femme I get more and more antsy to drop some of the medical stuff that we do that is not evidence based. Why do I continue to do things like weight checks and urine dips? Because it is expected. Or standard of care. And that makes me feel icky!

So, finally I had a prenatal last week and FaeryLady brings up that one of the midwifery lists recently had a discussion on why urine dips are not useful. I have thought this for a long time, and SageFemme had a good post on this very subject as well. Since I am still under supervision, I felt I couldn't quit until FaeryLady agreed, but had already decided that once I was on my own, urine dips would not be performed. Wahoo! The freedom of being able to say, "there is no evidence backing this procedure, so I'm not gonna do it."

And weight. Women don't need one more number that could make them feel poorly during their pregnancy. The important thing is the baby's growth and checking for sudden water weight. I will be able to SEE if a mom has sudden puffiness and I will be able to FEEL if the baby is growing appropriately or not. Why do we need to quantify otherwise? Besides, it is the foods you eat, no the pounds you gain that is the important thing in pregnancy, and I ask all my moms at every prenatal about their diet and we brainstorm ways to improve.

Prenatal care is not the measuring, charting and listening we do. Prenatal care is what the mother does to take care of herself and her baby in between visits. I can tell when something is veering off into not normal, but unless the mother is willing to change diet/behavior or follow advice and counsel, there is nothing I can do to prevent problems from blowing up!

I long ago quit putting hats on babies, although with my own baby for some reason I felt strangely compelled to put a hat on her.

I have two births coming up this summer, one a monitrice birth and one homebirth client. It's strange and probably best that I have not gotten any other calls. Mamas getting pregnant now are not due until March (and then I will be ready to go back into things full swing) but I have only these two. I thought I would be ready to get back into it and FaeryLady had told me to wait. I now agree with her and I"m surprised at myself and my reluctance to attend births while CottonBall is still so little. I had pictured myself with a baby at my breast, coaching daddies through catching their own babies. Well, that would work for a baby who would sit quietly at the breast when they aren't hungry. Not so, CottonBall. She nurses for food only thankyouverymuch and not at all for comfort. So, now I'm nervous and I've asked SuperDoula to help me tag team the monitrice birth and I don't know what will happen for the homebirth. I may try leaving CottonBall at home if PreacherMan is home.


Dollymama said...

I started refusing weight checks on my second baby. The first time around I normally didn't look at the scale and asked the nurse to not tell me the number. Many women have an unhealthy bunch of issues related to weight. Those numbers do nothing to help you!! Solid nutritional counseling is what will help. I wish I had learned more about empty calories I was taking in, though, such as juice and milk. I gained a lot while I was pregnant (I don't know how much I weighed, but I know how bad I looked and hurt). Some better info would have been helpful.

kris said...

wow you have covered so many things here. i never really considered all the things they do at those check ups as to if they were useful or not. but that was back when i trusted everything my OB said as true.