Not everyone who leans toward natural birth practices started there -- many have had bad experiences in hospitals or have been close to women who have. Sometimes it's women who read incredible amounts of literature on pregnancy long before peeing on the stick. It's not just patchouli-wearing, long-haired, barefoot hippies. It's law students, businesswomen, head of your PTA -- anyone. Especially with homebirth on the rise, it's safe to assume it's no longer just a fringe group of "weirdos."
Yet, many people still get accused of being conspiracy theorists, of thinking they "know better than doctors" and blown off like crazy freaks. Well guess what? It seems that many OBGYNs are letting their personal leanings interfere with their practice.
According to a new study, we aren't crazy when we point out that many common practices and recommendations aren't evidence-based -- less than a third of the American College of Obstetricians and Gynecologists recommendations are based on "gold-standard" scientific experiments.
According to Professor of Medicine, Dr. Andrew D. Auerbach, "more than two thirds" of recommendations are based on anecdotal evidence or even just expert opinions, which are wrought with personal biases. While opinion can be helpful where we don't know things, it doesn't always translate into what's best for the patients.
In the new study, Dr. Jason D. Wright of Columbia University in New York and colleagues went through 717 practice recommendations from ACOG, the nation's leading group of ob-gyns.
They found 30 percent of those were based on top-notch evidence, so-called randomized controlled trials. About 38 percent came from observational studies, whose value is limited, and 32 percent were purely expert opinion.
That's kind of scary to me, honestly. But it helps explain where quotes like these come from: "Twins are ready sooner because they grow faster than a singleton" and "In my experience, all Hispanic babies need formula."
I hate to say "I told you so," but seriously, when someone tells you that what your OB told you isn't sound, don't blow it off. When someone says, "Doctors don't know everything" or "I'd get a new doctor," most people aren't just trying to be self-righteous, arrogant assholes. Doctors CAN BE WRONG, and according to this study, they aren't using nearly as good of science as even I -- as a decently skeptical person -- believed they were. YOU are your best advocate. Do real research, ask around, ask people who disagree with you for sources of their claims, and find out yourself.
The study also noted that it's very important to go through literature and remove financial conflicts of interest from the office, and to make sure that panels for guideline review represent all stakeholders -- doctors and the patients alike. So yes, when we talk about offices having fingers in pies that hurt you as a patient, we're telling the truth.
When we have the Surgeon General, past and current, the Institute of Medicine, the World Health Organization, and the March of Dimes, to name a few, all saying that our hospitals and doctors are a huge part of the problem causing abysmal breastfeeding rates and premature birth and infant mortality, and then a study like this shows the good majority of our information isn't even based on good science ... well ... those home-birthers may not be sounding quite so crazy after all?
Are you surprised to find how little of the practices were using sound science?
Image via Daquella manera/Flickr