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Science is Fickle: I.V.’s and Episiotomies and VBAC’s, Oh My!

In late 2009, ACOG relaxed their position on fluid intake and I.V.’s.

Wah?! Did I just hear angels singing? Did the heavens open?

Here are ACOG’s, and therefore your OB’s, C.N.M.’s and hospital’s, new guidelines: http://www.acog.org/from_home/publications/press_releases/nr08-21-09-2.cfm

I Have Such An Ice Chip On My Shoulder

In essence it says ‘ice chips only’ are a thing of the past, and women ‘may drink modest amounts of clear liquids during labor if they wish’, including ‘water, fruit juice without pulp, carbonated beverages, clear tea, black coffee, and sports drinks.’ Solid food is still off limits, though.

I know, I know. I should be happy right? I suppose I am, especially after this becomes commonplace in the hospital. Funny thing about change in the hospital, though, is this….

Wait Sir, You Forgot Your Change

When the change is in favor of the woman and baby, it takes years and years to implement – evidenced, for example, by how long it took for the majority O.B.’s to stop doing routine episiotomies after ACOG changed their episiotomy position to halt the practice in 1983.

Yet in 2004 an ACOG study found that:

Women who deliver their babies attended by physicians in private practice have a seven-fold increased risk of undergoing an episiotomy compared to women attended by ob-gyn residents or hospital faculty physicians…The average rate of episiotomy use among hospital faculty physicians and residents was 17.7% [approx 600,000 women] compared to 67.1% [approx 2,000,000 women] among private practice physicians.

ACOG had to reiterate again in 2006 to their O.B.’s to stop this unnecessary cutting of woman’s genitals, because it was just too hard a habit to break, I guess. Ugh!

But, when change is in favor of the doctor, well that seems to happen right away – evidenced, for example, by the stricter VBAC policies and outright bans ACOG ushered in back in 1999. That took effect so fast I got whiplash.

Why Can’t I Get My Freak On About the New I.V. Guidelines?

Besides the fact that women will still have to be defensive in labor and advocate for themselves to avoid I.V.’s for years, ifnot decades, I just find myself being a little annoyed at ACOG’s slower-than-a-turtle findings. After all, how many women is this too little, too late for?

A LOT.

Trust Them, They’re Experts

Up until this announcement, women have been negotiating, arguing, and generally stewing over these types of nonsense guidelines. They’ve been made to feel like they are selfish, negligent, or stupid for even suggesting that an I.V. in labor isn’t something necessary.

Or heaven forbid they quench their thirst in labor, sometimes sneaking around behind the nurse’s back to sip something so they didn’t fall over from dehydration.

Did women’s bodies all of the sudden change in 2009 that now they have evolved into creatures that can handle drinking in labor? No. It’s just taken ACOG decades upon decades to catch up with what women have always known – when you are thirsty, drink. When you’re hungry, eat.

The Inevitable Question

The danger in ACOG changing their position is that women might start thinking:

What other routines are they wrong about? Are these outdated routines going to hurt me and/or my baby?

Let me so humbly suggest – you don’t have time to wait for ACOG to backpedal again.

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2 Responses to “Science is Fickle: I.V.’s and Episiotomies and VBAC’s, Oh My!”

  1. Awesome article, love your writing. Thank you for posting the new guidelines as well.

  2. I’m a wife myself, and this brought back memories of when I was pregnant and scared myself. If your pregnant and scared, give the Pregnancy Fear eBook a try. I love the author and she really knows her stuff.

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