Why Do Women Go Along with This Stuff?

Authors

  • Sheila Kitzinger MLitt,

    Corresponding author
    1. birth anthropologist, educator, and lecturer.
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  • Josephine M. Green BA(Hons), PhD, AFBPsS, CPsychol,

    Corresponding author
    1. Professor of Psychosocial Reproductive Health in the Mother & Infant Research Unit, University of York, United Kingdom.
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  • Beverley Chalmers DSc(Med), PhD,

    Corresponding author
    1. Perinatal Health Consultant and Professor at Queen's University, Kingston, Ontario, Canada.
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  • Marc J.N.C. Keirse MD, DPhil,

    Corresponding author
    1. Professor of Obstetrics and Gynaecology at Flinders University and Flinders Medical Centre, Adelaide, South Australia, Australia.
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  • Kathleen Lindstrom,

    Corresponding author
    1. Perinatal Program Manager for the Health Sciences Faculty at Douglas College in New Westminster, British Columbia, Canada, a Lamaze Certified Childbirth Educator, a DONA certified Doula, and a Doula trainer.
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  • Elina Hemminki MD, DrPH

    Corresponding author
    1. Research Professor at the National Research and Development Centre for Welfare and Health (STAKES), Health and Social Services, Helsinki, Finland.
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* Sheila Kitzinger, The Manor, Standlake, Witney, Oxford OX29 7RH, United Kingdom.

* Professor Josephine M. Green, Mother and Infant Research Unit, Department of Health Sciences, Area 4, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, United Kingdom.

* Professor Beverley Chalmers, Department of Community Health and Epidemiology, Queen's University, PO Box 21091, RPO Princess, Kingston, Ontario, K7L5P5, Canada.

* Marc J.N.C. Keirse, Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders University, Flinders Medical Centre, Bedford Park, SA 5042, Australia.

* Kathleen Lindstrom, Douglas College, P.O. Box 2503, New Westminster, BC, V3L 5B2, Canada.

* Elina Hemminki, MD, DrPH, STAKES, P.O. Box 220, 00531 Helsinki, Finland.

Abstract

PREFACE: Normal childbirth has become jeopardized by inexorably rising interventions around the world. In many countries and settings, cesarean surgery, labor induction, and epidural analgesia continue to increase beyond all precedent, and without convincing evidence that these actions result in improved outcomes (1,2). Use of electronic fetal monitoring is endemic, despite evidence of its ineffectiveness and consequences for most parturients (1,3); ultrasound examinations are too often done unnecessarily, redundantly, or for frivolous rather than indicated reasons (4); episiotomies are still routine in many settings despite clear evidence that this surgery results in more harm than good (5); and medical procedures, unphysiological positions, pubic shaving and enemas, intravenous lines, enforced fasting, drugs, and early mother-infant separation are used unnecessarily (1). Clinicians write and talk about the ideal of evidence-based obstetrics, but do not practice it consistently, if at all.

Why do women go along with this stuff? In this Roundtable Discussion, Part 1, we asked some maternity care professionals and advocates to discuss this question. (BIRTH 33:2 June 2006)

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