30 Aug 2018

The tests and procedures you should question when you're pregnant

From Afternoons with Jesse Mulligan, 1:20 pm on 30 August 2018

Pregnant women are too often getting tests, treatments and procedures that are not necessary due to a public perception that all healthcare interventions are beneficial, the NZ College of Midwives Deputy Chief Executive Alison Eddy says.

She hopes a new maternity campaign for healthcare professionals on the Choosing Wisely website will also educate the NZ public on which tests and procedures it's most important to make informed choices about.

The NZ College of Midwives recommends people question the following:

The necessity of more than two ultrasounds during pregnancy

If a pregnancy is progressing normally, two ultrasounds are enough for most women, Eddy says. More may be required if there are other clinical concerns.

Continuous electronic fetal heart rate monitoring - when there are no other risk factors

This isn't the only form of heart monitoring, Eddy says, and it has been shown to more likely to lead to a cesarian section due to something determined as possibly 'wrong' when there isn't actually anything wrong.

Epidurals in labour can have negative impacts on mother and baby, and most women given them are, in fact, having a healthy and normal experience of a normal physiological process, Eddy says.

"We, as a profession, don't believe [an epidural] should be routinely offered as a first line for women that are having a normal straightforward experience of labour.

"We have an obligation to make sure women understand that choosing an epidural during labour – if things are going completely normally – actually increases the chance of her needing to have a ventouse or a forceps birth, she's going to probably experience low blood pressure, there might be some wobbliness to her baby's heart rate, she's not going to be able to move, she'll be on a bed, we'll need to continuously monitor her baby, we'll quite likely need to use artificial hormones to stimulate the labour contractions because they tend to be reduced in the face of an epidural."

The campaign also recommends the clamping of an umbilical cord too soon after birth be questioned.

Eddy says people should feel comfortable asking the following questions about a medical test: What is the purpose? What are the risks? Are there other options? What happens if you do nothing?

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