Birth interventions: More or less sometimes equals the same

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In terms of interventions during labor and delivery to improve neonatal (birth) outcomes, today’s mantra might be less is more. Or not. Curious as to whether induced labor or Caesarean sections (C-section) affect how newborns fare, Dr. J. Christopher Glantz, a professor of obstetrics at the University of Rochester, reviewed the birth records of nearly 30,000 infants from ten upstate New York community hospitals not equipped with specialized neonatal intensive care units. Neonate outcomes were assessed in three ways: if a newborn was moved to an intensive care hospital; if the baby required immediate assisted ventilation; or if a child received a low Apgar score (a simple method used to assess newborn health based on a zero- to ten-point scale and completed at one and five minutes after birth. A lower score indicates poorer health).

The results, published in The Journal of Maternal-Fetal and Neonatal Medicine, found no difference in the outcomes for infants born in hospitals with the highest rates of induced labor or C-section and those with the lowest.

Since the study was retrospective and could not account for all confounding variables, Dr. Glantz advises that this study should not be used to change clinical practice. He doesn’t think that “no interventions should be the goal,” but he does think that “we can get by with fewer of them.”