No matter your level of health when you become pregnant, it’s important to understand what is happening in your body before, during and after pregnancy. Reliable information can help you identify potential concerns and make informed decisions about your maternity care. On this page, we help you understand what “healthy childbearing” looks like and how you can advocate for maternity care that supports your own healthy and satisfying experience of pregnancy and birth.
Healthy Pregnant Women
The great majority of pregnant women in the United States are well and healthy. The federal government’s Healthy People 2020 outlines health goals for the nation; It states that “nearly 85 percent of pregnant women in the United States — about 3.5 million women every year — enter labor at ‘low risk’ for problems.”
Low-risk pregnant women can expect an uncomplicated birth and a healthy newborn. Unfortunately, our maternity care systems often treat pregnancy and birth as medical conditions or disease states, rather than normal life processes. Childbirth care in U.S. hospitals involves a lot of interventions, even for low-risk women. Six of the ten most common hospital procedures in the country are maternity-related, and the most common operating room procedure is cesarean section.
That’s why it’s important that low-risk, healthy pregnant women are well informed about the kind of maternity care that is optimal for them.
Appropriate Maternity Care for Healthy Women
Pregnancy, labor and birth, and the postpartum period, involve healthy innate processes that a woman’s body and that of her fetus/newborn are prepared to carry out. These processes are regulated by powerful “chemical messengers,” or hormones. When we support these processes and avoid interfering with them, labor, birth, attachment and breastfeeding will often unfold naturally, reducing the need for medical interventions. It is important to find caregivers and places for giving birth that understand, respect and work with these inborn processes.
Maternity care that is supportive and respectful – and that reflects the best available research about what is safe and effective – can lead to:
- A healthy mother and newborn;
- A strong and connected family; and
- Parents who are informed, confident and ready to take on the demands and responsibilities of parenthood.
Routine Maternity Interventions
Many hospitals and health professionals use maternity interventions — such as labor induction, continuous electronic fetal monitoring and breaking of membranes — without hesitation, even when there is no clear need for them. It is wise to consider whether such practices are truly needed. There may be safer alternatives, including no action (“watchful waiting”).
Childbirth Connection’s national Listening to Mothers survey found high rates of intervention among women giving birthin U.S. hospitals. Without a good reason to use them, unneeded maternity interventions may:
- Disrupt the work your body and that of your fetus/newborn are prepared to do on their own (innate processes).
- Interfere with your relationships with your spouse or partner, other support people, your baby and/or your caregivers.
- Be uncomfortable and unpleasant.
- Cause more serious side effects.
- Lead to the use of yet more interventions to monitor, prevent or treat side effects.
- Waste resources of the employers, governments and families who pay for this care.
(The Giving Birth section of this website covers common interventions in more depth.) You might wonder why these interventions are used so often if there isn’t strong evidence that they are needed. It happens for a number of reasons: it might be the standard practice in that community, because that’s how health care professionals were educated and trained, due to pressure to speed up labor and birth, or for other reasons. Women themselves sometimes request interventions that are not medically needed, such as labor induction, for convenience.
It can take a long time between the appearance of new knowledge about best practice and routine provision of care consistent with that knowledge. Because of this, women have an important role to play in becoming informed and engaged and securing high-quality maternity care.
Of course, some women in specific situations need these interventions, but for healthy women, the best research finds that many interventions do not offer benefits and instead have the downsides listed above.
Unneeded procedures and tests can take on a life of their own. They can reroute your labor off in a more risky and less satisfying direction. It’s important for you to learn about the “cascade of intervention” and ways to avoid it.