Friday, August 6, 2010

High Tech vs High Touch

I found a really great post at the Midwife Next Door: "Thank you for touching me": the conflict between high-tech and high touch care.

I didn't realize that many prenatal care providers don't use touch anymore in the care they give to expecting women. Most care providers these days use ultrasound to check for fetal heart tones, fetal position, size, and overall well-being. Did you know that there's a technique care providers can use that's called Leopold's Maneuver that can check all of these things, and they only need to use their hands?

My obstetrician, his nurse-practitioner, and my midwife all use Leopold's Maneuver. I didn't have more than one ultrasound in each pregnancy, because my care provider was able to determine the baby's well-being with their hands. Not only was it extremely simple and helpful, but it's also comforting to have high touch care like that. I definitely prefer it over the cold jelly and hard probe of the ultrasound machine.

There is some question about the safety of ultrasounds. We don't know how safe ultrasonography is on a developing fetus, as no long-term studies have been done. Ultrasound machines are not regulated, and the wave frequency has not been tested for safety. We don't have any evidence against it, but we also have no evidence to support its routine use during pregnancy. Ultrasounds in the last trimester of pregnancy are also unreliable in determining a baby's size. The estimation can be off by a full pound, more or less. With these questions in mind, wouldn't you prefer to use a proven hands-on technique rather than an unproven technology?

I'll leave you with an excerpt from the post by the Midwife Next Door:

"Women in labor need hands-on care. It’s known that women who have a female birth companion with them during labor have fewer c-sections and faster births, with fewer epidurals needed. Why is this? I believe it’s because a machine can never replace a human, even if it is more accurate in certain assessments. A machine may be able to tell me that this woman is only 3 centimeters dilated, but my eyes and ears tell me that she looks and acts as if she’s in transition, and guess what? Most of the time, my eyes and ears don’t lie, and we have a baby within the hour.

"In our push to improve birth outcomes, we continue to move farther away from the hands-on, low-tech models of countries with exemplary birth statistics, such as the Netherlands, England, and other countries where midwife-attended births are the norm. Instead of looking for new machines to meet this goal, why not look to the example of cultures who are working within the midwifery model of care that is already meeting this goal?"

1 comment:

  1. Great post. I have had a midwife for all of my pregnancies (7) and the same midwife for 6 of my 7 pregnancies. I love this woman dearly. She missed the last two births. I pray that she makes it for this one (due any day).