The practice of medicine and obstetrics is constantly changing as new research emerges. And the American College of Obstetricians and Gynecologists (ACOG), which is the professional organization that most obstetricians look to for guidelines in order to take the best care of you and your baby during your pregnancy, plays a big role in setting up new trends and practices. For example, routine episiotomy was once considered standard of care to prevent tears, but now ACOG recommends against the procedure because it is associated with postpartum incontinence and other problems. Below are five trends for 2017 that may change the way your doctor or midwife practices. Since medical care is personalized for your particular pregnancy and baby, make sure to talk to your provider about what is best for you and your pregnancy.
Here are five 2017 trends in Obstetrics.
1. Delayed umbilical cord clamping after birth
Delayed cord clamping means waiting anywhere from 30 seconds to a few minutes to clamp and cut the umbilical cord instead of immediately following delivery. By delaying cord clamping, baby will get additional blood from mom, which contains oxygen-carrying iron stores. Although this is something that many midwives and doctors have been doing for a long time, it isn't universally practiced. ACOG has recently recommended that in healthy infants, cord clamping should be delayed at least 30-60 seconds.
2. Laboring in water
You may have heard that soaking in a tub during labor can help you cope with contraction pain. It's true! Immersion in water can help decrease the need for an epidural or other pain medications in women with healthy, uncomplicated pregnancies. However, once it's time to begin pushing it's best to get out of the tub because delivering baby in the water hasn't been well studied and there have been reports of serious complications. If you do choose to make a tub part of your labor experience, make sure that it has been properly cleaned and there is a plan in place to monitor the baby at appropriate intervals.
3. Cell-free DNA genetic screening
Cell-free DNA screening is the newest way to screen for genetic problems in the baby. This is a simple blood test that can detect pieces of the baby's DNA in mom's blood to determine if there may be a problem with the pregnancy.
4. Immediate postpartum IUD insertion
An IUD is one of the most reliable methods of birth control available. In the past, you would need to return to the office a few weeks postpartum to get an IUD. However now, immediately following birth, an IUD can be inserted, eliminating the need for an extra visit and an extra procedure. Talk to your provider to see if the IUD is the right choice for you.
5. Limiting interventions during low-risk labor
Physicians have gotten a bad reputation for unnecessary interventions during labor and delivery. While there are definitely times that interventions are needed for a safe delivery, limiting unnecessary interventions can also be beneficial. As a doctor who considers herself a midwife at heart, I was excited to see that ACOG recently came out in support of limited interventions in low-risk labors. They are encouraging the use of doulas, changing positions during labor, intermittent monitoring and non-pharmacologic methods of pain control in conjunction with women's birth plans.