Dear SHAPE Magazine

I’ve never been more disappointed, angered, or saddened at the state of affairs in the birth world in our country. This article is beyond misleading and does anything but present the facts or big picture. Shame on you, SHAPE Magazine and your editors, for publishing this article. I can guarantee that not only will I never buy your magazine again, but I will also look with disgust every time I see it on the stands at the checkout counters in the supermarket or airport terminals.

The article states:

The results showed that the average time between treatment and delivery was about 13 hours for the misoprostol+Foley combination, 14.5 hours for Foley+oxytocin, and 17 to 18 hours for those who only received a single method. Which means that simply adding misoprostol to the Foley method could potentially save you more than four hours of painful labor, according to the University of Pennsylvania Health System. A shorter labor also could potentially reduce the cost of health care.

And then this:

“Labor and delivery are resource-intensive,” says Dr. Levine. “There are costs associated with monitoring baby and mom, utilizing a bed in a hospital, and utilizing a nursing staff both during labor and postpartum. All of these are costs that would be directly affected by reducing labor time.”

After I read this shit show of an article, I decided to find the study that was conducted to find exactly what information SHAPE Magazine was leaving out.

This study was conducted in a hospital setting with a mean age of 27. All women were pregnant with a singleton, at 39 weeks gestation, with membranes intact, cervical dilation was no more than 2 cm, and Bishop score was less than 6. These clues alone tell me that baby is still gestating, so leave nature alone.

However, this study medically induced these healthy women at 39 weeks. There are very few legit reasons for medical induction. Adequate reasons for a medical induction are hypertension, preeclampsia, heart disease, gestational diabetes, or if there is a real concern for the health of the fetus. The actual risks of induction are rarely clearly communicated, but they include a hyperstimulated uterus (which contracts more frequently and therefore decreases oxygen to fetus), hemorrhage, infection, uterine rupture, and a failed induction (which translates to a cesarean birth).

Let me repeat: all of these women were labeled “healthy”, so why would a medical professional encourage a medical induction on a healthy mother? Not to mention this is before even reaching her estimated due date! Given the lack of true medical indication, it seems unreasonable to induce and interrupt the growing and maturation process of the fetus.

As I read more about the study, I found out:

The risk for Cesarean delivery was 24.2% with misoprostol alone, 27.6% with misoprostol and cervical Foley catheter, 28.5% with cervical Foley catheter alone, and 30.4% with oxytocin and cervical Foley catheter.

The national cesarean rate in the United States has remained around 32% (CDC 2014). The World Health Organization continues to recommend that a country have a 10-15% cesarean rate, and no higher. The United States is messing up, and this study falls right in line with our mediocre (at best) birth practices. Not only did this study have a cesarean rate of approximately ⅓, but all cesarean outcomes were excluded from the data conclusions. Like I said before, this SHAPE article was completely misleading.

The last thing I want to touch on is the length of labor and average length of gestation. The average length of labor for first time mothers in the United States is 16 hours. The average length of pregnancy for first time mothers in the United States is between 40 weeks and 41 weeks and 2 days. Again, why would you mess with nature? Allowing a baby to gestate to full term and allowing baby to decide their own birth date continues to be the most beneficial for baby’s health.

Birth is hard. Labor is not easy. The idea of shortening the time spent in labor sounds appealing. But this is process is so important in the start of a child’s life and in the transformation of a woman, and the information presented in this (borderline fraudulent) article is misleading. Robbing a woman and child of the full labor and birthing experience for the convenience or cost-effectiveness for a hospital is completely inappropriate. (It’s much more cost-effective to birth at home, but I don’t see any hospitals trying to lower healthcare costs by recommending this practice.) A risk-free solution to a shorter labor is chiropractic care of the pregnant woman. In fact, those seeking chiropractic care during pregnancy have been reported to experience 25-31% reduction in labor times. Maybe rather than recommending disrupting the gestation process, increasing risks to both mother and baby, and misleading the public by selectively reporting, SHAPE magazine could focus on sharing risk-free options to help both mom and baby during the labor and birthing process.

Lindsey Mathews, DC

@BIRTHFIT

@GigEmLindsey

Lindsay Mumma, DC

@BIRTHFITNC

Other resources:

https://birthfit.com/wp-content/uploads/2017/01/LTM-III_Pregnancy-and-Birth.pdf http://evidencebasedbirth.com/friedmans-curve-and-failure-to-progress-a-leading-cause-of-unplanned-c-sections/

http://evidencebasedbirth.com/evidence-on-inducing-labor-for-going-past-your-due-date/ http://www.mayoclinic.org/tests-procedures/labor-induction/basics/risks/prc-20019032

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2647084/