Maternity care, Politics, and Science...

Hey everyone!

So, so far Pushed has been very mind broadening. For the most part, it has made me question everything about our health care and how competent the professionals in high-level positions really are.
By popular belief, doctors and officials are to be trusted. We hold them to the highest regard. And yet, they are the ones that are doing the most harm to us.

I believe in science, more than anything, so to hear of stories of the ACOG, scientists, and doctors conducting and believing in research studies that are not valid, reliable or safe is catastrophic. Scientists and doctors -- two professionals that uphold the principles of science; they are who they are because of empirically-evident, scientific truth. There is no arguing with science if it is done right; unbiased and with attention to detail.

What struck me the most was the Toronto epidemiologist Mary Hannah, MD -- A woman -- who led a randomized controlled trial on which birthing procedure was best for breech babies; vaginal birth or cesarean. Strike 1, unethical. Although randomized controlled experiments are the best way to have unbiased, valid and reliable result, jeopardizing the life of a mother and her child unnecessarily off of a flip of a coin is beyond unethical. Strike 2, the way the experiment was conducted was not entirely accurate or truthful. There was an unfair comparison between vaginal birth and cesarean. In this case, the vaginal births were not physiologically natural. They were monitored and very heavily managed. With the outcomes that Dr. Hannah had, of course it's true that a vaginal birth of a breeched baby is unsafe. None of the physicians were trained to safely handle a vaginal birth of a breeched baby. The way the results were framed, Dr. Hannah made it seem like cesarean births were better and safer than vaginal births, but cesareans have other complications that are not natural and cause greater harm in the long-run than vaginal births. But, of course the ACOG did not care. They ran with the results and made every woman go through major abdominal surgery  without giving it a second glance. People questioned the validity and the structure of the study, they fought against it, they demanded a withdrawal of the study and demanded a better study that accurately represented childbirth. However, what did Dr. Hannah have to say about criticism? "The results of the study are the results, you don't withdraw them because somebody doesn't like them." Now, with that mindset, wouldn't you believe that the results of a better conducted observational study would be considered just as significant and valid? Apparently, according to the obstetric community, the answer is no. A physician recommended a redo of the study by making the study observational instead of a randomized controlled study. I believe this is a better choice because it is ethical and it gives an accurate representation of what generally happens in childbirth without altering it. The ACOG ignored it; deemed it inefficient. Another observational study was conducted by midwives Johnson and Betty-Anne Daviss about low-risk women planing midwife-attended home births in the US and Canada. The research showed that physiological births are safe and women are capable of having them with little to no intervention. Still, the obstetric community gave it no attention. So, by Dr. Hannah's ideology shouldn't the ACOG acknowledge the results and respect supporting evidence? I guess it's only okay to disregard results when it's convenient to officials in power. True science doesn't matter to them if it doesn't fit their beliefs. This just proves that the ACOG is biased. That is just disgraceful. You can't go above basic scientific evidence. Strike 3.

I am a firm believer in science. No matter what, observational and randomized controlled studies are both valid. I don't understand why in this case, observational research is "inefficient" when observational studies are used all the time, like in animal behavior research. That is just as valid as anything else.

How reliable is our healthcare if they are more tangled up in bureaucracy than in science?
That question will always haunt me....