A few weeks ago, I received an email from a family medicine physician who asked if I could join a group of midwives and doulas to talk to their residents (new doctors in training) about natural birth. The residents in their practice are getting more and more patients with birth plans that lean towards natural birth (surprise, surprise), and they needed an inservice on how to best take care of these women. The physician who contacted me mentioned that they are always looking for good scientific articles to provide evidence for their obstetrical care. I thought, ‘Cool! I can do that for them.’ You see, I am a faculty member at a College of Nursing, and I have access to thousands and thousands of medical journals (all online), online medical textbooks, and other information resources that are not available to the public. I’ve also been trained on how to evaluate and present research findings– both through my advanced practice registered nurse training (APRN) and my PhD program. Although my background is not OB (it’s cardiac), my training in research has given me a good foundation on which I can evaluate research in any clinical field.
I started reviewing some of the evidence on birth practices and summarizing it in a Word document. Then I thought– if I am giving this information to the residents, would other people find it useful? I looked around online and couldn’t find anything like what I was writing (that is free access, at least). There is one website I found– www.childbirthconnection.org, that does a pretty good job of summarizing evidence, but I felt like I could offer something unique by really critically evaluating research studies and including lots of references embedded in my blog articles– so that practitioners or interested women could go look at the research themselves if they want to. I also want each article to be easily printed and written in plain language so that women (not in the healthcare field) could read it, but the articles need to also be detailed enough and have enough statistics so that healthcare providers would be interested. (Doctors in particular LOVE data. They LOVE it. “Show me the data!” They always say.)
So, why the name of the blog? Well, evidence-based practice is a pretty hot topic right now in the healthcare field. That’s because it takes up to 20 years for research findings to be translated into clinical practice. Shocking, isn’t it? But totally true. The term “evidence based medicine” first appeared in 1990. And the definitive document on evidence based practice is the “Users’ Guides to the Medical Literature” published by JAMA (Journal of the American Medical Association). It’s a cute little book (kind of looks like one of those bibles that get handed to you by random people on a college campus), and it’s one that I happen to own from my days in the Master’s in Nursing program.
So…what exactly is evidence-based practice?
Evidence based practice means 1) being aware of the evidence that is the basis of your practice, 2) understanding the quality of the evidence, and 3) knowing whether or not you should apply the evidence to your particular situation.
So…Why does evidence-based practice matter to birthing women or practitioners who take care of birthing women?
Because practice that is not based on the best evidence is not BEST PRACTICE. Unfortunately, NON-evidence-based practice happens all the time in birthing situations. Why? Well, possible reasons are, “Because that’s the way we’ve always done things.” “Because sometimes it’s not in MY (the practitioner’s) best interest to follow best practices.” “Because I’m afraid of liability.” (that last one’s a BIG one in obstetrical care, and painfully relevant).
Please join me this summer as I search out the evidence for best practices in birthing. There are soooo many important things we can look at together. I will wear both my “research” hat and my “teaching” hat and I will do my best to dig out the evidence (using resources that I have, but many of you don’t), present the evidence, help you understand the quality of the evidence, and help you figure out whether or not that evidence can be applied to your particular situations.