Women’s Health Risks Associated with Orthodox Medicine - Part I - Antenatal Care

Antenatal Care

If you assume that more prenatal care equals better pregnancy outcomes, the following research reports may come as a surprise. Several studies have found that fewer prenatal visits to the doctor or fewer medical procedures resulted in similar or better outcomes than more visits or more care.

Other studies show that routine ultrasound screening of low-risk women does not translate to improved health in newborns. And when it comes to detecting cases of Down’s syndrome, traditional screening by ultrasound and maternal age is just as effective as the more costly method of blood serum screening.

The results of this study, conducted on over 57,000 women, show that those who received the most amount of prenatal care by their physicians had the worst pregnancy outcomes and the highest rate of cesarean sections and induced labor.

—Gissler M, Hemminki E, Amount of antenatal care and infant outcome. Eur J Obstet Gynecol Reprod Biol 1994 Jul; 56(1):9-14.

The results of this study show that the introduction of a new program of prenatal care consisting of an average of 2.7 fewer than usual prenatal visits was associated with maternal and infant outcomes that were similar to those of women receiving standard number of prenatal visits.

—McDuffie RS Jr, Beck A, Bischoff K, Cross J, Orleans M, Effect of frequency of prenatal care visits on perinatal outcome among low-risk women. A randomized controlled trial. JAMA 1996 Mar 20; 275(11):847-51.

This randomized study, conducted on approximately 16,000 women in Zimbabwe, evaluated the effects of a new prenatal program for pregnant women consisting of fewer physician visits (an average of 4 instead of 6 visits), and fewer medical procedures per visit, on maternal and infant outcomes. Women who received less prenatal visits and less medical procedures had significantly lower risk of delivering preterm babies and of experiencing severe hypertension and eclampsia. Other outcomes were similar in the two groups.

—Munjanja SP, Lindmark G, Nystrom L, Randomised controlled trial of a reduced-visits programme of antenatal care in Harare, Zimbabwe. Lancet 1996 Aug 10; 348(9024):364-9.

The results of this study show that routine ultrasound screening during pregnancy is not associated with improved newborn health. The study was conducted on 15,151 low-risk pregnant women randomized into two groups. Women in the first group received two ultrasound tests during their pregnancy, those in the second group received an ultrasound scan only if their doctor saw a specific medical need for the exam. No differences in perinatal outcome were detected between the two groups, indicating that routine ultrasound screening in low-risk women may increase health care costs without improving the health of women and their newborns.

—Ewigman BG, Crane JP, Frigoletto FD, LeFevre ML, Bain RP, McNellis D, Effect of prenatal ultrasound screening on perinatal outcome. RADIUS Study Group. N Engl J Med 1993 Sep 16; 329(12):821-7.

The results of this study show that routine ultrasonographic screening in low-risk pregnant women is not associated with higher rates of abortion for congenital anomalies or with improved health outcomes of infants born with treatable malformations.

—Crane JP, et al., A randomized trial of prenatal ultrasonographic screening: impact on the detection, management, and outcome of anomalous fetuses. The RADIUS Study Group. Am J Obstet Gynecol 1994 Aug; 171(2):392-9.

The results of this study show that blood serum screening, introduced as the most effective screening method for Down’s syndrome since 1993, is no more effective than traditional screening by ultrasound and maternal age at detecting cases of Down’s syndrome, and is significantly more costly. The retrospective study was conducted on all women who gave birth at one institution in the period 1993 to 1998. Overall, there were 31,259 deliveries, including 53 cases of Down’s syndrome. The traditional method of screening using maternal age in combination with ultrasound scans detected 68% cases of Down’s syndrome, corresponding to the same effectiveness of screening through blood markers. Traditional screening has been replaced by blood screening based on the unverified assumption that traditional screening could only detect one-third of Down’s cases. This study, however, demonstrates that the benefits of blood screening may be much less than supposed, and undermines the costs-benefit arguments for it.

—DT Howe, et al., Six year survey of screening for Down’s syndrome by maternal age and mid-trimester ultrasound scans. BMJ 2000; 320:606-610 (4 March).