Promoting evidence based practice in maternal care

doi:10.1136/bmj.324.7343.928

BMJ 2002;324:928-929 ( 20 April )

Editorials

Promoting evidence based practice in maternal care

Would keep the knife away

Papers pp 942, 945

The first 150 words of the full text of this article appear below.

In maternal health care there is a recognised gap between evidence of effectiveness and clinical practice. Indeed, too oftenroutine care is not evidence based and there is strong resistanceto stopping harmful or useless procedures.¹ Unnecessary caesareansection and episiotomy are good examples of the mismatch betweenevidence and practice and of the complexities that change entails,as two articles in this issue illustrate. ² ³

Unnecessary caesarean section is known to increase health risks for both mother and newborn child and adds burdens to healthcarebudgets. There has been a sustained growth in caesarean sectionrates worldwide that has reached epidemic proportions in LatinAmerica. A combination of factors contributes to this trend: providers'views on the safety of caesarean section,⁴ obstetricians' convenience,⁵and the configuration of healthcare systems.⁶ A fourth elementis patients' demand for surgical delivery, a hotly debated issue,especially inBrazil.

Contrary to anecdotal evidence that . . . [Full text of this article]

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Rapid Responses:

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