‘Labor guides’ can help combat pregnancy misinformation, study shows

“What we found with this study was when patients have that autonomy and have that empowerment, they end up doing better.” 

— Dr. Samuel Melville, resident physician at Oregon Health & Science University

By Sofia Resnick / Stateline

Providing “labor guides” to pregnant women helps combat misinformation that an increasing number of patients are getting from social media or artificial intelligence, according to a recent study.

Dr. Samuel Melville, a resident-physician in obstetrics and gynecology at Oregon Health & Science University and the lead author of the study, said he frequently hears patients quoting social media or AI when resisting medical interventions, such as inducing labor with medication.

The study, published in the Society for Maternal-Fetal Medicine’s journal Pregnancy, found that in a group of about 200 patients, those who received the labor guide reported more satisfaction and a sense of control than those who did not receive it. Initial evidence also showed a potential to improve medical outcomes. Melville’s hospital recently made labor guides available to all patients admitted to its labor and delivery unit.

“What we found with this study was when patients have that autonomy and have that empowerment, they end up doing better,” Melville said. “They’re more satisfied in their labor process.”

Melville noted that trust in the medical community is down since the COVID-19 pandemic, something other researchers have also observed around vaccine hesitancy.

He said many patients falsely believe any kind of intervention will make it more likely they will have to have a cesarean section, major surgery that comes with more risks. But he and his colleagues try to reduce the need for C-sections, he said.

“There’s been a lot of people on social media with limited experience in obstetrics who are counseling folks to not get evidence-based things in their labor to avoid being induced, even when it’s for medically indicated reasons,” said Melville, noting conditions like hypertension and gestational diabetes can precipitate the need for certain interventions. “And those things can oftentimes make patients very hesitant to accept treatment or evidence-based practices.”

Melville believes the guides have the potential to be revolutionary, for his practice and nationwide if other hospitals adopt similar practices. In the group that got the labor guides, women had a higher rate of vaginal delivery, which corresponded with lower blood loss and better neonatal outcomes.

“Less babies in that group needed resuscitation, which was really exciting,” Melville said, noting the study did not measure the statistical significance of this trend but they will continue to study it as more patients use the labor guides.

He also acknowledged that pregnant patients have valid reasons to be concerned about not being able to consent for medical procedures, some that are based in history. The credited inventor of modern gynecology is J. Marion Sims, who performed gynecological surgeries on enslaved Black women without their permission or pain medication in the 1840s. Much more recently, ProPublica reported, patients have been forced by judges, particularly in Florida, to have C-sections against their will.

Black women especially report racial discrimination and not feeling heard by medical professionals around their labor and birth decisions and have higher rates of complications and deaths nationally.

“As long as human history has been around, we’ve always really oftentimes struggled with consent around the obstetric practice,” Melville said. “I often tell patients when they come in for labor, ‘Our team makes the recommendations, but you make the decisions for your body, and I will never go against the decisions that you make for your body.’ Sometimes my recommendations will be stronger than others.”

Next on our Stories From The States podcast: Plans to rollback roadless rule threatens a New England forest

The federal Roadless Area Conservation Rule has been in place since 2001, but is under threat. In August, U.S. Agriculture Secretary Brooke Rollins announced her agency’s plans to rescind the rule “in its entirety.”

The roadless rule currently prohibits road construction, logging and mining on about 30% of the nearly 200 million acres of land managed by the U.S. Forest Service. The rule mostly applies to forested areas of the West, but a unique area in the White Mountains along the border of Maine and New Hampshire could have its landscape changed.

In Episode 50, Maine Morning Star reporter Kaitlyn Budion discusses the concerns of New England conservationists who think the rollback of the roadless rule would hurt one of the few unbroken stretches of wilderness in New England.