Evidence Based Practice 👀

Nothing chaps my hide more (this is a lie, there might be some things that annoy me more) than evidence based practice being used as a stick to beat birthing people with.

How?

Surely evidence based practice is a good thing?

Well, it is, as the base of a good service provision.

HOWEVER.

Many practitioners think evidence based care is providing care that is fully oriented on research findings without many other considerations.

Like this: ‘Evidence tells us that using individualised growth charts reduce the incidence of stillbirths, so I will be doing your fundal height measurement now.’ ‘You have a BMI over x so I’ll book your GTT as the evidence says you are at increased risk of developing gestational diabetes.’ Etc etc. But please consider, A: these are only offers, B: the discussion for people to make decisions they are ultimately happy with needs to be more complex than this, and simple research findings don’t translate well to individual complex situations. C: Research is not the be all and end all, AND D: very importantly, statistically significant benefits found by research may actually only bring marginal benefits in clinical practice, and quite possibly absolutely none to the individual.

This is why evidence based practice is a WHOLE lot more than regurgitating what the research says.

True evidence based care is made up of three elements, the holy triad if you will 😂

Yes, firstly (though this is not in order of importance) the research! It IS important to be aware of it and to utilise it after appraisal.

Secondly the expertise, education and experience of the caregivers is also important to consider. An obstetrician who has never seen a physiological birth is not the best person to support a homebirth, and a midwife who has worked on an antenatal ward for the last 10 years may not be the most useful when troubleshooting breastfeeding issues.

Lastly, and most definitely not least importantly, we MUST consider and *accommodate* client preferences, values, concerns and expectations to deliver evidence based care. This is non negotiable, but often forgotten. Not doing so is often the reason as to why people feel dissatisfied with their care.

So can we please start incorporating all three pillars of evidence based care. I promise, people will be so much happier!!