June 2015 – Dr. Neel Shah, Assistant Professor of Obstetrics, Gynaecology and Reproductive Biology at Harvard Medical School, published an article earlier this month opening the discussion about treatment intensity in childbirth in the US.
Dr. Shah’s article stems from the United Kingdom’s National Institute for Health and Care Excellence (NICE) new set of guidelines, published in December 2014, which offer evidence-based advice for the care of pregnant women and babies during labour and immediately after birth. This new set of NICE guidelines concluded that healthy women with straightforward pregnancies are safer to give birth at home, or in a midwife-led birth centre, than at a hospital with the care of an obstetrician.
Shortly after publication of the NICE guidelines, The New England Journal of Medicine invited Dr. Neel Shah to write a response to the advice put forward by NICE. Initially, Dr. Shah started his task with plans to form a rebuttal. However soon after delving further into the issue, he realized that such a rebuttal largely came from flaws in the American system, not the British one.
Dr. Shah’s response and discussion focuses around the questions of intensity of care in childbirth – when are medical interventions necessary? And, are hospitals always the best option for giving birth? He introduces his views, as an American obstetrician, while looking at the NICE guidelines and examples from the UK.
Dr. Shah’s full response, A NICE Delivery – The Cross-Atlantic Divide over Treatment Intensity in Childbirth, was published in June 2015 in The New England Journal of Medicine. A companion piece, Are Hospitals the Safest Place For Healthy Women to Give Birth? An Obstetrician Thinks Twice., released alongside the publication in The New England Journal of Medicine can be found in full online at The Conversation.
Further discussion regarding the topic of care intensity in childbirth in the US has also been presented from the New England Journal of Medicine featured as a webinar and forum discussion with NEJM Group Expert Talk. The full webinar hosted by Joe Elia featuring Dr. Neel Shah, Dr. Kirti Patel, and Dr. Toni Golen, can be viewed online.