Dr. Neel Shah works at Harvard Medical School.
By Raif Karerat
WASHINGTON, DC: Dr. Neel Shah, an obstetrician at Beth Israel Deaconess Medical Center in Boston and assistant professor at Harvard Medical School, believes some women may be better off having their baby in the United Kingdom as opposed to the United States.
In an opinion piece for the esteemed New England Journal of Medicine, Shah claims the majority of women with straightforward pregnancies may be better off across the pond: “… there are harms from doing too much just like there are harms from doing not enough and that’s a big paradigm shift in U.S. health care. Childbirth is one of the biggest illustrations of that: We err on the side of overdoing it and for the healthy majority, we end up causing a lot of harm from overdoing it in the interest of making it safe for the high-risk minority.”
In an interview with WBUR, Boston’s NPR news station, Shah explained that the difference comes down to a cultural difference in comfort with physician led birth compared to midwife-led birth.
“Obstetricians, who are trained to use scalpels and are surrounded by operating rooms, are much more likely than midwives to pick up those scalpels and use them,” he states in his NEJM piece.
“Most pregnant women are young, healthy people and yet we’ve come to a point where one in three women have major abdominal surgery to give birth. Between 1970 and 2010, the C-section rate has gone up 500 percent and it’s the most common surgery performed on human beings. It’s hard to believe that’s all truly necessary,” Shah explained during his interview with WBUR. “And the consequences are pretty severe — 20,000 avoidable complications to young healthy people every year, at a cost of $5 billion.”
At the end of the article, Shah offers little doubt that the United States offers outstanding care for medically complicated pregnancies. However, he does believe there are crucial lessons to be learned from the British system.
“As a U.S. obstetrician, I went from thinking the U.K is nuts to thinking how can we make it safe and convenient to have babies in low intensity settings, including at home,” he told WBUR. “It has totally turned around for me.”