We assume that hospital policies, standard procedures, and medical recommendations are built on the latest, most rigorous scientific evidence—but they’re not.

In fact, a shocking amount of maternity care is NOT based on high-quality research.

💡 One major study found that only 10-20% of obstetric practices are actually supported by high-level evidence.

That means up to 90% of what’s done in maternity care isn’t based on strong science—it’s based on tradition, habit, and policy.

Let’s break this down.

📊 The Numbers: How Much of Maternity Care is Based on Evidence?

A review of medical practices found that:

❌ 50% of standard maternity care practices have NO solid evidence to support them

❌ 20-30% of maternity interventions are known to be harmful or ineffective—yet still widely used.

❌ Only around 10% of what happens in maternity care is backed by high-quality, proven evidence.

🚨 Let that sink in: HALF of what is done in maternity wards has no strong evidence behind it, and a significant chunk is actually known to cause harm.

Yet these same policies are presented to women as though they are unquestionable medical truths.

So why does this happen?

⛔ Why the System Doesn’t Always Follow the Science

1️⃣ Hospital Policies Are Based on Risk Management, Not Physiology

Hospitals prioritise protocols that reduce their liability, even if they aren’t in the mother’s best interest.
Example: Time limits on labour exist not because they’re based on evidence, but because hospitals want to prevent legal risks and bed shortages.

2️⃣ Routine Practices Become “Normal” (Even When They Shouldn’t Be)

Many interventions were introduced decades ago and are still used just because “that’s how it’s always been done.”
Example: Continuous fetal monitoring has been shown to increase C-section rates without improving outcomes—yet it’s still standard practice in many hospitals.

3️⃣ Research Takes DECADES to Change Policy

Even when new studies prove a practice is outdated or harmful, it can take 15-20 years for hospitals to update their protocols.
Example: Routine episiotomies were once thought to be beneficial, but research has proven they cause more harm than good. It took decades for this to be widely acknowledged.

⚠️ Common Maternity Practices That Aren’t Evidence-Based

Here are a few routine interventions that don’t have strong evidence to back them up:

🚨 Inducing “Overdue” Pregnancies at 41 Weeks

The 40-week due date is an estimate, not an expiration date—and research shows that many babies aren’t ready until 42 weeks.
Yet, women are often told induction is “necessary” with little discussion about risks vs. benefits.

🚨 Routine Continuous Fetal Monitoring

Studies show it increases C-sections without improving outcomes for babies.
Intermittent monitoring is just as effective for most pregnancies but is rarely encouraged.

🚨 Lying on Your Back to Give Birth

This position narrows the pelvis and makes pushing harder, yet it’s still standard in many hospitals because it’s more convenient for staff.
Research supports upright, forward-leaning, or side-lying positions for better outcomes.

🚨 Immediate Cord Clamping

Babies are routinely separated from their placentas within seconds of birth, despite evidence showing that waiting at least 60 seconds improves oxygen levels, iron stores, and brain development.
Delayed cord clamping is the evidence-based approach but is still not standard in many hospitals.

🚨 Telling Women They “Must” Give Birth in Hospital

Research has shown that for low-risk pregnancies, home birth is just as safe as hospital birth—yet many women are led to believe that hospital birth is the only safe option.

💡 If these things aren’t backed by strong evidence, why are they still happening?

🔥 What This Means for You

🚀 If maternity care isn’t always based on science, then how do you know what’s truly necessary vs. what’s just routine?

Here’s the reality:

✔ Just because something is common doesn’t mean it’s best for you.

✔ Just because a doctor recommends something doesn’t mean it’s based on the latest evidence.

✔ Just because a hospital has a policy doesn’t mean you have to follow it.

The system assumes that women won’t question it.

🚀 But what happens when you do?

💡 How to Make Evidence-Based Decisions in Birth

1️⃣ Ask for the EvidenceIf a doctor or midwife recommends an intervention, ask:

💡 “Can you show me the research supporting this?”

Most won’t be able to. Not because they don’t care, but because many just follow protocol without questioning it.

2️⃣ Use the BRAIN Method (A Simple Tool for Making Informed Choices)Before agreeing to anything, ask:

B – What are the Benefits of this intervention?
R – What are the Risks?
A – Are there Alternatives?
I – What does my Intuition say?
N – What happens if we do Nothing?

🚀 This forces the conversation to be about evidence, not just hospital routine.

3️⃣ Know That “Hospital Policy” is Not Law

Guidelines are not rules.
You have the right to decline anything.
You are not legally required to follow hospital policies.

🌿 Reflection for Today

🚀 How much of what you’ve been told about birth have you assumed is based on science?

🚀 Does this change how you feel about hospital recommendations?

🚀 What will you do differently now that you know this?

Tomorrow, we’ll dive into how to balance intuition with medical advice—and how to make decisions you truly feel confident in.

Because birth isn’t just about following policies. It’s about knowing what’s right for YOU.

5.How Much of Maternity Care is Actually Evidence-Based?

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