Review of obstetric practices: identification of harmful and ineffective methods during labor

Abstract

Introduction: Despite obstetric advances, practices such as routine episiotomy and the early use of oxytocin are still applied without clear evidence, generating unnecessary risks. The literature suggests an evidence-based, woman-centered approach for safer, more humanized births. Reviewing and eliminating ineffective practices is crucial to ensure ethical obstetric care and better maternal and neonatal outcomes. Methodology: This study is a descriptive integrative review that aims to identify harmful and ineffective obstetric practices during labor and their impact on maternal and neonatal health. Using the PICo strategy, 529 articles were analyzed, of which 95 were selected and 8 fully met the established criteria. Results and Discussion: The review indicates that practices such as episiotomy, the use of synthetic oxytocin and the supine position during labor present more risks than benefits, often leading to unnecessary complications. Continuous fetal monitoring and artificial rupture of membranes are also excessive, increasing caesarean section rates and the risk of infection. In addition, practices such as fasting, enema and trichotomy are considered unnecessary. Alternative methods of pain relief should be prioritized to reduce interventions and promote a more humanized birth. Conclusion: It is essential to re-evaluate traditional obstetric practices, such as routine episiotomy and the use of oxytocin, based on scientific evidence. Individualized, woman-centered approaches, such as birth in an upright position and the support of a doula, improve maternal and neonatal outcomes.