Too Much, Too Soon

In this video, Prof Marleen Temmerman will discuss the concept of “too much, too soon” (TMTS), with an example of overuse of caesarean section births. TMTS refers to care provided before, during and after childbirth which can be too much, inappropriate and over-medicalised. TMTS describes overuse of non-evidence-based interventions, as well as overuse of interventions that are lifesaving if practiced appropriately but can cause harm if they are overused or applied routinely.

What are the issues?

• Unnecessary medical interventions (i.e., overuse of episiotomies, medically unnecessary caesarean section)

• Lack of evidence: conflicting recommendations within guidelines on harms and benefits of interventions.

• Unnecessary interventions can be a financial burden to the health system. The cost is exacerbated if the interventions results in unnecessary harm that would require treatment.

What can be done?

• High quality guidelines combined with consistent and proper use within clinical practice worldwide

In the next step we will discuss care which is ‘too little, too late’ which is describing provision of care below evidence-based standards, lacking adequate resources, or care which is unavailable or withheld until it is too late.