Wednesday, February 6, 2008

What do you think of this ACOG statement?

ACOG made public today its statement about home birth. Since it's copyrighted, I'm not going to reproduce it; go here to read it in its entirety.

Some tidbits to whet your appetite:

The American College of Obstetricians and Gynecologists (ACOG) reiterates its
long-standing opposition to home births. While childbirth is a normal
physiologic process that most women experience without problems, monitoring of
both the woman and the fetus during labor and delivery in a hospital or
accredited birthing center is essential because complications can arise with
little or no warning even among women with low-risk pregnancies.

...ACOG does not support programs that advocate for, or individuals who provide,
home births.

Unless a woman is in a hospital, an accredited freestanding birthing center, or
a birthing center within a hospital complex, with physicians ready to intervene
quickly if necessary, she puts herself and her baby's health and life at
unnecessary risk.

Choosing to deliver a baby at home, however, is to place the process of
giving birth over the goal of having a healthy baby.

So... tell us what you think!


Michelle said...

When ACOG provides sound statistical evidence that having a baby at a hospital is safer, I will listen. Until then, I will keep supporting a woman's right to choose where and with whom she gives birth. And, speaking of sound evidence, the BMJ published an excellent rigorous study of planned homebirths. The study was conclusive that homebirth is safe.

Michelle Bartlett, IMC Legislative Chair & Vice President

Karin said...

ACOG's utter unwillingness to even consider the option of a homebirth with a CPM tells me how out of touch they are with what families and mothers want. I noticed an interesting trend in the comments on the recent articles in the St. Louis Post-Dispatch. Because of negative experiences in hospital settings with the first birth(s), many families, incuding mine, researched and sought other options for subsequent births. The obstetricians and hospitals are failing our families in providing safe birth experiences for normal, healthy births, stripping mothers of their confidence and desires, while leaving many of us with a negative view of our hospital experiences.

The statistics on safety are out there for anyone to see. The WHO recommends a midwife model of care. Many countries that provide the midwife model of care have much better birth outcomes than we in the US do. I will continue to support the freedom to have the birth experience I want, both for me and for other families in Missouri.

My other objection to ACOG's statement centers around the "support" of birthing centers. Since few, if any, doctors are willing or able to provide backup care, this just isn't an option for the vast majority of families in Missouri. Most obstetricians need to realize that their medical training includes little to no support of natural birth for normal pregnancies and start working together with midwives instead of against them.

Karin Layher, St. Louis mom to 2 (one hospital birth, one homebirth) and expecting number 3 under the care of a licensed, legal homebirth midwife while in Germany for a year

Just me said...

If birthing at home is unsafe, as ACOG claims, then why does the World Health Organization recommend out-of-hospital birth? Why does the American Public Health Association advocate an increase in access to midwifery services? Why is midwifery legal (and sometimes subsidized by the government) in many states and several other countries across the world?
Is ACOG the only voice of reason among the rest of world? I think not.

Kolbi said...

*******ACOG acknowledges a woman's right to make informed decisions regarding her delivery and to have a choice in choosing her health care provider, but ACOG does not support programs that advocate for, or individuals who provide, home births. Nor does ACOG support the provision of care by midwives who are not certified by the American College of Nurse-Midwives (ACNM) or the American Midwifery Certification Board (AMCB).********

Don't many CNMs do homebirths? How can they support them, but not support homebirths? Also what is AMCB? I don't think I've heard of it.

They also mention that their goal is to reduce cesareans, but at the same time they are encouraging scheduled them and not allowing vbacs.

I think it is important to remember that, while many communities never went away from midwife-centered care, most women have gone back to the midwife as a reaction to the failing obstetric model that we have right now. It is not because it is trendy as the article claims. Women were unhappy with the accepted choice and actually started reading the studies that hospitals didn't mention. A little education has gone a long way.

Unknown said...

This "statement" is further evidence that ACOG just doesn't get it. There is nothing about this article that I believe to be accurate. For instance, "monitoring of both the woman and essential"
Well that's what a midwife does!
Do they not know that trained midwives are in fact capable of assessing and responding to an emergency situation?? Have all the OB parties involved in composing this statement ever met a real life midwife? Or have they heard from consumers who choose homebirth because they feel it is the safest place for them to have a healthy mom and baby? "Healthy baby" has a different meaning to me than I suspect is has to 'them.'

Rosa said...

Whatever happened to freedom of choice? Do you assume that we women don't know what is best for our babies and our births? The motherly instinct to care for and protect their baby is very strong. If homebirth was really so much more dangerous than hospital births we would catch on pretty fast, and homebirth would be a thing of the past.
Many of us have been unsatisfied with the obstetric model that is available, and are looking for a better way. A way where we can give birth and it's not just something that is done to us.

Unknown said...

Of course ACOG does not support homebirth. Its members are not trained to be of use in a planned homebirth setting. ACOG physicians are surgeons who may be helpful in "emergency" situations. Their desire and determination to feel appreciated and valued is normal. However, it has little bearing on our responsibility to secure the birthing freedoms that all Missouri families deserve!!!

Mme Prabhakar said...

"Choosing to deliver a baby at home, however, is to place the process of
giving birth over the goal of having a healthy baby."

This statement disturbing. First of all, it should be reformulated: Giving birth in a HOSPITAL is to place the processes of AVOIDING A LAWSUIT AND MAKING LIFE EASIER FOR HOSPITAL STAFF before the comfort and safety of mother and baby.

Lithotomy position. Continuous monitoring. Epidurals. Pitocin induction. Purple pushing. These are routine practices that have been PROVEN to be counterproductive and/or painful to the mother AND BABY in labor and afterward.

Homebirth is not about "selfish" women who care about their experience more than the health of their babies. Homebirth is about HUMAN BEINGS who demand to be treated with respect and with an eye on what scientific evidence clearly states- not what scared docs think will help them avoid lawsuits, or what short-staffed hospitals demand to save time and money. Until the hospital will stop routinely strapping women down on their backs with monitors, IVs, epidurals, catheters and whatever else makes their lives easier at the expense of moms AND BABIES, then I will choose to give birth at home!