ACOG Anti-Homebirth Statement!
I posted about this already, but wanted to repost it because it’s just such great fodder for comics ;o)
American College of Obstetricians and Gynocologists Statement on Homebirths
Washington, DC — 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 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).
Childbirth decisions should not be dictated or influenced by what’s fashionable, trendy, or the latest cause célèbre. Despite the rosy picture painted by home birth advocates, a seemingly normal labor and delivery can quickly become life-threatening for both the mother and baby. Attempting a vaginal birth after cesarean (VBAC) at home is especially dangerous because if the uterus ruptures during labor, both the mother and baby face an emergency situation with potentially catastrophic consequences, including death. 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.
Advocates cite the high US cesarean rate as one justification for promoting home births. The cesarean delivery rate has concerned ACOG for the past several decades and ACOG remains committed to reducing it, but there is no scientific way to recommend an ‘ideal’ national cesarean rate as a target goal. In 2000, ACOG issued its Task Force Report Evaluation of Cesarean Delivery to assist physicians and institutions in assessing and reducing, if necessary, their cesarean delivery rates. Multiple factors are responsible for the current cesarean rate, but emerging contributors include maternal choice and the rising tide of high-risk pregnancies due to maternal age, overweight, obesity and diabetes.
The availability of an obstetrician-gynecologist to provide expertise and intervention in an emergency during labor and/or delivery may be life-saving for the mother or newborn and lower the likelihood of a bad outcome. ACOG believes that the safest setting for labor, delivery, and the immediate postpartum period is in the hospital, or a birthing center within a hospital complex, that meets the standards jointly outlined by the American Academy of Pediatrics (AAP) and ACOG, or in a freestanding birthing center that meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers.
It should be emphasized that studies comparing the safety and outcome of births in hospitals with those occurring in other settings in the US are limited and have not been scientifically rigorous. Moreover, lay or other midwives attending to home births are unable to perform live-saving emergency cesarean deliveries and other surgical and medical procedures that would best safeguard the mother and child.
ACOG encourages all pregnant women to get prenatal care and to make a birth plan. The main goal should be a healthy and safe outcome for both mother and baby. Choosing to deliver a baby at home, however, is to place the process of giving birth over the goal of having a healthy baby. For women who choose a midwife to help deliver their baby, it is critical that they choose only ACNM-certified or AMCB-certified midwives that collaborate with a physician to deliver their baby in a hospital, hospital-based birthing center, or properly accredited freestanding birth center.
Now that I’ve reread it, they don’t ’support’ a woman’s right to choice at all, they ‘acknowlege’ it. Making my whole comic sort of nonsensical. So, back to the drawing board! More comics to come!
and my friend Talithat (hi Tawaret!) wrote this…
This just in:
The National Association of Car Washers (NACW) advises all automobile owners that washing a car in one’s own driveway is placing your car at risk. While you may own the car, NACW cannot approve taking cleaning it into your own hands.
We advises all responsible owners of dirty cars to only allow licensed car washers to clean your car and only in licensed car washing facilities. Any other choice is to put both you and the vehicle at greater risk.
hee hee hoooooooo!
Love,
Heather
This Musing is directly related to this Comic Your Choice
This Musing is directly related to this MusingAnti-Homebirth Press Release and Response! And this Comic A Mile Away!
sewathomemama said,
February 15, 2008 @ 12:07 am
that’s alright, they don’t need to support my decision to homebirth. the feeling is mutual, because i don’t support what they do, either. besides, i don’t remember asking them permission to have my baby at home & i damn sure don’t remember giving a f**k what they think about my birth choices!
uberhausfrau said,
February 15, 2008 @ 5:49 am
someone on another board stated (loose quote) eating places one at risk for choking but its ridiculous to expect or require you to have some trained in the heimlich manueveur every time you put something in your mouth.
djinneyah said,
February 15, 2008 @ 9:04 am
meh. they can disapprove all they want. my babies will continue to be born on my living room floor.
the thing that kills me is they give this statement like their disapproval makes it law. how delusional do you have to be?
amyphilo said,
February 15, 2008 @ 10:22 am
This is why when my husband wanted me to go to an OBGYN because they were in network, for my well woman exam, I told him that I completely despise OBs and will never give them any money or business unless I HAVE TO.
I would rather pay an out of network midwife than an in network OB even if it’s 5 times more expensive out of pocket (though I am sure the OB charges the insurance companies out the wazoo).
When I decided to have a sonogram for my second, just to find out if he was going to need pink clothes or could wear his brother’s (I really wanted to go shopping but didn’t get to) they found a low lying placenta and wanted me to come back for follow up. I decided to wait AS LONG AS POSSIBLE into the pregnancy for the follow up to make sure the placenta had moved up higher and I wasn’t going to have to have a c-section for placenta previa. The OB who did the sono seriously tried to scare me by saying that if you are at home and have a home birth and placenta previa you can bleed out in 5 minutes.
I knew she was just trying to scare me so I talked to my midwife and she said there would be signs of that in labor and you would transport. But it was moot since I knew it wasn’t placenta previa anyway.
IMHO OBs just want to scare moms so they can keep their power over us. It doesn’t make for a very peaceful pregnancy or delivery or postpartum period, that’s for sure.
The same is true of hospital nurses and pediatricians with all their scaring you into giving the baby formula for “excessive weight loss” (actually usually caused by their advice, drugs, or the IV making you think the baby was large when really he was overinflated with fluid), scaring you into giving the baby expensive vaccines for which they could triple bill and over charge the insurance company since they are administered in office, etc.
The nurses at my hospital where I delivered Isaac pressured me into letting him go to the nursery for which they charge $700 per night, and he was there for less than 5 hours, and asleep the whole time.
I wonder how much money the pharmaceutical companies, hospitals, and the OBs would lose if everyone had home births or natural vaginal births in the hospital instead of incredibly profitable c-sections which take only an hour.
By the way I saw the Business of Being Born and it was great! If you can all get to a screening you should!
amyphilo said,
February 15, 2008 @ 10:36 am
I think it was Dr. Sears who said that having an OB / hospital birth is like hiring a doctor (surgeon? can’t remember) to babysit your child in case of emergency.
I am sure that our children are in far greater danger with some of the babysitters and caregivers people sometimes hire than they are in our bellies for 43 weeks, or born at home.
It’s so funny that they can talk about complications happening super fast when the complications that happen like that are so incredibly common in hospitals and caused by the interference and overreaction on their part.
Example: pitocin, epidural, continuous electronic fetal monitoring
Gee I wonder why your baby might be in distress
Could it be that you are starving him of oxygen because you would rather have your baby’s birth scheduled / induced / whatever so you can go to the oh-so-safe hospital so you decided to induce and get your hospital birth out of the way because you needed child care?
Pitocin… epidurals… HELLO!!!!! OBs don’t be so freaking stupid!
If you just had your baby at home or waited to go into labor before going to the hospital then a lot fewer of these mommies and babies would be dying.
But OBs don’t tell women that and women don’t seem to want to know.
I have tried to warn SEVERAL pregnant friends about the risks of induction, epidurals, etc. They did not listen. Instead they went along with whatever the doctor wanted. They ended up with c-sections.
I have SEVERAL friends who were told by their OBs: let’s go ahead and induce at 38 weeks (this being the first trimester that they decided this) or Let’s induce at 37 weeks or you won’t be able to have this baby vaginally because it’s going to get too big, your baby is already (fill in the blank) pounds!!!!
I even had one friend deliver a 4 or 5 pound baby who was I think a second c-section. Oh, so good on that timing there.
Let the baby come when the baby is ready!
wiffersnapper said,
February 16, 2008 @ 10:10 am
Talk about doctors and their scare tactics… when our first was born a whole twelve days early (”but first babies are NEVER early!”) they made us leave her in the NICU for an extra six days. During that time she did nothing but lose weight, and, although I stated quite clearly that I was BREASTFEEDING, they insisted that she had to have an IV anyway. Then they proceeded to tell us, during her stay, that she MIGHT have/develop: 1) an infection, 2) jaundice, 3) a bowel obstruction, 4) IUGR, 5) excessive throwing up (like 2 tsp is a lot!), 6) failure to thrive. She never showed any signs of any of those things, and we finally told them that if they wouldn’t willingly release her, we were taking her AMA.
We brought her home and she did nothing but EAT (my milk!) for about two weeks, during which time she put on a half an ounce a day. Tell me they were feeding her enough! Thank God, our regular doctor is a sensible man. He said, when he saw her at one day out of the hospital, “I’m a little concerned about her weight. What are you doing for feeding?” I replied, “I’m letting her nurse whenever she wants.” He said, “Good. Keep doing that, and she’ll be fine.” And, lo and behold, she was, and still is!
Incidentally, total cost for the delivery and care of this baby, who wasn’t even really sick: $30,000. You have to wonder why insurance companies aren’t the ones coming down on hospitals for their unnecessary interventions!
Robyn L. Coburn said,
February 19, 2008 @ 2:26 am
>>>
Here’s the statement that had me reeling!
Apparently the World Health Organization’s target figure of around 10% was not discovered scientifically.
When I was in Bradley birth classes I learnt that 5-10% of pregnancies will have some problem that would genuinely need a cesarian to save the life of mother and/or baby. So I guess that figure was derived from the same science that is part of WHO’s investigation.
Plus let’s talk about grammar for a moment. You don’t need some special “scientific way” to make a recommendation - you can use the same ordinary technology with which you publish a press release. I suppose they mean “there is no science that would support any ideal goal figure”.
Except there is.
sheepdoc said,
February 20, 2008 @ 1:51 pm
According to a lecture by either Ina May Gaskin or Dr. Mardsen Wagner (can’t remeber which) the WHO recommendation of 12-15% was reached very scientifically when Brazil asked WHO for help w/ their skyrocketing (80% plus in private hospitals) c/s rate. The science of 12-15% was based on the USA then current rate and it was impolitical (and financially unpleasant) to put the rate any lower. Dr. Odent, an actual man of science, on his website, lists 7% as the rate above which c/s does more harm than good. Makes sense since most midwives that don’t have to exclude breech, multiple, vbac run at about 4-6% Isn’t it funny how the midwives that don’t work w/ vbac, multiple and breech have c/s rates around 10%.