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| 11/10/2006 10:35 AM |
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Any comments, Henci?
maria.
ACOG Statement of Policy
As issued by the ACOG Executive Board
OUT-OF-HOSPITAL BIRTHS IN THE UNITED STATES
Labor and delivery is a physiologic process that most women experience
without complications. Ongoing surveillance of the mother and fetus is
essential because serious intrapartum complications may arise with little or
no warning, even in low risk pregnancies. In some of these instances, the
availability of expertise and interventions on .an urgent or emergent basis
may be life-saving for the mother, the fetus or the newborn and may reduce
the likelihood of an adverse outcome. For these reasons, the American
College of Obstetricians and Gynecologists (ACOG) believes that the
hospital, including a birthing center within a hospital complex, that
conforms to the standards outlined by American Academy of Pediatrics and
ACOG,1 is the safest setting for labor, delivery, and the immediate
postpartum period. ACOG also strongly supports providing conditions that
will improve the birthing experience for women and their families without
compromising safety.
Studies comparing the safety and outcome of U.S. births in the hospital with
those occurring in other settings are limited and have not been
scientifically rigorous. The development of well-designed research studies
of sufficient size, prepared in consultation with obstetric departments and
approved by institutional review boards, might clarify the comparative
safety of births in different settings. Until the results of such studies
are convincing, ACOG strongly opposes out-of-hospital births. Although ACOG
acknowledges a woman's right to make informed decisions regarding her
delivery, ACOG does not support programs or individuals that advocate for or
who provide out-of-hospital births.
1American Academy of Pediatrics and /American College of Obstetricians and
Gynecologists. Guidelines for Perinatal Care, 5th Edition. Elk Grove
Village, IL, AAP/ACOG, 2002.
Approved by the Executive Board October 2006
The American College of Obstetricians and Gynecologists 409 12th Street, SW,
PO Box 96920. Washington, DC 20090-6920 Telephone 202 6385577
By: maria |
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| 11/14/2006 7:57 PM |
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We have abundant evidence of the safety of planned home birth with a qualified birth attendant and birth in certified birth centers. Note: Coming soon: Evidence Basis for the CIMS' "Ten Steps to Mother-Friendly Childbirth" will be published in the spring of 2007 and will include definitive evidence that birth at home and in free-standing birth centers results in equally good or better outcomes with much less use of potentially risky medical interventions such as cesarean surgery.
Here's what I think this is about: As the professional organization for obs, ACOG sets the legal standards for obstetric care. This is a sweet deal for them as they are, in effect, setting the guidelines under which they are regulated just as if logging companies and coal companies could write their own regulatory guidelines--oh, wait, they already do that. At any rate, by putting out a document that says that out-of-hospital birth is dangerous and they don't approve, they are hanging home birth midwives and providers of care at out-of-hospital birth centers out to dry along with the few obstetricians still willing to back up out-of-hospital providers. Those midwives and doctors can then be sanctioned in any way regulatory boards or hospital obstetric departments see fit, even subjected to prosecution, and they won't have a leg to stand on in court should something, however unavoidable, go wrong at a birth. At the same time, ACOG is ducking the ethical obligation their obs have to provide back up care to women choosing to birth out of the hospital who develop complications and need obstetric expertise. I didn't think my opinion of ACOG could sink any lower, but somehow they manage to continually exceed expectations.
-- Henci By: Henci Goer |
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| 12/05/2006 10:26 AM |
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How infuriating.
maria. By: maria |
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| 12/08/2006 11:00 PM |
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Fascinating! I hope one of you is going to reply to Amy Tuteur's comment...
In the meantime, many women are so weary of this all that they chose to birth without assistance. For obvious reasons, these women don't want to go to a hospital, especially if they have had a prior c-section, whether there is a CNM or not, and they cannot afford a midwife, if one is even legal in her state. With the industrialization of birth (as someone called it in the blog) the art of midwifery is in danger. I think that even most CNM's in hospitals approach birth in a too medicalized way.
More and more women are now educating themselves about birth. After having had 3 wonderful homebirth myself, this is also the route we followed. We could not afford to pay for my midwife out of pocket again, our insurance did not cover homebirth. I went to see a CNM in a hospital to see if this is what we should then do, but this was such a bad experience, so unreal, that I decided rather quickly that this was not for me. I felt treated as if I really could not know what was best for me because I was not 'the doctor'. Things I said were dismissed (I had been pregnant 5 times before for goodness sake!!!!!!!!!!!!!!!!!!!), my views on birth not respected.
I educated myself even more, educated my husband, and felt comfortable, even called, doing this on my own. I was a solo birther anyway, liking to be left alone, private, so this was not surprising to me, my midwife nor my husband. My midwife supported us and taught us a few things and we called her afterwards for a baby well check.
Eventhough I had had a great midwife with my other births, this one was the best of all (relaxed, peaceful and relatively painless) and I felt I had experienced birth in a way I hadn't before. Food for thought maybe...
maria. By: maria |
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