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ACOG statement on home birth - Page 2

post #21 of 42
Interesting that they lumped OOH birth centers in here. Those CNM's who rely on OB's for their birth centers to be legal may now be screwed. I would expect some backlash from ACNM, but so far no statement that I can find. And I do think that this statement is in direct response to the BJM published CPM study.
post #22 of 42
Quote:
Originally Posted by gemasita View Post
So back-up OBs have to go against ACOG, right? That is sad for so many midwives.
EXACTLY.
post #23 of 42

but what can we do about it?

I suggest that we take this opportunity not to rant and rave like the righteously angry women that we are, thus giving them the opportunity to dismiss us, but be calm and rational and send communication to ACOG respectfully requesting that until such time as they do get "convincing" evidence on the safety or unsafety of homebirth that they decline having an "official statement of policy" because to do so would be to make an uninformed conclusion that they themselves admit they have no basis on which to make.
post #24 of 42
Yea, well, maybe when they come up with a set procedure other than the fact it is completely 100% OK not to inform a patient about a potential pregnancy complication I will believe this.

After my daughter's stillbirth, and the fact that 1) They completely failed to inform my husband and myself of the fact she had a 2 vessel cord; and 2) the fact that given my history of very fast labor they allowed me to walk around for 3+ weeks breech with the "we will see what happens when you go into labor" is perfectly acceptable standard of practice, I have decided from now on I will 100% be homebirth. That I no longer trust a medical professional with my care or my child's care.
post #25 of 42
Thread Starter 
Quote:
Originally Posted by mom2seven View Post
Interesting that they lumped OOH birth centers in here. Those CNM's who rely on OB's for their birth centers to be legal may now be screwed. I would expect some backlash from ACNM, but so far no statement that I can find. And I do think that this statement is in direct response to the BJM published CPM study.
ACNM is preparing a statement, it hasn't been released yet. They are trying to team with other associations like the APHA to strengthen the response. I will suggest that the AABC be approached, too. I think you are absolutely right that FSBC's are at risk here as well.
post #26 of 42
Quote:
Originally Posted by Ruthla View Post
Gee, is anybody surprised here? Like they'd ever admit that they're not needed at births, and women are perfectly safe without them?

I like how they phrased the scientific studies: not "studies have been done that prove hospital birth is safer" but rather " We don't like the studies that show out of hospital births are safer, so we'll just phrase that to say you can't prove out-of-hospital births are safe."
Have you guys seen the movie/read the book Thank You for Smoking ? Even though it's fictional (based on life) it provided interesting insight into the workings of such interest groups as ACOG.

Quote:
Originally Posted by Marilyn82 View Post
Here is what I want to know...why does the ACOG think they have the right to make blanket statements regarding the safety of birth and set standards for maternity care? The ACOG is a TRADE UNION, people! That's it...why on earth do they think they are the end-all and be-all for all practitioners, hospitals, etc??? UGH!
Because anyone can make blanket statements. They say "look we're doctors this is what we say". Most people aren't going to question it. Heck, I even use most doctor organization statements as jumping off points (but that's all)

Quote:
Originally Posted by nurnur View Post
Oh and they forgot to mention....that with all their wonderful technology the U.S. is ranked 29th in the world in maternal mortality (WHO 2000), and 27th in Infant Mortality (U.S. Dept. of Health and Human Services 2004). Of course they have fancy words to explain that aways too. Ya, that's the care that seems safest to me....
Here here! I just LOOOOOVe how no OB care people ever point that out. That data is available thru Mothers’ Index and State of the World’s Mothers 2006 report too, but the way the healthy mother initiative thing is written you see how dangerous birth *can* be, but you have to really dig and think to discover that the US is pitiful compared to most other developed nations. We need an indepth report exclusive of developed nations to really advance and streamline women's care. The healthy mother initiatve is great for what it does, but it won't help us.
http://www.savethechildren.org/publi...2006_final.pdf
We get ranked #10 tied with the UK because they take into account the following:
lifetime risk of maternal mortality
percent of women using modern contraception
percent of births attended by skilled personnel
percent of pregnant women with anemia
adult female literacy rate
participation of women in national government

infant mortality rate
gross primary enrollment rate
percent of population with access to safe water, and
percent of children under age 5 suffering from moderate to severe nutritional wasting

Emphasis mine- our ranking of perinatal safety is skewed )

Quote:
Originally Posted by BeckiCNM View Post
ACNM is preparing a statement, it hasn't been released yet. They are trying to team with other associations like the APHA to strengthen the response. I will suggest that the AABC be approached, too. I think you are absolutely right that FSBC's are at risk here as well.
Can't wait to read it!
post #27 of 42
yeah yeah, the world wrong and the ACOG is right, they are as non partisan as the FDA :

How many hospitals are actually equiped to perform a section within minutes? Hm?
post #28 of 42
Becki--Do you know if the ACNM has been working with NARM on preparingn their response to the statement?

Katie Prown
Legislative Chair
Wisconsin Guild of Midwives
post #29 of 42
That is just so sad!!!!

Here in Canada we pay taxes to cover healthcare and the government covers the care of a midwife...and they are allowed to have homebirths (with certain restrictions and guidelines).

Our government and OB's seem to feel homebirth is perfectly safe....

The only reason OB's in the U.S are against birthing outside a hospital is because they cannot profit from it.....they don't really give a care about women/infant healthcare....if they did they wouldn't give the poor care that they do during normal childbirth....

Our government regulates how many midwives are able to work....therefore they can stack the deck in favour of OB's and clients (our OB's had to many clients to handle anyways...so, the few that go to midwives actually helps them)...we also have certain restictions and once a mom fits into a certain criteria she has to be taken over under OB care...

I love the way our system works (except for the restrictions on homebirths/midwives...which is why I went unassisted)...but, just like in the U.S...it really does feel like OB's run the show...



~Charlene~
post #30 of 42
Quote:
requesting that until such time as they do get "convincing" evidence on the safety or unsafety of homebirth that they decline having an "official statement of policy" because to do so would be to make an uninformed conclusion that they themselves admit they have no basis on which to make.
Wow, that is powerful. And right on!
post #31 of 42
Yeah, if word got out that OBs were not necessary for normal birth, they'd be out of a job.



Thanks, but I'll stay at home.
post #32 of 42

ACOG statement on home birth

First--it doesn't matter what the statistics are or the studies show, mothers still have the right to decide where and with whom they give birth, (and of course they are wrong about the evidence)
and second--it's time for Moms to get really mad again. The problem is that the midwives are mostly carrying the political ball here, and we are busy midwifing! Moms have their babies and wander off to mother--til their next baby.
Third--its so very clever of them to not say you can't have your baby out of hospital--just that they will nail anyone who tries to help you. But they are SO worried about your safety.
fourth--you can have an on-demand section tho--I guess there's great research --no--rigorous research to support that?
af
Kip
www.greenhousebirthcenter.com
post #33 of 42
Kip, it is so great to see you on MDC!
A voice of reason and long experience.
post #34 of 42
Thread Starter 
Quote:
Originally Posted by kprown@mac.com View Post
Becki--Do you know if the ACNM has been working with NARM on preparingn their response to the statement?

Katie Prown
Legislative Chair
Wisconsin Guild of Midwives
From what I'm hearing, both MANA and AABC have been involved.
post #35 of 42
I think my favorite part of the statment is this:

Quote*****
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.
*****

Well duh! We set the standard of care, and we have a duty to protect those hospitals that pay us big $$ for licensing OUR standard of care!

ACOG is trying to protect it's own interests in licensing their "standard" as well as protect the doctors who are members. Not to mention, taking aim at the insurance companies, some of which DO reimburse for midwifery care.
post #36 of 42
I haven't read the other posts, so sorry if I'm repeating, but this is what I see when I read that statement:

Quote:
We at ACOG know that if you choose to birth at home or in unaffiliated birth centers, we will lose money on the interventions and C-sections you would be pressured to have. We want to encourage you to birth in hospitals so we can continue to get as much money as we can.
If that's not a conflict of interest, I don't know what is!
post #37 of 42
As a mama that had a (overall good experience with midwife-attended) hospital birth with my first, and is now planning on a FSBC birth with #2, what can I do to help? I'd love to have a homebirth one day, but the FSBC route was the best for us this time around for financial and other reasons.

Who do I have weight with? Who do I write? Our FSBC is well loved in the community, and the thought of that option not being available makes me want to cry for all of the women like myself that for various reasons need that option avaiable, as well as the option of homebirth.

I love to advocate, to write letters...I just want to know where to direct my energy most effectively at present (I'll be 37 weeks pregnant tomorrow so I'm running out of energy LOL).

Please let those of us that would like to speak up for our midwives and our choices know where to best direct our efforts, please.
post #38 of 42
Grrrrr.....:

Even if it were "safer" to be in a hospital, that is not the ONLY concern with women like me who choose to homebirth!!
post #39 of 42
Check out the OBGYN.net forum for the discussion on it. There is a doctor who assisted in the verbage and doesn't much enjoy being challenged on his "feeling" that this is correct but dismisses other opinions that might be "emotionally" based. Ha! His feeling is not an emotion apparently.

If you need a link to it, PM me I don't want to violate the link-up rule to another forum.
post #40 of 42
Quote:
Originally Posted by metromidwife View Post
Check out the OBGYN.net forum for the discussion on it. There is a doctor who assisted in the verbage and doesn't much enjoy being challenged on his "feeling" that this is correct but dismisses other opinions that might be "emotionally" based. Ha! His feeling is not an emotion apparently.

If you need a link to it, PM me I don't want to violate the link-up rule to another forum.
Ok, I feel a lot more enlightend now. One of the policy authors is from my home state where we came dangerously close to passing a bill legalizing DEM's last year. He states that this new policy is in response to such initiatives. Got it. I'm guessing next year they are hoping this will silence those OB's who embarassed the AMA by testifying in favor of the bill last year. Very nice.

OK, just since this has me so down, want a laugh? The AMA sent a professional lobbyist to testify against the bill. After issuing all these dire predictions of dead babies, dead mothers, and so on....

A committee member said 'Do you have any studies to support these contentions?'

Silence.

"Um, no."

"Thank you, that will be all."

I can only hope that the legislators will be that sharp in the upcoming session!
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