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ACOG's new statement on home birth (x-posted)  

post #1 of 23
Thread Starter 
I really apologize if this has already been posted, and I posted the copyright stuff so I hope it doesn't violate the UA. I am dying for some opinions, and am still stewing about mine (will post later)

ACOG NEWS RELEASE


For Release:
February 6, 2008

Contact:
ACOG Office of Communications
(202) 484-3321

communications@acog.org

ACOG Statement on Home Births

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.

# # #

The American College of Obstetricians and Gynecologists is the national medical organization representing over 52,000 members who provide health care for women.
post #2 of 23
Just ranted about this on the blog (link below) this afternoon.

It makes me angry... trying to think of it as a good thing, though. Maybe they see that the days of technocratic supremacy are on the wane? A gal can hope, right?
post #3 of 23
Wow, I had no idea ACOG was still this back-asswards. That statement is so full of fear and non-sense, and so lacking in evidence or rationale, its rather frightening! It's such a bunch of baloney I'd have to laugh, except all I can think about is how many people will actually buy in to this :Puke

Oh, and last time I checked birth center midwives couldn't perform "live-saving emergency cesarean deliveries and other surgical and medical procedures that would best safeguard the mother and child" either...what makes a birth center so much more acceptable than a home birth (Not that I'm anti-birth center, their arguments just don't hold up to their own reasoning!!)
post #4 of 23
Yes, yes, yes. ARGGHH.

So, I'm so glad they had a task force on the rising c/s rate. Anyone else notice they neglected to mention any RESULTS that have come from that task force?

Oh, and the fear-mongering sure is tiresome, isn't it? Wow. That's takes up so much energy, they must all be exhausted.

To assume that every homebirth advocate and every midwife and every homebirthing mother is so negligent to not care about the welfare of her own baby (or herself) takes the cake.

I never knew so many people could go to school for so many years and still end up so incredibly ignorant.
post #5 of 23
Quote:
Originally Posted by linaee View Post
I never knew so many people could go to school for so many years and still end up so incredibly ignorant.
no kidding!
post #6 of 23
Quote:
Originally Posted by linaee View Post
Yes, yes, yes. ARGGHH.

So, I'm so glad they had a task force on the rising c/s rate. Anyone else notice they neglected to mention any RESULTS that have come from that task force?

Oh, and the fear-mongering sure is tiresome, isn't it? Wow. That's takes up so much energy, they must all be exhausted.

To assume that every homebirth advocate and every midwife and every homebirthing mother is so negligent to not care about the welfare of her own baby (or herself) takes the cake.

I never knew so many people could go to school for so many years and still end up so incredibly ignorant.
It doesn't sound ignorant to me, more like evil... to blatantly and without regard to the truth, to fear monger like that... unreal!!! It sounds more like they're "going on the warpath" to me... lots of drums banging.... (and I'm part native american and I do not find the above statement offensive to ...uh, me.. or any other na's, thanks) and it pisses me off. That some women will read this and hear "homebirth is scary and irresponsible and it's putting my selfish wishes above having a healthy baby" really really pisses me off..... AGH!
- Jen
post #7 of 23
Thread Starter 
Quote:
Originally Posted by Wittyone View Post
Wow, I had no idea ACOG was still this back-asswards.
This is exactly what got me. I feel like I'm reading something from the Victorian Era or something. There is so much else that I find degrading, and insulting (as an almost-midwife), but I'm so angry I can't even post it coherently. :
post #8 of 23
Is this to retaliate against "the big push"?

This is so sad...
post #9 of 23
Oh.My.Gawd. ohmygod. Oh.My.God. Obviously, we're in Orwell's 1984, right????

I'm not even sure if I can post clearly.

But let's start with this

Quote:
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.
Of course! Clearly all the oldies and the fatties should have c/s because they're (we're ) so high risk! God forbid a woman over 35, or a woman who weighs over 200lbs, push out a baby in their delicate condition! They might become... empowered! They might start questioning authority! We might lose them to those crazy (and unsafe) lay midwives!

Quote:
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.
The hell?!?!?! So, the BMJ study with data from over five THOUSAND births, using over two THOUSAND different midwives, wasn't scientifically rigorous?!?!?!

Quote:
Choosing to deliver a baby at home, however, is to place the process of giving birth over the goal of having a healthy baby.
Right. Riiiiiiight. I mean, OBVIOUSLY, when I got pregnant with my fourth child, my goal was not to have a healthy baby, but to have a homebirth. Clearly having a homebirth was much more important to me than having a healthy baby. Got me there, ACOG. Idiots.

Quote:
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.
Some of the most unneccessary interventions upon women I've seen have been performed by ACNM-certified midwives. When I lived in Yuma, I saw ACNM-certified midwives do AROM, push for pit, cut episiotomies, schedule inductions, and suggest scheduling c-s. So I guess that's why ACOG loves em so much.

Quote:
Childbirth decisions should not be dictated or influenced by what's fashionable, trendy, or the latest cause célèbre.
I follow all the gossip and trends, and for every Ricki Lake and Pam Anderson homebirths, there are 10 Victoria Beckham and Britney Spears scheduling c-s. Off the top of my head I can name multiple celebs who have had c-s: Gwyneth Paltrow, Trista Sutter, Gwen Stefani, Angelina Jolie, Christina Aguilera, Brooke Shields...
post #10 of 23
How has the human race survived? If homebirth is so unsafe and only ACNM-certified or AMCB-certified midwives that collaborate with a physician should attend births, how has the world continued?????????
post #11 of 23
Quote:
Originally Posted by linaee View Post

I never knew so many people could go to school for so many years and still end up so incredibly ignorant.
It's called Educated Beyond One's Intelligence.
post #12 of 23
Like I mentioned on another board I post at...

Does it really surprise us? Of course ACOG doesn't want to support homebirth. If they admitted it was a safe alternative (in their eyes...of course we know it is), more ladies would consider it and take all that money away from the docs and hospitals. Since birth generates so much income for hospitals this isn't something ACOG will ever endorse.
post #13 of 23
Wow. Naive little me thought this might be something good, or even vaguely truthful as far as homebirthing goes. What a sucker.

It does, unfortunately, make sense that ACOG would be protecting the best interests of their members (OB GYNS) rather than looking after the well-being of women and their babies. It's really saddening that everything in America comes down to time and money, and anything that bucks those trends is bad or dangerous.

I cannot believe the ignorance and pomposity in this part, particularly:
Quote:
Choosing to deliver a baby at home, however, is to place the process of giving birth over the goal of having a healthy baby.
Gods forbid that a woman would want to have an active part in the birth of her child, rather than preferring to be flat on her back, strapped to all manner of crap, poked, prodded, and yelled at by some a-hole OB because he's cranky at the prospect of being slightly late for the game he has box seats for. And/or being sliced open and her baby being ripped from her innards in an unnecessary C-section because some impatient OB has decided she's 'not progressing.'

How DARE any woman not prefer the above scenarios to having a calm, natural, safe birth in the comfort and familiarity of her own home. Any woman who would put her and her baby's needs above the well-being of the establishment and status-quo is obviously a danger to herself and others.

It is nice that they mention how 'concerned' they are with the prevalence of c-sections, but then completely omit any of their findings. Hmmm... maybe because it would scare the shit out of a lot of pregnant women to find out it's around 20%?!? It scares me.


I found in a Harvard Med women's health newsletter for Sept 2000, a figure from the ACOG's Evaluation of Cesarean Delivery
Quote:
In 1999, the procedure accounted for 22% of the 3.9 million live births in the United States.
post #14 of 23
Quote:
Originally Posted by KristinDoula View Post
It's called Educated Beyond One's Intelligence.
AKA Rising to one's level of incompetence.
post #15 of 23
Quote:
It is nice that they mention how 'concerned' they are with the prevalence of c-sections, but then completely omit any of their findings. Hmmm... maybe because it would scare the shit out of a lot of pregnant women to find out it's around 20%?!? It scares me.
Lorelei-
the cesarean rate is now closer to 30%
Quote:
In December 2007, the National Center for Health Statistics released the preliminary U.S. national cesarean rate for 2006: 31.1%
This is a great link and the childbirth connection in general is a fantastic resource
http://www.childbirthconnection.org/...nk=274&area=27
Mothering actually had an article last summer on Cesareans, http://www.mothering.com/articles/pr...e-of-fear.html



Heather
post #16 of 23
Heather,
I didn't figure it had gone down any. 30% is even more crap-your-drawers scary. Nearly 1/3 of all births in the US are sections? Holy Cow!
And yet homebirth is 'dangerous.' Hmmm... good thing logic doesn't come in to play when organizations issues these types of statements, huh?


Thanks for the good links!
Shai
post #17 of 23
I am not surprised. I definitely think it is in retaliation over "The Business of Being Born." Let's hope the other birth film in the works "Pregnant in America" comes out soon to keep peoples attention on this subject.

If obstetricians and hospitals are so safe, why do countries the most midwives and home-births have the best outcomes?
post #18 of 23
Quote:
Originally Posted by time4another View Post
Lorelei-
the cesarean rate is now closer to 30%

This is a great link and the childbirth connection in general is a fantastic resource
http://www.childbirthconnection.org/...nk=274&area=27
Mothering actually had an article last summer on Cesareans, http://www.mothering.com/articles/pr...e-of-fear.html



Heather

Where I live, the latest is that they are shooting ("projecting") for 50% c/s rate...and building new surgical suites to accommodate. That is why I felt it necessary to organize screenings of BOBB and have Jennifer Block come here. I am so, so excited and everything is coming together.

As to why this press release? IMO, ACOG is very threatened and once people find more out about this film (it has just added a TON of screenings and releases in more theaters), they actually *might* start to ask questions. *GASP*

However will the OB's manage if their patients start asking questions during their 5-10 minute office visits? They might have to go see the film and read "Pushed" so that they have *answers*!

Ahhhh...it feels good to let it all out.
post #19 of 23
The Association of Sleepwear Manufacturers reiterates its long-standing opposition to nude sleeping.
post #20 of 23
Thread Starter 
Quote:
Originally Posted by pigpokey View Post
The Association of Sleepwear Manufacturers reiterates its long-standing opposition to nude sleeping.
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Mothering › Forums › Archives › Birth Professional › ACOG's new statement on home birth (x-posted)