My comments in red to this new ACOG statement.
ACOG NEWS RELEASE
For Release: February 6, 2008
Contact: ACOG Office of Communications
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. Monitoring of of both mother and the unborn do occur at home. Complications are more likely to arise following the medical interventions introduced by the medical team in the hospital.
ACOG acknowledges a woman's right to make informed decisions regarding her delivery oh, really... 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. Hospital birth is trendy. Babies have been born at home and in fields with and without midwives long before hospitals and physicians participation in birth. 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. following intervention, that is. 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. Attempting a VBAC, immobile, tied down to monitors and receiving pharmaceuticals is far more dangerous. Surgical birth is almost always more dangerous than vaginal birth. 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. Why won't OBs just cooperate and back up homebirth midwives?
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, What are you doing to reduce it? Nothing that I can see.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 My age has nothing to do with it. Why are young women having so many cesareans, then? , overweight, obesity and diabetes what is ACOG doing to help women with nutrition. NOTHING. Most women tell me their OB never mentioned nutrition except for prescribing vitamins. Most women tell me, I am the first physician to mention pregnancy nutrition and referral to the Brewer Diet.
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 hospitalof course, it does!, or a birthing center (So kind of ACOG to extend their support to a birth 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. Most OBs in America would have not been able to deliver my third son feet first safely in my own bed.
ACOG encourages all pregnant women to get prenatal care and to make a birth plan Most OBS don't look at birth plans. . 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. I'd like to know what ACOG member has attended a homebirth, ever? 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.
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The American College of Obstetricians and Gynecologists is the national medical organization representing over 52,000 members who provide health care for women.
I am so glad I am not an OG/GYN.
More responses from the natural birth community can be read at The True Face of Birth
Wednesday, February 6, 2008
My comments in red to this new ACOG statement.