Shame On You ACOG and AMA
I was saddened as I read this article from ABC news about ACOG, the AMA, and homebirths. ACOG, the American College of Obstetricians and Gynecologists, has obtained the backing of the AMA for their “Resolution 205″, which basically states (erroneously) that planned home births are not safe. And they’re proposing legislation on this issue.
Medical doctors are a vital part of health care. But they are not the only piece of the puzzle, especially when it comes to childbirth. When a healthy woman has a planned homebirth with a qualified midwife in attendance, the outcomes are just as good as hospital births. With homebirths, the rate of intervention is far lower, maternal satisfaction with the birth process is higher, and the cost is dramatically lower. Several European countries have fantastic outcomes with large numbers of their population choosing homebirth.
Our son was born at home two months ago. His birth was far from easy. I was in continuous labor for 45 hours, and there is no doubt in my mind that had I been in hospital and uneducated about childbirth, our son and I would have been subjected to Pitocin at the very least, and more likely, a c-section. Our midwives were very competent. They checked the baby’s heart rate regularly, and it never faltered. Had there been any indication of an actual medical problem, they would have taken me to a hospital. But a long, painful birth in an of itself is not a medical problem. Unfortunately, ACOG would disagree – they like to impose artificial time frames on a natural process that was never set up around a clock or a doctor’s schedule. For some women, this is fine. For me, it is most certainly not. While I strongly believe that homebirth is a better option for healthy mothers, I would never dream of saying that all healthy women should have to give birth at home. I understand that this is a very personal decision, and that each woman should be able to labor and birth where she is most comfortable, and have access to competent, licensed caregivers, regardless of where she chooses to give birth. It seems that ACOG and the AMA do not want to offer me that same measure of respect. It’s painfully clear that this is a turf war, and the conflict of interest for ACOG and the AMA is glaring like a neon sign. Every woman who chooses to give birth at home with a midwife means one fewer patient for ACOG. That’s pretty much the whole story. Research indicates that safety is not compromised when healthy women choose to give birth at home. And midwives generally don’t accept unhealthy women or high risk pregnancies. So ACOG and the AMA have chosen to take the undeniably sleazy route of hiding their primary interest (money) under the thin disguise of being concerned about the safety of mothers and babies.
Since homebirths are so much less expensive than hospital births (we paid our Colorado-registered midwife $3000 for the birth and all prenatal and postpartum care), you would think that health insurance carriers would have a vested interest in crying foul with regards to Resolution 205. But I guess they would rather pay for hospital births. I find it sad that ACOG is so determined to squeeze every possible dollar out of the birth industry. If Jay and I decide to have another baby, we’ll have another homebirth. And since I would refuse all intervention in a hospital setting anyway, would they really want me in their delivery ward for 45 hours, scaring away all the other patients with my yelling? Maybe they should rethink this…
You ought to know better than to publish something like this. You got lucky, you and your baby made it through alive. Why do you think interventions were created? Because in the bad old days, babies and moms didn’t make it a lot of the time. The outcomes of planned home births only match up with the outcomes of hospital births only if you twist and spin the data like a pretzel. You have to take out moms of certain racial groups, economic and educational status, etc. Then you can get the the magic number you seek, to justify the dangerous activity you are promoting. Don’t even start with the “natural” talk, “natural” will get you infant and maternal mortality of the 1800’s. Does that sound like a good thing or a bad thing? You home-birthers are just control-freaks who don’t trust doctors, and are willing to cut off your nose to spite your face. Pity the poor babies who won’t make it, but would have, if their moms had been in a hospital.
Educated Mom – Your comments are insulting and hurtful, but I’m choosing to respond in the same respectful tone that I wrote the post. I made it very clear in my post that I would never dream of telling other women how or where to birth their babies. I pointed out that this is a very personal decision – my concern with the AMA and ACOG is that they would like to take away my right to have my babies at home, with competent, licensed midwives.
Interventions do help in some circumstances during birth. But in the U.S. we WAY overuse them (that’s why our intervention rate is so much higher than countries in Europe where midwives provide most prenatal care.) Please show me the data you’re referring to when you say “pity the poor babies who won’t make it, but would have, if their moms had been in a hospital.” I don’t believe you’ll be able to find any data that backs up your implication that planned homebirth with a licensed midwife results in higher infant mortality than hospital birth with a doctor.
In the 1800s, people didn’t know about basic things like hand washing. Lots of mothers died from infections caused by a lack of basic hygiene. Your assertation that “natural” childbirth will end up with mortality rates similar to what existed 200 years ago is incorrect. We know vastly more about childbirth, and about disease prevention than we did two centuries ago.
There is a time and a place for medical intervention in childbirth. A mother with medical conditions that threaten her health or that of her baby is not a good candidate for a home birth. Neither is someone who lives far from a hospital and isn’t able to travel to a location nearer a hospital for the birth.
I researched pregnancy and birth for years before I got pregnant. I was highly educated about the history of obstetrics, the use of interventions both here and in other developed countries (many of which have better infant mortality rates than we do), the possible side effects of medications and interventions during birth, and the risks of both home and hospital birth. Our choice to have our baby at home wasn’t because I don’t trust doctors. When my husband injured his knee, we went to the best knee surgeon we could find. But pregnancy isn’t an illness. Had I developed a complication during pregnancy or during delivery, I would have gladly worked with a doctor. But since all the tests I had during my pregnancy indicated that all was well, I chose to have my baby with a midwife instead. At no point did I ever (or would I ever) endanger the health of my child or myself. Call me “lucky” if you like, but I know that I did more research on pregnancy and childbirth than most other women I’ve seen.
You are obviously in support of hospital birthing, and that is fine. Although I believe that home birth is a better option, I would never tell you that it would be a better option for you aswell, or that you should have to have your babies at home. But ACOG and the AMA want to pass legislation that would take away licensed and certified midwives who assist in homebirths. That is what I object to.
Educated Mom:
Thank you for your comment. You make good points. I would love to see your data. If you like, I can also share our data and have you show us how it is twisted. Also, to confirm that I am really talking to “educated” mom, I’d like to request that you share your name and credentials.
The only place I trusted to have my two girls was in the hospital in case something went wrong. But I’m glad I live in a country where I had the options. To make the home births or midwife illegal is not American. educated mom needs to quit telling other people what to do whether she has an education or not.
Educated Mom is almost certainly a medical doctor or associated with the healthcare industry.
Remember, for much of the 1900’s, tens of thousands of totally unnecessary hysterectomies were forced on women because of the greed of the AMA and American medical establishment. Other women’s diseases were shrugged off as “feminine stress” for decades.
Greed and rampant egotism have plagued the Western physician establishment since it was created in the 1800’s. In the 1800’s male doctors in Europe and here in the AMA refused to make hand-washing a standard practice for doctors before delivering babies. Even after it was proven that it saved thousands of babies per year.
After initial evidence that hand washing massively reduced infant mortality, the AMA actually passed a directive to its members NOT to wash hands, causing thousands of additional newborn deaths for YEARS after the scientific proof of the practice was established.
Just Google “puerperal fever” and “Semmelweis”. In 1850 after Dr. Semmelweis in Europe identified that doctors were killing 10% or 20% of newborn babies with the germs on their hands, it took the AMA FIFTY YEARS to acknowledge that simple fact.