The AMA has adopted three new resolutions concerning home birth and midwifery care. Resolutions 204 and 239 attack home birth midwives, with 239 coming as a direct response to recent legislation in Massachusetts. Resolution 205 condemns home birth, regardless of who provides it, and makes clear that the hope and intent of the AMA is to outlaw the practice:

“RESOLVED, That our AMA develop model legislation in support of the concept that the safest setting for labor, delivery, and the immediate post-partum period is in the hospital…”

The Big Push For Midwives has put out a press release in response to the AMA resolutions.

“It’s unclear what penalties the AMA will seek to impose on women who choose to give birth at home, either for religious, cultural or financial reasons—or just because they didn’t make it to the hospital in time,” said Susan Jenkins, Legal Counsel for The Big Push for Midwives 2008 campaign. “What we do know, however, is that any state that enacts such a law will immediately find itself in court, since a law dictating where a woman must give birth would be a clear violation of fundamental rights to privacy and other freedoms currently protected by the U.S. Constitution.”

The Big Push press release also notes: “The resolution did not offer any science-based information for the AMA’s anti-midwife or anti-home birth position.”

Indeed, the AMA is following ACOG’s lead in ignoring and discounting the growing body of scientific evidence for the safety of planned home birth with a trained midwife for women with low-risk pregnancies and the excellent outcomes achieved by Certified Professional Midwives. They are also out of step with their colleagues in other countries where midwives providing home birth are a seemlessly integrated part of the health care system. RCOG – the Royal College of Obstetricians and Gynecologists, which is the British equivalent of ACOG – supports the increased provision of the home birth option for women, in
a joint statement with the College of Midwives which begins:

“The Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) support home birth for women with uncomplicated pregnancies. There is no reason why home birth should not be offered to women at low risk of complications and it may confer considerable benefits for them and their families. There is ample evidence showing that labouring at home increases a woman’s likelihood of a birth that is both satisfying and safe, with implications for her health and that of her baby.”

Using the same body of scientific information, why do the British doctors come to the conclusion that home birth with a midwife is a safe choice with “considerable benefits” while the American doctors decide it should be outlawed? A possible answer comes from the Big Push Press Release:

“Maternity care is a multi-billion dollar industry in the United States,” said Steff Hedenkamp, Communications Coordinator for The Big Push for Midwives. “So it’s no surprise to see the AMA join the American College of Obstetricians and Gynecologists in its ongoing fight to corner the market and ensure that the only midwives able to practice legally are hospital-based midwives forced to practice under physician control. I will say, though, that I’m shocked to learn that the AMA is taking this turf battle to the next level by setting th stage for outlawing home birth itself—a direct attack on those families who choose home birth, who could be subject to criminal prosecution if the AMA has its way.”