An ordinary extraordinary day in a young boy’s life. Wake up. Go downstairs. Meet freshly born little brother. Ask what’s for breakfast.
The Sunday Photo Album is a regular feature of the Safe Birth Blog. If you would like to submit a picture, please email soracolvin@gmail.com.
The Columbus chapter of Ohio Families for Safe Birth is at Columbus’s Community Festival this weekend (Friday, Saturday, and Sunday, June 27-29) handing out flyers and signing up supporters of our legislative campaign for legal out-of-hospital childbirth options in Ohio. If you’re going to be there, look for them at the CHOICE booth. Hopefully we’ll get some pictures and a report next week!
We may have some work to do before we’re a household name, but Ohio Families for Safe Birth is working hard to get the word out about our mission and activities. Thanks to Melissa Lewis – who is also the photographer responsible for our beautiful header and index page pictures – OFSB is now on MySpace, and Krista Cornish Scott has set up a Facebook group for us. If you’re already a MySpace or Facebook user, link us, please!
In a recent press release from The Big Push for Midwives, Susan Jenkins was quoted as follows: “Unfortunately, when it comes to legislation, money talks, and the AMA has a lot of money. Some even go so far as to say Big Medicine is the new Big Tobacco.”
Consumers and midwives aren’t the only ones concerned by this apt comparison. An increasing number of physicians are making their objections heard. They want the American College of Obstetricians and Gynecologists, the American Medical Association, and the public to know that the positions of their professional organizations do not represent either their own beliefs or the best interests of their patients. Many of these doctors have experience with home birth families and cordial working relationships with home birth midwives. They know first-hand that the AMA and ACOG’s representation of home birth and professional midwifery care does not match the reality.
Dr. Daniel Bowen, OB/GYN and founder of Ohio Physicians for Midwives (OPfM), writes, “As an obstetrician, I have been working with families who have chosen home birth since I started into private practice in 1993. The fears expressed in the latest ACOG position paper on home birth are unfounded and I can assure the medical community that these families are not a fringe element choosing that which is “fashionable, trendy or a cause celebre’.” This is an intelligent, thoughtful and well-read clientele. They are doctors, nurses, business executives, artists, musicians and, yes, even lawyers. Home birth families cannot be simply painted with one brush.”
California OB/GYN Stuart Fischbein has written a pointed letter to ACOG, detailing his concerns about their position statement and the resulting AMA resolution. With his kind permission, we’ve posted it on the Ohio Physicians for Midwives website, here. Those who claim that the AMA resolution isn’t really trying to outlaw home birth should consider Dr. Fischbein’s reminder of the consequences of ACOG’s change of position on VBAC. Thanks to ACOG, it is now near-impossible for a mother to have a VBAC in many U.S. hospitals – even without the “model legislation” that the AMA has promised to develop “in support of the concept” that all women should give birth in the hospital.
Denise Plunger is a family practice doctor in Florida. She’s also a board certified lactation consultant, the author of a parenting book, and a mother of three sons, the youngest of whom was a planned home breech birth. Her blog, Permission to Mother, has addressed the ACOG statement and she also recently shared her feelings about the AMA.
If you know a doctor who supports informed consent, evidence-based practice, and freedom of choice of birth place and care provider, why not ask him or her to join OPfM? As more doctors speak up, maybe Big Medicine will get the message: the public doesn’t need to be “protected” from home birth. Far from being a major cause of the critical problems in modern American maternity care, midwives are part of the solution.
Certified Professional Midwives are now free to practice in Missouri. Check out the Friends of Missouri Midwives’ press release with details about their Missouri State Supreme Court victory reinstating the law which physicians organizations challenged last summer. The Court ruled today that the Missouri State Medical Association and its co-plaintiffs “have no standing to challenge the constitutional validity of section 376.1753, and for that reason, the judgment is reversed.”
The Citizens for Midwifery blog links to a petition opposing the American Medical Association’s resolution. Here is the text of the petition:(click here to sign)
Whereas, women maintain the basic human rights of privacy, bodily integrity, and the rights to choose their care provider and place of birth;
Whereas, the practice of giving birth in hospitals attended by doctors has coincided with rapidly rising rates of cesarean section, induction, epidural, and surgically assisted vaginal birth;
Whereas, many of the physicians attending births in the hospital setting have contributed to the rise of the use of the aforementioned interventions, and have been unable or unwilling to change their training and practices to reverse these trends;
Whereas, the American Medical Association and the American College of Obstetricians and Gynecologists’ positions against home birth are not based on scientific evidence, but on the financial and professional concerns of the physicians that participate in their organizations;
Whereas, for the past century certain physicians have carried out campaigns to eradicate the practice of home birth to support their own professional gain;
Whereas, home birth with either a Certified Nurse Midwife or a Certified Professional Midwife in attendance is scientifically proven to have outcomes equal to or better than hospital birth with fewer interventions and higher levels of satisfaction;
Resolved, that the undersigned concerned citizens object to any legislation, either at the state or national level, which restricts a woman’s right to choose her place to give birth, including her right to choose to birth at home.
And here is the text of AMA’s “resolution 205″, supporting this statement from ACOG. The AMA has apparently now voted to remove the reference to Ricki Lake which was pounced on with delight by the media.
AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES
Resolution: 205
(A-08)
Introduced by: American College of Obstetricians and Gynecologists
Subject: Home Deliveries
Referred to: Reference Committee B
(Craig W. Anderson, MD, Chair)
Whereas, Twenty-one states currently license midwives to attend home births, all using the certified professional midwife (CPM) credential (CPM or “lay” midwives), not the certified midwives (CM) credential which both the American College of Obstetricians and Gynecologists (ACOG) and American College of Nurse Midwives (ACNM) recognize ; and
Whereas, There has been much attention in the media by celebrities having home deliveries, with recent Today Show headings such as “Ricki Lake takes on baby birthing industry: Actress and former talk show host shares her at-home delivery in new film” ; and
Whereas, An apparently uncomplicated pregnancy or delivery can quickly become very complicated in the setting of maternal hemorrhage, shoulder dystocia, eclampsia or other obstetric emergencies, necessitating the need for rigorous standards, appropriate oversight of obstetric providers, and the availability of emergency care, for the health of both the mother and the baby during a delivery; therefore be it
RESOLVED, That our American Medical Association support the recent American College of Obstetricians and Gynecologists (ACOG) statement that “the safest setting for labor, delivery, and the immediate post-partum period is in the hospital, or a birthing center within a hospital complex, that meets 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” (New HOD Policy); and be it further
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, or a birthing center within a hospital complex, that meets standards jointly outlined by the 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.” (Directive to Take Action)
Fiscal Note: Implement accordingly at estimated staff cost of $1,929.
Jennifer Block’s Pushed Birth weblog has printed two scathing responses to the American Medical Association’s anti-home birth resolution. The AMA and American College of Obstetricians and Gynecologists (ACOG) bias against autonomous midwifery and home birth is not shared by their colleagues in Canada and Great Britain, both of which have better maternal / child health outcomes than the United States. In both countries, midwifery care and the provision of home birth services is an integrated part of the health care system.
The first response is from Canadian researcher and physician Andrew Kotaska, who specializes in rural maternity care. He “invites ACOG to join the rest of us in the 21st century” and declares, “If ACOG and the AMA are passive-aggressively trying to coerce women into having hospital births by trying to legally prevent the option of homebirth, then their actions are a frontal assault on women’s autonomy and patient-centered care.”
The second response is from Britain’s National Childbirth Trust (NCT) and Independent Midwives’ Association (IMA). Their statement reads, “The NCT and IMA call on the ACOG to reconsider their position as a matter of urgency. Following the example of its international counterparts it should consider all available evidence on the benefits and risks of home birth… Home birth should be considered a mainstream option and offered as a regular choice for pregnant women using the health service, whichever country they reside in. For a healthy woman with a straightforward, low-risk pregnancy, home birth is a safe option… The views of the NCT and IMA are supported by UK Government policy which seeks to reduce unnecessary interventions in childbirth and increase the numbers of women who experience a normal birth.”
The AMA has
“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.”
Here is a story of another Ohio mother who is planning to leave the state to give birth. She writes, “we weighed our options and decided that it was important enough to us to have another homebirth with legally acceptable help.” She and her family are driving to a friend’s home in California to await labor and will then return to Ohio with their newborn.
A few months ago, one of the OFSB board members made a similar decision, although she did not travel across quite so many states. Like the family driving to California, she had recently moved from a state with licensed midwives to Ohio and returned there to give birth.
There is no way of knowing how many Ohio families give birth out of state because of the dearth of legal home birth care providers here, but with two confirmed cases so far this year, it is not unreasonable to assume that there have been and will be others. These are babies who would almost certainly have been born here in Ohio if there were licensed midwives to attend their births.
For a mother to leave her home and community, often for several weeks, in late pregnancy, is a stress on the family. For many families, it means a separation as the husband cannot take weeks off work. These mothers feel that giving birth with a legal, licensed midwife is a better, safer option for them than either a hospital birth or an underground home birth in their own community, bu to get it, they have to give up the physiological advantage of giving birth in their own home.