ACOG requests unsourced anecdotal home birth "data"

This really bothers me. I'm about to give birth to my son in November with no to low intervention and the aid of fantastic midwives at my birthing center. I've often thought about a home birth b/c I want to birth in water. We'll see.

I don't know much about the ACOG, but it definitely smells like money and power. Ugh..frustration, yet of course it isn't surprising

All of my 3 children were born in the hospital, but 2 of them were actually delivered by OB nurses anyway, because the obstetricians weren't waiting IN THE DELIVERY ROOM when the babies were ready to come out. (My family has a history of VERY fast birth experiences.) I probably could have saved money, time, and trouble by having home births with nurse-midwives, but they were technically "high-risk" pregnancies so I suppose hospitals were a requirement.

Ann

Here is a copy of the request from ACOG with the address to report "adverse outcomes" --but where is the address to report favorable outcomes?


ADVERSE OUTCOMES MIDWIFE BIRTHS

p, li, div { margin:0in; margin-bottom:.0001pt;} As you all know, SB 477, a bill to license certified professional midwives to provide
out-of-hospital maternity care services was signed by Gov. Jim Doyle as Act 292 this past year.
Under previous law, only nurse midwives, who work primarily in hospital settings, were eligible for licensure.

The Department of Regulation and Licensing has set up administrative rules to determine policies in granting of licensure, scope of practice and professional conduct.

Generally, many insurers cover midwife care -- provided she is licensed according to state law and works in a hospital or approved birthing center. Not all midwives are certified nurses; those who aren't are sometimes referred to as lay midwives.

Insurance coverage is spottier for those midwives who are not certified nurses, or who assist home birth or otherwise work outside the traditional hospital setting.

The Wisconsin Section would like to document any adverse outcomes that physicians might encounter in their practice by patients who are assisted by professional midwives.

Please send this information to the W/ACOG office to be kept on file for future discussion. Send to: W/ACOG, P.O. Box 636, Pewaukee, WI 53072.


http://www.acog.org/acog_sections/di...&bulletin=1821


Several years ago, a Licensed Midwife in Arizona delivered more babies than BOTH OB/GYNs in the same area did combined....they were furious at her! When she had a transfer, they wouldn't even let her off the elevator--even if the laboring mother requested the LM to stay with her!

I get asked why I don't want to become a doctor. Why I want to be a CNM. This is why - to rearrange a quote -
It's the patient stupid! ACOG needs to remember that these are women and babies not some piece of turf with a dollar bill attached.

It seems apparant that everyone, except maybe ACOG, can plainly see how these actions are based in turf protection, salary protection, and cronyism. They continue to deserve the wooden spoon. After my tenure in L&D where I delivered hundreds of babies in the absence of the MD I feel very confident that a HUGE majority of hospital births could safely take place in the home.

As long as there's good prenatal care, I'm all for it. I draw the line at the "freebirthing" thing, tho...the ones where they have no prenatal care at all, and want to give birth without a CNM, or even a lay midwife. Unfortunately, I think that's the "anecdotes" they will want to use to "prove" how unsafe a home birth is.

I have mixed feelings. After the birth of my (first) DD 3 yrs ago, I had a severe post partum hemmorhage - the MD told me that was a 'classic example of why women have babies in the hospital - if that had been a homebirth I may not be alive right now.' I don't know how it could have been predicted either.

What is scary about maternity units, IMHO is they are either 'feast or famine.' Where I work they are sometimes SO busy that they are most likely unsafe, esp when they are floating M/S nurses there who have never even been oriented to the unit.....but it isn't like you can predict when the 'busy times' will be. It could be absolutely dead and then 3 women in labor walk in at the same time.....

You have cited truths about Labour and Delivery Wards. The danger in nursing shortages with untrained obstetrical nurses ( not to mention the non -presence of midwives!) is acute. We are only citing problems but what influences such scenarios. Obstetricians expect to deliver babies, this is their bread and butter. Obstetricians are rarely around 24 hours a day - babies make their own schedules for delivery, despite our best efforts to beat nature. Hence the need to have trained personnel. Dilemmas and tragedies occur when the unexpected occurs which happens a lot in deliveries. . Good training goes a long way to anticipate and deal promptly with ante or post partum hemmorhages and they occur - the key is to know how to deal with it effectively and quickly. Where I worked no nurse could be sent to the L &D without orientation and training - .Hence nurses worked lots of overtime, and burnt out rapidly!!! Which also affected hiring and retention. . Home births in North America are relatively new and still viewed with scepticism by MDs. So the answer lies in leaving nursing alone, stop coerciveness , bullying and threats when we are actually shrinking as a skilled professional group expected to address the needs of increasing complex illnesses.

Once again the medical community is watching their flanks and seeking to control yet another part of healthcare.

Midwives for hundreds,no scratch that, thousand or so years delivered infants, often with less complications and adverser results than doctors/medical men. This included death of the mother from childbed fever. As the forerunners of modern hosptials were taking hold, doctors began waging a pitted battle move childbirth from the home to the hospital, and under their supervision as opposed to midwives. This despite it was often the case women who delivered in hospitals had a higher rates of childbed fever and death rates from the same.

The next tactic was to wage war against midwives as "witches" and seek to have the vast knowledge many of these women had of herbal medicines out lawed (read how the FDA came into being).

End result was that for a very long time afterward childbirth was something that "happened" to a woman, almost like a disease process, with little or consideration for her input.

Midwives and home births are a very large percentage of births in many countries, and of those countries most have much lower rate of infant and mother mortality than the USA. This despite the United States spends vast sums on health care.

One almost has to take some pity on OBs. I mean unlike other specialists they aren't running around in scrubs on Oprah touting their latest book, nor are they on PBS selling skin care. Take away pre-natal care and childbirth, what have they got?

As a NICU nurse, there's no freaking way I'd have a home delivery. I think this sector needs to be tightly regulated, as ACOG suggests, although they were a bit naive putting out that question amongst the fury of the "natural birth" folks.