ACOG requests unsourced anecdotal home birth "data"

Thousands of Activists Nationwide Force Physician Group to Scrub Its Website


The American College of Obstetricians and Gynecologists (ACOG) has launched an internal request for unsourced, anecdotal homebirth transfer stories. Stating that the organization is "concerned that recent increases in home delivery will result in an increased complication and morbidity rate," obstetricians have been asked to submit stories about homebirth-to-hospital transfers, with outcomes reported by the physician handling the transfer. Just hours after its launch, ACOG's site went "viral," with thousands of women entering the site to relay stories of their positive homebirth outcomes. ACOG has since moved its request to a firewall-protected, members-only section. (See http://www.thebigpushformidwives.org...s_Research.pdf)

ACOG recently stated that legislative opposition to legalization of "lay" midwives and homebirths is one of its highest organizational priorities. In the August 2007 ACOG State Legislative Update Year in Review, ACOG disparaged certified nurse-midwives as "fickle" allies, stating that "Whereas nurse-midwives have been ACOG's front-line defense against these bills, that's no longer a sure thing." Referring to 2007 legislative activity in Missouri (that in 2008 finally granted CPMs, CNMs and CMs the legal authority to attend homebirths in that state), the 2007 ACOG report said, "For example, in Missouri, 'lay' midwife bills get introduced year after year. These bills have been stopped--up to now--mainly by deft political maneuvering and hardball tactics employed by the State Medical Society, not by any persuasive testimony about comparative safety or quality of care."

ACOG's most recent attempt to mine for unsourced homebirth data suggests a concerning return to the days when obstetrics was saddled with Archie Cochrane's infanous Wooden Spoon Award as the least evidence-based specialty in medicine. In fact, there is a worldwide abundance of scientifically rigorous studies demonstrating the safety of homebirth, including another just published August 31, 2009 by the Canadian Medical Association Journal: http://www.cmaj.ca/cgi/rapidpdf/cmaj.081869v1.pdf.

ACOG would do well to bring itself into alignment with the American Public Health Association, the World Health Organization, the Royal College of Obstetricians and Gynecologists and other organizations and experts that write policies based on evidence-based studies demonstrating that homebirth is a safe option and that care by licensed and certified professional midwives actually improves perinatal outcomes while decreasing health care costs. Real concern for maternal-newborn outcomes would suggest making greater access to the midwifery model of care a far higher priority than, say, legislative concerns over money and turf. And since the United States spends more money annually on obstetrical care than any other nation in the world and presently finds itself ranked below Cuba and just above Croatia in terms of Infant Mortality Rate, this would be especially true. As the saying goes, "There are reasons, and there are results."