Friday, July 4, 2008

A Response to the AMA Resolution

Submitted by Jeanne Batacan as an example of an "Opinion" page contribution for local papers in response to the AMA's Resolution against homebirth.

The American College of Obstetricians and Gynecologists (ACOG) is now pushing for the American Medical Association (AMA) to lobby Congress for a law banning out of hospital birth.

Despite a statement by ACOG, regarding a patient's right to informed consent and informed refusal, it seems that more and more decisions and "recommendations" made by ACOG, are moving further away from that basic tenet. This is resulting in thousands of women being stripped of their basic right to choose safe maternity care based on balanced informed consent or informed refusal.

Not all ACOG members are happy with the current situation. Dr. Fischbein, a California physician stated, "ACOG's little 'guideline' paper on vaginal birth after Cesarean (VBAC) in 2004 where the word readily was changed to immediately has had the chilling effect of doing away with VBAC options at hundreds if not more hospitals. Not due to patient safety, or the ideal of giving true informed consent but really, let's be honest, to fear of litigation. I have seen how patients have become counseled by obstetricians at facilities where VBAC has been banned. They are clearly given a skewed view of the risks of VBAC but rarely told of the risks of multiple surgeries. If a hospital cannot handle an emergency c/section for VBACs - and most emergencies are for fetal bradycardia, hemorrhage (i.e. abruption) or shoulder dystocia, not for ruptured uteri - then how can they do obstetrics at all?" Indeed.

ACOG needs to defend their position in encouraging the AMA to lobby Congress for yet another
restriction on the freedom of choice that belongs to all women and their families. Those choices include midwifery care and the right to give birth wherever best fits their needs and desires.

Today's Midwives are well trained professionals and are required to have obstetrical backup. Interestingly, in the countries that have the lowest maternal and infant mortality rates the vast majority of pregnancies and births are managed by midwives.

The U.S. spends more money on maternity care than any other country in the world. Yet, we rank somewhere below 32nd (NOT 1st) in maternal and infant safety. Our maternal mortality rate is on the rise, as well a premature birth, epidemic rates of labor induction and Cesarean Section. Knowing this, ACOG needs to turn it's attention on reversing this alarming and shameful trend by welcoming the superb care that midwives provide and then, taking a long hard look at -- what is it, that Singapore, Sweden, Japan, Hong Kong, Iceland, France, Finland, Norway, The Czech Republic, Germany, Switzerland, Spain, Israel and TWENTY-NINE other countries are doing so much better than us?

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