The Big Push Press Release: Physicians Take Anti-Midwife Smear Campaign to the Airwaves

I was getting ready to write about this myself--thinking of calling it, "ACOG Makes a New Friend"--but the indomitable Big Push Campaign beat me to it and their release is so pointed that I have nothing more to add!

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Home Birth Mothers, Celebrities, Insulted on National TV FOR IMMEDIATE RELEASE WASHINGTON, D.C. (September 11, 2009) – Referring to women who choose to give birth in out-of-hospital settings as "hedonistic" and likening childbirth to a "spa treatment," members of the American College of Obstetricians and Gynecologists, a trade group representing the professional and financial interests of OB/GYNs, took their anti-midwife campaign to the airwaves in a Today Show segment rife with insults, stereotypes, and misinformation, using one family's tragedy as a platform for the organization's well-funded assault against choices in childbirth. "About the only thing ACOG has right is that women are choosing out-of-hospital deliveries in record numbers," said Steff Hedenkamp of The Big Push for Midwives Campaign. "What Erin Tracy and other apologists for the group's anti-midwife position fail to see is that one of the forces driving women to seek out-of-hospital care is the paternalistic, profit-driven model of maternity care that far too many of its own members provide." During the segment ACOG reiterated its claim, which has been thoroughly debunked by a large and growing body of medical literature, that out-of-hospital delivery is unsafe. Describing women who choose to give birth in private homes and freestanding birth centers as "hedonistic" mothers who knowingly put the lives of their babies at risk for the sake of an "experience" they believe will be like a "spa treatment," members of the group echoed last year's position statement claiming that women who choose out-of-hospital deliveries base their decisions on what's "fashionable" or "trendy." "ACOG clings to this ridiculous fantasy that women choose to deliver their babies outside of the hospital because they want to be like Ricki Lake, Demi Moore or Meryl Streep and that if women would only watch enough fear-mongering stories on morning television they'll be brainwashed back into hospitals," said Katherine Prown, Campaign Manager of The Big Push for Midwives. "Insulting our intelligence and promoting policies that deny us choices in maternity care are not exactly winning strategies for stemming the tide of women seeking alternatives to standard OB care." Earlier this year, a New York City couple lost their baby during a planned home birth under the care of a Certified Nurse-Midwife. Licensed and regulated in all 50 states, Certified Nurse-Midwives are trained to provide hospital-based maternity care. By contrast, Certified Professional Midwives, who undergo specialized clinical training in out-of-hospital birth, are legally authorized to provide care in 26 states, although outdated regulations effectively prevent them qualifying for licensure in the state of New York. Legislation to license and regulate Certified Professional Midwives is currently pending in an additional 18 states, despite staunch opposition from the American Medical Association, which has joined with ACOG in adopting position statements that would deny families who choose out-of-hospital maternity care legal access to nationally credentialed midwives with specialized training to provide it. The Big Push for Midwives Campaign represents thousands of grassroots advocates in the United States who support expanding access to Certified Professional Midwives and out-of-hospital maternity care. The mission of The Big Push includes educating national policymakers about the reduced costs and improved outcomes associated with out-of-hospital birth and advocating for including the services of Certified Professional Midwives in health care reform. Media inquiries: Katherine Prown (414) 550-8025, katie@thebigpushformidwives.org ### The Big Push for Midwives Campaign | 2300 M Street, N.W., Suite 800 Washington, D.C. 20037-1434 | TheBigPushforMidwives.org

Physicians & Birth

A few weeks ago, I read an older book titled Woman-Centered Pregnancy and Birth. I marked the following quote to share because I thought it succinctly summed up one of the primary issues in maternity care:

"The major problem which arose almost as soon as physicians started attending women in birth is the same problem which exists today in obstetrics: physicians use their medical techniques when they are not really necessary and their technology and practices often create more problems than they solve. It is possible to appropriately apply this criticism to nearly every form of technology which has been used by physicians on women in birth from the 1500's to the present."

I also noted an observation from the book Birth Tides: Turning Towards Homebirth: "To these people, it seems as thought the medical system has been reduced to a form of social control. [Another woman] makes the point, however, that controlling women has always been an intrinsic part of antenatal care."

I think the recent AMA resolutions I've posted about and the situation with private midwifery in Australia lend credence to the idea that the medical system is a form of social control!

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Molly
CfM Blogger

Another Interesting Attempt by the AMA

I already posted about the AMA's outrageous move regarding "ungrateful patients" (luckily, the resolution did NOT pass!). Though it isn't directly related to midwifery, I cannot help but post about the other quite arrogant maneuver also suggested recently:

AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES
Resolution: 605 (A-09)

Introduced by: Illinois Delegation

Subject: Removing the Word "Provider" in Reference to Physicians
Referred to: Reference Committee F (David C. Fleeger, MD, Chair)

Whereas, Physician status becomes eroded when addressed by the word "provider"; and

Whereas, The word "provider" conveys subservience, lack of independence, lack of authority, lack of decision making, lack of specialized knowledge, lack of separation from other ancillary personnel, lack of respect for the MD degree, servant status; therefore be it

RESOLVED, That our American Medical Association consider the generic terms "health care providers" or "providers" as inadequate to describe the extensive education and qualifications of physicians licensed to practice medicine in all its branches (New HOD Policy); and be it further

RESOLVED, That our AMA institute an editorial policy prohibiting the use of the term "provider" in lieu of "physician" or other health professionals for all AMA journals and publications. (New HOD Policy)

Fiscal Note: Staff cost estimated at less than $500 to implement.

Received: 05/05/09

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The most significant phrase is this, "The word 'provider' conveys subservience, lack of independence, lack of authority, lack of decision making, lack of specialized knowledge, lack of separation from other ancillary personnel, lack of respect for the MD degree, servant status..."

So, they would prefer a word that conveys "being the boss"? I think this resolution is further indication of a desired erosion of personal rights with regard to medical and health care decision making. Not only should women not be allowed to choose midwifery care or homebirth (according to the AMA), but they may also not view physicians as there to "serve" them, but instead as an ultimate authority and ruler supreme?! Hmm. As someone else on a discussion group noted, "I'm beginning to think that the ordinary citizen needs to rise up and [have a resolution] not to be called 'patients' because that implies a lack of independence, subservience, lack of authority about their own bodies, lack of decision making, lack or respect, servant status..." No kidding!

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Molly
CfM Blogger

Grassroots Network: ICAN responds to AMA’s latest outrageous move

Dear Friends,

The American Medical Association is out-doing itself. The organization is opposing key parts of Obama’s health care reform plans, for which they are being roundly criticized even by physicians (letters to the editor in the New York Times). They are, of course, working on anti-CPM and anti-home birth “model” legislation to put into place their resolutions from last year.

But to top off their display of arrogance, the objective of a new proposed resolution seeks to punish patients who are not “compliant” with the idea that doctors should not have to put up with patients who seek to assert their right to make the final decisions on their own medical care.
International Cesarean Awareness Network (ICAN) has posted an excellent press release on this latest outrage, which I have also pasted below.

Sincerely,
Susan Hodges, “gatekeeper”



From ICAN:

AMA Resolution Would Seek to Label “Ungrateful” Patients

Redondo Beach, CA, June 11, 2009 - At the American Medical Association’s (AMA) Annual Meeting next week, delegates will vote on a resolution which proposes to develop CPT (billing) codes to identify and label “non-compliant” patients (1) [2]

The resolution complains:

“The stress of dealing with ungrateful patients is adding to the stress of physicians leading to decreased physician satisfaction.”

“This resolution is alarming in its arrogance and its failure to recognize, or even pay lip service to, patient autonomy,” said Desirre Andrews, the newly elected president of the International Cesarean Awareness Network (ICAN).

If approved, the resolution could hold implications for women receiving maternity care. For pregnant women seeking quality care and good outcomes, “non-compliance” is often their only alternative to accepting sub-standard care. Physicians routinely order interventions like induction, episiotomy, or cesarean section unnecessarily.

Liz Dutzy, a mother from Olathe, Kansas, delivered her first two babies by cesarean and was told by her obstetrician that she needed another surgical delivery. “My doctor told me that I needed to have a cesarean delivery at 39 weeks, or my uterus would rupture and my baby would die.” She sought out another care provider and had a healthy and safe intervention-free {home} birth at 41 weeks and 3 days gestation.

A recent report by Childbirth Connection and The Milbank Memorial Fund, called “Evidence-Based Maternity Care: What It Is and What It Can Achieve ,” (2) [3] shows that the state of maternity care in the U.S. is worrisome, driven largely by a failure of care providers to heed evidence-based care practices. For most women in the U.S., care practices that have been proven to make childbirth easier and safer are underused, and interventions that may increase risks to mothers and babies are routinely overused. The authors of the report point to the “perinatal paradox” of doing more, but accomplishing less.

The resolution proposed by the Michigan delegation of the AMA could threaten patient care and patient autonomy for several reasons:

• Billing codes that would categorize any disagreement and exercise of autonomy on the part of the patient as “non-compliance” “abuse” or “hostility” could create a pathway for insurance companies to deny coverage to patients
• Use of these labels fails to recognize patients as competent partners with physicians in their own care
• Tagging patients as “non-compliant” fails to recognize that there is not a “one size fits all” approach to care, that different opinions among physicians abound, and that patients are entitled to these very same differences of opinion
• Labeling patients as “non-compliant” may, in fact, be punitive, jeopardizing a patient’s ability to seek out other care providers

The resolution also fails to address how it would implicate patients navigating controversial issues in medical care, like vaginal birth after cesarean (VBAC). While a substantive body of medical research demonstrates that VBAC is reasonably safe, if not safer, than repeat cesareans, most physicians and hospitals refuse to support VBAC. (3) [4] The language in the resolution suggests that patients who assert their right to opt for VBAC could be tagged as non-compliant, even though their choice would be consistent with the medical research.

“The reality is that the balance of power in the physician-patient relationship is decidedly tipped towards physicians. The least patients should have is the right to disagree with their doctors and not be labeled a ‘naughty’ patient,” said Andrews.

About Cesareans: When a cesarean is medically necessary, it can be a lifesaving technique for both mother and baby, and worth the risks involved. Potential risks to babies from cesareans include: low birth weight, prematurity, respiratory problems, and lacerations. Potential risks to women include [5]: hemorrhage, infection, hysterectomy, surgical mistakes, re-hospitalization, dangerous placental abnormalities in future pregnancies, unexplained stillbirth in future pregnancies and increased percentage of maternal death.

Mission statement: ICAN is a nonprofit organization whose mission is to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery and promoting vaginal birth after cesarean. ICAN has 110 chapters in North America and Europe, which hold educational and support meetings for people interested in cesarean prevention and recovery.



(1) Resolution 710 “Identifying Abusive, Hostile or Non-Compliant Patients” [6]

(2) Evidence-Based Maternity Care: What It Is and What It Can Achieve [7]

(3) http://www.ican-online.org/ican-in-the-news/trouble-repeat-cesareans [8]

Grassroots Network: More organizations support out-of-hospital birth!

Note from Molly: The links to the midwifery editorial referenced below are kind of touch and go. If you have trouble accessing it, go here and then do a search for the editorial title (The 'Authorities' Resolve Against Home Birth) or for the author's name (Nancy Lowe), and you'll be able to read it that way!

Dear Friends,

The Big Push has issued a news release highlighting the fact that organizations including nurses and perinatal specialists have recently made statements supporting the use of midwives and the choice of out-of-hospital birth. In particular, the editorial by Nancy Lowe, editor of the Journal of Obstetric, Gynecologic, & Neonatal Nursing, the official journal of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) here is an especially good statement.

Read the release below, forward it, and follow the links below to read the various statements!

Sincerely,
Susan Hodges, "gatekeeper"


PushNews from The Big Push for Midwives Campaign
CONTACT: Steff Hedenkamp, (816) 506-4630, steff@thebigpushformidwives.org
FOR IMMEDIATE RELEASE: Tuesday, February 17, 2009


Physician Groups Out-of-Step as the Number of Health Care Organizations In Support of Certified Professional Midwives (CPMs) and Out-of-Hospital Birth Rapidly Increases

Nurses, Perinatal Health Care Specialists Echo Consumer Reports Magazine in Calling for Integrating Midwives into U.S. Maternity-Care System


WASHINGTON, D.C. (February 17, 2009)Two major health care organizations have joined the growing number of groups calling on policy makers to increase access to Certified Professional Midwives (CPMs) and out-of-hospital maternity care. Acknowledging the large body of evidence supporting the safety of home delivery with CPMs, who are specifically trained to care for mothers and babies in out-of-hospital settings, nursing and perinatal health care organizations criticized the American Medical Association (AMA) and the American College of Obstetricians and Gynecologists (ACOG) resolutions calling for bans on CPMs and home birth. The groups also joined Consumer Reports magazine in highlighting the need for a major overhaul of the U.S. maternity care system.
"I am very proud to be an American, but I am embarrassed that our country, founded on the ideals of individual liberty and freedom, can also support 'authoritative' initiatives such as these by the ACOG and AMA, initiatives that are founded on neither science nor an understanding of the physiologic and psychosocial needs of mothers and babies," said Nancy K. Lowe in an editorial published in the Journal of Obstetric, Gynecologic, & Neonatal Nursing, the official journal of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN). "What is most risky about home birth in the United States is that for most women who desire it there is a scarcity of qualified providers of home birth services." [Read the complete editorial here.

Consumer Reports magazine cited the desire for economic gain as one of the driving forces limiting access to CPMs and Certified Nurse-Midwives (CNMs), who are licensed in all 50 states and practice primarily in hospital settings, but who remain subject to anti-competitive regulations promoted by the AMA and ACOG. CPMs are legally authorized to provide out-of-hospital care in just half the states, while advocates working to reform the law in the remaining states face stiff resistance from physician groups seeking to establish a monopoly on the maternity care market in the U.S.

"Midwives provide a safe and cost-effective alternative to the current model, where the market is dominated by high-cost, high-tech specialists producing less-than-optimal outcomes," said Katie Prown of The Big Push for Midwives Campaign. "Babies delivered by midwives are far less likely to be pre-term or low birth-weight, which are two of the leading causes of neonatal mortality and of the enormous costs associated with long-term care. Midwives and out-of-hospital birth are an integral component of responsible health care reform, and the AMA and ACOG know this. That’s why they’re fighting so desperately to protect their turf, even if it means denying women maternity-care options in the process."

The National Perinatal Association (NPA) added to the growing list of organizations calling on the AMA and ACOG to end their vendetta against midwives and home birth and instead follow the World Health Organization’s (WHO) call to "'work in a spirit of recognition and respect for each other’s authority, responsibility, ability and unique contribution.'" [See their statements on place of birth and on midwifery here.

The Big Push for Midwives is a nationally coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states, the District of Columbia and Puerto Rico, and to push back against the attempts of the American Medical Association Scope of Practice Partnership to deny American families access to legal midwifery care. Through its work with state-level advocates, the Big Push is helping to build a new model of U.S. maternity care built on expanding access to out-of-hospital maternity care and CPMs, who provide affordable, quality, community-based care that is proven to reduce costly and preventable interventions as well as the rate of low birth-weight and premature births.

Media inquiries: Steff Hedenkamp (816) 506-4630, steff@thebigpushformidwives.org.

Birth Video Contest, Breastfeeding Posters, & Midwifery Editorial

You may have already heard that Birth Matters Virginia is having a birth video contest (you do not have to live in VA to participate). I'm sure it will be exciting to see the results!

I recently came across some very nice free educational posters and other breastfeeding resource materials from the British Columbia Baby Friendly Network (I originally found the link on the Passion for Birth blog)

Finally, I wanted to mention an editorial in the Journal of Obstetric, Gynecological, and Neonatal Nursing called The Authorities "Resolve" Against Homebirth. Written by a CNM it is a look at the AMA and ACOG's position against homebirth. I learned about this editorial from the Woman to Woman blog, which includes several good quotes from the editorial.

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Molly Remer
CfM Blogger

Grassroots Network: NEW! CfM Tool Kit: Stand Up for Home Birth

Dear Friends,

Citizens for Midwifery officially announces a new addition to our website, our Advocacy Tool Kit: Stand Up for Home Birth!

Take a look here. You will find a comprehensive collection of information, facts, links, how-to’s, talking points for any occasion, and other useful advocacy tools, organized in sections. We would recommend you start with the Introduction section, but also read the new articles in the Important Information section: About AMA & ACOG, Safety, and Rights. Also take a look at the Resources section within the Tool Kit.

CfM developed this Tool Kit in response to the American Medical Association’s anti-home birth “Resolution 205” (adopted last spring): “… 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 ….” as well as the American College of Obstetricians’ continued opposition against access to home births and the midwives that attend them. Neither organization has any reputable evidence to support these positions.

Our purpose was to provide information and tools for everyone to use to undermine the “authority” of the AMA and ACOG and make the case for access to home birth and home birth midwives. Some of the material is oriented for use with legislators, specifically to help them learn and understand more about the nature of ACOG and the AMA and why their motives and opinions should not be trusted, in addition to understanding the evidence and “bigger picture” regarding routine maternity care and midwife-attended home birth. However, virtually all of the material is useful for many situations and circumstances.

Please make use of the information, fact sheets, and links!

Sincerely,

Susan Hodges, “gatekeeper”

Grassroots Network: ACNM responds to AMA Resolutions

Dear Friends,

The American College of Nurse Midwives has responded to recent AMA Resolutions (regarding home birth and regarding doctor supervision of midwives) with a letter to the AMA and addenda. While these are understandably written from ACNM’s viewpoint and interests in the CNM and CM credentials, overall the documents are excellent, and do a good job of affirming home birth and pointing out the outrageousness of ACOG/AMA behavior regarding these issues. The addenda are organized by topic and the statements are well-documented. In my opinion the ACNM has done an outstanding job of refuting all the main issues raised by the AMA’s Resolutions, especially the anti-home birth resolution 205 (see Grassroots messages 806032, 806033, 806037 and 807038). The addenda in particular should prove to be excellent resources (including all the references) for supporting the option of planned home birth.

You can read (and download) these documents here:

Letter to AMA
Addenda

Sincerely,
Susan Hodges, “gatekeeper”

Grassroots Network: More responses to AMA Resolution

Dear Friends,

The AMA’s “Resolution 205 on Home Deliveries” and reactions to it have continued to be in the news and on blogs.

For example, ABC News ran a story on July 11 and so far there have already been 170 comments, with most people expressing strong feelings that home birth should remain a choice, and that the AMA is out of line.

Many of you may want to write letters to the editor (especially in response to news articles) or write on blogs. Several organizations have now come out with formal statements, which include information and quotes that could be useful:

The Midwives Alliance of North America has posted a "President’sEditorial: Doctors Ignore Evidence, AMA Seeks to Deny Women Choices in Childbirth" that includes excellent information as well as references.

The Maine Association of Certified Professional Midwives posted a press
release:

“Midwives Remain Committed to Women’s Birth Choices, Despite AMA Resolution that Aims to Restrict Them.”

Holistic Moms Network has a press release “Parenting Group Denounces AMA Resolution Against Homebirth: Members of the Holistic Moms Network Say Homebirth is a Safe Choice And Must Remain a Legal Right.”

The ACNM also has a statement but it is only accessible to ACNM members (as of Sunday evening 7/13/08).

This will not be the last Grassroots Network Message on this topic and what you can do!

Sincerely,
Susan Hodges, “gatekeeper”

Grassroots Network: Jennifer Block on AMA Resolution to outlaw home birth

Dear Friends,

If you haven’t seen it yet, Jennifer Block had an opinion piece published in the LA Times on July 9: Big Medicine's blowback on home births. Why do U.S. doctors strong-arm women into our standard maternity care system?

This is a well-written (and quotable!) response to the AMA’s resolution to “outlaw” home birth (see previous post).

Sincerely,
Susan Hodges, “gatekeeper”

Grassroots Network: Big Push responds to AMA’s apology for racism

Dear Friends,

You may have seen this news today:
AMA To Issue Apology for Past Transgressions Toward Black Physicians
Kaiser Network Daily Reports reported:

The American Medical Association on Thursday is scheduled to release a formal apology for its "historical antipathy" toward black physicians and to express regret for a "litany of transgressions," the Washington Post reports. AMA's transgressions include not allowing blacks to join the group and not speaking out on legislation to end racial discrimination. According to the Post, "The apology marks one of the rare times a major national organization has expressed contrition for its role in the segregation and discrimination that black people have experienced in the United States."

…..

According to the AP/Los Angeles Times, former AMA president John Nelson offered a similar apology at a 2005 meeting on improving health care and eliminating disparities. AMA in 2004 joined the National Medical Association, a black physician group, and other minority physicians' groups to form the Commission to End Health Care Disparities. According to the AP/Times, "The new apology is more formal" and is also part of the organization's effort to improve its image (Tanner, AP/Los Angeles Times, 7/10).

Read the whole report here.

The Big Push for Midwives has immediately issued a press release, doing a great job at tying the AMA news to midwifery and additional actions the AMA should take!

Sincerely,
Susan Hodges “gatekeeper”

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.

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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?

Blogs on the AMA

Reality Check posted regarding AMA's removal of references to Ricki Lake in response to public outcry, but leaving the rest of of the resolution intact....

Some blog comments referencing CfM here (this one urges people to join CfM, which we appreciate!) and here.

Homebirth Petition

From MCFI e-news

"Resolutions were recently introduced by the AMA to support ACOG's position against home birth and to '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.'" "Please help send a message to the AMA and ACOG, and to our state and federal legislators, to tell them that we object to these resolutions and we view legislation that would restrict a woman's right to choose a home birth as a being contrary to scientific evidence and a violation of women's basic human rights." Petition

AOL News on the AMA Resolution

Ricki Lake was interviewed by AOL News regarding the comments made by the AMA singling her out for her promotion of homebirth. There have been TONS of comments on the article already, so if you check it out, be warned that you may be in for some long (and sometimes frustrating) reading.

Grassroots Network: Comments re AMA on Huffington Post Blog

The AMA is getting the heat regarding their Resolution on Homebirth (see previous post). You can contribute to the conversation! Ricki Lake, Abby Epstein and Jennifer Block wrote on the Huffington Post blog, and the comments are pouring in, some negative, some positive.

You can read the blog and comments so far here.

You do have to sign up/log in before you can post comments. However, after you have read some of the more ignorant/hostile posts, you may feel moved to sign up! This is a place where you can speak up for facts that support midwife-attended home birth, and point out that the issue is not making “all” women have natural childbirth at home, but that the AMA does not have any business dictating that “all” women give birth in hospitals (or specifically accredited birth centers which are few and far between).

There probably are other blogs where this discussion is going on, but this is the first one pointed out to me.

Some thoughts to consider:

The AMA and ACOG are the health care professionals who have brought us the highest cesarean section and induction rates ever in the US, along with the worst standing yet for perinatal mortality and worsening rates for maternal mortality. Furthermore, rates for premature birth have been increasing, and recent studies have connected this increase with the increase in cesarean sections (for example, see here). The same professionals who have brought us these sad outcomes are claiming their way is best???

Many complications in labor and delivery actually are caused by medical practices and interventions, and are not common problems of pregnancy, labor or vaginal birth. Denying food and drink during labor, preventing or discouraging mothers from walking and other physical activity during labor, using drugs to "start labor” (ie, induction) or hasten labor (augmentation), not “allowing” mothers to be in a vertical position to push the baby out, using directed breath-holding pushing, are all examples of routine hospital/obstetric practices (most not even considered to be interventions) that have been shown to interfere with the normal process of labor and cause complications, causing harm and not benefits to mother or baby. These practices are rarely if ever used by midwives in the home setting, who have very low rates of cesarean section (ie, low rates of transfer to the hospital for cesarean section) and very low rates of other interventions (see http://www.cfmidwifery.org/pdf/CPM2000.pdf and http://www.cfmidwifery.org/pdf/cesarean2x.pdf ).

One has to ask if modern obstetricians are even competent to attend normal birth, as they seem unable to resist meddling with the process and causing problems in so many ways. There is no question that sometimes interventions, even cesarean sections, are needed and can be life saving. However, it is likely that many fewer mothers would have complications if typical routine obstetrical practices did not interfere with the normal process so much.

If there is going to be legislation, maybe it should require obstetrician wanna-be’s to complete midwifery training before their OB specialty training. In my personal opinion, ACOG and the AMA have no business trying to restrict women’s choices when it comes to birth.

Sincerely,
Susan Hodges “gatekeeper”

Grassroots Network: AMA Resolution to outlaw home birth

At their annual meeting over the weekend, the American Medical Association voted on two Resolutions that both denigrate CPMs and appear to be an effort to solidify medical monopoly of birth by seeking to prevent home births and to increase MD control over midwives.

You can find AMA's many Resolutions here (scroll down). Two especially egregious resolutions are:Resolution 205 Home Deliveries (32KB), Resolution 239 Midwifery Scope of Practice and Licensure (38KB).

Resolution 205 includes a resolve to develop model legislation in support of the concept that the safest setting for labor, delivery, and the immediate postpartum 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.

As usual, the AMA has provided no scientific evidence to support the statements or intent of the resolutions.

Clearly, the medical profession is getting desperate!

The Big Push for Midwives has issued a press release. For a version on Big Push letterhead (that you could download and print) go here.

Sincerely,
Susan Hodges gatekeeper