Homebirth Outlawed?

The AMA and ACOG have put out a statement saying they want to outlaw homebirth.  You may already know about this.   It scares me to think that they would try to do this.  Women should have the right to choose where they want to birth.  Freedom of choice!

There is something simple you can do.  Sign this online petition.  There is a request for a donation AFTER you sign it, but even if you don’t donate, your signature gets added.  So please go add yours.

My favorite response I have read to the statement so far is from an Obstetrician!

Douglas H. Kirkpatrick, MD
The American College of Obstetricians and  Gynecologists
PO Box 96920
Washington, DC  20090-2188
Dear  Sir:

I am a practicing OB/ GYN in southern California and Fellow of  ACOG and
recently was informed by midwife colleagues of your recommendation and
encouragement for the AMA to lobby Congress for a law banning out of hospital  birth.
Funny, that I had to hear of this decision from outside sources and was  never
approached by my college to see how I or my local colleagues felt about  it. I
have grave concerns regarding my organization taking such a stand. I think  we
are all agreed that ACOG has a statement regarding patients rights to
informed consent and informed refusal. Yet, it seems with every decision our
organization moves further away from that basic tenent. ACOG’s little  “guideline”
paper on 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 you think this is  untrue you
are, sadly, out of touch with real clinical medicine.

As  to out of hospital birthing, please give me the courtesy of an
explanation as to  the data you used and the process by which an organization which is
supposed to  represent me came to this conclusion. Any statement saying that it
is as simple  as patient safety and that one-size fits all hospital birth
under the “obstetric  model” of practice should be applied to all patients is,
putting it nicely, not  really in line with what best serves all our patients.
In many instances,  hospitals are not safe, certainly not nurturing and have a
far worse track  record for disasters than home birth. Even when emergency
help is nearby this is  true. The focus of all of us in medicine should be on
reigning in trial lawyers  and tort reform and lobbying Congress for that. The
best interest of the college  members and the patients we serve would be for my
organization to spend its time  and energy on something that has true benefit.
Removing choices from  well-informed patients and caring doctors and midwives
is wholly un-American.

So please send me detailed information on how ACOG decided  outlawing home
birth was a wise thing to do. You must have scientific data to  take such a
drastic stand. Please make it available to me so that I may share it  with
likeminded colleagues. I would also like to know the process by which this  came to
pass. Who first raised this issue and why? What committee reviewed all  the
data and did its due diligence in interviewing those of us with longstanding
experience in backing midwives who perform out of hospital births. There must be
a fine, non-confidential paper trail you can share with your members.
Specific  names of committee member who voted for this would be enlightening and I am
 requesting this information. I would like to know the background and
expertise  regarding out of hospital birth for each member who had a hand in the
decision  to go to the AMA.

We live in an odd era where once something is  said or recommended by a
legitimate organization such as ACOG it has deep  ramifications never intended such
as becoming fodder for trial lawyers trying to  squeeze the lifeblood and
dignity out of your members. Or forcing women to  travel hundreds of miles in
labor to find a supportive facility. Or even worse,  to have them arrive in a
VBAC banned hospital and refuse surgery. Can this be  the best we can do for our
patients?  Rmember, your VBAC statement was  meant to be only a recommendation
but quickly became the rule by which hospital  administrators, risk managers
and anesthesia departments of smaller hospital  banned this option for
thousands of women. An option, that in proper hands, was  the safe and accepted
standard of care for 30 years. In fact, you still have an  ACOG VBAC brochure that
recommends this option! For those of us working at  smaller hospitals where
VBAC was banned due to lack of emergency help  (anesthesia, OR crews, etc.)
there is a big question that has perplexed us that  no administrator seems to be
willing or able to answer. That question is: “If a  hospital cannot handle an
emergency c/section for VBACs, and most emergency are  for fetal bradycardia,
hemorrhage (ie. abruption) or sholder dystocia not for  ruptured uteri, then
how can they do obstetrics at all?” For they seem to still  be able to have a
maternity ward without in house anesthesia. Will someday ACOG,  in their great
wisdom but seeming disconnect from reality, make a  “recommendation” that
little hospitals stop providing obstetric services? Will  this better serve women
and their communities throughout America?

I am frightened and angered by what you have done in my name. Now  I ask you
to defend your position in encouraging the AMA to lobby Congress for  another
restriction on the freedom of choice that belongs to women and their
families. Those choices include midwifery and the right to have the most  beautiful
and life changing event occur wherever best fits their desire.  Midwives are
well trained and required to have obstetrical backup. They have  very special
relationships with their patients and want the very best outcomes  for them. They
do not need me or you to police them. We have a habit in out  country over
the past 40 years of thinking we can legislate out stupidity. All  that has done
is erode the individual freedoms that belong, by birthright, to  each of us.
I would hope you trust your Fellows to know their specialty,  their
colleagues, and what is best for the patient as an individual. These  decisions do not
belong to politicians or faceless committees. You should have  more faith in
your members to give balanced informed consent. Again, my  recommendation to
you is to put all your considerable energy into changing our  legal malpractice
system. Those of us actually practicing medicne and caring for  patients know
this to be the greatest threat to the mission and responsibility  we have
chosen to undertake.

I look forward to your response and  possibly the beginning of a meaningful
dialogue.

Sincerely,

Stuart J. Fischbein, MD  FACOG
Medical Advisor, Birth Action Coalition

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8 Comments on “Homebirth Outlawed?

  1. Impressive and inspirational! Tomorrow I will be watching Amazing Grace, which if you haven’t seen it you might want to check it out, a movie about William Wilberforce, the youngest Lord of the House of Commons who worked tirelessly for abolition of slavery in or through England. We have to be as tireless as he was and it is easier going when you have a voice of reason across the isle. Kudos to this doctor and I think I will send him a thank you note. Thanks to you at this blog for sharing this with the rest of us.

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  2. So many great points here! My favorite quote is: “If a hospital cannot handle an
    emergency c/section for VBACs, and most emergency are for fetal bradycardia, hemorrhage (ie. abruption) or sholder dystocia not for ruptured uteri, then how can they do obstetrics at all?” Exactly! How can hospitals claim they are so safe if they are afraid to even attampt to handle a VBAC???? Hellloooo!!!! I have had one homebirth and three hospital births. The h.b. was AWESOME! Hospitals ones? Not so much…. But the thing I hear from people most often is what if something goes wrong? I say, if it goes wrong at least I know I didn’t cause it! Meaning the majority of problems are caused by OB’s meddling around and forcing labor. My first 2 births were nothing short of a horror film and I have my OB and CNM, Cytotec and Pitocin to thank for that…. At home, I would not have been forced into labor! Truly, I will give birth in a field before going intentionally to a hospital!

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  3. I had both my children at home for many reasons. Not being in a hospital, I would have no access to pain killers which I believe are harmful to the fetus. At home in very long labors, I would not be pushed into a c-section. I also did not want to be hooked up on monitors because it limits the ability to have movement which aids in the birth.

    I had CNMs at both my births, I knew the risks, and I had physician backups available.

    If a woman has been counselled appropriately and she has no apparent problems, then she should have the choice to decide where she gives birth.

    The obs today are lacking in many abilities that used to be the norm — how to turn a breech, how to keep your patient from tearing to avoid an episiotomy. We have turned labor and delivery into an automated factory with no thought to individual care.

    Giving birth is normal, it is not an illness. Yes, there are risks, but all of life is a risk. We should be able to choose.

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  4. You see, where I live CNM’s only do hospital births and I could find NO OB’s that were even willing to be back-up. In fact, when I told the OB I had been seeing that I was planning a homebirth with a doula and a midwife, he said, “That’s fine, but you might DIE.” Right in front of my three children! Needless to say, I didn’t go back to him.

    There is an apparent power struggle I find extremely juevinile going on in our country. Instead of everyone working together for what is best for mom and baby, everyone is pitted against each other like squabbling babies! -More concerned about who is right than who is getting hurt- mom and baby. It is really stupid. But true, nonetheless! I wonder when/if the world of obstetrics are planning to grow up and realize their machines and worshipped technology are no match for God-given talent, calling and intuition of a really excellent midwife and doula? Probably never. Thus the reason women are leaving the hospitals and their controls.

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  5. I was pleased to post this with the petition signature:

    “Surely outlawing Homebirth is yet another step backward, just like ousting Midwives.
    It will only serve to push pregnant women to have their births ‘underground’.
    How any group of people can come together and decide they can ‘control’ women having natural births is beyond me, totally rediculous and power freaks.
    Women are able to give birth naturally without complications anywhere they wish…. Maybe your decision to outlaw/ban homebirths would make an actual rise in homebirths, as women protested and showed you all who really controls birth, the pregnant women themselves!”

    They sure are frignthened of women aren’t they! I think that they must realise how powerful women really are.

    [Reply]

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