ACOG: Fear and Litigation Motivation

It is interesting that on the same day ACOG (via help from NBC) tries to use fear to motivate moms to birth in hospitals

they admit that

fear of litigation motivates them to make decisions, rather than evidence based choices.

Using Fear to Motivate Moms:  NBC Today show and MSNBC showed a segment on Extreme Birth showing a home birth with a sad outcome.  There are a lot of great posts about it.  I don’t have much to add to what these bloggers have said.

• Stand and Deliver:  Code Mec, Code Mec
• It’s Your Birth Right:  The Perils of ACOG
• Reality Rounds: Calls Code BullSh**
• Here is a great response from the Big Push:  Homebirth Mother’s Insulted on TV

My take on the whole thing?  I feel sorry for this family that lost their baby.  It is very sad.  I don’t know all the details about what went on, but regardless it is a horrible loss.   There are babies who die in hospital settings as well.  There are no guarantees with birth or in life.

Parents have the right to gather information and make the best choice for them.   Fear doesn’t need to be a part of this equation.  Intuition can and should be!    So I think that this news piece was biased and unfair.  Thumbs down for NBC.

OBs making choices based on fear:

The Unnecesarean posted about the ACOG survey just released a survey where

More than 63% of ob-gyns report making changes to their practice due to the risk or fear of liability claims or litigation

You need to go and read the Unnecesarean post above for all the details.  But I am sure they will not be surprising.  I don’t know what the answer is to this.  Except for parents to educate themselves on their choices and be aware that their “scare providers” may not be making their choices based on evidence based research, rather they are making choices out of FEAR!

Then I think a perfect post that wraps both of these topics up nicely is at Science and Sensibility:  Home Birth The Rest of the Story.

What I found most enlightening is her section on why moms really are choosing home birth.  It isn’t so they can have a spa like experience.  (who came up with that idea?)  She talks about the 6 healthy birth practices and how less than 2% of moms get 5 of these during a hospital birth.

LESS than 2% of moms are experiencing these things.

1. Let labor begin on its own

2. Walk, move around, and change positions throughout labor

3. Bring a loved one, friend, or doula for continuous support

4. Routine interventions not included in this survey result. 

5. Avoid giving birth on the back and follow the body’s urges to push

6. Keep mother and baby together – it’s best for mother, baby, and breastfeeding

There seems to be a problem with the way things are done in the hospital.

As a doula I can attest that it is REALLY difficult to see all of these things happen in a hospital setting.  #5 and #6 seem to be the main hang ups in many of the births I attend.  They just love to get mom in that “special” pushing position.  Then they typically seem to “have to take the baby to make sure he/she is ok.”  Baby may be on mom for 5 minutes, but it is less likely to have baby longer before being separated, unless mom and dad are really forceful!   OK, #1 is another huge problem too.