A fellow doula, Tabaré Depaep, J.D., Esq., CLD (CAPPA), wrote up this response and said that I could share it with the world!
As most of you already know, ACOG (American College of Obstetricians and
Gynecologists) is collecting data on elective home deliveries, even if there
were no adverse outcomes (see their data collection form at
http://www.acog.org/survey/hdComplications.cfm). Here is my tongue-in-cheek
response (I am a lawyer and a doula):*
*Complications Related to Hospital Delivery*
We at Doulable Birth are concerned that high rates of elective hospital
delivery have resulted in an increased complication and morbidity rate.
Reports from clients indicate that doulas are being called in to try and
prevent these emergencies, and in some instances doulas and doula
organizations have even suggested legal proceedings against the hospitals
and doctors that seem unable or unwilling to learn from and address the
deficiencies of their practices. To attempt to determine the extent of the
problem, a registry of these cases will be maintained by Doulable Birth on a
year-by-year basis.
If you have attended a patient who came to you after an unsuccessful attempt
at elective hospital delivery, whether in the emergency room, operating room
or labor and delivery suite, please complete the following survey even if
there was no adverse outcome. Include only current events after June 15,
2009.
State:
Hospital:
Month/Year of Delivery:
Gravida:
1 – 2 – 3 – 4 – More
Para:
1 – 2 – 3 – 4 – More
Maternal Age:
Less Than 20 – 20-25 – 25-30 – 30-40 – Greater than 40
Gestational Age:
Less than 30 weeks – 30-36 – 36-40 – Greater than 40
Problem:
(check all that apply)
Convenience Induction
Artificial Rupture of Membranes
Augmented Labor/Pitocin to Distress
Defensive Medicine (e.g., procedures designed merely to prevent lawsuits)
Epidural Induced Fever
Episiotomy
Formula Supplementation
Healthy Baby Removed From Mother Post-partum
Healthy Baby Sent to Nursery
Iatrogenic Infection
Major Abdominal Surgery (“C-section”)
No Continuity of Care
Profit Driven Healthcare (e.g., unnecessary tests/procedures)
Protocol Driven Healthcare (e.g., mandatory IV, monitoring, etc.)
High-tech/low-touch care
Fetal Outcome:
(check all that apply)
Fetal Intolerance to Labor
Delayed/Unsuccessful Breastfeeding
Delayed/Unsuccessful Bonding
Routine Deep Suctioning
Sepsis Workup
Unnecessary Bath
Gestational Age at Induction:
2nd trimester – 1 month before due date – 2 weeks before due date –
on due date – she’s late, she’s late for that very important date
Length of Labor Prior to C-Section:
Scheduled prior to labor – less than 30 minutes – less than an hour
– Seriously they let it go that long?
Guesstimation of Fetal Weight Prior to Induction:
Off by: less than a pound – 1-2 pounds – Greater than 2 pounds
– “Ma’am based on the ultrasound we think you’re carrying twins.”
Dilation Prior to Epidural:
> 8 cm – 6-8 cm – 4-6 cm – 2-4 cm – 1-2 cm – why wait?
Number of Hospital Attendants:
A basketball team (5) – A baseball team (9) – A soccer team (11)
– Bring on the marching band
This survey *IS NOT* collecting any identifying information from the
respondents. To help detect accidental duplicate submissions, please select
the numeric value of your birthday month + day, divide by the square root of
your home address, and subtract the absolute value of the ACOG minion that
came up with their survey in the first place.
For example: ((April (4) + 19) / Ö5922) – ½-25½= -24.07
I hope you enjoyed my survey as much as I enjoyed writing it!
—
Tabaré Depaep, J.D., Esq., CLD (CAPPA)
Birth Doula, Breastfeeding Educator
Sleep Coach
cell 818.679-0947
pager 562.214.0346
That was great! I’m going to link to it! 🙂
LOVE IT TO PIECES. I’m Facebooking this right now!
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As I said on another blog post… what a bunch of creeps! I am beyond baffled that this organization is considered a “high authority” in pregnancy and birth and yet they do NOTHING that is beneficial to a woman who is pregnant or laboring. I feel like there’s no safety.
This is the best! Thanks for sharing. 🙂
stark omission of “iatrogenic neonatal vasovagal episode”
Ha! I enjoyed this. I agree, the ACOG survey is skewed and can never produce useful results because of bias in collection. Not that a little thing like that would stop anyone.
Part of my discussion with Patricia Grube: You should be suspicious. Last year they came out and made a statement against homebirth based on Level C evidence (consensus opinion). I wrote a direct response to that announcement and to which their replies by Dr. Hale were nonresponsive. (see post on my blog) Now, it seems, they are out to find out if they were correct. This is ass backwards thinking and reeks of bad research technique. “Here is what I think now we will try to find evidence to prove it!!” By the way, if they don’t, you will never be told. Completely lacking in objectivity and, as I said before, what do the anecdotal stories mean without comparison to successes? Also, I do not see them asking members to report data on bad outcomes in hospital births as they have already concluded that hospitals or birthing centers attached to hospitals are the safest place to give birth. This is just such a witch hunt. Thanks, Dr.F
Humor makes the pain a little less so thanks Tamare.
Not a survey, but the MAMA Campaign is looking for positive homebirth stories with Certified Professional Midwives to help promote the efforts for federal recognition. http://mamacampaign.squarespace.com/grapevine/2009/8/28/share-your-birth-story-with-the-mama-campaign.html
THIS IS CLOSE TO PERFECT…We all were thinking it, but YOU DID IT!
I know it is sad that we even have to waste our precious time on such inane matters.
Oh, you could have gone SO MUCH FURTHER with the Fetal Outcomes section!
1. Meconium inhalation
2. Oral Aversion
3. Food Allergies
4. Allergy to penicillin
5. Spinal/cervical misalignment
6. Scalpel injury
(My first baby had/has #2-4, second has 3-5… both unscheduled, non-emergent c-sections after hours of labor.)
But overall, this is awesome. 😉
It is very obvious that you ladies enjoy homebirth and I’m glad if you’ve had good experiences of your own with this method. Unfortunately not all scenarios work out as favorable as you like to think. For example, someone please explain to me how a doula could handle a uterine inversion especially when at home? What do you think the outcome actually would be? I’ll take a scary birth attended by a “profit driven” OB-GYN and two “defensive medicine” RN’s over imminent death anyday.
Thanks for hearing me out. I’d love to hear any seriously valid points to this.
Kevin
Beeeeeautiful!
In addition to collecting positive birth stories, it is crucial we bust the American myth that hospitals are safer for birth. We know it’s the opposite, statistically, for most women. Collecting hospital birth horror stories and educating the public Take cord prolapse, for instance — ACOG loves to trot that out, but ACOG fails to state that it’s much more likely to occur in hospitals, where women’s amniotic sacs are routinely ruptured and when that happens before the baby’s head is well-engaged, it makes cord prolapse more likely by flushing the cord out in advance of the baby’s head.
We need a serious public education campaign about the inherent perils of hospital birth which all but evaporate when you choose to stay at home with a good birth attendant like a certified professional midwife.
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You. Are. Brilliant!!!
First off doulas do not do any medical things, so a midwife would be at a homebirth. She is trained in emergencies, such as uterine inversion.
Typically uterine inversion is CAUSED by interference in the third stage of birth. Pulling on the cord (cord traction) can actually cause it. A midwife would typically be more hands off and hopefully by letting the placenta detatch on its own and mom push it out, it lowers the risk of such things as uterine inversion.
Can anyone get a screen shot of the ACOG survey page? It requires a log-in to actually get to it…I’d love to have a screen shot to post on my blog just to provide some “proof” to the sceptics who might doubt that ACOG is actually doing this.
Hi Jenn, I posted a copy on my blog site a couple days ago at http://www.supportdrfischbein.com
Just log on and scroll down.
Here is a link with a screen shot
http://keyboardrevolutionary.blogspot.com/2009/08/acog-gets-f.html
FABULOUS!
“Laughter is the greatest weapon you have” or something along those lines – Mark Twain
You missed one major hospital induced complication…
Pit to Distress
made me smile on some parts and remember with a cringe on other parts
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