Response to ACOG Homebirth Survey

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