Friday, June 20, 2008

The Business of Being Born II

Found this news article on the BOBB website. Insightful. Thought I would share!


BREAKING NEWS FROM BOBB HEADQUARTERS

At their annual meeting over the weekend, the American Medical Association voted on two Resolutions that seek to prevent home births and to increase MD control over midwives (click here to read Resolutions 205 and 239).

The initial draft of Resolution 205 included a personal attack on Ricki Lake and our film "The Business of Being Born" which read:

Whereas, There has been much attention in the media by celebrities having home deliveries, with recent Today Show headings such as "Ricki Lake takes on baby birthing industry: Actress and former talk show host shares her at-home delivery in new film..." (for full text of the original Resolution, scroll down to 205)

News outlets including the AP quickly picked up this story yesterday as it hit TMZ, E!, USA Today, Daily News, FOX, and Ricki will be featured on Good Morning America this weekend as well. (If you Google "Ricki Lake, AMA" you will see the bloggers are all over this!)

Filmmakers Abby Epstein and Ricki Lake teamed up with journalist and Pushed author Jennifer Block to pen the following response for the Huffington Post and also submitted a seperate Op-ed to the Washington Post this morning:

DOCS TO WOMEN: PAY NO ATTENTION TO RICKI LAKE'S HOME BIRTH

Ladies, the physicians of America have issued their decree: they don't want you having your babies at home with midwives.

We can't imagine why not. Study upon study have shown that planning a home birth with a trained midwife is a great choice if you want to avoid unnecessary medical intervention. Midwives are experts in supporting the physiological birth process: monitoring you and your baby during labor, helping you into positions that help labor progress, protecting your pelvic parts from damage while you push, and "catching" the baby from the position that's most effective and comfortable for you—hands and knees, squatting, even standing—not the position most comfortable for her.

When healthy women are supported this way, 95% give birth vaginally, with hardly any intervention.

And yet, the American Medical Association doesn't see the point. Yesterday it adopted a policy written by the American College of Obstetricians and Gynecologists against "home deliveries" and in support of legislation "that helps ensure safe deliveries and healthy babies by acknowledging that the safest setting for labor, delivery, and the immediate post-partum period is in the hospital" or accredited birth center.

"There ought to be a law!" cry the doctors.

The trouble is, they have no evidence to back up their safety claims. In fact, the largest and most rigorous study of home birth internationally to date found that among 5,000 healthy, "low-risk" women, babies were born just as safely at home under a midwife's care as in the hospital. And not only that, the study, like many before it, found that the women actually fared better at home, with far fewer interventions like labor induction, cesarean section, and episiotomy (taking scissors to the vagina, a practice that according to the research should be obsolete but is still performed on one-third of women who give birth vaginally).

Which is why the American Public Health Association supports midwife-attended home birth. The British OB/GYNs have read the research, too, and have this to say: "There is no reason why home birth should not be offered to women at low risk of complications... it may confer considerable benefits for them and their families. There is ample evidence showing that labouring at home increases a woman’s likelihood of a birth that is both satisfying and safe..."

The other trouble with the American MDs is that they seem to have lost all respect for women's civil rights, indeed for the U.S. Constitution – the right to privacy, to bodily integrity, and the right of every adult to determine her own health care. The "father knows best" legislation they are promoting could indeed be used to criminally prosecute women who choose home birth, say, by equating it with child abuse.

Research evidence be damned, the doctors want to mandate you to go to the hospital. They don't want you to have a choice.

We think they're spooked. The cesarean rate is rising, celebrities are publicizing their home births (the initial wording of the AMA resolution actually took aim at Ricki for publicizing her home birth on the Today Show!), people are reading Pushed and watching The Business of Being Born, and there's a nationwide legislative "push" to license certified professional midwives in all states (The AMA is against that, too, by the way).

The docs are on the defensive.

After all, birth is big business—it's in fact the most common reason for a woman to be admitted to the hospital. And if more women start giving birth outside of it, who will get paid? Not doctors and not hospitals.

"The AMA supports a woman’s right to make an informed decision regarding her delivery and to choose her health care provider," the group said in a statement. But if it really supported women's birth choices it wouldn't adopt a policy condemning home birth and midwives.

Because if U.S. women are to have real birth choices, everybody needs to be working together to provide them, not engaging in turf wars at their expense.

Late yesterday, the AMA changed the wording on the final resolution 205 to omit the line about Ricki. (Hmmm...) They are now attributing the original language to the American College of Obstetricians and Gynecologists (ACOG) who drafted the initial statement.

Stay tuned for more news to come....

The BOBB Team


Here's the Resolution 205:

AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES

Resolution: 205

(A-08)

Introduced by: American College of Obstetricians and Gynecologists

Subject: Home Deliveries

Referred to: Reference Committee B

(Craig W. Anderson, MD, Chair)


Whereas, Twenty-one states currently license midwives to attend home births, all using the certified professional midwife (CPM) credential (CPM or "lay” midwives), not the certified midwives (CM) credential which both the American College of Obstetricians and Gynecologists (ACOG) and American College of Nurse Midwives (ACNM) recognize[1]; and

Whereas, There has been much attention in the media by celebrities having home deliveries, with recent Today Show headings such as “Ricki Lake takes on baby birthing industry: Actress and former talk show host shares her at-home delivery in new film” [2]; and

Whereas, An apparently uncomplicated pregnancy or delivery can quickly become very complicated in the setting of maternal hemorrhage, shoulder dystocia, eclampsia or other obstetric emergencies, necessitating the need for rigorous standards, appropriate oversight of obstetric providers, and the availability of emergency care, for the health of both the mother and the baby during a delivery; therefore be it

RESOLVED, That our American Medical Association support the recent American College of Obstetricians and Gynecologists (ACOG) statement 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 American Academy of Pediatrics (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” [3] (New HOD Policy); and be it further

RESOLVED, That our AMA 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.” (Directive to Take Action)


Fiscal Note: Implement accordingly at estimated staff cost of $1,929.

Received: 04/28/08



[1] http://www.acog.org/departments/stateleg/MidwiferyYearinReview2007.pdf, accessed March 18, 2008

[2] www.today.msnbc.msn.com/id/22592397, accessed March 18, 2008

[3] www.acog.org/from_home/publications press_releases/nr02-06-06-2.cfm, accessed March 18,2008

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