1. What Doctors don't want birthing moms to know is that most of what they do in a hospital is not proven to be safer - leading to a better outcome, but purely legal CYA (covering their a$$).

Add to that the fact that many of the "complications" of childbirth women experience under an OB's care are a direct *result* of their "interventions"... well, they have their paychecks to worry about.

Home birth is safe for most women and their babies.
http://www.sexynursingbra.com

Posted at 11:41AM on Jun 18th 2008 by Carrie

2. In other breaking news.....Gangsters Unhappy About Elliott Ness Investigation

Of course they're unhappy. Nobody wants their dirty linens aired.

This past weekend, the American Medical Association (AMA) adopted a resolution to introduce legislation outlawing home birth. The resolution doesn't offer any science based information.

Posted at 1:36PM on Jun 18th 2008 by Sandyone

3. It's almost funny that ACOG and AMA are freaking out about The Business Of Being Born, The Big Push and other artifacts of advocacy that show home birth with a trained attendant (OB, FP, GP, Midwife...) as a safe and available option for American women. Home births presently account for 1% of all births in the US. Why do they feel so threatened?

I'm thinking it's a case of ACOG and AMA members being caught in the midst of snookering pregnant women and lashing out in desperate defense.

An examination of countries with better maternity outcomes than the US would show that home birth is not only an accepted practice, but part of the mainstream medical system.

Of the tragic consequences the AMA and ACOG site as reasons not to have a home birth, most are easily identifiable at home long before they become an emergency (midwives at home are a cautious lot) and some have remedies that are safely administered in the home setting. However, they fail to point out that statistically, women and infants die of the exact same obstetric emergencies in hospital settings at about the same rate as they do in home birth situations. And, alternately, many obstetric emergencies are iatrogenic, meaning the docs and nurses cause them via the type of care they give, which is almost entirely avoided at home births.

Methings ACOG and AMA doth protest too much!

Posted at 2:11PM on Jun 18th 2008 by mamaloo

4. My baby was born at home and it was the best decision I ever made. And I am a very cautious person who also counts three doctors and one RN among my close relatives. My only regret is that there were so few options in terms of a OB or GP willing to provide me with back-up care.

Professional midwives are legal here in VA, but the doctors acted like I was asking them to collude in a pre-Roe v. Wade abortion. It's a shame that many doctors are so threatened by a perceived loss of power that they can't recognize that homebirth properly managed is a very safe option for women. Incidentally, the one supportive MD I found was from Canada who saw no problem providing me we supplemental services as this is a normal situation where she is from.

Posted at 3:42PM on Jun 18th 2008 by ARJ

5. I don't know about the AMA as an organization... maybe it does feel threatened. But I really trust my OB and I really think that the reason he doesn't advocate a home birth is because he truly believes that it is erring on the side of caution to have your baby in a hospital. He has seen it all (after 35 years) and I know he cares deeply for all of his patients. Maybe he doesn't have all the figures about homebirthing (I sure don't) but he gives his advice based on what he does know -- what he does know is that things sometimes go wrong no matter where you have a baby.
Anyway, I don't agree with any legislation that would outlaw homebirths, but if my doctor wants to give his experienced opinion, I welcome it.

Posted at 5:34PM on Jun 18th 2008 by Maureen

6. How do you know that your doctor has "seen it all?" If he has never seen a home birth, then he hasn't seen it all. This is a huge problem; very few obstetricians have actually observed, let alone participated in, a normal physiological labor. They have NO IDEA what women sound like, the positions they assume to facilitate the birth, or how to support the woman outside of using medications. Studies consistently show that home birth is just as safe as hospital birth and less interventions are used. Too many women don't recognize the real risks of interventions and too many women don't know that many medications used in labor have not been approved by the FDA for use on pregnant women. In fact, one of these drugs, Cytotec, has not only not been approved, the FDA warns doctors against its use (btw this drug is one of the drugs in the abortion pill RU486) Too many women don't consider the effects of any interventions on not only the baby but the mother and the labor itself. Women have the right to fully informed consent and to make their own decisions about the place of birth. If your doctor has seen a planned homebirth with a woman who was considered low risk then maybe he has seen it all; but most doctors haven't seen this. In light of the fact that they haven't likely observed this personally, they should look to the medical literature for evidence of the safety and efficacy of home birth. It is appalling to me that ACOG and AMA can take positions that are contrary to what one finds in the medical literature. peace....

Posted at 10:29PM on Jun 18th 2008 by Kat

7. I had three home births with midwives. Since I wanted my tubes cut after my fourth, I opted to go to a hospital, but I found a midwife who could help me with a waterbirth in the smallest close hospital. Ruthe was born about 10:30 pm, but we didn't see much of the nurses, cause the next child born that night had Down's Syndrome and the staff was very busy for the rest of the night. I believe most women can have a safe home birth experience, but certainly not all. My best friend has had four C sections - that's just how it turned out for her. We both have great kids, no matter how they got here. Just wanted to weigh in that all women should make their own informed decisions about the most intimate experiences of their lives. I'm glad to see someone promoting education and empowerment. More information, how is this a bad thing? Someone might take their birth experience into their own hands? It's her body, after all.

Posted at 3:23AM on Jun 19th 2008 by Heatherlynn

8. Home births are great for women and children that have no complications. However what happens when there is a complication?

The utility of having a fully staffed medical hospital on hand is priceless. Because that staffed and trained hospital is equipped to deal with complications unlike your bedroom.

The reasons for not having a home birth is for the minority of women and children who have complications during birth. There is little that any midwife can do when a birth goes wrong and requires the hands of a train physician who has dedicated their lives to studying the human body and life itself.

For those of you who seem to have disdain against all doctors and science based medicine, I have one question, you seem to say that home birthing is safer. How is it safer? Do you have any documentation that compares all of the births in hospitals compared to births at home?

What are you basing the idea that home birthing is safer? Why because someone with a warm smile said it was, as opposed to a colder more impersonal doctor?

The medical system has it's faults and one is that doctors are often distant, that doesn't mean that they don't care. It means they've spend more time studying the human body as opposed to someone who spent time studying catering to your wants and needs.

All I ask you to do is question what any one tells you no matter if there your midwife or your doctor. I think if you do this enough you may see who can provide a better argument for what is better for you and your children.

Posted at 7:50AM on Jun 19th 2008 by Don

9. Don, there are a bunch of studies available and they all show the same thing: there is little difference, statistically between home birth and hospital birth in terms of mortality (mother and/or baby) and a big difference in favour of home birth in terms of morbidity (mother and/or baby). So, when people say that home birth is safer, they mean that you have about the same chances of dying in hospital as in home and you have less chance of being injured (experiencing long lasting pain, infection, cutting...) at home than in hospital. Ergo, taking in all factors, home birth appears an as safe or safer option than a hospital birth FOR LOW RISK PREGNANCIES.

Concerning mother/baby pairs who have complications that arise in labour and/or birth, home birth attendants (who include OBs, GPs, FPs and midwives) are trained in assessing maternal and fetal health, know when things are starting to head out of their scope of practice and can treat, on site, for things that are within their scope of practice.

For example, in the case of hemorrhage, home birth attendants carry oxytocin injections for active management of third stage (designed to prevent or diminish hemorrhage) as well as back up meds in case a hemorrhage happens (which are administered as an ambulance is called for transport to hospital) - this happens pretty rarely and it's even rarer that the hemorrhage is so bad it is fatal, but this is exactly how it would be treated in hospital.

The midwives that I work with, who delivered one of my sons in hospital and one at home (hospital was because I as 36.6 wks when I went into labour with prolonged PPROM, making it the safest place for me to give birth when all my circumstances are factored in) can verify that the vast majority of hospital transfers are because mothers request epidurals. A minority of transfers are for suspected complications. An incredibly rare (as in a few times in a life of practice) mothers are transfers because there is an emergency underway and those transfers happen in a timely fashion that is not different than how fast an obstetric team can respond to a similar emergency in hospital.

I don't think anyone would ever claim that all births should happen at home, however it should absolutely be an option easily available to women who have low risks.

The Royal College of Obstetrics and Gynaecologists in the UK recently released a statement saying that home birth should be available to all low risk women who desire them. Most provinces in Canada have midwives on the government health scheme, providing service in hospital and home. What is it about Canadian and UK vagin@s and uteruses that is so magical? What is wrong with the uteruses and vagin@s of US mothers that makes them so dangerous that they MUST be in hospital?

Posted at 5:39PM on Jun 19th 2008 by mamaloo

10. Don, there are a bunch of studies available and they all show the same thing: there is little difference, statistically between home birth and hospital birth in terms of mortality (mother and/or baby) and a big difference in favour of home birth in terms of morbidity (mother and/or baby). So, when people say that home birth is safer, they mean that you have about the same chances of dying in hospital as in home and you have less chance of being injured (experiencing long lasting pain, infection, cutting...) at home than in hospital. Ergo, taking in all factors, home birth appears an as safe or safer option than a hospital birth FOR LOW RISK PREGNANCIES.

Concerning mother/baby pairs who have complications that arise in labour and/or birth, home birth attendants (who include OBs, GPs, FPs and midwives) are trained in assessing maternal and fetal health, know when things are starting to head out of their scope of practice and can treat, on site, for things that are within their scope of practice.

For example, in the case of hemorrhage, home birth attendants carry oxytocin injections for active management of third stage (designed to prevent or diminish hemorrhage) as well as back up meds in case a hemorrhage happens (which are administered as an ambulance is called for transport to hospital) - this happens pretty rarely and it's even rarer that the hemorrhage is so bad it is fatal, but this is exactly how it would be treated in hospital.

The midwives that I work with, who delivered one of my sons in hospital and one at home (hospital was because I as 36.6 wks when I went into labour with prolonged PPROM, making it the safest place for me to give birth when all my circumstances are factored in) can verify that the vast majority of hospital transfers are because mothers request epidurals. A minority of transfers are for suspected complications. An incredibly rare (as in a few times in a life of practice) mothers are transfers because there is an emergency underway and those transfers happen in a timely fashion that is not different than how fast an obstetric team can respond to a similar emergency in hospital.

I don't think anyone would ever claim that all births should happen at home, however it should absolutely be an option easily available to women who have low risks.

The Royal College of Obstetrics and Gynaecologists in the UK recently released a statement saying that home birth should be available to all low risk women who desire them. Most provinces in Canada have midwives on the government health scheme, providing service in hospital and home. What is it about Canadian and UK uteruses that is so magical? What is wrong with the uteruses of US mothers that makes them so dangerous that they MUST be in hospital?

Posted at 5:41PM on Jun 19th 2008 by mamaloo

11. Response to Mamaloo

It would be helpful if you could link some studies stating so(I.E. backing up what you say with evidence)

Yes the Royal College of Obstetrics and Gynecologists did say they fully support unassisted normal birth. They also stated that women should be fully informed about the risks involved and I Quote "The RCOG would like to stress that at present, the practice of free birth is new to the UK and little research exists regarding its safety and success".

Source: http://www.medicalnewstoday.com/articles/75424.php

I am all for women choosing home birth if it is safe, my wife had considered it with her midwife, however we had some previous complications so we decided to give birth in a hospital with our midwife as well as a OBGYN present(Our midwife and OBGYN share an office together), it was a great experience and there was little to no intervention with our sons birth.

Yes there are studies that show a positive outcome for home births. such as

http://www.medicalnewstoday.com/articles/29083.php

However in the United States you have to careful about how your midwife is, there has been a debate about people calling themselves midwifes that have no medical training.

http://www.medicalnewstoday.com/articles/40992.php

The only point I would like to make is make sure to get the proper prenatal care and carefully weigh the risk involved in home births before making any decisions. Make sure your birth is as safe as possible which is usually in a hospital, you can have a midwife deliver in a hospital.

Posted at 7:32AM on Jun 20th 2008 by Don

12. Don, I didn't speak about UC in the UK, I spoke of home birth. Not only did RCOG make a public statement recently stating that home birth is considered as safe as in hospital birth for low risk pregnancies, it is actively promoting home birth as a partial solution to the financial crisis UK's maternity services are experiencing. Because, not only is home birth (with a trained attendant) as safe as in hospital birth, it's also very cost effective.

"Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States."
The Johnson, Davis Study, the most recent and most extensive study
http://www.bmj.com/cgi/content/full/330/7505/1416?ehom

"There was no increased maternal or neonatal risk associated with planned home birth under the care of a regulated midwife. The rates of some adverse outcomes were too low for us to draw statistical comparisons, and ongoing evaluation of home birth is warranted."
http://www.cmaj.ca/cgi/content/full/166/3/315?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=homebirth&andorexactfulltext=and&searchid=1091066389470_8790&stored_search=&FIRSTINDEX=0&sortspec=relevance&resourcetype=1&journalcode=cmaj

"No significant differences between the two groups regarding fetal and neonatal death, labor- related complications, or low 5- minute Apgar scores were detected, regardless of whether the comparisons were crude or adjusted for confounders."
http://www.thefarm.org/charities/mid.html

I am unaware of any study that shows that there is a large discrepancy in numbers showing that planned home birth with a trained attendant is markedly less safe for low risk pregnancies. And, ever if there were, it is a patient's right to choose their care, especially in the US where health care is a la carte.

If you had cancer that required chemo and radiation for treatment, but decided you wanted to limit your therapies to naturopathy, that is totally your right to do. There are no laws forcing you to undergo treatments that you believe are antithetical to your personal philosophies and spiritual beliefs, that you believe are unnecessary, that you believe are abhorrent, that you believe are ultimately detrimental to your health. Surgeons (which is what obstetricians are), do not have the right to force women to do what they don't want and often done medically need to do.

Noone would suggest that a women who feels hospital birth is the safest option for her or that women with a history of obstetric complications should be giving birth at home. Hospital birth has its place. So does home birth.

Posted at 11:04PM on Jun 21st 2008 by mamaloo

13. This story is very frightening to me. We need to realize that childbirth is NOT AN ILLNESS. Childbirth is one of the most natural processes on this earth! Many women are not comfortable with their bodies so they don't realize the beauty in giving birth. Labor is absolute, meaning that it will happen with or without "medical intervention. The preparation of the mother is the key. The problem is that we buy into the notion that childbirth=pain, suffering, and countless hours of agony and wait. Every woman is different. Every birth is different. Why would any doctor want to take away a women's choice. One word, MONEY. Epidureals, C-sections, iv's, supplements- given to you & your baby for no reason, use of hospital bed, nurse & doctor assistance,etc..... all add to the medical community decision not to promote homebirths.

I encourage all women to seek true knowledge about their reproductive rights and not be passive.

Also, check out the story that the "medical community" just published about hospitals failing to offer new mothers support with breastfeeding. Why is that? Oh yeah, breastfeeding is free, so it must be bad right? The hyprocrisy is laughable.

Posted at 12:37PM on Jun 19th 2008 by InformedWoman

14. I can't speak for all mothers/hospitals, of course, but I had some trouble establishing breastfeeding with my first (not because of any trouble getting going; but his latch was HARD. Painful, even on the finger--imagine on the breast!), and the hospital where I stayed was so extremely kind and helpful. I had nurses/lactation consultants in helping me whenever I wanted...and there was a free LC service in the hospital that I used after we went home.

So, I guess...just as doctors shouldn't demonize home birth, nor should we demonize hospital birth. There is a place for both in this wide world of mothering experiences!

Posted at 2:52PM on Jun 19th 2008 by Rebecca

15. Statistics show that home births are generally safe. Midwives rule out the option for higher risk patients. We chose freestanding birthing center supervised by certified nurse midwives for 2 of our 3 children who were born in the late 80's and early 90's. They were wonderful experiences for us. I made this choice after having a regular hospital birth in 1986 in Gastonia NC which was overly supervised and not a good experience ---enema, shaving, unnecessary episiotomy (which tooks months to heal.) The staff was not supportive of my decision to avoid pain medications or to keep the baby with me after she was born. If we had any more babies, we would have strongly considered home birth. Childbirth is a natural healthy event, not a medical procedure. Women need to be able to make their own educated decisions on this. I worry that my daughters will not have the options I had when they give birth. I congratulate Ricki Lake for exposing the issues involved and working to keep choices available.

Posted at 4:21PM on Jun 19th 2008 by dsmythfreeman

16. I have three children. I had three normal, low-risk pregnancies. My first two children were born in hospitals with midwives and no drugs. My third child was born at home. If I had known and been more confident in my ability to birth babies with my first child, I would have had them all at home. It was a wonderful and empowering experience! I encourage all pregnant women I meet to look at all of their options when it comes to birth. American women are being pressured by society to think a medicated birth in a hospital is the only viable option. Many women have given me the "Are you crazy?" stare when they find out I had a home birth. "You mean it was planned?" they often ask me. Home births are slowly, slowly, slowly becoming mainstream and that's what scares doctors and hospitals. Birth is a huge money maker. So, keeping women uneducated and scared about birth is the perfect solution to the rise in women discovering their midwifery options. In my opinion...a woman with a normal, low-risk pregnancy will have a better experience and outcome with a midwife and limited interventions (if any at all)...and, yes...homebirths ARE SAFE (read the real statistics) and absolutely heavenly! I watched "The Business of Being Born" as soon as it came out on DVD...very good and reliable information. I relived my births all over again!

Posted at 4:29PM on Jun 20th 2008 by marria (2manykids2littletime.com)

17. I wish Ricki Lake said that she is encouraging mothers to homebirth and that her intention is to shed light on birth and empower women to make informed choices. Rather than "The point of her film, she says, was not to encourage women to have home births but to provide them with a full range of information about birthing options. "I can't imagine they are scared everyone will have a home birth because I did."
seems like a cop out after her incredable film.

Posted at 2:21AM on Jun 21st 2008 by islandmamma

18. http://www.youtube.com/watch?v=2pN58kf3Ims
A little ditty as a response to all this.

Posted at 1:57AM on Jun 22nd 2008 by Demetria