Excellent press piece

[Click HERE to go to the story.]

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Quite surprisingly, this piece about  midwives and homebirth is quite balanced if not a bit to the left. Kudos. One of my favorite lines:

““All women have choices,” Rach Zeller of Buffalo Homebirth says. “They can refuse anything that they’re being asked to consent to. They need to take it upon themselves to really understand what the ramifications are of what procedures they allow.

So we are back to the old question we birth advocates keep going round and round about. The age-old question of “Which came first, the chicken or the egg?” Is it the doctors who need to change or the women who need to stand up and demand birth be allowed to progress as GOD intended? Because let’s face it – women’s bodies were created and I believe INTRICATELY DESIGNED to give birth. And like any other God-thing that we humans get our hands into, we may never fully understand the ramifications of messing with that perfection.

Interesting turn of phrase

Interesting. Hmmm… Note the recent practice bulletin by ACOG regarding induction of labor:

“A physician capable of performing a cesarean should be readily available any time induction is used in the event that the induction isn’t successful in producing a vaginal delivery,” Dr. Ramin concluded. “These guidelines will help physicians utilize the most appropriate method depending on the unique characteristics of the pregnant woman and her fetus.”

Obstet Gynecol. 2009;114:386-397.

Ok, so all we need is “a physician capable of performing a cesarean” to be “readily available” should an induction be “unsuccessful”. Interesting. But for a VBAC “trial of labor” hospitals should have “immediate access” to anesthesiologists? Hmmm….

And on the use of oxytocin: “The main adverse effects of oxytocin are dose-related uterine tachysystole and category II or category III FHR tracings.”

But for  nipple stimulation, which is often a labor augmentor (if you want to medical-ize it) used by midwives at home births, the risks include “uterine tachysystole with FHR decelerations and increased trend in perinatal death.”

Interesting isn’t it? That oxytocin doesn’t carry a risk of perinatal death but NIPPLE STIMULATION does?

Interesting indeed.

Only if…

“It’s a numbers thing,” says Dr. Shelley Binkley, an ob-gyn in private practice in Colorado Springs who stopped offering VBACs in 2003. “You don’t get sued for doing a C-section. You get sued for not doing a C-section.”

I’ve seen this quote before, but it never quite made me as angry as it did this morning when I was reading it in the context of THIS TIME MAGAZINE ARTICLE. This California mom has to drive 100 miles to have the chance for a VBAC. Give me a break!

I understand liability, I truly do, and I understand that to continue offering care for the majority of patients, one must sometimes eliminate care for the minority. But hey. This is ridiculous. As a VBAC mom myself, I would have to drive at least 100 miles and then only have “permission” for a “trial of labor” within a very small window of opportunity. “Only if” my incision was of type A, “Only if “ my bag of waters hadn’t been broken more than 12 hours, “Only if” the baby was in a perfect position (by obstetrical definitions), “Only if” the labor didn’t last more than X number of hours, “Only” if it progresses well, “Only” if I would have continuous fetal monitoring, “Only if………”

By the time all of the restrictions had been placed on me I’d have a better chance of delivering my baby vaginally in a snow storm in the middle of April. Yeah, it happens, but rarely. Birth was not meant to be a 3-ring circus with planned events and bright lights.

This mom, in the Time article, said her biggest fear was the drive and that she might not make it to the hospital.

If only… she gets that lucky. It might be her best chance at a natural birth.

ACOG Official Position on Homebirth

 You can read the release in it’s entirety HERE. Basically more of the same. Homebirths are risky, hospitals are better, blah blah blah. No statistics, no data, just more of the same. It makes me sick. The patronizing tone that accompanies these statements infer, “Be a good little girl and do what your doctor tells you.” God forbid you think for yourself, ask questions, read, educate, listen, HEAR, make choices for yourself. Oh no. We can’t have that. Ugh. Can you hear me screaming?

I recently came across Britain’s Royal College of Obstetrician’s and Gynaecologist’s statement on homebirths. It was released in April of 2007. The overall tone is one of a deep respect for childbirth choices and a woman’s right to choose where and with whom she gives birth. The high spots are as follows:

“There is no reason why home birth should not be offered to women with low risk of complications and it may confer considerable benefits for them and their families.”

“The review of the diverse evidence available on home birth practice and service provision demonstrates that home birth is a safe option for many women.”

“The observational data available show lower intervention rates and higher maternal satisfaction with planned home birth compared with hospital birth.”

“It is aknowledged that there are no known risk assessment tools which have an effective predictive value concerning outcomes in the antenatal period and labour.”

“UK maternity policies recognise that, for the majority of women, pregnancy and childbirth are normal life events and that promoting women’s experience of having choice and control in childbirth can have a significant effect on children’s healthy development.”

“There is ample evidence showing that labouring at home increases a woman’s likelihood of a birth that is both satisfying and safe, with implications for her health and that of her baby.”

Contrast this with the ACOG’s statement and you’re probably left scratching your head. Me too. Add that to the fact that in 2005, shortly after the major study linking better outcomes with CPM’s and homebirths, the OB.GYN.News put out a very favorable article. The title? “Planned Homebirths Safe, Study Suggests“.  AOG’s article on safety of homebirth  Makes ya go “Hmmm… ” doesn’t it???