Oh. My. Goodness.

Here is a fantastic doctor doing what so few do (or at least they don’t make headlines). He seems to be really genuine about advocating for women in the rough spot of wanting a normal birth after thay have had a surgical one. As a VBAC mom, this gets my goat everytime.

I want to send this guy flowers.


Domicilary Obstetrics

Here in the US, homebirth midwives normally seek to remove and distinguish themselves from the term “obstetrics”. It conjurs images of sterile green hospital walls, episiotomies, paternalistic care, and the dreaded bed and stirrups of 2nd stage.

I recently came across the term used in a most delightful way at the Homebirth Australia site.. It’s definition most creativily defining what homebirth midwives do:

However, domiciliary obstetrics is the ‘art of invisibility’ and without complications a woman gives birth herself, supported and aided by her midwife. -Jan Pilgrim

I would love to have turned that phrase. “The art of invisibility”. Yes! A watchful eye, careful watching, gentle hands. THIS is the art of the midwife.

Who’da thunk it?

A WOW news release on MedLine this morning regarding the safety of planned homebirths. Get this:

All of the outcomes studied occurred with comparable frequency in the planned home and hospital birth groups. These included intrapartum death (0.03% vs. 0.04%), intrapartum and neonatal death within 24 hours of birth (0.05% vs. 0.05%), intrapartum and neonatal death within 7 days (0.06% vs. 0.07%), and neonatal admission to an intensive care unit (0.17% vs. 0.20%).

[My note: actually, the numbers show slightly better outcomes at home. 😉 ]
“As far as we know, this is the largest study into the safety of home births,” the authors note. The findings, they conclude, indicate that with proper services in place, home births are just as safe as hospital births for  low-risk women.  ~ BJOG 2009;116:1177-1184

NOw of course this is a “foreign” publication (British Journal of Gynecology) so I don’t know how much credibility it will get here in the trenches, but WOW. Very cool that the news is getting out there to US med students and physicians!

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???

Well Said Mr. Jefferson!

“I know of no safe depository of the ultimate powers of the society but the people themselves;                                                   and if we think them not enlightened enough to exercise their control with a wholesome discretion,                                      the remedy is not to take it from them, but to inform their discretion by education.”    ~Thomas Jefferson

Well said. Very well said. The ACOG could use a bit of this advice. Constantly trying to “save” women from themselves, it absolutely enrages me that many will perform abortions under the argument of “It’s your body.” but will refuse VBAC’s, natural labors, laboring without intervention, denying women their birthing rights. And they do this in such a sneaky way. It’s unlawful for them, speaking broadly, to outright deny you services. You have rights you know. But if your decision/wishes conflict with the OB, then by golly, you can take your “rights” elsewhere. They simply write you a letter and dismiss you from their care. This is how they monopolize the childbirth experience and make it about their decisions and not ours.

When will we, birthing women with daughters who will be birthing women someday, stand up and LEARN the truth about birth and begin telling others about it? As usual, an educated mind is a healthy one and the future of birth depends on what we do TODAY to impact the birth culture.