The American College of Obstetricians and Gynecologists (ACOG) reiterates its long-standing opposition to home births. While childbirth is a normal physiologic process that most women experience without problems, monitoring of both the woman and the fetus during labor and delivery in a hospital or accredited birthing center is essential because complications can arise with little or no warning even among women with low-risk pregnancies.
And what exactly would they do about it in a birth center? They can't perform surgery there or something. That's when hospital transfers happen, and as long as you don't live in the middle of nowhere, what's the difference between a transfer from a birth center and a transfer from home? They make it seem like birthing at home, you're not monitored at all, but in reality, the same type of monitoring is used at home as would be in a birth center (intermittent monitoring via doppler).
ACOG acknowledges a woman's right to make informed decisions regarding her delivery and to have a choice in choosing her health care provider, but ACOG does not support programs that advocate for, or individuals who provide, home births. Nor does ACOG support the provision of care by midwives who are not certified by the American College of Nurse-Midwives (ACNM) or the American Midwifery Certification Board (AMCB).
Wait up a minute here ACOG... So you support Certified Nurse Midwives, but not people who provide homebirth services? You do realize that's quite a contradiction in a lot of states, right?
Childbirth decisions should not be dictated or influenced by what's fashionable, trendy, or the latest cause célèbre. Despite the rosy picture painted by home birth advocates, a seemingly normal labor and delivery can quickly become life-threatening for both the mother and baby. Attempting a vaginal birth after cesarean (VBAC) at home is especially dangerous because if the uterus ruptures during labor, both the mother and baby face an emergency situation with potentially catastrophic consequences, including death. Unless a woman is in a hospital, an accredited freestanding birthing center, or a birthing center within a hospital complex, with physicians ready to intervene quickly if necessary, she puts herself and her baby's health and life at unnecessary risk.
You're right. Birth should not be influenced by what's trendy. That's why I won't be having an induction, or a c-section, or bringing my son or daughter into the world in one of the oh-so-pretty birthing rooms at Las Palmas that all my friends are googly eyed over. Anyone who think homebirth is something to do because it's trendy is crazy. Less than 1% of American moms do it. It's hardly this year's Ugg boots.
And again, I reiterate, what on earth would they do in a freestanding birth center, that they cannot do at home? Just because you go somewhere to give birth does not automatically make it safer. (And FYI, a birth center in a hospital complex is a vile alternative for anyone who doesn't want a hospital birth. Most even LOOK like hospital rooms, and hospital policy reigns. Go freestanding if you go birth center unless you like hospital births.)
Advocates cite the high US cesarean rate as one justification for promoting home births. The cesarean delivery rate has concerned ACOG for the past several decades and ACOG remains committed to reducing it, but there is no scientific way to recommend an 'ideal' national cesarean rate as a target goal. In 2000, ACOG issued its Task Force Report Evaluation of Cesarean Delivery to assist physicians and institutions in assessing and reducing, if necessary, their cesarean delivery rates. Multiple factors are responsible for the current cesarean rate, but emerging contributors include maternal choice and the rising tide of high-risk pregnancies due to maternal age, overweight, obesity and diabetes.
It's concerned ACOG? Well, then why has absolutely nothing been done about it? And yes, you CAN set a goal for how much you want to bring it down to. The World Health Organization did it years ago, and with great effectiveness. In fact, adoption of their standards would serve a lot of people.
The availability of an obstetrician-gynecologist to provide expertise and intervention in an emergency during labor and/or delivery may be life-saving for the mother or newborn and lower the likelihood of a bad outcome. ACOG believes that the safest setting for labor, delivery, and the immediate postpartum period is in the hospital, or a birthing center within a hospital complex, that meets the 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.
If having an OB/GYN on hand lowers the likelihood of a bad outcome, then why does every birth center and homebirth midwife have such better outcomes on the whole than the hospitals? It's not to say bad stuff doesn't happen sometimes. It does, but in studies which are actually fair (as in, they only count PLANNED homebirths that have a midwife present, and the baby is full term when born) homebirth has better outcomes than hospital birth. No baby ever caught a drug-resistant superbug from being born at home. No baby or mom ever died of a Cytotech labor induction at home. No mom ever lost her uterus due to a botched unnecessary c-section at home. And again, WHAT would they do for problems that arise at a birth center, that they can't do at home? Have these people ever been to a birth center before?
It should be emphasized that studies comparing the safety and outcome of births in hospitals with those occurring in other settings in the US are limited and have not been scientifically rigorous. Moreover, lay or other midwives attending to home births are unable to perform live-saving emergency cesarean deliveries and other surgical and medical procedures that would best safeguard the mother and child.
Um, no midwife can do a c-section or surgical procedure, not even ACOG's approved CNM's. That's where hospital transfers come in... you know, exactly the same thing that would happen during a birth center delivery that went wrong. And if it hasn't been studied rigorously, then why do you people seem to know enough to make bold statements like this one?
ACOG encourages all pregnant women to get prenatal care and to make a birth plan. The main goal should be a healthy and safe outcome for both mother and baby. Choosing to deliver a baby at home, however, is to place the process of giving birth over the goal of having a healthy baby. For women who choose a midwife to help deliver their baby, it is critical that they choose only ACNM-certified or AMCB-certified midwives that collaborate with a physician to deliver their baby in a hospital, hospital-based birthing center, or properly accredited freestanding birth center.
Yes, a healthy safe outcome for mother and baby. Is that what they call c-sections, which up the risk of death for both by 400%? Is that what they call inductions, which up the risk of uterine rupture? Having a baby at home most certainly does not place the process over the outcome. It actually spares the mom and baby in question from some pretty serious dangers that lurk around every corner of today's US hospitals.Oh, and I particularly love the guideline to choose a midwife who's nothing more than some OB's sock puppet. These are the CNM's who induce people all the time, and tell you that you need to have your baby by 40 weeks, and basically are no better than an OB. There are some great CNM's in this world, and I should know, but the ones ACOG is recommending are not them.
So yeah, like I said, this whole statement was a gigantic crock, but it did explain a lot. The mainstream people trust ACOG for their guidelines, and they literally come out and say that going anywhere, no matter where that is, to give birth, is safer than doing it at home.
Now, how do we debunk this crap?
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