Amber | Indy Week

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Re: “Midwives seek autonomy in N.C.

What a shame Obstetricians continue to hold a near monopoly on birth and thwart the rights of women to make educated and informed decisions about their birth. The American College of Obstetrics and Gynecology (ACOG) is a trade organization designed to protect the best interest of its members obstetricians. It is obviously in obstetricians best interest to continue to remain in total control of birth. Cesarean sections require less time and generate far more money than natural, normal birth. The World Health Organization (WHO) has made clear that no cesarean rate above 10-15% is justifiable, yet, obstetricians in this country have a 30%+ rate of c-sections, 2-3 times the WHO recommendation. Maternal death is on the rise in this country for the first time since 1977, women are losing ground, and desperately need more midwifery care. Obstetricians receive training on interventions and surgery, and when they are needed, they can be life saving. We should all be grateful for the skills of obstetricians when they are needed. Midwives receive training on normal birth, and when complications and problems arise, they refer their patients to the specialists (obstetricians) as needed. Unfortunately, obstetricians receive very little, if any, training in normal birth. Of course obstetricians have superior skills with regard to interventions and surgery, but midwives have far more skills regarding normal birth. My first two births, attended by obstetricians in hospitals, were traumatic. My prenatal visits with my obstetricians were often just 5-10 minutes. With my third pregnancy, I received care from a homebirth midwife what a difference! Each prenatal visit lasted about an hour. In addition to basics such as fetal heart tone monitoring and blood pressure checks, my midwife talked with me extensively about nutrition, exercise, and other healthy pregnancy issues. I had a fabulous homebirth and would never consider going near a hospital to give birth to a baby again, unless of course a complication developed and I needed specialized care. The US ranks near bottom for neonatal health and well being among developed countries. The countries around the world with the best maternal and neonatal outcomes are also the countries with high rates of midwifery and homebirth. Recent coverage of the benefits of homebirth from Rikki Lakes Business of Being Born documentary followed with a stern statement from ACOG denouncing homebirth. Interestingly enough, ACOG has yet to issue a statement condemning elective cesareans, even though the data shows that elective cesareans result in far higher rates of maternal and fetal death, increased infant breathing problems, higher rates of infection, and a number of other problems, as compared to vaginal birth. ACOG and many obstetricians opposing homebirth are always quick to tout an anecdotal horror story of a homebirth tragedy. The truth is, most of us who have birthed in a hospital can also tell you anecdotal horror stories of hospital births, including unnecessary life threatening infections, medication mistakes, and yes, even dead baby stories. These types of decisions shouldnt be based on anecdotal horror stories, but hard facts. The fact is, the homebirth data makes clear that planned homebirth is safe, and outcomes are just as good, if not better than hospital births. To ensure the well being of pregnant women, the best solution would be for OBs to collaborate with midwives, both CNMs and CPMs. For a number of reasons, some women are going to choose homebirth. It is in the best interest of all women choosing homebirth to have legalized and licensed midwives who can practice openly, consult with OBs, and accompany women to the hospital if a complication arises. Many women right now are forced to go underground for care, or decide to forgo prenatal care altogether and have an unassisted homebirth. Hopefully, the NC legislature will help make birth safer and increase birth choice for NC women by legalizing CPMs.

Posted by Amber on 05/30/2008 at 12:46 PM

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