Breaking News from Ricki Lake and BOBB

June18, 2008 Dear BOBB Friends and Supporters: We wanted to make sure you are all aware of the news story that has exploded over the last 24 hours regarding the recent AMA Resolution against homebirth and Ricki's response to being named in it. In February of this year, one month after the premiere of BOBB, the American College of Obstetricians and Gynecologists (ACOG) reiterated its long-standing opposition to home births. In an obtuse reference to The Business of Being Born, ACOG stated, "Childbirth decisions should not be dictated or influenced by what's fashionable, trendy, or the latest cause célèbre."  If that wasn't enough, ACOG, this past weekend, introduced a resolution to the American Medical Association (AMA) at their annual meeting. The resolution commits the AMA to "develop model legislation in support of the concept that the safest setting for labor, delivery, and the immediate post-partum period is in the hospital...". The reasoning for this resolution begins, "Whereas, There has been much attention in the media by celebrities having home deliveries, with recent Today Show headings such as "Ricki Lake takes on baby birthing industry: Actress and former talk show host shares her at-home delivery in new film...". (Resolution 205, click here to read). Since when did Ricki become an evidence-based data point? What are they so afraid of? Just last week, Medical News Today reports that "about 8.2% of infants born in the US in 2005 had low birth weights, the highest percentage since 1968." US infant mortality rates continue to rank us below 30 other countries, 22% of pregnancies are induced, and most worrisome of all, in the last 4 years, the maternal mortality rate has risen above 10 per 100,000 for the first time since 1977. To us, these seem like the troubling trends, not home birth. News outlets including the AP quickly picked up this story yesterday as it hit TMZ, E! USA Today, Daily News, FOX. Ricki will be featured on Good Morning America this Saturday discussing the controversy. (If you Google "Ricki Lake, AMA" you will see the bloggers are all over this!) Filmmakers Abby Epstein and Ricki Lake teamed up with journalist and Pushed author Jennifer Block to pen the response (following at the end of this email) for the Huffington Post (click here to read). Late yesterday, the AMA changed the final wording on resolution 205 to omit the mention of Ricki. (Hmmm...) The AMA says that the American College of Obstetricians and Gynecologists (ACOG) drafted the initial statement so any issues should be taken up directly with them. Stay tuned for more news to come... The BOBB Team DOCS TO WOMEN: PAY NO ATTENTION TO RICKI LAKE'S HOME BIRTH Ladies, the physicians of America have issued their decree: they don't want you having your babies at home with midwives. We can't imagine why not. Study upon study have shown that planning a home birth with a trained midwife is a great choice if you want to avoid unnecessary medical intervention. Midwives are experts in supporting the physiological birth process: monitoring you and your baby during labor, helping you into positions that help labor progress, protecting your pelvic parts from damage while you push, and "catching" the baby from the position that's most effective and comfortable for you-hands and knees, squatting, even standing-not the position most comfortable for her. When healthy women are supported this way, 95% give birth vaginally, with hardly any intervention. And yet, the American Medical Association doesn't see the point. Yesterday it adopted a policy written by the American College of Obstetricians and Gynecologists against "home deliveries" and in support of legislation "that helps ensure safe deliveries and healthy babies by acknowledging that the safest setting for labor, delivery, and the immediate post-partum period is in the hospital" or accredited birth center. "There ought to be a law!" cry the doctors. The trouble is, they have no evidence to back up their safety claims. In fact, the largest and most rigorous study of home birth internationally to date found that among 5,000 healthy, "low-risk" women, babies were born just as safely at home under a midwife's care as in the hospital. And not only that, the study, like many before it, found that the women actually fared better at home, with far fewer interventions like labor induction, cesarean section, and episiotomy (taking scissors to the vagina, a practice that according to the research should be obsolete but is still performed on one-third of women who give birth vaginally). Which is why the American Public Health Association supports midwife-attended home birth. The British OB/GYNs have read the research, too, and have this to say: "There is no reason why home birth should not be offered to women at low risk of complications... it may confer considerable benefits for them and their families. There is ample evidence showing that labouring at home increases a woman's likelihood of a birth that is both satisfying and safe" The other trouble with the American MDs is that they seem to have lost all respect for women's civil rights, indeed for the U.S. Constitution - the right to privacy, to bodily integrity, and the right of every adult to determine her own health care. The "father knows best" legislation they are promoting could indeed be used to criminally prosecute women who choose home birth, say, by equating it with child abuse. Research evidence be damned, the doctors want to mandate you to go to the hospital. They don't want you to have a choice. We think they're spooked. The cesarean rate is rising, celebrities are publicizing their home births (the initial wording of the AMA resolution actually took aim at Ricki for publicizing her home birth on the Today Show!), people are reading Pushed and watching The Business of Being Born, and there's a nationwide legislative "push" to license certified professional midwives in all states (The AMA is against that, too, by the way). The docs are on the defensive. After all, birth is big business-it's in fact the most common reason for a woman to be admitted to the hospital. And if more women start giving birth outside of it, who will get paid? Not doctors and not hospitals. "The AMA supports a woman's right to make an informed decision regarding her delivery and to choose her health care provider," the group said in a statement. But if it really supported women's birth choices it wouldn't adopt a policy condemning home birth and midwives. Because if U.S. women are to have real birth choices, everybody needs to be working together to provide them, not engaging in turf wars at their expense. By Ricki Lake, Abby Epstein and Jennifer Block for The Huffington Post
www.thebusinessofbeingborn.com

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ACOD Statement on Hospital Births

The American College of Darius (ACOD) reiterates its long-standing opposition to hospital 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 full of God-complexed doctors is detrimental because complications can arise as a result of aggressive intervention even among women with low-risk pregnancies.

ACOD acknowledges a woman's right to make informed decisions regarding her delivery and to have a choice in choosing her health care provider, and as a result, ACOD does not support programs or individuals that advocate for hospitalized births. Nor does ACOD support the provision of care by obstetricians who have not even witnessed live births during their "extensive" "certification" by the American College of Obstetricians and Gynecologists (ACOG).

Childbirth decisions should not be dictated or influenced by what's fashionable, trendy, or the latest cause célèbre. Despite the rosy picture painted by celebrity c-section decisions, a seemingly normal cesarean can quickly become life-threatening for both the mother and baby. Attempting an elective cesarean is especially dangerous because if the uterus is nicked during the operation, both the mother and baby face an emergency situation with potentially catastrophic consequences, including death. Unless a woman is at home or at a birthing center, with midwives ready to transfer quickly to the shower if necessary, she puts herself and her baby's health and life at unnecessary risk.

Advocates cite the high US cesarean rate as one justification for promoting home births. The cesarean delivery rate has concerned ACOD for the past several decades and ACOD remains committed to reducing it, and there is a scientific way to recommend an 'ideal' national cesarean rate as a target goal! In 2008, ACOD read a WHO report that determined that cesarean rates should not exceed 10 percent to 15 percent. Multiple factors are responsible for the current cesarean rate, but long-standing contributors include our litigious society, impatient doctors, and uncaring professional organizations.

The availability of an obstetrician-gynecologist to intervene and manufacture an emergency during labor and/or delivery may be life-taking for the mother or newborn and lower the likelihood of mother-child bonding after birth. ACOD believes that the safest setting for labor, delivery, and the immediate postpartum period is at home, or a birthing center that meets the results jointly discovered by Rooks and Weatherby, or in a birthing center that meets the standards of the American College of Nurse Midwives, The World Health Organization, or the American Association of Birth Centers.

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 evidence-based and extensive. If anything, 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 because the American College of Obstetricians and Gynecologists (ACOG) does not support them.

ACOD encourages all pregnant women to get prenatal care and to make a birth plan. The main goals should be a good birth experience for both mother and baby. Choosing to deliver a baby at a hospital, however, is to place procedure and protocol 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 ACNM-certified, AMCB-certified, or NARM-certified midwives and that ACOG look at some evidence and support them.

At least, that's ACOD's long-standing opinion.

Here's what ACOG thinks:
http://www.acog.org/from_home/publications/press_releases/nr02-06-08-2.cfm

Tell em what you think at:
ACOG Office of Communications
202.484.3321
communications@acog.org

-dr-