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-

Marathons and Birth

Marathon action on Sunday was especially inspirational after my Friday and Saturday barhopping extravaganza. Especially this guy who ran it wearing a duck costume:



The NYC marathon hits all five boroughs, including our beloved Bronx, so Ellen and I watched from 138th and Grand Concourse -- somewhere between miles 20-21, where runners hit the infamous "wall," when the body runs out of glycogen to burn and switches to fat, causing dramatic fatigue.

My friend Julie (F3939) ran her first marathon this year, managing to beat out Katie Holmes (F127) and Sean John "P. Diddy" Combs (44778). You can check NYC marathon results here yourself. Julie is a great inspiration, and may have even inspired yours truly to try and do the same. Ahem --- MAY!

One person Julie did not beat, and who was also inspirational was women's winner Paula Radcliffe. The female marathon world record holder ran the NYC marathon (her first in 2 years) just nine months after giving birth. Her training regimen was halted for less than 2 weeks due to the birth, stopping the day before she gave birth and resuming just twelve days later.

It seems hard for me to imagine a woman running the day before giving birth. Then again, as the Sydney Morning Herald so gracefully put it: "Paula is having a baby, not having her legs cut off." I wonder if it really is so unimaginable to train for a marathon so late into a pregnancy or so soon after. No idea what the risks involved are. I would imagine them to be numerous. I would also imagine such a feat would be out of the question after a c-section.

I think this story does more to illustrate the single-minded approach marathoners need to be successful than any statement about birth, though. More people have probably been moved by her perseverance (insanity?) in running than by her choices in childbirth. Thoughts?

And now, a photo I took from mile 21 of the NYC marathon, illustrating the huge diversity of the runners, and the lack of toilets (look closely):

click for larger
-dr-

Apocalypto -- a movie about natural water birth

With a central focus on the unpredictable nature of birth, Mel Gibson's Apocalypto does a great service to shed light on the need for a naturalization of birth.



Ancient Mayan Jaguar Paw (below) is taken prisoner by angry brutes for a nearby urban center leaving his pregnant wife (above) and son stuck in a deep hole with no way out. The wife and son try their best to get out, despite rocks and panthers falling on them.

And then it starts pouring rain, and the water collects in the hole. Just as they're about to drown, the mom has an amazing water birth, and Jaguar Paw makes it back just in time after sprinting wounded for 2 days straight.


More than the decline of an ancient civilization, or an obloquy against Jews, Apocalypto is a movie about natural childbirth. I don't quite understand why some people find the scene funny, as I think it's a powerful testament to human ability and a somber reminder of how the medicalization of birth is leading to an increase in potentially harmful interventions.

Marsden Wagner, former head of Maternal and Child Health for the European Office of the World Health Organisation (WHO), discusses the "safety" of technological interventions in the birth process:

As with other technological interventions used at the time of birth, those using active management of labor seem bent on playing down or hiding any risks and reassuring everyone that it is "safe". For example they claim, "On balance, active management of labor is safe for the fetus, notwithstanding any associated dystocia. It is also safe for the mother" (O'Herlihy 1993). First, it must be said that such statements reveal a failure to understand "safety". Since every medical procedure or technology has side effects and risks, no technology is 100 percent "safe". In every case, it is necessary to balance the chance of a good result (efficacy) with the chance of a bad result (risk). With any intervention under consideration, the chance of a good result or bad result can be scientifically determined. Instead of telling the woman that the intervention is "safe", she should always be told all information on the efficacy and risk. But the decision as to whether the good chance outweighs the bad chance should not be made by the doctor, who is taking no chances, but can only be made by the person taking the chance --- the woman. Therefore the doctor can never say that any procedure is "safe" but only tell the woman the chances and let her decide (Wagner 1994).

Click here for more.

Not to mention, it's a great action flick pitting man vs. man vs. nature vs. sun gods, and vs. Spaniards (eventually).

-dr-