Wednesday, October 28, 2009

Obstetricians, and Out-Of-Hospital Birth

The terms "obstetrician" and “out-of-hospital birth” are usually oxymorons or cannot be used in the same sentence without becoming the butt of a joke, such as "military" "intelligence."

Obstetricians are against Out-Of-Hospital birth! I know, they made an exception for birth centers, we'll get to that in a moment.

ACOG, originally put out a proclamation stating that “out-of-hospital birth” was unsafe. They later amended that statement and exempted accredited birthing centers. The wording of the ACOG statement is actually bit confusing on its face, because it only considers Certified Nurse Midwives or Certified Midwives (CMs have passed the American Midwifery Certification Board exam) , which excludes the CPM or licensed midwife. The wording allows for accredited free standing birth centers, but emphasizes that birth is only safe with immediate physician and cesarean section capability, which free standing birth centers don't have.

(Click here to read, ACOG statement)

Remember, the above is a revised statement, originally, free standing birth centers were not endorsed by ACOG.. so why did ACOG add accredited free standing birth centers to the approved list?

The popular belief is that ACOG is a trade association and is responsive to its membership. Free standing birth centers work very closely with obstetricians, in some cases are owned by obstetricians, but generally have backup and collaboration agreements with ACOG members. Allegedly, these member obstetricians put pressure on the organization to protect their own income and caused ACOG to reverse themselves. The above paragraph sounds totally plausible and is most probably, what actually occurred.

Even with the above statement, obstetricians are not in favor out-of-hospital birth, whether it is an accredited birth center, or whether it is homebirth! This makes the out of hospital midwives, furious, regardless if they are a ACNM certified or CPM certified.

Could anything be done so that obstetricians become hearty supporters of out-of-hospital birth? I believe the answer is YES, however, I don't think the midwives will be supportive of the steps necessary to make the OB's supporters.

Tune in tomorrow to see what it will take and what the backlash will be.


1 comment:

  1. Does it matter that OBs approve of home birth?