It's Your Birth Right!!

It seems as if ACOG is at it again. They started the day with comments on the Today Show creating unnecessary fear around home birth and simultaneously, they once again showed their true colors re: the financing of their medical decisions. 

Let’s start with the Today Show and their segment called “Today Investigates.”

The segment opened with Matt Lauer using the description “Extreme Birth” to introduce the topic of home birth.  Who knew… home birth is considered “Extreme Birth” I wonder if that is like extreme sports. I do love snowboarding so perhaps that works … ummmm NOT!! … But I digress….

The writers, narrator, and editors did a fine job of pretending to show both sides of the story while they were creating fear and apprehension for parents considering a home birth. All of this unfortunately at the expense of a grieving couple who tragically lost their newborn infant. They held up this couple as an example of what can happen during a home birth. The piece was definitely tainted to the side of home birth opponents and was full of inflammatory tones and biased comments.

As the segment opens, we are told that a growing number of women are choosing to give birth “with NO drugs, NO doctors, in the comfort of their own home,” in a tone that suggests that families who choose home birth must be crazy.  In perfect 48 Hours Investigates, or Dateline fashion, the piece goes on to tell the tragic story, of the McKenzie family who lost their baby.  At one point they reference the long labor the mother had and stated in another accusatory tone, that the family was “Coached NOT by doctors but by Muhlhahn and her staff,” as if a midwife and her staff are incapable of coaching and supporting a laboring woman.  

After exploiting this couple, the piece cuts to a clip of Mr. Goldman, Contributing Editor to New York Magazine, where he says … “One of the doctors I spoke to said that he thought that home birth had become almost the equivalent of a spa treatment for women. That it was this sort of hedonistic concept of birthing.”  I don’t know about any of you but in 15 years I have NEVER witnessed a labor that I would say is in anyway equivalent to a spa treatment???  WTH??!!!

They then move to a clip from someone in the “mainstream medical community” who believes the hospital or a birth center within a hospital is the only safe place to birth a baby.  I am sure we can all guess who that “mainstream medical community” is.  Dr. Erin Tracy…delegate from ACOG tells the viewing audience that emergencies can arise and if we can’t intervene within minutes, the life of the mother and baby could be in danger. While I agree that emergencies can arise, I would also add that with the exception of a very FEW RARE cases, the TRUE STAT emergencies for normal low risk women that I have seen have been the result of induction agents causing too many and too strong of contractions, the unnecessary artificial rupture of membranes, and fetal distress caused by hypotension related to epidural administration. Having said that, if we did not intervene when we did not need to, emergencies would DECREASE significantly. 

The piece also suggests that women, who are choosing home birth, may be doing so due to celebrity trends, as if women are not intelligent human beings who are able to look at the evidence and make an educated and conscientious choice about their birth location. 

The story then shifts in a weak attempt to show the “other side.” It shows a happy couple who had a wonderful home birth with their son who happened to weigh in at a whopping 10lbs.  I would bet money that they would have had a cesarean in the hospital.   They also show comments from renowned physician Dr. Mardsen Wagner where he gives support to home birth due to the inherent nature of the intervention intensive hospital system. 

While they did show these things supporting homebirth, I say it is a weak attempt at neutrality because of a couple of points.  First during narration about home birth advocates they decided to use the word alleged as if homebirth advocates are somehow perhaps liars or criminals.

“They allege that hospitals often treat normal births like medical emergencies out of fear of malpractice lawsuits and wind up performing unnecessary c/sections…”

Then they reported from the CDC, which stated that homebirth in 2005 resulted in fewer deaths than hospital births for every 1000 babies born and then concluded with “but doctors say it’s impossible to compare the two…” due to the risk of the patients in the hospital.  Note … The word alleged is somehow missing when the DOCTORS are quoted.  I thought the mainstream media usually supported the data of the CDC.  And if not the CDC how about the data from the recent Canadian study that controlled for risk and showed that YES planned homebirth is SAFE! And it’s obvious they did not really consult any midwives or midwife organizations regarding this piece.  For more also check out  Amy Romano’s blog post about the Today Show segment.

The segment ends advising families considering homebirth to ask their midwife questions.  The two questions they mention… Do you have malpractice insurance and do you have a collaborative agreement.  While I agree with the collaborative agreement question, I am not quite sure what malpractice insurance has to do with the expertise and clinical skill set of any particular midwife. 

Perhaps however, the issue of malpractice insurance came up because many members of ACOG have recently admitted to changing their practice based on malpractice insurance. Perhaps they assume midwives somehow practice the same defensive medicine that they practice.  And yes they have put it down in black and white.  It seems our precious ACOG, while giving statements to the Today Show, was also releasing a statement summarizing the results of their 2009 medical liability survey. The results are not that shocking to me but the fact that they are once again putting it out there in black and white, showing us what is really on their minds is a bit shocking.  They have no shame as they say… YEP… we do more cesareans because we are afraid of getting sued. REALLY??!!  In fact … “Of the survey respondents who reported making changes to their obstetric practice as a result of the risk or fear of professional liability claims or litigation… 29% reported performing more cesarean deliveries.”  

So it seems that those home birth advocates can do more than simply  “allege that hospitals often treat normal births like medical emergencies out of fear of malpractice lawsuits and wind up performing  unnecessary c/sections …” ACOG has documented that this is indeed fact.  You can see the results of the survey yourself.  Once again, in defense of their own self interest, ACOG and the “mainstream medical community,” whoever that may be, are making decisions based on dollars and sense instead of research and common sense. And so the fight goes on.

In Birth and Love
Nicole