NEWS FROM BOBB HEADQUARTERS
NOVEMBER 2008
20/20 is airing a special hour on Motherhood and will be featuring "The Business of Being Born". Elizabeth Vargas interviewed filmmakers Ricki and Abby for this special.
Airing on ABC November 7, 2008.
Check your local listings for times and channel.
JUNE 2008
NCT and IMA Press Statement on ACOG actions on home birth
NCT and the Independent Midwives' Association (IMA) voice concern over actions of ACOG on home birth:
NCT and the Independent Midwives' Association (IMA) today voiced concern at the recent actions of the American College of Obstetricians and Gynaecologists (ACOG), that seek to undermine and threaten American women's opportunities to give birth at home.
The NCT and IMA call on the ACOG to reconsider their position as a matter of urgency. Following the example of its international counterparts it should consider all available evidence on the benefits and risks of home birth. Women in America should have access to home birth rather than being limited simply to the medicalised model of birth available in US hospitals.
In February this year the ACOG reiterated its long-standing opposition to home births. More recently, the ACOG, 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...".
NCT and IMA are members of the Maternity Care Working Party (MCWP), which advises members of the United Kingdom Parliament on maternity care and services.
Counted among the membership of the MCWP, are the Royal College of Obstetricians and Gynaecologists (RCOG), the UK equivalent of the ACOG, as well as the Royal College of Midwives. These two organisations issued a joint statement in April 2007 on home births which states:
"There is no reason why home birth should not be offered to women at low risk of complications and 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, with implications for her health and that of her baby." (Royal College of Obstetricians and Gynaecologists/Royal College of Midwives Joint statement No.2, April 2007)
NCT and IMA also believe that all women should have access to a home birth and up-to-date evidence-based information that addresses their questions, so they can make the right choice for them.
Home birth should be considered a mainstream option and offered as a regular choice for pregnant women using the health service, whichever country they reside in. For a healthy woman with a straightforward, low-risk pregnancy, home birth is a safe option. It is important that midwives provide care for women at home and that they have experience in home birth, receive active support and supervision, and that their training needs are met. Women's individual needs must be assessed and the back up of a modern hospital system, with good communication and transport links, are important, should transfer be needed.
The views of the NCT and IMA are supported by UK Government policy which seeks to reduce unnecessary interventions in childbirth and increase the numbers of women who experience a normal birth.
In England for example, the Government explicitly wants every woman to have opportunities to make well informed decisions about their care throughout pregnancy, birth and postnatally by the end of 2009. This includes a guaranteed choice of place of birth. Depending on circumstances three options will be available:
home birth
birth in a local midwife-led unit
birth in a hospital supported by midwives, anaesthetists and consultant obstetricians.
The opportunity for home births is increasing in the UK, albeit slowly. In 2006, 39% of women indicated that this had been discussed as an option at the start of their pregnancy, compared to 18% in 1995. The home birth rate for the UK as a whole currently stands at 2.6%, but in some areas this rate is higher than 10%. In Wales in particular, where the Government has set a target for home birth at 10%, the rate is higher than in other parts of the UK.
JUNE 18, 2008
At their annual meeting over the weekend, the American Medical Association voted on two Resolutions that seek to prevent home births and to increase MD control over midwives (click here to read Resolutions 205 and 239).
The initial draft of Resolution 205 included a personal attack on Ricki Lake and our film "The Business of Being Born" which read:
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..." (for full text of the original Resolution, scroll down to 205)
News outlets including the AP quickly picked up this story yesterday as it hit TMZ, E!, USA Today, Daily News, FOX, and Ricki will be featured on Good Morning America this weekend as well. (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 following response for the Huffington Post and also submitted a seperate Op-ed to the Washington Post this morning:
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.
Late yesterday, the AMA changed the wording on the final resolution 205 to omit the line about Ricki. (Hmmm...) They are now attributing the original language to the American College of Obstetricians and Gynecologists (ACOG) who drafted the initial statement.
Stay tuned for more news to come....
The BOBB Team