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 at its annual meeting 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 and the American College of Nurse Midwives support women choosing 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 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 waging turf wars at their expense.