U.S. Medical Associations Fail To Support Women's Choice In Home Births, Opinion Piece Says

Main Category: Nursing / Midwifery
Also Included In: Pregnancy / Obstetrics
Article Date: 11 Jul 2008 - 9:00 PDT

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An American Medical Association resolution stating that "the safest setting for labor, delivery and the immediate postpartum period is in the hospital" or an accredited birth center "falls flat" because of a lack of "credible research" to support the claim, Jennifer Block, author of "Pushed: The Painful Truth About Childbirth and Modern Maternity Care," writes in a Los Angeles Times opinion piece.

According to Block, "[p]lanning a home birth with a midwife may sound old-fashioned, ... but a solid body of research shows that for healthy women who seek a normal, nonsurgical birth, there are several benefits," including one-on-one care and monitoring from a midwife trained to support the normal labor process. Block writes that in contrast to the United Kingdom, hospital maternity care in the U.S. is "typically not supportive" of the physiological birth process. More than half of pregnant women are induced into labor, or it is sped up with artificial hormones; the vast majority of women labor and push in a flat-on-the-back or leaning-back position; and nearly one-third of women end up giving birth through caesarean section, Block adds. In addition, increased use of c-sections "has led to an epidemic" of preterm births and maternal deaths throughout the country, Block says.

This has led some women to give birth outside of a hospital, and "[o]rganized medicine can't believe this," Block writes. Earlier this year, the American College of Obstetricians and Gynecologists issued a statement that said "choosing to deliver a baby at home ... is to place the process of giving birth over the goal of having a healthy baby," a position that implies "women who choose home birth are selfish and irresponsible," Block adds. Block says such statements are in contrast to a joint statement from the United Kingdom's Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives, which says, "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."

According to Block, AMA's statement calls for legislation that could be used against women who choose home birth, possibly resulting in criminal child-abuse or neglect charges. She concludes, "Women are simply caught in a turf war over the maternity market, and it would appear that the physicians' groups are perfectly willing to trample the modern medical ethic of patient autonomy -- grounded in our legal rights to self-determination, to liberty and to privacy -- in their grab for control. If these groups were truly making maternal and child health a priority, they'd be reforming standard maternity care, not strong-arming women into it" (Block, Los Angeles Times, 7/9).

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