1 post tagged “childbirth”

Ok, people. Prepare to be shocked. And awed. Great Britain's equivalent to the American College of Obstetricians and Gynecologists (ACOG), the Royal College of Obstetricians and Gynecologists (RCOG), issued a joint statement with the Royal College of Midwives explaining their position on home births.

Their position couldn't be any different from ACOG's.

Here's the full statement. The summary alone will blow your socks off.

Ahem. They issued a joint statement with midwives. See ACOG? Midwives are NOT the enemy.

RCOG and RCM then discuss not only the physical benefits to home birthing (due to lower levels of significant interventions like induction, augmentation, perineal trauma and surgical delivery), but acknowledge that the process of birth -- and its resulting emotional and psychological effects -- are quite important and should be considered when studying childbirth, whether in a hospital or at home.

They honestly state the risks and complications of birthing at home (all of which could also occur in a hospital). They conclude that transfer to a nearby hospital should be a backup plan, if serious complications with the mother or baby occur. They also recognize that some mothers choose to transfer for non-critical reasons, such as epidural anesthesia.

When discussing how to achieve best practices for childbirth, they state: "Both the RCM and the RCOG believe that to achieve best practice within home birth services it is necessary that organisations’ systems and structures are built to fully support this service. These will include developing a shared philosophy, fostering a service culture of reciprocal valuing of all birth environments. Comprehensive involvement by local multidisciplinary teams and users to underpin home birth practices within a clinical governance framework results in a quality service which demonstrates commitment to supporting women in their choices." (Emphasis added by me.)

They further flesh this out by placing birthing decisions into the hands of mothers and encourage care providers to give women unbiased information on the risks and benefits of home birth. They also encourage fathers to be involved in the decision-making and childbirth processes!

This next quote made me blink. Then I read it again to make sure I had read it correctly the first time: "It is acknowledged that there are no known risk assessment tools which have an effective predictive value concerning outcomes in the antenatal period and labour." Hallelujah! Finally, doctors who admit they have no way of predicting the future, especially the future of a woman's pregnancy and birth experience. When was the last time you heard ACOG admit it didn't know something?

RCOG and RCM conclude with recommendations about continuity of care, the importance of communication during the antenatal period, and the necessary service structures that should be in place to handle unexpected emergencies. They encourage employers and government entities to be supportive of home births and warn that discriminatory practices based on place of birth are harmful to both women's health and children's development.

Their conclusion? That while home births may not be suitable for every woman or preferred by most women, they are perfectly acceptable and safe for women at low risk of complications.

My only quibble with this? They don't explain what "low risk of complications" means. That simple phrase leaves an open door for unscrupulous care providers to provide biased information on the risks and benefits of both home and hospital births or to coerce a mother into a model of care she may not be comfortable with.