Despite quality and repeated research that indicates the contrary, ACOG has quietly released a new policy regarding out-of-hospital births (birthing centers included). 

First below is an analysis from a member of Citizens for Midwifery, followed by the policy.  Even if you do not believe homebirth or birth centers are right for you personally, it is still a huge blow to women's right to choose where the safest place for her to give birth is.  Birth is not an illness - and it's time women start making their thoughts known as consumers to these precedent setters.

 

Read on:

 

New ACOG Policy on Out-of-Hospital Births

Dear Friends,

It has just come to my attention that the Executive Board of the American
College of Obstetricians and Gynecologists (ACOG) in October issued a new
"Statement of Policy" regarding out-of-hospital births in the US. The
statement in its entirety is included below. You will note that there is no
URL for this new policy statement. ACOG chose to make this policy statement
available on-line only to their members, and did not provide any press
release about it.

In the statement ACOG claims that studies (comparing hospital and
out-of-hospital birth outcomes) are "limited" and "not scientifically
rigorous".

The following sentences summarizes their policy: ".ACOG strongly opposes
out-of-hospital births. Although ACOG acknowledges a woman's right to make
informed decisions regarding her delivery, ACOG does not support programs or
individuals that advocate for or who provide out-of-hospital births."

People I have spoken with have suggested several possible implications. One
is that because ACOG essentially establishes the legal "standard of care,"
this statement takes out-of-hospital birth AND free-standing birth centers
out of the standard. This not only gives OBs a strong basis for refusing to
even interact with midwives or others who even just advocate for OOH births,
let alone provide that service, but makes those OBs who DO support birth
centers or home births or work with home birth midwives at legal and
professional risk. Furthermore, this supports the agenda of the American
Medical Association's recently formed Scope of Practice Partnership (SOPP),
a coalition of state medical associations and national medical specialty
societies (such as ACOG) whose purpose essentially is to oppose any attempt
by health professionals to obtain legislation or rules that permit or extend
practice without physician control. (Of course the latter includes all
licensed midwives - CNMs, CPMs, etc.)

At this time, we do not have any suggestions for meaningful or effective
consumer actions to take. However, if you know of an OB who is friendly to
normal birth, out-of-hospital birth, the right of women to choose where they
give birth, etc., especially if they are members of ACOG, it would not hurt
to make sure they know about this new policy and might take whatever action
they can take with ACOG.

Surely some other organizations will be producing statements; I will let you
know about these as they come along.

Sincerely,

Susan Hodges, "gatekeeper"

Available only to ACOG members through their website. No press release on
the website. As of 11/11/06

ACOG Statement of Policy
As issued by the ACOG Executive Board

OUT-OF-HOSPITAL BIRTHS IN THE UNITED STATES

Labor and delivery is a physiologic process that most women experience
without complications. Ongoing surveillance of the mother and fetus is
essential because serious intrapartum complications may arise with little or
no warning, even in low risk pregnancies. In some of these instances, the
availability of expertise and interventions on .an urgent or emergent basis
may be life-saving for the mother, the fetus or the newborn and may reduce
the likelihood of an adverse outcome. For these reasons, the American
College of Obstetricians and Gynecologists (ACOG) believes that the
hospital, including a birthing center within a hospital complex, that
conforms to the standards outlined by American Academy of Pediatrics and
ACOG,(1) is the safest setting for labor, delivery, and the immediate
postpartum period. ACOG also strongly supports providing conditions that
will improve the birthing experience for women and their families without
compromising safety.

Studies comparing the safety and outcome of U.S. births in the hospital with
those occurring in other settings are limited and have not been
scientifically rigorous. The development of well-designed research studies
of sufficient size, prepared in consultation with obstetric departments and
approved by institutional review boards, might clarify the comparative
safety of births in different settings. Until the results of such studies
are convincing, ACOG strongly opposes out-of-hospital births. Although ACOG
acknowledges a woman's right to make informed decisions regarding her
delivery, ACOG does not support programs or individuals that advocate for or
who provide out-of-hospital births.

(1) American Academy of Pediatrics and /American College of Obstetricians
and Gynecologists. Guidelines for Perinatal Care, 5th Edition. Elk Grove
Village, IL, AAP/ACOG, 2002.

Approved by the Executive Board October 2006

The American College of Obstetricians and Gynecologists 409 12th Street, SW,
PO Box 96920. Washington, DC 20090-6920 Telephone 202 6385577

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