Monday, October 13, 2008

ACOG vs. Homebirth

ACOG (American College of Obstetricians and Gynecologists) released a statement opposing the choice of homebirth for women earlier this year (specifically, after the release of "The Business of Being Born"), saying, "Choosing to deliver a baby at home, however, is to place the process of giving birth over the goal of having a healthy baby." This is a ridiculous statement on their part. I chose to birth my babies at home because I believed it to be the best and safest place -- with no time constraints, augmentation of labor, or restricted laboring and birthing positions.

ACOG is the one failing, not midwives! The statistics coming out of the majority of American hospitals are disgraceful. We have the worst statistics and spend more per birth than any other country in the world. I am outraged by the suggestion that by birthing at home, I am putting my baby at risk. The statistics are on my side, not on theirs. I am a mother that loves my children -- how dare ACOG accuse me otherwise. I am an educated woman, with a Bachelor of Science -- my husband has a Master's Degree and is a CPA -- we are intelligent people who researched our options and made an educated decision about where to birth our babies.

ACOG is using the fear of childbirth to scare women into keeping birth in the hospital. I am so tired of scare tactics when it comes to childbirth. This is a normal, natural process! How on earth did we ever make it to this point in time? Doctors have been attending birth in a hospital for less than 100 years. Both my parents were born at home.

This is a woman's rights issue. It's not about health care. ACOG is trying to take away our choices. The insurance companies listen intently to what ACOG has to say already. I am always talking with women who want to have a homebirth, but their insurance will not cover it. A homebirth will cost anywhere between $2500-$5000. That is significantly less money, so it just seems absurd that the insurance won't cover a midwife. This is a perfect example of the influence ACOG has in taking away our rights and choices as birthing women. Instead of attacking the midwives and homebirth, ACOG needs to fix their own set of problems. And here's the kicker: Only 1% of women give birth at home. Why do the doctors care so much?

ACOG wants to interfere with the licensing of midwives. Really, OBs are almost in a different profession. That sounds crazy to the average reader, I bet. Doctors are trained to look for something to go wrong. I believe that they want something to go wrong so they can be the hero, save the baby, save the day. They talk about the goal of having a healthy baby, but they are all scheduling inductions and c-sections. Anyone who has done any research at all knows that these are not in the best interests of the baby!

I really take issue with ACOG dismissing women who value the birthing process, as if it doesn't matter. It is okay to want a good birth experience. How dare them make a woman feel bad about that, like she is being a bad mother for desiring that for herself and her baby. Birth matters! It is a doctor's way of dismissing women's valid requests for good health care and respectful, positive births. Recently, a report on NPR stated that the level of empathy a mother has for her child is directly related to whether she had a c-section. So obviously, the birth process does matter. As I've mentioned before, there is a link between postpartum depression and not feeling the birth, whether the birth is a c-section or with an epidural. The birth hormones are not released naturally when the process is tampered with. These hormones play a role in bonding and breastfeeding too.

Our maternal death rate and infant mortality rate in this country are outrageous, so don't tell me that it's about a healthy baby! Mothers and babies are dying in hospitals as often, or more, than at home. This is about pride. They need us to believe that we need them. Don't get me wrong, about 3 % of women actually do need a c-section for various reasons. We need doctors trained in this type of surgery. But when a woman wants a natural, unmedicated birth, she should go to a midwife, not a surgeon.

I can't help but laugh at the timing of ACOG's statement. If you have not seen "The Business of Being Born," you absolutely must. Link to it, watch the fantastic trailer, and just buy it. You'll want to watch it over and over and pass it on to your pregnant friends. If you don't want to fork over the $30, rent it on Netflix. These are the only two ways you can see this movie. If I were a doctor, I wouldn't want my "patients" to see it. I've picked up a number of students who saw this movie, fired their doctors, hired midwives, and have had wonderful, intervention-free birth center births and homebirths. Birth is great, but I believe it's better when you get it out of the hospital.

When we decided, at 33 weeks, to have a homebirth, I had people say to me, "That just seems so dangerous, so irresponsible." I have to tell you, for every single thing that happened -- whether it was the Group B Strep test at 36 weeks, or where to deliver the placenta (it was a water birth), whether to give the baby the eye drops or a Vitamin K shot after the birth -- I had to give the midwife an answer to all these questions. I had to be informed on what these things were. I was in total control. All the responsibility was placed squarely on our shoulders. When you birth in a hospital, it's so easy to just turn all the decision-making over to the doctor or nurses. You just follow along with procedure and protocol.

I absolutely believe that birth, in this day and age, is safer outside of a hospital with a capable midwife attending your birth. We must fight for our rights as birthing women, even if you are finished having children or don't even have children, to stand up to ACOG and demand that this right to birth at home not be taken away. ACOG should not be allowed to be in charge of licensing a midwife to practice. They really don't even know what a midwife does -- if they did, they would learn from them and adopt their practices!


Christina Pond said...

Food for thought. On your wedding day, how much preparing do you do? How much do you stress and toil over finding the perfect dress and matching shoes? You want EVERYTHING on that day to be PERFECT.

But compared to giving birth, your wedding day looks like prom!

Giving birth is the most incredible moment of your life, I believe. So much of who I am has been defined by pregnancy, giving birth and mothering. Everything else in life seems small compared to the beauty and importance of these things! How you are made to feel on that day MATTERS.

AND HOW DARE they say what they said! Implying that you are going to harm your baby! There is more harm and risk in the hospitals these days they way C-sections are passed out like halloween candy!

I am stirred up now Donna!!!! ;-)

You are a person I will never forget! You have truly been a life changing person to know! God has used you as a tool to reach to me, and open my eyes about a lot of things!

THANK YOU!!! I can't wait to teach!

Donna Ryan said...

I haven't had any comments for quite a while... Christina, yours was worth the wait! You'll be a great teacher.

Heidi said...

You got me all excited too so now what? How do we communicate this to our insurance compainies? The plan we had in Maryland that carried over to Emma's birth here in Texas ended up reimbursing us.
I don't know the Texas insurance laws but I do know that Texas is one of 2 or 3 states that won't allow peole to buy invidual health insurance plans with maternity coverage. How do we start to change insurance companies?

Donna Ryan said...

Heidi, I think about this sort of thing all the time. It is so unfortunate that ACOG has so much power in this country. The insurance companies listen to them and base a lot of their policies on what ACOG, along with hospital administrators, etc., say. That's why it is so difficult to even find a midwife covered on many insurance plans, let alone an out-of-hospital midwife! Ironically, it would save them a lot of money if they would cover these midwives.

Just recently, I had someone watch "The Business of Being Born," and decide that she was going to have her baby at home. As she started looking into it, calling her insurance, she found out that, not only would they not cover homebirth, but they wouldn't even cover a midwife in a hospital. Talk about taking away a woman's choices! So, now she is having her baby in the hospital, with an OB, and it will cost her insurance company at least twice, maybe even three times as much as a homebirth would have.

OK, so what can we do? If your insurance DOES cover homebirth, or midwives of any kind, let them know how much you appreciate that. Write them a letter saying so. Imagine, if all women did this, and they (the insurance company) were saving all this money, and having satisfied customers, they'd be all over it! They'd tell ACOG to bug off!

What if your insurance doesn't cover midwives? You absolutely should write them and express your concern over not being offered choices in your health care. I did this with our 3rd birth. We were pushed into birthing at a particular hospital, but we didn't agree with several of their policies. We demanded to be given choices in where to give birth. They told us there were no other choices, but in reality there were. We found out 5 weeks postpartum that we would have been covered at a different hospital, but we had already paid out of pocket and had the baby at home. In the end, after several appeals and a hearing, the insurance acknowledged their mistake and paid for our homebirth. You have to be given choices! Fight for them!

There are also midwifery groups, probably a lot that I should be researching! Citizens for Midwifery and The Big Push for Midwives are the two most popular groups. I'd encourage you to go to their websites and get involved. This is a fight worth fighting!

April said...

It is amazing to me that anyone can be allowed to determine where you birth your baby. They are ok if you want to abort your unborn child, but if you decide to give birth, you had better do it their way. What idiots. They claim that women deserve choices and that they have rights in regards to killing their unborn child. Where are our rights in birth? Shouldn't we have the same rights and choices?
For the record, abortion makes me ill. I cannot even comprehend how someone can even think of a child as a choice.
Women should have the right to birth their child safely. How awful that in this "business of birth"innocent children are being harmed.

Angie said...

I've read this post before, but that was before I was pregant and going through this very thing. Now I'm all fired up. I have spent the last three months battling with my insurance to cover a CPM. They see home as "a valid place of service" (aka: okay to birth at home) but only cover CNMs, all of which work in hospitals in my area. I finally made the choice to just go for it and have my homebirth knowing insurance will not cover a dime and in the end will cost me almost double what a hospital birth would. A hard thing to swallow. We pay for this insurance and now are not even able to use it. Someday I hope this will change and I'll keep fighting for it long after I'm done having children so hopefully my girls will be able to choose where and with whom they want to birth their babies.

cheertyme2003 said...

I have had SO many people make that EXACT statement to me. That my experience was more important than the health of my son. I had a traumatic birth four months ago and no ONE understands, I guess they think that phrase is comforting or something, idk.