Recently, I have become aware that the powers that be in the Obstetric world, ACOG, have decided that women should not be allowed to birth their babies at home or in a pool of water. http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Obstetric_Practice/Immersion_in_Water_During_Labor_and_Delivery. http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Obstetric_Practice/Planned_Home_Birth.

Unfounded Concerns

They are quite convinced that they should decide for women how they birth their babies because the committee opinions they issued contain no real facts but are simply their stated “concerns”. I wonder how the people entrusted to provide women with safe options for their gynecologic and obstetric care could take this stance against the natural, non-interventive choices available to women and continue to support choices known to cause great harm like labor induction, elective cesarean section and epidural anesthesia. I have to wonder about the motivations of such an opinion. And as a midwife and provider of both homebirth and waterbirth, I feel personally offended.

A Better Model of Care

Over and over, the midwifery model has been shown to improve outcomes for mothers, babies and families (http://www.midwife.org/index.asp?bid=1247) and yet midwifery is not the standard of care in the United States. In the countries where the best maternity care is seen, midwifery is the standard of care for low-risk women. In these same countries, homebirth and waterbirth are available to women. They have studies showing the safety of these obstetrical choices that we in America cannot accept. I am unsure why; as far as I know, women and babies are the same worldwide.

Less is More

Birth is part of the human experience. It is NOT a medical event until it proves itself abnormal. So the same as we can trust people to live day to day within the physiology of their bodies safely without medical intervention, we can trust childbirth to go well. Conversely, there is no place in childbirth where we can go to eliminate all risk and all poor outcomes. A risk/benefit ratio is always appropriate. In almost all cases, less is more in birth. Midwives provide an environment in which their patients can labor naturally and we know that a home-like environment, and waterbirth make labor progress well with little stress to the baby and less trauma to the mother. But homebirth and waterbirth are not without any risk, and this is why we are so vigilant in caring for our clients and why we have coverage from an obstetrician as well as a hospital. But what comes first and foremost, is the basic right of people to make decisions for themselves and to have excellent care, not discrimination, within those decisions.

A Better Way

Midwives believe that women can make informed decisions for themselves about how and where they give birth. It is their RIGHT as women. I challenge ACOG to examine why they are so opposed to waterbirth and homebirth and make sure it is not their fear of their excellent competition (Midwives) but for the true concern of women and babies.