Friday, March 21, 2008

A Reflection on the ACOG Statement on Homebirths

By: Misty M. McGovern, Student Midwife

Much has been said in my community in the few weeks about the recent ACOG (American College of Obstetricians and Gynecologists) anti-homebirth anti-midwifery press release. If you are a member of even just one natural parenting, natural birthing, midwifery or attachment parenting group, you have probably heard plenty of outrage about it. I find this subject to be of the utmost importance to myself and to all other women in this place we call "home". We must assure that women's rights, not doctor's pocketbooks, are protected first and foremost. As women, we have a responsibility to ourselves, and to our sisters and daughters, mothers and aunts, to make our voices heard and to speak up for ourselves and all women in this country and worldwide.

The German philosopher Arthur Schopenhauer (1788 - 1860) once said: "All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident." I love this quote, and used it as a tag line in all of my signatures for a very long time. It can be tested against so many things and found to be true. I think back to acupuncture. Not all that long ago, in my lifetime, acupuncture was considered irrational, illogical and irresponsible. Then, it was considered down right *dangerous* by western society. If you used it in place of allopathic medications, you were basically considered to be writing your own death certificate.

Thousands of years of predictable results, even documented results, were not good enough to convince our doctors of the safety and efficacy of the treatment, even when our western lab-made medicines could do nothing more. However, now that the gold standard of double blind studies have "proven" that acupuncture indeed does work, and quite well, attitudes are changing! Now, the acupuncturists, and those who had been "sold" on acupuncture already knew this, they didn't need double blind studies to tell them, just age old experience. Acupuncture is now more accepted in our society, and you can find an acupuncturist almost as easily as you could find a McDonald's! Acupuncture has even been incorporated into nursing textbooks and has turned into a viable (though, granted, not ideal in the eyes of western medicine) alternative or adjunct to western treatments.

The same can be said about homebirth, and midwifery. For thousands of years women relied on other women to help them through their labors and births. It was a sacred event into which men were not welcomed in most societies. Women were empowered with the task of bringing forth life, and allowing the human species to continue on. But at some point in history we relinquished our power to the doctors. Even in the early obstetrical years, properly trained midwives consistently had better maternal and fetal outcomes than did doctors. This fact, though often overlooked by the "professionals", still holds true today.

This brings me back to Arthur Schopenhauer. First, midwifery and homebirth were ridiculed. This began in the late 1840's (possibly quite a bit sooner, depending on who you ask!) when midwifery was looked at as second class care for poor people. When I was in high school in the 1990's, my best friend's aunt had a baby using a midwife. I asked my mother what a midwife was exactly and she replied, "Oh, that's what poor people use to deliver babies when they can't afford a doctor. It's quite irresponsible!" That was all I knew of midwifery until researching it on my own after deciding to have children. Midwives of today continue to battle ridicule!

"...Second, it is violently opposed." This is where I really think we are now. This is part of the reason that I think midwives, midwifery advocates, and women as a whole should both rejoice, and scream even louder in protest as a result of the recent ACOG statement! We are making a difference, and we are causing change. This change is evident in the fact that ACOG and its members feel attacked by midwifery. They feel like midwifery is a threat to their pocket books, and this has them all in a bunch! We must keep them backed into a corner with our superior care of women; our superior maternal/fetal outcomes; our superior cesarean section rates; and our superior breastfeeding rates! We should continue to make them shake in their boots about us, until they finally realize that which we all already know: that competent midwifery care is ideal for the normal, healthy, low risk pregnant woman's care.

Eventually, this will be "accepted as self-evident." To quote ACOG, "The main goal should be a healthy and safe outcome for both mother and baby." We already know that in low risk, normal pregnancy, women that birth with midwives who maintain non-interventive policies fare far better statistically than induction, epidural, lithotomy position, cesarean section happy OBGYNs. We don't need their "scientifically rigorous" studies to prove it to us. The ACOG statement just brings us one step closer to our ultimate goal, which is a total reintegration of the midwifery model of care for women and babies throughout the country, and the world. Let’s take the outrage that we feel boil up from deep in our bellies upon reading the statement and turn it into energy to create positive change. After all, women are strong, and tired of being bullied. We're ready to take back what is ours, one empowered birth at a time.

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