Time Magazine discusses Homebirth

16 May 2009 at 9:56 pm 1 comment

I found this online today. I’m not sure if it appears in the print version as well. Unfortunately, the article only mentions nurse-midwives, and it is a major oversight to omit the rigorous training of professional midwives who are licensed in 26 of our 50 states.

It has some sentences that seem promising enough at first glance: “Modern medicine can eliminate a lot of the risk (of childbirth)but in doing so, it can also turn what could be a joyous experience for the mother into the equivalent of an all-day appendectomy.” But while the sentence acknowledges that many women are losing the joy of birth, the sentence doesn’t acknowledge that modern medicine may actually create — not eliminate — risk in childbirth with unnecessary routine interventions and restrictive protocols. Also, deservedly categorized as “high-risk” are the premature births, but how many of those premature births could have been avoided had they not been caused by inductions before 42 weeks gestation, under the seductive guise that a scheduled birth is less stressful than a spontaneous one? Medically, a baby is full term at 37 weeks, but what if that baby wouldn’t have been born until 41 if left on his own? That is 4 weeks his lungs would have had to mature in the safety of the uterus.

But the article does a good job highlighting some of the more-often discussed indications of why homebirth is a safe option, referring to the Oregon study and the British Medical Journal  findings. It also makes a fair statement about why OB’s may be “soured” on the entire concept of homebirth, as they only see the births that become complicated. OB’s are never brought in on the homebirths that are progressing as normal, unmedicated, physiological labor should — which is most of them! But combine that with our country’s zeal for litigation, where there is zero tolerance for a less-than-perfect baby, it doesn’t seem so unreasonable for an OB to be unsupportive of homebirth.

What I find most heartening, though, is that this article has appeared in Time — hardly the publication of Radicals. Homebirth is slowly, slowly making its way into more and more women’s menu of birthing options. Homebirth is also facing grave opposition, but I remain ever hopeful.

–maria  (this is cross-posted on my own blog)

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Entry filed under: Uncategorized.

Quick link: LA Times on childbirth and c-sections a bend in the path

1 Comment Add your own

  • 1. Steff Hedenkamp  |  18 May 2009 at 1:46 am

    Sharing the following Letter to the Editor, which is posted on The Big Push for Midwives Campaign headlines page:

    LETTER TO THE EDITOR:

    I would like to point to a factual error in Jeffrey Kluger’s May 16 article, “Doctors Versus Midwives: The Birth Wars Rage On.”

    The author states that home births “attended by trained nurse-midwives are no less safe than hospital births . . . providing the midwives are affiliated with a nearby hospital to which the mothers can be brought in case of complications.” He then follows with a quote stating that the “‘most comprehensive study of this was published in the British Medical Journal in 2005,” says Melissa Cheyney, an assistant professor of anthropology at OSU and a practicing midwife herself. “It showed that for low-risk [home] births in the U.S. and Canada, the infant mortality rate was roughly 1.7 per 1,000, or about the same as it is in hospitals.'”

    In fact, this study examined the outcomes of all births attended by Certified Professional Midwives (CPMs) in North America during the year 2000, not the outcomes of babies delivered by Certified Nurse-Midwives (CNMs), whose practices are primarily hospital-based. The CPM is the only national midwifery credential in the US that requires specialized training in out-of-hospital settings and that prepares midwives to develop expertise in out-of-hospital birth, and the vast majority of babies born at home and in birth centers are delivered by CPMs. No CNMs participated in the 2005 BMJ study referenced in “Doctors Versus Midwives.”

    Moreover, the objective of the study was to evaluate the outcomes of CPMs in “jurisdictions where the practice is not well integrated into the healthcare system,” (read the study here) not in situations where midwives are affiliated with a nearby hospital. CPMs are not legally authorized to practice in just under half the states. The fact that they produce excellent outcomes in the face of less-than-ideal practice environments in many states is a testament to the rigorous educational and training process required to qualify as a CPM.

    In recognition of the need for midwives with expertise in out-of-hospital birth, since publication of the BMJ study, Virginia, Utah, Wisconsin, Missouri, Maine and Idaho have joined the growing number of states that legally authorize CPMs to provide maternity care, with legislation pending in a dozen more states. As CPMs become more fully integrated into our health care system, we see the “Doctors Versus Midwives” wars transform into “Doctors Working With Midwives” partnerships.

    To learn more about the contributions of CPMs to our maternity care system, please attend the May 21st Issue Briefing on Out-of-Hospital Maternity Care and Health Care Reform at the Sewall-Belmont House, 144 Constitution Avenue, NE from 8:00 to 9:00 am. Speakers include the authors of the 2005 BMJ study as well as an economist and public health specialist with expertise in the clinical and economic benefits associated with out-of-hospital deliveries under the care of CPMs.

    Katherine Prown, PhD
    Campaign Manager, The Big Push for Midwives Campaign

    Reply

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