My first response to ACOG’s press release for their newest “Committee Opinion” on homebirth was, like many of you, what’s new? Remember the last opinion statement in 2008, the one that accused women of caring more about their birth experience than the safe arrival of their child, and attacked homebirth as a trendy cause celebre? (Because, before hospitals, women birthed their babies where?). This one appears to be slightly less aggravating although they’re still squeezing as much as they can out of the flawed and infamous Wax analysis published last year.
The press release begins with ACOG’s ostensible commitment to informed choice, at least it pertains to other types of care providers:
“As physicians, we have an obligation to provide families with information about the risks, benefits, limitations and advantages concerning the different maternity care providers and birth settings.”
Fair enough — sensible even. But mothers: how many of you were counseled by your physician during your prenatal visits on their cesarean and induction rates, or the risks of pitocin to start and stimulate labor? The rest of the release is more or less the same-old same-old though it does acknowledge that the “absolute risk of planned homebirth is low.”
If the tables were reversed and midwives attended the majority of births, and had a large, powerful and politically divisive trade union, would we charge forward with an all out media attack on the obstetric industry, highlighting the dangers of hospital birth and deceptive physician practices? Probably not. As a profession, we do not desire to further the division between physicians and midwives. It’s not about attacking the competition. It’s about safeguarding women’s ability to determine where and how to bring their children into the world.
Certified Professional Midwives (CPMs) do have a trade union, so to speak, in the National Association of Certified Professional Midwives (NACPM), but it is a relatively new organization, and since not all midwives are registered as CPMs, the organization does not represent the entire body of US midwives.
As it is now, third-party journalists, researchers, activists, and physicians are increasingly illuminating the pitfalls of modern obstetrics and doing a fine job of critiquing that which needs to be critiqued in our maternity care system. But in order to really reach into the minds and hearts of American women we need more than rational analysis and deconstruction. We need to move beyond the political and the scientific debates. We need a large enough PR campaign aimed at reframing the debate in the public sphere, not a mud-slinging campaign. We need a campaign that promotes woman-centered midwifery care and out-of-hospital birth in a context that is complimentary to conventional obstetric care. There is room, and need, for both models to harmoniously coexist.