US Docs Say To Women: Ignore Ricki's Birth

Docs to Women: Pay No Attention to Ricki Lake's Home Birth
Posted June 18, 2008 | 02:26 PM (EST)

Ladies, the physicians of America have issued their decree: they don't want you having your babies at home with midwives.

We can't imagine why not. Study upon study have shown that planning a home birth with a trained midwife is a great choice if you want to avoid unnecessary medical intervention. Midwives are experts in supporting the physiological birth process: monitoring you and your baby during labor, helping you into positions that help labor progress, protecting your pelvic parts from damage while you push, and "catching" the baby from the position that's most effective and comfortable for you -- hands and knees, squatting, even standing -- not the position most comfortable for her.

When healthy women are supported this way, 95% give birth vaginally, with hardly any intervention.

And yet, the American Medical Association doesn't see the point. Yesterday at its annual meeting it adopted a policy written by the American College of Obstetricians and Gynecologists against "home deliveries" and in support of legislation "that helps ensure safe deliveries and healthy babies by acknowledging that the safest setting for labor, delivery, and the immediate post-partum period is in the hospital" or accredited birth center.

"There ought to be a law!" cry the doctors.

The trouble is, they have no evidence to back up their safety claims. In fact, the largest and most rigorous study of home birth internationally to date found that among 5,000 healthy, "low-risk" women, babies were born just as safely at home under a midwife's care as in the hospital. And not only that, the study, like many before it, found that the women actually fared better at home, with far fewer interventions like labor induction, cesarean section, and episiotomy (taking scissors to the vagina, a practice that according to the research should be obsolete but is still performed on one-third of women who give birth vaginally).

Which is why the American Public Health Association and the American College of Nurse Midwives support women choosing home birth. The British OB/GYNs have read the research, too, and have this to say: "There is no reason why home birth should not be offered to women at low risk of complications... it may confer considerable benefits for them and their families. There is ample evidence showing that labouring at home increases a woman's likelihood of a birth that is both satisfying and safe..."

The other trouble with the American MDs is that they seem to have lost all respect for women's civil rights, indeed for the U.S. Constitution -- the right to privacy, to bodily integrity, and the right of every adult to determine her own health care. The "father knows best" legislation they are promoting could indeed be used to criminally prosecute women who choose home birth, say, by equating it with child abuse.

Research evidence be damned, the doctors want to mandate you to go to the hospital. They don't want you to have a choice.

We think they're spooked. The cesarean rate is rising, celebrities are publicizing their home births (the initial wording of the AMA resolution actually took aim at Ricki for publicizing her home birth on the Today Show!), people are reading Pushed and watching The Business of Being Born, and there's a nationwide legislative "push" to license certified professional midwives in all states (The AMA is against that, too, by the way).

The docs are on the defensive.

After all, birth is big business -- it's in fact the most common reason for a woman to be admitted to the hospital. And if more women start giving birth outside of it, who will get paid? Not doctors and not hospitals.

"The AMA supports a woman's right to make an informed decision regarding her delivery and to choose her health care provider," the group said in a statement. But if it really supported women's choices it wouldn't adopt a policy condemning home birth and midwives.

Because if U.S. women are to have real birth choices, everybody needs to be working together to provide them, not waging turf wars at their expense.

Thanks for posting this!

I find it really interesting how the rhetoric by groups such as the AMA focus on 'what's best for the mother and baby'. In many instances I would be surprised if they really knew?

For example, was it necessary to jab me with pethedine AGAINST my will while i laboured? Was it in my best interest? I think not! Having a mother birthing her baby while off in la la land is not what i determine to be in the 'best interests' of mother and baby.

And with all this interference/intervention, do they look at the bigger picture of how many women may be experiencing PND as a result of their birth experience at a hospital? where time pressure is at an all time high? (i had a midwife enter my room at 4.30am to tell me that if i was a decent person i would be gone by 8am to free the bed!! WTF?).

If anything, the Ricki Lake documentary is an example of how women can and have the choice to direct their own birth, for the interests of themselves and their baby. Although homebirth is not something that I personally could do (or could I?! LOL!), it gave me the hope that through informed choices, i can be the empowered woman i know i am to birth my babies without someone chasing me around a room with a loaded syringe!

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After all, birth is big business -- it's in fact the most common reason for a woman to be admitted to the hospital. And if more women start giving birth outside of it, who will get paid? Not doctors and not hospitals.

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That gets right to the heart of the issue. In the United States, healthcare is an industry rather than a public service and is run as such. The point of a business is the make money. I know that's horribly cynical but I think its true. I hear a LOT of talk about how bad the system is here, but really compared to that one this is Utopia.

I am SO glad I had my baby here. She was born in a quiet dim public hospital room after 17 hours of labor using gas alone and two hours of pushing. I was allowed to get up, squat, move the way I needed to. I had three midwives who only left me to change shifts and they were fantastic labor coaches too. When I told my American mother later on the phone about the birth she was absolutely scandalized and told me no way on God's green earth would I have been permitted to labor like that in a U.S. hospital. They would have drugged me up and butchered me. Then a few weeks later my SIL had a slow labor with little progress after 24 hours and then a sudden delivery of a healthy albeit meconium covered baby and mother again assured me that SIL would have had a caesar.

My mum does social work with pg women and young mothers, so she sees it all the time. It seems that the prevailing mode of thought is that birth is a medical emergency and must be controlled. Aus mainstream is lightyears ahead. Scares me still just thinking about what Lila's birth would have been like back in the states. I am so glad I had my baby here.

Hmm, all I can say is - only in America! Well hopefully only in America. . .No offence to anyone who is from the US but it is sooo sad that these women don't have real choices. And it's all about money . . .
I bought the Business of Being Born from you Kelly and when I watched it last week I was completely appalled with the way that birth has largely been handled in America over the last century. I had no idea that midwife led care was such a minority over there.
I found the doco largely informative, and all I can say is good on Rikki Lake for getting the message out there.

Mmm, I heard about this. Great article, though.

Doesn't surprise me. In the UK the Obs get paid the same no matter where you birth, so at home means money for less work - no wonder they're OK with it! But the hospital have a policy of "in and out ASAP so we get more money" so if you go in then you're likely to be bullied into the hospital being paid more. If you birth at home it gets money for nothing so that's fine, but if you're in they get paid more for surgery than for a happy woman so guess who suffers?