We were aware that the Today Show was producing this segment for several months now, but we were shocked at the heading: “The Perils of Midwifery.” A historical section of our film The Business of Being Born documents the public smear campaign physicians groups launched against midwives in the early 1900’s from which the midwifery profession never fully recovered. It is so disheartening to see these old tactics at work again, especially at a time when our country is in the midst of healthcare reform which could finally give all women access to midwifery care in hospitals and increased options for birth center and home births. It’s getting harder to ignore the systematic assaults on women’s birth options that ACOG (American College of Obstetricians and Gynecologists) has been orchestrating since The Business of Being Born premiered two years ago.
ACOG’s first public response to BOBB came in June 2008, when they introduced a resolution to the American Medical Association (AMA) at their annual meeting which commits the AMA to "develop model legislation in support of the concept that the safest setting for labor, delivery, and the immediate post-partum period is in the hospital." The second paragraph of the resolution read: “Whereas, There has been much attention in the media by celebrities having home deliveries, with recent Today Show headings such as “Ricki Lake takes on baby birthing industry: Actress and former talk show host shares her at-home delivery in new film.” The resolution did not offer any science-based information for the AMA's anti-midwife or anti-home birth position and after public backlash, ACOG wisely eliminated the specific reference to Ricki. (Read our initial response co-written with Jennifer Block: http://www.huffingtonpost.com/ricki-lake-jennifer-block-and-abby-ep...
A few weeks ago, ACOG made a public plea asking its members to submit anecdotal, anonymous data about patients who planned out-of-hospital deliveries on their website. According to the request, which was originally linked from ACOG’s home page, they are “concerned” about the “problem” of growing numbers of women seeking out-of-hospital maternity care. Once again, this request was taken off the homepage and after public backlash and made accessible only by pass codes.
You may be wondering why women seeking expanded birthing options would be a “problem” for ACOG? “Just follow the money,” says Steff Hedenkamp of The Big Push for Midwives Campaign. “ACOG does not want to continue losing patients to Certified Professional Midwives and out-of-hospital birth, so they’re telling members to send in more of the same old tall tales that far too many OBs love to scare women with.” Analysts expect the group to use the anecdotal data collected from members to support its ongoing state and federal lobbying campaigns aimed at denying women access to out-of-hospital maternity care and Certified Professional Midwives.
Now of course we understand that ACOG is a trade organization representing the financial interests of its members but it’s still a wonder that with the United State’s unacceptably high infant mortality rate, skyrocketing c-section and premature birth rates and disappearance of options like VBAC, the physicians would waste so much money and energy waging a media campaign against out-of-hospital birth? As if home births, birth centers and midwives are the real “perils” out there. What about the perils of having no access to prenatal care? It’s also a wonder that the press doesn't expose the safety record of hospitals. But then again, most parents who have bad outcomes in hospitals are silenced by gap clauses with cases settled out of court. The fact that homebirth midwives demand transparency certainly conveys a more honorable stance towards letting the public evaluate the safety profile.
The Today Show should hold themselves to higher journalistic standards than playing up the tragedy of a stillborn baby born at home without explaining that this same phenomenon happens all the time in hospitals. Although our hearts go out to any couple who loses a child, it’s a shame to see a personal tragedy exploited to serve a political agenda. Yes, complications can arise at any birth and as we showed in the final climatic scenes of BOBB, it is essential that homebirth midwives work in collaboration with physicians and hospitals to ensure a safe outcome for their clients. But the Today Show failed to say that the midwife in question has an excellent safety record. They also chose not to mention the most recent study out from the Canadian Medical Association, which supports the safety of home birth for low-risk women. http://www.cmaj.ca/
On a positive note we’d like to point out that in contrast to the official position of ACOG, many of its members are not opposed to out-of-hospital birth and are embarrassed by the tactics ACOG is using to scare women into hospital births. Recently, we spoke off the record with the Chief of Obstetrics at a major New York Hospital about ACOG’s actions. This OB/GYN felt the public solicitations for anecdotes on ACOG’s website was a “huge mistake.” This OB/GYN, who attended a screening of BOBB at Weill Cornell Medical College last year, toured us through Labor & Delivery proudly sharing that he had banned the use of Cytotec, which he called a “toxic drug.” He said he has also placed strict limits on the use of Pitocin, which “drove everyone crazy” but had the direct effect of lowering the hospital’s c-section rate and drastically reducing the number of babies in the NICU. He recognizes the need for more evidence-based protocols in maternity care and was delighted to share his success with us. Like many physicians, he feels the solution is to make the hospital experience as “home-like” as possible. Apparently, he feels this is a more productive use of physician’s time and energy than trying to scare women out of home birth. Amen.