Great Editorial

Excerpt from an article in The Journal of Obstetric, Gynecological and Neo Natal Nursing, Published Jan.21, 2009 (bolding is mine, the stuff I really dig!)

...."I was born in the United States and I am very proud to be an American, but I am embarrassed that our country founded on the ideals of individual liberty and freedom, can also support "authoritative" initiatives such as these by the ACOG and AMA, initiatives that are founded on neither science nor an understanding of the physiologic and psychosocial needs of mothers and babies. What is most risky about home birth in the United States is that for most women who desire it there is a scarcity of qualified providers of home birth services. There is no system of care that provides the needed safety net if transfer to a different type of care is required during labor. Rather, women who desire to birth at home sometimes chose providers unwisely, and those who require transfer are often treated with disdain and disregard as though their decision to give birth outside the hospital system is irresponsible, reckless, and perhaps immoral. There is nothing more inhumane or uninformed than this attitude toward women who desire to birth at home and the qualified providers who are willing to attend them.

When will we remember that pregnancy, childbirth, and lactation are normal healthy physiological processes that are a continuum and do not require medical intervention unless there is a medical problem? A woman's body and the physiology of pregnancy, labor, birth, and lactation are designed to promote the well-being of the fetus and newborn. When will we establish optimal outcomes as the goal of health care during the childbearing cycle, rather than attempting to reduce by small increments the incidence of morbidity and mortality that is compounded by the very interventions we use to attempt to avoid such problems? We all know that in our current health care milieu for childbearing women, the protection of normal is not valued or supported, except in a very few locales. Those who support normalcy are usually swimming upstream against a system that treats every laboring woman as a surgical case. The idea that a normal spontaneous birth is by design the best outcome for a healthy woman and her infant is neither believed nor entertained as a basic concept. Most U.S.-trained physicians and sadly most U.S.-trained nurses have minimal experience with normal labor and birth. Without fetal monitors, intravenous lines, infusion pumps, epidurals, pitocin, endless charting, and rules theses individuals are helpless and unskilled to provide the kind of informed human support and wise guidance that a laboring woman needs while the normal process of labor and birth unfolds.

Why do 1% to 2% of U.S. women even want to birth at home? For most it is simply because they sincerely believe that the process is normal and healthy and does not require the environment of an "illness" system to support it. For these women, birth has a unique, earthy, and frequently spiritual component that they want to experience fully under their own terms. They want to actively labor and birth, rather than to have labor happen to them, give over control to a system and people with their own rules, and be delivered of their babies. Some desire home birth because of the subculture of their religious communities, while others are overtly afraid of what may happen to them in the hospital. They may be "on the edge" of the allopathic medical system and be very resistant to interventions that the system thinks are in their best interest. Does this make them wrong? No, it simply means that the system is not meeting their needs for holistic care that supports normalcy. ....

.... The primary danger is that the "system" does not support this choice. To pretend that a normal healthy woman cannot give birth safely without the trappings of a U.S. hospital is not only audacious but also uninformed. Perhaps it is time for a new woman's movement, one that embraces the normalcy of childbirth and puts mothers and babies back on the center stage rather than the system's need to defend the interventionist subculture it has developed and that it must financially support. This system has not improved outcomes for mothers or babies while the cost of care has continued to escalate keeping pace with unnecessary intervention. The recent initiatives of our medical colleagues, the "authorities," simply highlight the painful reality that the "Emperor has no clothes!"