Asssited by a certified midwife

In a move that seems to run counter to women’s autonomy, the American Medical Association (AMA) and the American College of Obstetricians and Gynecologists (ACOG) have issued resolutions to back any proposed legislation that would make it difficult — or virtually impossible — for women to have planned births at home.

Strangely, there is no pending proposal for legislation to limit all births to hospitals. But the medical associations felt it necessary to issue their resolutions anyway.

The ACOG said it does not intend to criminalize the practice of home birthing. But its official statement calling for public legislation tends to prove otherwise. If all that the doctors wanted was to tell the public what they think about home births, they could have issued a simple public service announcement.

A spokesman for ACOG spelled out the organization’s position in no uncertain terms: “We are against home births, period.”

The ACOG declared in its announcement that home births are not safe. The AMA, in supporting the ACOG position, stressed that hospitals or birthing centers near a hospital complex are the safest places for childbirth.

Women’s groups say women should have the choice of where they want to give birth.

The American College of Nurse-Midwives issued its own statement which unequivocally supported home births. The group referred to a British study that supports their position. A well-regarded study in the UK has found that home births are not more risky than hospital births. There are no comparable studies on the subject in the U.S.

Approximately 1 percent of U.S.-born babies are delivered outside of the hospital system. Despite the minuscule proportion, some sectors view the issue as a face-off between the medical system (which in a number of recent well-publicized cases has not exactly been safe for babies) and expectant mothers (who wish to depart from it).

ACOG members who dissented with the group position said it is obvious ACOG wants home births to be banned.

They said the ACOG statement — which AMA has now approved — will be a serious disincentive. Since AMA now says home births are dangerous, health insurance providers afraid of litigation may start refusing to support doctors who supervise the midwives (who are directly involved in home births).

Some members believe the ACOG should not coerce women into giving birth in hospitals by agitating for legislation that removes the home birth option.

An increasing number of women have opted for home births in recent years. The reasons for doing so include:

* Belief that the family and the newborn benefit immensely from home births.

* Aversion to impersonal and authoritarian atmosphere in hospitals.

* Dislike for certain routine hospital practices, e.g. oxytocin stimulation, episiotomy, forceps delivery, etc.

* High hospitalization costs.

* Fear of in-hospital infections and life-threatening mistakes.

Home birth may be safe for a healthy woman with low-risk pregnancy, particularly if assisted by a certified midwife.

But hospital births are advisable for women with high-risk indications, or pre-existing medical conditions (e.g. heart problems), or have had previous miscarriages or caesarean deliveries.

Safety Tip:

* If you want a homelike birth at the hospital, make sure you and your partner discuss your ideal birth experience with the doctor before labor begins.