so the today show did a recent scare segment re homebirth (originally titled 'the perils of midwifery' but later changed to 'the perils of homebirth' and naturally the birthing blogosphere has been abuzz
of course the topic of home birth has been a contentious one for quite some time as these earlier links attest.
some of the debate focuses on the rights to even have a homebirth, some on the safety of homebirth
the australian healthcare system has been duking it out over homebirth for a while . heres some of the latest from over there http://www.thepunch.com.au/articles/homebirth-wars-confusing-a-right-with-whats-right/
despite the evidence regarding the safety of homebirth http://www.bmj.com/cgi/content/full/330/7505/1416 the american college of obstetrics and gynocology has been on a campaign to remove the choice of homebirth... they put out a press release in february 2008 in which they re-iterated their stance http://www.acog.org/from_home/publications/press_releases/nr02-06-08-2.cfm and now they are using the media to skew public perception as to the dangers of homebirth and the competancies of midwives.
Lamaze Healthy Birth Practices
The six Lamaze Healthy Birth Practices below are supported by
research studies that examine the benefits and risks of maternity care
practices. Therefore, they represent "evidence-based care," which is the gold
standard for maternity care worldwide. Evidence-based care means "using the best
research about the effects of specific procedures, drugs, tests, and treatments,
to help guide decision-making." Please note: The English versions
were revised in 2009.
Let Labor Begin on Its Own
Walk, Move Around, and Change Positions Throughout Labor
Bring a Loved One, Friend, or Doula for Continuous Support
Avoid Interventions That Are Not Medically Necessary
Avoid Giving Birth on the Back and Follow the Body’s Urges to Push
Keep Mother and Baby Together – It’s Best for Mother, Baby, and
Ten Steps of the Mother-Friendly Childbirth InitiativeFor
Mother-Friendly Hospitals, Birth Centers,* and Home Birth Services
CIMS designation as “mother-friendly,” a hospital, birth center, or home birth
service must carry out the above philosophical principles by fulfilling the Ten
Steps of Mother-Friendly Care.
A mother-friendly hospital, birth center, or home birth service:
Offers all birthing mothers:
Unrestricted access to the birth companions of her choice, including
fathers, partners, children, family members, and friends;
Unrestricted access to continuous emotional and physical support from a
skilled woman—for example, a doula,* or labor-support professional;
Access to professional midwifery care.
Provides accurate descriptive and statistical information to the public
about its practices and procedures for birth care, including measures of
interventions and outcomes.
Provides culturally competent care—that is, care that is sensitive and
responsive to the specific beliefs, values, and customs of the mother’s
ethnicity and religion.
Provides the birthing woman with the freedom to walk, move about, and
assume the positions of her choice during labor and birth (unless restriction is
specifically required to correct a complication), and discourages the use of the
lithotomy (flat on back with legs elevated) position.
Has clearly defined policies and procedures for:
collaborating and consulting throughout the perinatal period with other
maternity services, including
communicating with the original caregiver when transfer from one birth site
to another is necessary;
linking the mother and baby to appropriate community resources, including
prenatal and post-discharge follow-up and breastfeeding support.
Does not routinely employ practices and procedures that are unsupported by
scientific evidence, including but not limited to the following:
IVs (intravenous drip);
withholding nourishment or water;
early rupture of membranes*;
electronic fetal monitoring; other
interventions are limited as follows:
Has an induction* rate of 10% or less;†
Has an episiotomy* rate of 20% or less, with a goal of 5% or less;
Has a total cesarean rate of 10% or less in community hospitals, and 15% or
less in tertiary care (high-risk) hospitals;
Has a VBAC (vaginal birth after cesarean) rate of 60% or more with a goal
of 75% or more.
Educates staff in non-drug methods of pain relief, and does not promote the
use of analgesic or anesthetic drugs not specifically required to correct a
Encourages all mothers and families, including those with sick or premature
newborns or infants with congenital problems, to touch, hold, breastfeed, and
care for their babies to the extent compatible with their conditions.
Discourages non-religious circumcision of the newborn.
Strives to achieve the WHO-UNICEF “Ten Steps of the Baby-Friendly Hospital
Initiative” to promote successful breastfeeding:Have a written breastfeeding policy that is routinely communicated to
health care staff;
Train all health care staff in skills necessary to
implement this policy;
Inform all pregnant women about the benefits and
Help mothers initiate breastfeeding
within a half-hour of birth;
Show mothers how to breastfeed and how to
maintain lactation even if they
should be separated from their infants;
Give newborn infants no food or drink other than breast milk unless
Practice rooming in: allow mothers and infants
to remain together 24 hours
Encourage breastfeeding on
Give no artificial teat or pacifiers (also called dummies or
Foster the establishment of
breastfeeding support groups and refer mothers
to them on discharge from
hospitals or clinics
† This criterion is presently under review.