Elizabeth Day's blog

"The Doctors": Carrying on the Homebirth Turf War?

Mon, 08 Sep 2008 13:05:11 -0400

I've recently been following a series of emails from women who have been solicited for stories of homebirth by producers of a new spin-off of the "Dr. Phil" show, called, "The Doctors." Apparently, the questionnaire included the following questions:

Did you have a child at your home?
Did you want to have a soothing experience where you were in control and could bond with your child?
Did it not go the way you planned?
Do you regret having a home birth?
Do you regret using a midwife instead of going to a hospital?
Did you have your second child the traditional way in a hospital?
If you or someone you know regrets having a home birth please tell us your story below.

One of the associate producers, Judith Sanchez, is working on the project. She solicited Ricky Lake and Abby Epstein to appear on the show and they have declined. If you would like to write to her and give her your opinion, you can email her at judith.sanchez@cbs.com or call her at (323)956-8289. I have drafted the following email to send to her. Maybe it will give you some ideas.

Judith,

I wanted to write you a quick email about an upcoming episode of "The Doctors" that I understand will be focused on home birth. I have received forwarded messages that indicated that the questions for home birthers who might appear on your show are decidedly negative and it appears that your show is less interested in the best research and more interested in fishing for negative stories that would produce a sensationalist, anti-midwifery show. I hope that this is not the case, but I want to direct you to some interesting and relevant facts.

1. Although it spends more on maternity care than any other industrialized nation, the United States still ranks 37th in infant mortality. According to "The CIA World Factbook," Singapore led the world with an infant mortality rate of 2.30 per 1,000 live births, followed by Sweden with a rate of 2.76 and Japan at 2.80. The United States' rate of 6.37 ranked just 37th, behind South Korea and Cuba and just ahead of Croatia.

2. In all the other countries that have better infant mortality rates than we do, including most European nations, midwives attend approximately 75% of births. In the Netherlands, which is near the top, over a third of births still take place at home. In the United States, midwives attend only 10% of births. Only 1% of births take place at home.

3. 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.

4. The American Public Health Association and the American College of Nurse Midwives support women choosing home birth. In addition, the British counterpart for ACOG, the Royal College of Obstetricians and Gynaecologists have stated that "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..."

While you are fishing for stories about disastrous home births, may I point out that there are just as many or more stories of negligence, injury, and death for hospital births. I sincerely hope that you will not try to undo the many years of work that birth advocates have dedicated to the fight for evidence-based care, mother-friendly care, and the preservation of a woman's right to choose how, where, and with whom she will birth. I myself gave birth at home. I understood that there were certain risks involved with doing so, but having read the research and having seen so many hospital births as a doula and the sub-standard, even unethical care that women received in the hospital setting I determined that the risks associated with birthing at home were more acceptable to me than the risks associated with giving birth in a hospital.

Thank you for your consideration. If your show can truly become a reliable and "must-go-to" source for the latest breakthroughs and cutting-edge practices and procedures, you must develop a sense of trust with your viewer. Part of developing that trust is to make sure that the information you give is not sensationalistic or biased, but based on the best evidence.

Sincerely,
Elizabeth Day, LCCE, CD(DONA)

Birth On Labor Day

Tue, 02 Sep 2008 00:17:13 -0400

September is finally here, and Labor Day is going to be so much more than a break from school. All around the world, women are taking part in "Birth On Labor Day." An arts-based movement to bring attention and awareness to the crisis in maternity care and to inspire communities to make the changes that will create childbirth choices that work for mothers. The event revolves around performances all around the world of Karen Brody's play, "Birth". "Birth" tells the story of eight women's birth experiences and paints a picture of how low-risk mothers are giving birth today.

Find a local performance by checking out the BOLD website at www.boldaction.org. Or think about hosting a performance in your city next year. In 2009, BOLD has announced that women can be bold any time of the year, so start planning now to host the play or the BOLD Red Tent in 2009 and put the spotlight on maternity care in your community.

VBAC Coalition, Step 2

Fri, 11 Jul 2008 16:07:04 -0400

If you read my last blog entry, you know that I'm working with several other women in our community to form a VBAC Coalition that will work to pressure area hospitals to reverse their bans on VBAC.

Now that we have formed our core group, we have divided the work into several categories.

1. I'm in charge of developing a list of contacts for hospitals--names, addresses, phone numbers, etc. In addition to sending a letter to every physician telling them about what we are doing, we will be contacting the decision makers at the top and scheduling a meeting with them to present our case. Some of the people on our list include

The CEO
The Department Head of Obstetrics
The Department Head of Anesthesia(because VBAC Bans often result from anesthesiologists who don't want to be on site while a woman is VBACing.)
The Nurse Manager over Obstetrics (or Director of Women's and Children's Health)
The VP of Mission and Ethics (some other similar jobs might be a director of compliance or risk management)

2. Another woman is in charge of compiling the evidence, including relevant statistics, research studies, and such.

3. Another woman is in charge of circulating a petition (our goal is to obtain at least 300 signatures to present to the hospital to show them that this is important to many women in our community) and collecting letters from a recent letter-writing campaign.

4. Another woman is in charge of research--in other words, getting to the bottom of the issue. As we make phone calls trying to find out which issues and which people are really responsible for the ban, it seems as though everyone is pointing their fingers at someone else. The hospital points its finger at their malpractice insurance provider. The insurance provider claims they never put any such pressure on the hospital to quit providing VBACs. We have to truly understand the issue before we can give them a compelling reason to change.

5. Another woman is compiling a binder of all our work to present to hospital administration when we meet with them.

I really think this is going to work. Stay tuned for step 3!

Sign the Petition

Fri, 20 Jun 2008 11:43:00 -0400

The recent resolution by the American Medical Association opposing Home Birth is all over the message boards today. Resolutions were introduced by the AMA to support ACOG's position against home birth and 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, or a birthing center within a hospital complex, that meets standards jointly outlined by the AAP and ACOG, or in a freestanding birthing center that meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers."

Sign the Petition Today! Please help send a message to the AMA and ACOG, and to our state and federal legislators, to tell them that we object to these resolutions and we view legislation that would restrict a woman's right to choose a home birth as a being contrary to scientific evidence and a violation of women's basic human rights.

VBAC Coalition

Wed, 18 Jun 2008 22:15:10 -0400

If you are looking for an inspiring little birth activism project for your area, I have an idea for you. Join hands with other women in your area and form a "VBAC Coalition." According to ICAN, over 3,000 hospitals across the United States have instituted facility-wide bans on Vaginal Birth After Cesarean. In our town, women are being told that they must have a repeat cesarean regardless of their present health status and regardless of the reason for their previous cesarean. We know that these bans are not only un-supportable by good evidence, but they are also a basic violation of a woman's Patient Rights and Human Rights.

If you would like to take on the hospitals, here's a place to start. Check back on birthactivist.com for further steps and updates as we go through this process.

Step 1: Form a coalition. Gather together with a small group of women representing your local birth network, ICAN chapter, La Leche League Chapter, as well as individual women who have been affected by the VBAC Ban (or who just care deeply, even if they've never had a C-Section)

Our coalition consists of a chapter leader of BirthNetwork, a mom who has had one previous cesarean, a mom who demanded for herself a successful VBAC despite the ban, a mom who had an "HBAC" or Home Birth After Cesarean because of the ban, and a Certified Nurse-Midwife who is our resident "safety and statistics expert." We met together today to discuss our plan of action to pressure our local hospitals to reverse the ban.

Stay tuned for step 2! "

Cesarean a "Pre-Existing Condition"?

Wed, 04 Jun 2008 01:21:08 -0400

A recent article in the New York Times highlighted a new problem that women are facing after a cesarean. Some women who apply for individual insurance policies are being charged higher premiums and some are being denied coverage if they have had a previous cesarean section. It looks like insurance companies are now counting the financial risks of repeat cesarean on their bottom line and they aren't willing to take the risk. However, more and more hospitals are banning the option of a vaginal birth after cesarean (VBAC) altogether, citing vague recommendations by ACOG and pressure from their own malpractice insurance providers, revealing they aren't willing to take the risk either.

A Victory for Missouri Midwives and Moms

Mon, 26 May 2008 07:17:16 -0400

My deep congratulations to the women and families of Missouri! I was raised in Missouri and I feel a close connection to the struggle of midwives in that state, where it is a felony to practice midwifery. My youngest sister was delivered at home almost 23 years ago by one of the most competent, talented midwives in the state, despite the illegal status of midwives. However, after many years of fighting, a midwives licensure bill just passed the Missouri Senate in its final hours. Unfortunately, there was not sufficient time for the bill to make it to the House, so they still have a fight ahead. But finally, there is hope. Do you ever wonder if we birth activists are making a difference? Be assured, we are. Read on for the media release in its entirety. . .

VBAC Bans Tracked Across the Country

Fri, 16 May 2008 10:06:14 -0400

Final Numbers are available for VBAC Bans across the country! Local birth activists polled hospitals that have Labor and Delivery Units. You can access this information on the ICAN Website by selecting the Advocacy Link. Then search ICAN’s Hospital VBAC Policy Database by state or zip code to find out if your local hospital bans VBACs or not.

Barbara Stratton, a national VBAC activist who reversed several bans, has opened up a national yahoo group for people actively working on reversing bans across the nation. VBACtivist@yahoogroups.com. This is a great place for people to share ideas and strategy with people all over the country. She only wants people to join who are actively working on reversing bans. If you are interested in making a difference in your area, please join the group.