Amazing Article

A refreshingly accurate September 11, 2008, article in the Evanston Review, "Home delivery?" by Nancy Burhop, highlights the extreme home birth maternity care shortage facing home birth families in approximately half the country, with a focus on the state of Illinois.

The article features an obstetric nurse, Aime Graimer, who chose home birth for the last two of her seven children's births. Graimer wanted to have two of her prior births at home as well, but was unable to find care:

"I was interested in having the last four at home," she said, "but that wasn't an option until the last couple of years, because I couldn't find anyone to attend the births at home."

Because the main opponents to home birth in the United States, the American College of Obstetricians and Gynecologists did not agree to be interviewed for the article, the reporter draws some of her own conclusions:

It seems odd, then, that ACOG supports a woman's right to have an elective Caesarean section. That major surgery opens the womb to deliver the infant, and puts mother and baby at risk. The U.S. has the highest rate of Caesarean births in the world, over 30 percent and growing, according to the Center for Disease Control.

You can read ACOG's official but unreferenced Position Statement on Home Birth here, and an exchange between ACOG and a concerned obstetrician and member of ACOG asking the group to defend its position on Home Births here.

Illinois nurse-midwife, Jennifer Gagnon, CNM, one of only five nurse-midwives who attend births at home in Illinois, wonders about the opposition's extreme position against home birth and points out much better results in other parts of the world where home birth is common:

"In Europe home births are common. If hospital birth is safer, then why is it that in the Netherlands, where 34 percent are home births, they have a maternal death rate of 5 per 100,000, while the U.S. has 17 per 100,000, and 99 percent of our births are in the hospital?"

There are four sidebars that accompany the article. (They appear as links to "Related Stories") Of particular interest is the "Just Asking," in which author Burhop reveals that both ACOG and the American Medical Association declined requests to be interviewed for the article. Both ACOG and the AMA have vowed to lobby against laws to license Certified Professional Midwives (CPMs). Gainer lists four questions that she would have posed to the groups:

• What do you recommend for women who, for personal, monetary, cultural or religious reasons, don't want to have their baby in a hospital?


• What if a woman lives in a rural area far from a hospital? Wouldn't it be better to have a certified midwife in attendance?


• Are you looking at the consequences of all the intervention that goes on in hospital births to see if there are ways to reduce Caesareans and encourage more natural childbirth, with women in control of what happens to them?


• With obstetricians and gynecologists leaving Illinois in droves due to out-of-control liability insurance costs, wouldn't licensed midwives be a welcome addition to the field ?

ACOG's silence is deafening. As the trend to license CPMs picks up steam (with four more states gaining legal recognition in as many years), ACOG went running to its "big brother," the American Medical Association (AMA). In response to ACOG's requestion, the AMA passed the now infamous Resolution 205 vowing to lobby against CPM licensure. (Download the Word Document of AMA's Resolution here.)

Neither physicians group offers any practical solution to the maternity care crisis facing home birth families across the United States.