Re: ACOG statement
From: Gordon Goldman (obgyndoc@swbell.net)
Tue Nov 14 06:57:23 2006
Kris,
This is hardly a "random" statement. It is the ACOG response to what
the majority of ACOG membership perceives (yours truly included) as
an increasingly serious threat to optimum women's healthcare being
provided by lesser qualified practitioners. This is especially
pertinent with regard to the performance of potentially catastrophic
procedures, without allowing for the provision for backup when they
arise. The statement is very clear with regard to the reasons for
this, especially with regard to the lack of well controlled studies
documenting safety and outcomes.
While I will not publicly or privately engage you or anyone else in
any 'flame war' or other debate, I can tell you that I was a member
of the committee that produced that statement and feel it is entirely
appropriate. I am certain that there are those in the lay and/or
medical community who may disagree with it for any number of
emotional and/or social reasons, but medically the statement stands
upon solid grounds.
--
Gordon M. Goldman, M.D., FACOG
Chair, Missouri Section, ACOG
On Nov 13, 2006, at 8:36 PM, Kris Bagiu, CPM, RM wrote:
> Can any ACOG members here share some insight as to what motivated
> this random statement? How does it affect obstetricians willing to
> back up midwives (CNMs and DEMs) in OOH birth including free-
> standing birth centers?
>
> Thanks...
>
> ----
> ACOG Statement of Policy
> As issued by the ACOG Executive Board
>
> OUT-OF-HOSPITAL BIRTHS IN THE UNITED STATES
>
> Labor and delivery is a physiologic process that most women
> experience without complications. Ongoing surveillance of the
> mother and fetus is essential because serious intrapartum
> complications may arise with little or no warning, even in low risk
> pregnancies. In some of these instances, the availability of
> expertise and interventions on .an urgent or emergent basis may be
> life-saving for the mother, the fetus or the newborn and may reduce
> the likelihood of an adverse outcome. For these reasons, the
> American College of Obstetricians and Gynecologists (ACOG) believes
> that the hospital, including a birthing center within a hospital
> complex, that conforms to the standards outlined by American
> Academy of Pediatrics and ACOG,1 is the safest setting for labor,
> delivery, and the immediate postpartum period. ACOG also strongly
> supports providing conditions that will improve the birthing
> experience for women and their families without compromising safety.
>
> Studies comparing the safety and outcome of U.S. births in the
> hospital with those occurring in other settings are limited and
> have not been scientifically rigorous. The development of well-
> designed research studies of sufficient size, prepared in
> consultation with obstetric departments and approved by
> institutional review boards, might clarify the comparative safety
> of births in different settings. Until the results of such studies
> are convincing, ACOG strongly opposes out-of-hospital births.
> Although ACOG acknowledges a woman's right to make informed
> decisions regarding her delivery, ACOG does not support programs or
> individuals that advocate for or who provide out-of-hospital births.
>
> 1American Academy of Pediatrics and /American College of
> Obstetricians and Gynecologists. Guidelines for Perinatal Care, 5th
> Edition. Elk Grove Village, IL, AAP/ACOG, 2002.
>
> Approved by the Executive Board October 2006
>
> The American College of Obstetricians and Gynecologists 409 12th
> Street, SW, PO Box 96920. Washington, DC 20090-6920 Telephone 202
> 6385577
>
> --
> Kris Bagiu, CPM, RM
> Denver, CO
