Re: ACOG statement
From: art fougner, md (evsono@pipeline.com)
Tue Nov 14 08:11:30 2006
At the risk of speaking for Kris, I think she was asking if there were a
sentinel event which initiated the cascade leading to this statement.
Art
At Tue, 14 Nov 2006, Gordon Goldman wrote:
>
>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
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
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