I also do not want to engage in a debate regarding this subject. However, I do feel that I need to say a few things about it.
First of all, ACOG is wrong with regard to the evidence about “out of hospital births”. First, I would point out that outside of the confines of the United States, the vast majority of births occur “out of hospital”. Now this varies anywhere from mud huts to home births to maturnity centers. Unfortunately, with all of our arrogance regarding our hospital system, including our technology, the United States still ranks 12 in perinatal outcomes in the world. Further, a study published in the New England Journal of Medicine in ’89, reviewed births undertaken in a birth center setting, demonstrating the safety, as well as a dramatically lower cesarean section rate and excellent outcomes. In June 2005, the British Medical Journal published an article comparing 5000 low
risk births delivered in a hospital setting in the United States and Canada and matched them with 5,000 out of hospital matched low risk births. The studies conclusion was that it was safer to deliver a low risk pregnancy out of the hospital and the cesarean section rate was 30% in the hospital group, compared with 5% in the out of hospital births.
Birth Centers across the country, of which there are approximately 180, are accredited by the American Association of Childbearing Centers. Their oversight includes strict adherence to policies and procedures, combined with site visits, etc. In addition, they meticulously database their outcomes, which, for over 20 years, have continued to reinforce the safety. The incidence of truly acute transfers from an accredited birth center is less than 1% and those outcomes are predominantly good – which is more than I can say for any hospital setting.
Finally, I would add that it is very disappointing to me that ACOG wastes its time, energy and money issuing statements such as this recent example, yet remain essentially impotent with regard to liability reform, reimbursement and the rights of an OB/GYN.
Lynn
