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Re: ACOG statement From: Louana George, RN, LM, CPM, MA (westsidebirthservice@juno.com) Mon Nov 27 16:50:09 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Efrain Ramirez: "Re: Fetal Fibronectin and Twin gestation" Previous message: Efrain Ramirez: "Re: ACOG Statment" In reply to: Danae Steele: "ACOG statement" Next in thread: Meenan, Anna: "Re: ACOG statement" The primary training of a midwife is in complications so she can recognize the early signs and transfer or intervene. Then she is trained to know that birth is essentially a normal event and comes to pregnancy and birth from that perspective. A woman in pregnancy and birth is considered normal until signs indiciate otherwise. In labor, a midwife is trained in the art of "watchful waiting." Women are allowed to ambulate, eat and drink as desired, and choose positions that help her labor effectively. It is unusual for a midwife to do many vaginal exams as the 1cm/hr is not strictly adhered to. There is a lot of hand holding and communication that goes on between the midwife and the laboring woman as well as fetal monitoring (usually by hand held doppler). Even if the outcome is good for mother and baby, if the mother is displeased with her experience the midwife will continue to communicate with her to help her work through her dissatisfaction and the reasons for it. So I would say the reason for good outcomes are: 1. Good communication, 2. Attention to normal and deviations from normal, 3. Leaving the woman to labor without restrictions and technological interventions. That's not to say that some of a midwife clients won't need induction or c-section--just not at the rate that is currently being seen in the hospitals in this country. Louana At Mon, 27 Nov 2006, Danae Steele wrote: > >I am sorry to hear the tone of some of this discussion. I think this is an entirely appropriate forum for this discussion, and a timely topic. I do value the input of midwives, and think that all of us can benefit by listening to eachother and learning. Name-calling is immature and destructive. > > I am sorry that ACOG came out with this statement. It flies in the face of many studies which have shown that OOH birth for low-risk women, and attended by a trained midwife, has very low risks to babies (with comparable risks of babies of low-risk mothers born in hospitals), and much lower risks to mothers of interventions, operative vaginal deliveries, and Cesarean sections. > > Doesn't anyone else on this list wonder how midwives get those good outcomes? What are they doing in OOH births that we aren't doing in the hospital? Obviously, there are lots of diffferences. I wish ACOG would focus on getting the best outcome for both mothers and babies, no matter where the births take place. > > And, I understand fully the risks we M.D.s take when consulting for OOH midwives. It would be wonderful to figure out ways to make it safe for the doctors to consult when needed. It would also be to the benefit of mothers if midwives and physicians could talk politely and respectfully to eachother. Who knows, maybe we could all learn something in the process. > > Contrary to some of the beliefs expressed here, I think that as long as women are allowed to make decisions regarding their own health care (which will hopefully be forever), some will choose to give birth out of the hospital, for a myriad of reasons. I would hope that all of us could focus on how to make birth as safe as possible for all mothers and all babies. > >-- > Danae Steele, M.D. > MFM > Green Bay, WI > Next message: Efrain Ramirez: "Re: Fetal Fibronectin and Twin gestation" Previous message: Efrain Ramirez: "Re: ACOG Statment" In reply to: Danae Steele: "ACOG statement" Next in thread: Meenan, Anna: "Re: ACOG statement"

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