Here is a link to ACOG Comm-Opin#669_PHB_Aug2016 — the obstetrical profession’s most recent, and in my opinion, most ‘honest’ statement about professionally-attended and planned OOH childbirth. ACOG’s new opinion lists both pros and cons, which is a first.
Many of the studies that the authors used were seriously flawed — for example data from Pang 2002 study and Wax Meta-analysis (2010). Due to methodological problems, these studies were unable to distinguish btw planned vs. unplanned OOH birth, attended vs. unattended, term vs premature, and the preventable deaths of healthy newborns vs. babies with lethal birth defects. When it comes to relative safety, these are fatal flaws that also make birth activists question the motives of the researchers.
However, many others studies included used to prepare ACOG’s new PHB statement were well done . They confirmed the relative safety when comparing planned hospital and OOH births. Most midwives (myself included) believe this group of studies from the Canada, the Netherlands, the UK and the MANA Statistical Project (2004-2009) all faithfully represents the professional practice of midwifery and safe OOH childbirth services.
I printed a dozen copies of ACOG Opinion #669, and equal number of #664, which is ACOG’s most recent statement acknowledging the right of mentally competent pregnant women to decline medical recommendations even if the obstetrician believes that it may put her or her baby at serious risk.
I believe that providing copies of these two ACOG Opinions Numbers 669 & 664) make an important contribution to the process of providing information prospective clients.
Direct URL to download ACOG’s opinion # 664 on the right of childbearing women to decline medical advise
http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Ethics/Refusal-of-Medically-Recommended-Treatment-During-Pregnancy