GOOD NEWS! I am extreame encouraged by the recent and unexpected turn of event in the political saga between ACOG and Ca LMs. ACOG’s two newest Committee Opinions on PHB (#669) and a pregnant woman’s right to refuse medical recommendations (#664) are an answer to our prayers. Clearly, these ACOG policy statements are nothing less than… Continue reading Brave New World: American midwives & obstetricians finally on the same (winning!) team ~ How, What, When & Why
Category: 21st Century Healthcare in US
ACOG’s Committee Opinion #669 ~ Planned & Professionally-attended Home Birth
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… Continue reading ACOG’s Committee Opinion #669 ~ Planned & Professionally-attended Home Birth
Oregon Public Health report on Planned OOH birth-related perinatal mortality
Link to HEALTH EVIDENCE REVIEW COMMISSION (HERC) COVERAGE GUIDANCE: PLANNED OUT-OF-HOSPITAL BIRTH Approved 11/12/15 http://www.oregon.gov/oha/herc/CoverageGuidances/Planned-out-of-hospital-birth-11-12-15.pdf Oregon-collected data on planned out-of-hospital birth –> pages 33 & 34 In 2011, the Oregon Legislature passed House Bill 2380, which required the Oregon Public Health Division to add two questions to the Oregon Birth Certificate to determine planned place of birth… Continue reading Oregon Public Health report on Planned OOH birth-related perinatal mortality
California 2012 Law for Critical Congenital Heart Defects — applies ONLY to hospitals
https://www.aap.org/en-us/advocacy-and-policy/state-advocacy/Documents/2013%20CCHD%20Newborn%20Screening%20Bills,%20Regulations,%20and%20Executive%20Orders%20-%20AAP%20Division%20of%20State%20Govt%20Affairs.pdf Assembly Bill No. 1731 CHAPTER 336 An act to add Article 6.6 (commencing with Section 124121) to Chapter 3 of Part 2 of Division 106 of the Health and Safety Code, relating to public health. [Approved by Governor September 15, 2012. Filed with Secretary of State September 15, 2012.] legislative counsel’s digest AB 1731,… Continue reading California 2012 Law for Critical Congenital Heart Defects — applies ONLY to hospitals
VBAC Concluding Statement (part 5) A Better Way ~ Opportunities to improve the situations
A Better Way ~ opportunities to improve the maternity care & the VBAC situation in California: What society needs is a rational system for providing ‘mother-baby-father-friendly’ maternity care, one that functions logically for childbearing families by meeting their practical as well as biological needs. The goal is nothing less than affordable, accessible, women-centered, mother-baby friendly… Continue reading VBAC Concluding Statement (part 5) A Better Way ~ Opportunities to improve the situations
VBAC Position Statement: Part 4 ~ The Post-Cesarean Problem for California Mothers & Midwives
Work-n-Progress ~ last edit Aug 18, 2015 The Magnitude of the Post-Cesarean Problem in California and its affect on childbearing women and their midwives Over 600,000 babies are born in California every year. With a 33% Cesarean section rate, around 200,000 women are added to the post-Cesarean/potential VBAC pool each year. Not all of them… Continue reading VBAC Position Statement: Part 4 ~ The Post-Cesarean Problem for California Mothers & Midwives
VBAC Positon Statement: Part 3 ~ Cost of high CS rate & low VBAC rate, hospital VBAC bans
Part 3: Ethical, Economic, and Personal Costs of a high-Cesarean/low-VBAC rate As fully described in Part 2, the multiple serious complications caused by placenta previa and/or and placenta accreta-precreta are not routine childbirth problems that are prevented by new obstetrical technologies or easily solved by modern obstetrical techniques. Instead they are extremely serious, often life-threatening… Continue reading VBAC Positon Statement: Part 3 ~ Cost of high CS rate & low VBAC rate, hospital VBAC bans
VBAC Position Statement: Part 2 ~ Cesarean rates & risks; availability of VBAC
Part 2: Risk of Primary and Repeat Cesareans and the Unintended Consequences of VBAC bans by hospitals and obstetrical groups As discussed in part 1, hospitals and obstetricians attribute policies banning VBAC to their concerns over possible lawsuits. Viewed from this perspective, there may be a legitimate economic reasons for hospitals and obstetrical practices to… Continue reading VBAC Position Statement: Part 2 ~ Cesarean rates & risks; availability of VBAC
VBAC Position Statement, part 1 ~ Ca LMs and Overview of VBAC Controversies
The VBAC Controversy and Ca LMs Part 1 ~ VBAC in California ~ Access-to-Care & Denial-of-Service Issues Adapted and expanded upon from Jan Kemal’s VBAC article posted on the Science & Sensibility website http://www.scienceandsensibility.org/?s=vbac Introduction: Cesarean section is the single most frequently performed major surgery in the world today. The CS rate in the US, which is… Continue reading VBAC Position Statement, part 1 ~ Ca LMs and Overview of VBAC Controversies
CCM Preamble to VBAC Statement: Part 3 ~ Developing a rational maternity care out of the ashes of our illogical system
Part 3 ~ Part 2 chronicled the the history of how Twilight Sleep drugs, episiotomy, forceps, manual removal of the placenta and other interventions became the standard for normal childbirth services in the US from 1910 to 1980. The relationship of the obstetrical model to normal childbirth has changed very little since obstetrics was standardized in… Continue reading CCM Preamble to VBAC Statement: Part 3 ~ Developing a rational maternity care out of the ashes of our illogical system