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About the ACNM and Homebirth

From gastaldo@gte.net Fri Jul 18 02:10:44 PDT 1997

 

Rosie O’Donnell made disparaging remarks about homebirth while talking to a hospital based CNM on her show of July 3. She was disapproving, and obviously uninformed.

The CNM being interviewed should have jump in and corrected Ms. O'Donnell...

ACNM recently placed on its web page its 1993 schizophrenic statement on homebirth:

"The American College of Nurse-Midwives has acknowledged the safety of home births throughout its history...Gradually, more nurse-midwives, and doctors, have become comfortable with the safety of planned home birth."

If ACNM acknowledged the safety of planned homebirth, why did ACNM need to gradually become more comfortable with that safety? Is safety dangerous? (The 1997 ACNM schizophrenic homebirth pronouncement is taken from the ACNM's 1993 text, Having your baby with a nurse-midwife.[NY: Hyperion 1993:24])

Perhaps the CNM being interviewed by Ms. O'Donnell did jump in and correct Ms. O'Donnell's disparaging remarks about homebirth.

If so, I would be much reassured.

 

Rosie O'Donnell...was...obviously uninformed.

This misinformation was exposed in 1992 when the British House of Commons determined that organized medicine's "hospitals are safest" boast was based upon "unproven assertions" and that British women had been getting biased, anti-homebirth information.

After studying homebirth in depth, the British government concluded:

"[We] must draw the conclusion that the policy of encouraging all women to give birth in hospitals cannot be justified on grounds of safety...[I]t is no longer acceptable that the pattern of maternity care provision should be driven by presumptions about the applicability of a medical model of care based upon unproven assertions...Hospitals are not the appropriate place to care for healthy women...We recommend that the Department of Health vigorously pursue the establishment of best practice models of team midwifery care..."

"[A] 'medical model of care' should no longer drive the maternity service and women should be given unbiased information...including the option, previously denied to them, of having their babies at home..." [House of Commons Select Health Committee, Second Report 1992. Quoted in Department of Health (Britain). Changing Childbirth HMSO Publications Centre, P.O. Box 276, London, SW8 5DT. Thanks to Trudy Saunders (071-972-2000 ext. 4155), Assistant to Baroness Julia Cumberlidge, Parliamentary Under Secretary of State for Health, in the office of Virginia Bottomley, Parliamentary Secretary of State for Health, Wellington House, 133-155 Waterloo Road, London SE1 8UG.]

Even after this statement by the British government, British women aren't aware that obstetricians unscientifically and anti-competitively drove birth into hospitals.

Community Midwife Barbara Troutt of Manchester (UK) recently wrote that she is often asked regarding homebirth, "Oh, is that still allowed, I thought that was stopped years ago." [Midwives 1996;109(1303):235].

Readers of the sci.med.midwifery newsgroup may recall that British obstetrician Malcolm Griffiths told me the reason British OBs forced birth into hospitals:

 

What motivated 1940's UK ob/gyn's was establishing a professional position for themselves. Until that time medical involvement in maternity care was not at a specialist level.

The fact of the matter is, Ms. O'Donnell was intentionally MISinformed - like most of the rest of us - and the CNM she was interviewing apparently did nothing to remedy the situation - probably because SHE was similarly misinformed.

While it is nice, as noted above, that ACNM changed to mere homebirth schizophrenia in 1993 after the 1992 British government expose of the truth about obstetric libel of homebirth...

And while it is nice that ACNM reissued its mere homebirth schizophrenia in 1997...

Now that the truth is out - now that it is known that a massive anti-homebirth anti-competitive libel campaign was unscientifically launched by obstetricians to drive birth into hospitals - it would be far better for ACNM to let the Midwives Alliance of North America (MANA) handle homebirth publicity.

In 1995, ACNM devoted an entire issue of the Journal of Nurse-Midwifery to a home study course on how to do homebirths. [The home study program on home birth. JNM (Nov/Dec)1995;40(6): entire issue]

Immediately afterward, ACNM President Joyce Roberts issued forth with rumblings about coming ACNM certification of non-nurse midwives. [Roberts J. The certification of non-nurse midwives by the American College of Nurse-Midwives. JNM (Jan/Feb)1996;41(1):1-2.]

In response to the Nov/Dec 1995 ACNM homebirth home study course, nurse-midwifery professor Janice Keller Kvale, PhD, CNM of Case Western University stated, "for too long, home birth has not been an accepted option within North American health care systems." Dr. Kvale conveniently failed to mention that CNMs unscientifically/indirectly took part in the obstetricians' homebirth is child abuse libel. [Kvale JK. Letter. JNM (May/Jun)1996;41(3):227]

ACNM President Joyce Roberts responded to the Nov/Dec 1995 ACNM homebirth home study course by congratulating the ACNM for having provided a resource for "the fullest scope of nurse-midwifery practice that includes homebirth"; and for having "captured the critical elements" of homebirth while at the same time "reflect[ing] the ACNM standards for nurse-midwifery practice." [Roberts J. Letter. JNM (May/Jun)1996;41(3):227-8]

ACNM President Joyce Roberts cannot possibly know whether the ACNM home study course "captured the critical elements" of homebirth - because, as Kvale [1996] noted in her letter to JNM, "Too many of the interventions commonly used in hospital labor and delivery suites are based on tradition or peer acceptance and not on sound science...Randomized controlled trials and other research methods are necessary to test ways to make hospital birth safer and less costly, just as they are needed to test the safety of [techniques used during -TDG] birth in the home."

Yale Professor or Nurse-Midwifery Varney Burst has noted that the ACNM's official opposition to homebirth was only removed after homebirth midwives "within and outside the profession" caused hospital nurse-midwives to feel "belittled, unappreciated, hurt, angry, and bitter." [Varney-Burst H. "Real" midwifery. Journal of Nurse-midwifery 1990;45(4):189-91]

Varney-Burst somehow forgot to mention in her 1990 article that "real" hospital (nurse) midwives had quite unscientifically - but officially - joined obstetricians' in their "homebirth midwives are dangerous" slander as follows:

"[The hospital is]...the preferred site for childbirth because of the distinct advantage to the physical welfare of mother an infant." [ACNM 1973,1976]

Again, as was determined by the British government in 1992, there was never any "distinct advantage" to initiating birth in the hospital.

As British research statistician Marjorie Tew has concluded, the British maternity system is run by obstetricians who "withhold and pervert knowledge in order to maintain public ignorance and delusion." [Tew M. Safer childbirth? A critical history of maternity care. London: Chapman and Hall, 1990.]

Things are not all that different here in the U.S....

There was never any evidence for the reported American College of Obstetricians and Gynecologists (ACOG) pronouncement that homebirth is "child abuse." (This was the headline of the Oct.1, 1977 issue of Ob.Gyn.News.)

Although official ACNM opposition to homebirth was removed in 1980, in 1982, Professor Barbara Katz Rothman, Ph.D. of New York University noted,

"The ACNM has not been supportive of home births; indeed, some certified midwives doing home births have felt that the [ACNM] was 'out to get them.'" [Rothman BK. Giving birth: alternatives in childbirth. NY: Penguin 1982.]

Professor Varney Burst forgot to mention that, while hospital midwives were feeling merely "belittled, unappreciated, hurt, angry, and bitter"; homebirth midwives were being arrested, imprisoned and prosecuted - just for attending homebirths in spite of unscientific obstetric pronouncements blindly supported by organized (i.e., hospital) nurse-midwifery.

ACNM [1993] advises, "You do not want to be transferred to a hospital where nurses and doctors take a scornful view of homebirth"...

But ACNM [1993] does not mention the fact that the ACNM officially participated (see above) as obstetricians unscientifically fashioned this widespread "scornful view" of homebirth.

In 1986, the ACNM Foundation decided "to provide the information about nurse-midwifery that people need to know." [Rooks JP. Introduction. In Rooks JP, Haas JE (eds). Nurse-Midwifery in America: A report of the American College of Nurse-Midwives Foundation. Washington, D.C. 1986]

According to the ACNM Foundation's "Summary of National Survey Findings," people need to know that direct entry (homebirth) midwifery - nurse-midwifery's main economic competitor - is "an older occupation offering questionable and sometimes illegal services." [ACNM Foundation 1986]

The ACNM Foundation's "Proposed Changes and Selected Comments" section indicates that some CNMs believe that statutes and regulations should be changed to "make lay-midwifery illegal." [ACNM Foundation 1986]

According to the ACNM Foundation's schizophrenic "Overview," whereas some nurse-midwives claim nurse-midwives should abandon the title "midwife" ("many people assume that all midwives are 'lay,' meaning to them, untrained and not professional"); other nurse-midwives claim that nurse-midwives should NOT abandon the title "midwife" - because of "the positive historical and traditional associations with the name 'midwife'...(!)" [ACNM Foundation 1986]

In the 1990s, members of the ACNM suggested that non-nurse homebirth midwives should start calling themselves "traditional birth attendants" so that nurse-midwives could have the title "midwife."

I think ACNM's "we're midwives and you are traditional birth attendants" nonsense has disappeared - but now we apparently have anti-homebirth propaganda (by omission) coming from CNMs - on national television.

Yale Nurse-Midwifery Professor Varney-Burst announced in the most recent edition of her textbook that the ACNM has now decided to "assume responsibility for" the education of homebirth midwives. Indeed, this is the stated reason why Prof. Varney Burst changed the title of her textbook - from Nurse-Midwifery to Midwifery.

I don't mind CNMs calling themselves simply "midwives" now; but no midwife should allow millions of people in America to be further misinformed about birth.

If the CNM didn't speak up to correctly inform Ms. O'Donnell, she should have...

I am afraid that, in regard to homebirth, anti-science is being paraded as science and censorship is parading as "moderation" or "filtration."

In anticipation of further moderation/censorship, I will be posting this directly to the sci.med newsgroup and the chiro-list e-mail list, both of which are unmoderated.

I seem to remember that sci.med.midwifery has an archive which includes "moderated" (censored) posts.

If the sci.med.midwifery "moderators" (censors) intend to keep up their "moderation" (censorship), I would like to see sci.med.midwifery state at the bottom of every post that is accepted that some posts AREN'T accepted and may be found at http:

I'll bet that people would visit the archive of sci.med.midwifery censored articles more often than the newsgroup...

This veneer of staid "science" in medicine would be exposed as the mere veneer that it is...

Sometimes people have "inflammatory tones" because they have been grossly and unjustly inflamed...

Fetuses, I believe, are being grossly inflamed to the point of death because of two obstetric myths: 1) shoulders get impacted at the inlet in shoulder dystocia; and 2) McRoberts doesn't increase any pelvic diameters.

If the shoulders get impacted at the inlet, what force pushes the head out of the vagina?

And why do two 1995 "Operative Obstetrics" texts illustrate all the ways to deal with shoulder dystocia by showing the shoulders at the OUTLET...

We are quite possibly talking about fetal death here - and whole lifetimes spent caring for children with cerebral palsy...

We also may be talking here about OBs desperately trying to blame cerebral palsy on something else - after they failed to prevent it with electronic fetal heart rate monitoring and cesarean section...as they jammed sacral tips up to 4 cm into birth canals and caused many shoulder dystocias - after squashing fetal skulls.

Whether or not jamming the sacral tip up to 4 cm into the outlet is causing problems with fetuses, I suspect that obstetricians don't really want to find out - which is the "reason" I believe OB-GYN-List owner Geffrey Klein, M.D. began censoring my posts from OB-GYN-List...

Check out my "FIGO 97" and "Episiotomy" posts on sci.med. If they aren't still up, e-mail me and I will e-mail you a copy (they are nearly identical. My slightly censored letter in the July 1997 Mothering is included in my sci.med posts, just mentioned.

Let's end this anti-homebirth tomfoolery now.

Let's also end routine fetal skull squashing [Gastaldo 1992;19:230] - or at least let's make sure women are informed of the biomechanical hazards of dorsal and semi-sitting delivery...

The FIGO 97 Obstetric Congress being held in Stockholm Aug 3 to 8 could take a big bite out of past and present obstetric crime...

Todd D. Gastaldo, D.C.

IMPORTANT NOTE: I am not currently practicing chiropractic - except insofar as the practice of chiropractic includes freedom of speech. While in Oregon doing library research I have voluntarily forfeited my California chiropractic license so as not to have to pay the annual licensing fee. (Under California law, any licensed D.C. may voluntarily forfeit his/her license, and may, at any time, reactivate said license by providing the Board of Examiners with "twice the annual amount of the renewal fee...[He or she]...shall not be required to submit to an examination for the reissuance of the certificate." [Section 12, Act Regulating the Practice of Chiropractic...Issued by the Board of Chiropractic Examiners...Act Includes Amendments Through October 1993]

"Yes, I sold [Gastaldo] a modem.  That was one of the biggest mistakes

of my entire life and I regret it more than any other error of my life."

As Todd very well knows (he and I have mailed one another on this matter a few times before now) the situation in the UK currently is very different to that in UK in 1940's or in most of the USA currently.

• Homebirth requests cannot be refused.
• Obstetricians are no longer (generally advising against home birth in low risk cases).
• Many of us - I'm not the exception - are actually more than accepting about home births for such women.

It is naive to imagine that there is some global conspiracy against homebirths by midwives, obstetricians or politicians - anymore than there is a global conspiracy by the 97% of UK women who request hospital birth.

Recently I had a query about our local home births protocol - "Did this mean that low risk women no longer be allowed to choose hospital birth!" - I was able to reassure the inquirer that informed choice was our absolute aim!

Dr. Gastaldo saw this remark of "OB in UK" and posted the following to the usenet:

“Mystery OB/British homebirth (Oregon, too)”…
http: