Back in November, I viewed a screening of Ricki Lake and Abby Epstein's documentary, The Business of Being Born. Applauded by the American College of Nurse Midwives, I too agreed it was an excellent perspective of the more natural side to childbirth, without all the excess medical interventions that sometimes occur in the hospital setting.

Well, the American Medical Association (AMA) had quite the opposite view of this film. Their alarm and disagreement with Lake's documentary prompted them to establish a resolution against home births stating, "The safest setting for labor, delivery and the immediate post-partum period is in the hospital or a birthing center."

The AMA also issued another resolution to regulate licensure and scope of practice of nurse midwives and oversee their practice. Not very desirable for nurse midwives who practice outside of the hospital setting.

The Big Push for Midwives, a national campaign organized to advocate for regulation and licensure of Certified Professional Midwives (CPMs) throughout the U.S. is appalled. Steff Hedenkamp, Communications Coordinator for the Big Push for Midwives stated:

“Maternity care is a multi-billion dollar industry in the United States. So it’s no surprise to see the AMA join the American College of Obstetricians and Gynecologists in its ongoing fight to corner the market and ensure that the only midwives able to practice legally are hospital-based midwives forced to practice under physician control. I will say, though, that I’m shocked to learn that the AMA is taking this turf battle to the next level by setting the stage for outlawing home birth itself—a direct attack on those families who choose home birth, who could be subject to criminal prosecution if the AMA has its way.”

My opinion? I don't really care for the "thou shalt not" stance the AMA seems to be taking. I think it all boils down to money, control, and lawsuits.

As far as where my thoughts on home births lean, I am not opposed to them. In fact, I believe they can provide a natural, comfortable, and even empowering environment for women to deliver their babies. Home births have been the method of delivering babies far longer than the hospital setting, and I also feel the hospital setting can become too "medical." Pregnancy is treated like a disease instead of a natural process.

I am also of the opinion that women who choose home births have uncomplicated pregnancies for safety purposes. Ideally these women should have received proper prenatal care, have done their research, will be attended by a licensed, certified midwife, and have a well, thought out plan in the event of an emergency. The lines of communication must be open between the mother-to-be, her midwife, and an obstetrician in the hospital in case of an emergent transfer.

I feel that the hospital setting, with an operating room and neonatal intensive care unit, would be more suitable for women and/or their unborn babies with serious medical conditions, such as placenta previa or neural tube defects, among other health issues.

I'm also of the opinion that most women feel more comfortable in the hospital setting because of the usually quicker access to care in the event of an emergency. I support either decision, whether home birth or hospital.

There is also the option of a birth center. It offers more natural birth options, fewer medical interventions (inductions, augmentation of labor with Pitocin, constant external fetal monitoring, episiotomies, or drugs) yet may be connected to a hospital.

The bottom line is, no matter how this debate eventually pans out, I feel all women should know what their options are for their labor and delivery experience. The delivery of one's baby is an amazing, life changing experience. Therefore, it deserves careful consideration on the part of women, their families, and their health care providers to make the experience as positive and safe as possible.

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