ACOG Admits That Doctors are Killing Babies, calls for reform
In the Committee Opinion dated April 2013, already published online, the American College of Obstetricians and Gynecologists states:
“Morbidity and mortality rates are greater among neonates and infants delivered during the early-term period compared with those delivered between 39 weeks and 40 weeks of gestation. Nevertheless, the rate of nonmedically indicated early-term deliveries continues to increase in the United States.”
Read original here, or in printable PDF format here.
Morbidity and mortality – death and severe damage. That is what doctors have been knowingly doing, while at the same time criticizing midwives who try so hard to keep mothers healthy and safely get babies to full term.
It is admirable that ACOG has published this recommendation to avoid managed (meaning forced, by induction or c-section) or “elective” early deliveries, (“elective” usually meaning that the doctor insisted that it was necessary until the mother agreed), but while ACOG has always publicly been opposed to these early deliveries they have done nothing to penalize those doctors who commit this particular brand of malpractice. They have also done nothing to support those who are actively working to prevent them. Who would that be? Midwives. Without the midwives setting a standard by providing the option for normal birth, there would be no normal against which to compare abnormal, and very little pressure from consumers (parents) as long as those consumers have no other options for care.
Medical management of birth has resulted in the United States having a truly appalling record of maternal/infant mortality and an even worse record for morbidity, all while suffering the highest costs in the world.
ACOG further defines some of the common ridiculous excuses for early delivery which are not valid: “suspected macrosomia, well-controlled gestational diabetes, and documented pulmonary maturity with no other indication”. In other words, even ACOG admits that the worn-out excuse about your baby getting too big just does not pass any reasonable test of logic or evidence. Nor do slightly elevated blood sugars which are under control; also, just the fact that your baby will be able to breathe does not mean that they are ready to come out. If your doctor tells you any of those things as an excuse for delivery prior to 39 weeks, RUN and find another provider because they are not even following their own professional association’s guidelines! They are placing your baby at risk of harm for no valid reason.
I strongly applaud ACOG’s stance on avoiding nonmedically indicated early delivery, but will not hold my breath to see if anyone in the hospital world will suddenly begin to listen to such excellent advice. This opinion paper appears at least in part to have been financially motivated by the fact that Medicaid in one state is already refusing to pay for unnecessary delivery before 39 weeks, which is a great advance in safety for babies! So apparently the only real pressure on doctors to improve their practice policies is coming from financial incentives; loss of Medicaid reimbursement, and loss of OB patients to midwifery care. Why were damaged babies not enough incentive? Why are the doctors who have been, and are still doing, this kind of callous harm not being investigated and censured, instead of still practicing?
There are so many cries from doctors for accountability in the midwifery field, yet it appears that the accountability needs to be in the medical field which is free to ignore their own associations’ guidelines, common sense, and the terrible outcomes created by the proliferation of such poor care practices. If it takes more states refusing to pay for deliberately damaging babies, then listen up legislators and insurance carriers – start paying for quality of care, not quantity of care. This is not a free-for-all, these are people’s lives that are being casually endangered. If reforms must be led by monetary incentives rather than through accountability measures, then please start penalizing poor performance.
Just to put this into perspective; if a midwife did these things, she would be in jail, not paid a fat salary.
first, do no harm
March 12, 2013 - LCarr Copyright 2013 Highland Midwife www.highlandmidwife.com
The president of ACOG has posted a wonderful message here.
In case it disappears, I will quote it unedited and in its entirety below, for educational purposes. -LCarr
With Delivery Times, Defer to Mother Nature
Posted on March 22, 2013
Let nature take its course. Over the years, Ive found this saying particularly applies to the process of giving birth. My personal experience as an ob-gyn and reams of scientific research demonstrate that Mother Nature knows best when a child is ready to be born. The start of natural labor is the main sign, but were not always patient enough to wait for it.
Today, one in three babies in the US are born by cesarean - the delivery of a baby through an incision in the mothers abdomen and uterus. The rate of labor induction is also at an all-time high. Unfortunately, many of these births occur before the pregnancy is considered “term” at 39 weeks. These upward trends have long been a source of concern in the medical community, especially considering the increased risks to a baby who may not be fully developed at delivery.
Among cesarean deliveries, an estimated 2.5% (more than 100,000 births each year) are scheduled on a designated date by the mother and her doctor. Some women cite reasons such as a lower risk of future incontinence, better sexual functioning after childbirth, and fear of pain as motivations to schedule cesareans. Inevitably, some cesareans (and labor inductions, too) are scheduled before a pregnancy is full term, increasing the risk of negative outcomes for the newborn, including respiratory problems and time spent in the neonatal intensive care unit. The fact remains that due dates are estimates, and you can never be sure that the infant will have reached optimal maturity at the time of a scheduled delivery.
Women should keep in mind that cesarean delivery is no walk in the park. While its a safe option, cesarean delivery is a major surgery and comes with a number of risks, such as placental complications in future pregnancies, problems with anesthesia, infection, and longer recovery times.
Certain urgent situations - such as preeclampsia, eclampsia, multiple fetuses, fetal growth restriction, and poorly controlled diabetes - may make it necessary to deliver the baby before the onset of natural labor. However, newly issued guidelines from ACOG remind women and ob-gyns that in uncomplicated pregnancies, a vaginal birth that occurs after the natural onset of labor is ideal. Additional new ACOG guidelines reaffirm that cesareans and labor inductions should only be performed when medically-necessary.
Delaying delivery until labor starts naturally may not make ob-gyns too popular with a patient whos uncomfortable and near the end of her pregnancy, but its a decision that will pay dividends by giving the baby the extra time it needs to face the world.”