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Choosing Where To Have Your Baby
cesarean delivery: a multicenter study. Am J Obstet Gynecol 2005;193:1656–62. 9. Wen SW, Rusen ID, Walker M, Liston R, Kramer MS, Baskett T, et al. Comparison of maternal mortality and morbidity between trial of labor and elective cesarean section among women with previous cesarean delivery. Maternal Health Study Group, Canadian Perinatal Surveillance System. Am J Obstet Gynecol 2004;191:1263–9.
CHOOSING WHERE TO HAVE YOUR BABY Editor: As a proud member both of the American College of Nurse-Midwives (ACNM) and Midwives Alliance of New York and the new owner of an independent midwifery practice offering home birth services, I was very excited to see the Share With Women handout in the September/ October 2009 issue of the Journal of Midwifery & Women’s Health.1 ‘‘Choosing Where to Have Your Baby’’ promised to be a wonderful resource to share with my clients. The front of the handout appeared fairly balanced. It gave an appropriately brief history of place of birth and then listed pros and cons of home, birth center, and hospital. My excitement dimmed slightly at the bottom of the first page when I read: ‘‘If you are struggling to keep food on your table or need help with other serious social problems, hospital usually have social workers and other folks that can help you.’’ Home birth practices help with social issues including applying for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), contacting social workers, and getting food on one’s table. As my bumper sticker says, ‘‘Midwives help people out.’’ Still, all and all, I was not displeased, until I turned the page. While the title of the handout is ‘‘Choosing Where to Have Your Baby’’, the heading for the second page actually seems to be: ‘‘Hospital Birth is Right for Everyone, but Home or Birth Center is Only Okay for Some.’’ Women are taken through various situations in which a home birth and birth center birth may or may not be right for them, told when it should not be for anyone (this list is debatable) and which questions they should ask for each place. The following were missing: ‘‘Hospital birth might be right for you if.’’ and ‘‘Hospital birth might not be right for you if.’’. With this portion of the discussion absent, it leaves the reader with the impression that hospital birth is the ‘right’ choice for everyone. Also, under ‘‘For more Information’’, why are no home birth-friendly sites listed? Where does JMWH
Journal of Midwifery & Women’s Health www.jmwh.org
suggest that women go to educate themselves about home birth? While, I am sure that the intentions in publishing this piece were good, the final product is lacking and unbalanced. Please consider readdressing the issue in the near future. K. Michelle Doyle, CNM, NYS LM on behalf of Midwives Alliance of New York Troy, NY
REFERENCE 1. Share with Women. Choosing Where to Have Your Baby. J Midwifery Womens Health 2009;54:421–2.
Editor Reply: Thank you for your interest in the recent Share with Women on choosing a place for birth. The purpose of the handout is to provide an overview of the options for where to give birth, and not to promote or focus on a specific setting. The content was developed and reviewed by certified nurse-midwives (CNMs) and a certified professional midwife (CPM) who collectively have experience in all three birth settings: home birth, birth center, and hospital. The recommended indications for consultation, collaboration, and referral of care that are listed in the handbook on home birth by the American College of Nurse-Midwives (ACNM)1 were used to identify relative and absolute contraindications to giving birth at home or in a birth center. Your points about the assistance home birth midwives provide with social issues, and the potential implied message that there are no reasons not to have a hospital birth are acknowledged. While the Find a Midwife practice locator can identify midwives who attend home births, there are no home birth-specific Web sites in the ‘‘For More Information’’ section. These potentially negative assertions and omissions were unintentional. Fortunately, a Share with Women patient education handout focusing specifically on home birth is under development, and I look forward to sharing it with our readers. Frances E. Likis, CNM, NP, DrPH Editor-in-Chief
REFERENCE 1. American College of Nurse-Midwives. ACNM Home Birth Practice Handbook. Silver Spring, MD: Author; 2004.
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CHOOSING WHERE TO HAVE YOUR BABY Editor: As a proud member both of the American College of Nurse-Midwives (ACNM) and Midwives Alliance of New York and the new owner of an independent midwifery practice offering home birth services, I was very excited to see the Share With Women handout in the September/ October 2009 issue of the Journal of Midwifery & Women’s Health.1 ‘‘Choosing Where to Have Your Baby’’ promised to be a wonderful resource to share with my clients. The front of the handout appeared fairly balanced. It gave an appropriately brief history of place of birth and then listed pros and cons of home, birth center, and hospital. My excitement dimmed slightly at the bottom of the first page when I read: ‘‘If you are struggling to keep food on your table or need help with other serious social problems, hospital usually have social workers and other folks that can help you.’’ Home birth practices help with social issues including applying for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), contacting social workers, and getting food on one’s table. As my bumper sticker says, ‘‘Midwives help people out.’’ Still, all and all, I was not displeased, until I turned the page. While the title of the handout is ‘‘Choosing Where to Have Your Baby’’, the heading for the second page actually seems to be: ‘‘Hospital Birth is Right for Everyone, but Home or Birth Center is Only Okay for Some.’’ Women are taken through various situations in which a home birth and birth center birth may or may not be right for them, told when it should not be for anyone (this list is debatable) and which questions they should ask for each place. The following were missing: ‘‘Hospital birth might be right for you if.’’ and ‘‘Hospital birth might not be right for you if.’’. With this portion of the discussion absent, it leaves the reader with the impression that hospital birth is the ‘right’ choice for everyone. Also, under ‘‘For more Information’’, why are no home birth-friendly sites listed? Where does JMWH
Journal of Midwifery & Women’s Health www.jmwh.org
suggest that women go to educate themselves about home birth? While, I am sure that the intentions in publishing this piece were good, the final product is lacking and unbalanced. Please consider readdressing the issue in the near future. K. Michelle Doyle, CNM, NYS LM on behalf of Midwives Alliance of New York Troy, NY
REFERENCE 1. Share with Women. Choosing Where to Have Your Baby. J Midwifery Womens Health 2009;54:421–2.
Editor Reply: Thank you for your interest in the recent Share with Women on choosing a place for birth. The purpose of the handout is to provide an overview of the options for where to give birth, and not to promote or focus on a specific setting. The content was developed and reviewed by certified nurse-midwives (CNMs) and a certified professional midwife (CPM) who collectively have experience in all three birth settings: home birth, birth center, and hospital. The recommended indications for consultation, collaboration, and referral of care that are listed in the handbook on home birth by the American College of Nurse-Midwives (ACNM)1 were used to identify relative and absolute contraindications to giving birth at home or in a birth center. Your points about the assistance home birth midwives provide with social issues, and the potential implied message that there are no reasons not to have a hospital birth are acknowledged. While the Find a Midwife practice locator can identify midwives who attend home births, there are no home birth-specific Web sites in the ‘‘For More Information’’ section. These potentially negative assertions and omissions were unintentional. Fortunately, a Share with Women patient education handout focusing specifically on home birth is under development, and I look forward to sharing it with our readers. Frances E. Likis, CNM, NP, DrPH Editor-in-Chief
REFERENCE 1. American College of Nurse-Midwives. ACNM Home Birth Practice Handbook. Silver Spring, MD: Author; 2004.
195