Restraint of Trade?

 Restraint of Trade:

A
purposeful, financially motivated stance to avoid

reconciliation
on the recent Home Birth and CPM statement which

contradicts
ACOG's Committee Opinion on “Seeking and

Giving
Consultation” published May 2007

ACOG hit the
public with a news release on February 8, slamming citizen's rights
to give birth at home and further invalidated women's freedom of
choice by undermining certain types of midwives not under the
umbrella of the ACNM (American College of Nurse-Midwives).
Unfortunately,
the association contradicts itself when it comes to their press
release published May 2007 on Seeking and Giving Consultation with
other 'health care providers'. Key points in this restraint of trade
was their stance on Home Birth and the Certified Professional Midwife, whom they nastily invalidated by replacing the professional name with that of "lay midwife".
Reiterating once
again, they refuse to support the freedom of Home Birth or Midwives
not trained by ACNM or certified by the AMCB (American Midwifery
Certification Board), completely ignoring the Certified Professional
Midwife and her means of certification in its statement.
ACOG has chosen to specifically block out and restrain the CPM,
willfully knowing this is a group of competently educated,
intelligent midwives with common training and experiences who provide
optimal care during pregnancy, labor and birth in a home setting,
birth center setting or in a hospital setting. In many other states,
the CPM is quite legal and accepted by the powers that be. ACOG
purposefully is promoting the interest and cause of their
association, suggesting they are the sole 'authority' on birth in
America. Not so in all other countries of the world, and countries
who also, lose the fewest babies.
ACOG continues
in its attempts to take away citizen choice by not collaborating with
the CPM model of care, to the detriment of women everywhere in their
childbearing years. ACOG states in its February release “ childbirth should not be dictated or
influenced by fad or fashion, etc.” suggesting midwifery care at home, is 'fashionable and scientifically unsafe"  This is bovine fecal material at its best.

For one, let's examine the word
dictate. It means to speak or act domineeringly; to issue as an order; to impose,
pronounce, or specify authoritatively.
What citizen's
are unaware of, is that the obstetrician is really the fad or fashion
that came to be some 200 years ago, with a campaigned effort to
completely eradicate the midwife. The fad that started it all was the
secret “forceps” seductively coercing upper class women of a
'need' for this instrument to be able to give birth - and turned
birth on its heels and her attendants into a trendy, fashionable, and expensive,
service. Then came pain relief, manipulating millions of women
into fearing the normal work and pain of birth as something so
terribly horrific they lost belief in themselves, in the natural,
physiological process that has been normal and in place for millions
of years, birth without man's medicine goes quite normally in most circumstances. 

With the
scientific evidence public and available they have no leg to stand
on. There is simply no study, anywhere that suggests giving birth at
home, or in a birth center with a properly trained attendant, is
unsafe. The revenues of childbirth, the need for control, the turf
battles have become more important than serving citizen's in America.
ACOG's
Committee Opinion on Seeking and Giving Consultation suggests they
ought to get with their own program and begin collaborating and
offering secure and stable backup for home birther's. ACOG states,
and I quote “consultations usually are sought when practitioners
with primary clinical responsibility
recognize conditions or situations that are beyond their level of
expertise or available resources...”
currently many midwives are 'tattletaled on' by four year old Ob's
grown tall if a transport from home to hospital is necessary. I need not point out the obvious, that participating in being a tattletale on midwives is not equal or collegial consulting. 

Ironically, many
Ob's have completely stopped utilizing scientifically proven
procedures that promote normal birth such as pelvimetry, abdominal
palpation, offering nutrient dense counseling, easy exercise
suggestions to turn a breech to a vertex, and good, plain old
authentic compassion and caring for women in the process of labor and
birth in favor of playing with high tech 'toys'. The results can been seen when a women in labor at 40 weeks gestation is suddenly told her baby is breech because of
the quick ultrasound that dictates surgical birth, when an MD expert
in palpation, would have picked up on it much sooner and given his
patient exercise techniques that would encourage the baby to turn,
etc. Why are midwives not whistleblowing and jailing Ob's who
knowingly refuse to follow the scientific research?

Even more
astounding is a scene in the film “The Business of Being Born”
where doctors are asked the simple question “How many natural
births do you see?” “Almost never” is the answer! This begs the
question, what do doctor's today know about normal birth compared to
midwives?
The midwife is
only doing her job, transporting for judicious reasons. An example by
one doctor about the inequality between Md's and Midwives goes a
little something like this:

“You
have a general practitioner, your regular doctor. During a routine
visit, he finds a cardiac anomaly, which is reason for concern and
further investigation and diagnosis. Since he is not a cardiologist
specialist, he will refer you to one. He makes the call, the
appointment and both Md's consult and refer with one another
respectively about an optimal health care plan for you. The
cardiologist takes over your care, the problem is resolved either by
surgery or specialized treatment, etc. And once again, you return to
your general practitioner for ongoing care”.

This is not the
case with midwives yet in NY, unless you are a CNM working in a
hospital. Shocking and horrifying, is the tattletale mentality some
Md's have when they find out a family chooses to birth at home.
The midwife is
hunted down like a wayward witch out of control, state boards are notified, her home and
family are invaded, and she is possibly arrested for transferring
care to a hospital or MD when a low risk, home birther needs expert
care outside of her scope of practice. All the while, the members of
ACOG knowingly violate their own statements on seeking and giving
consultation with other providers. I'm not sure if the folks at ACOG who release these statements consult with their own membership at times! Many Ob's want to support home birth and midwives, and midwives everywhere are grateful for such positive and collegial support, but are blocked from doing so by tyranny and a need to control women's freedoms.  Here are few wise reasons to work together: 

The
Obstetrician-gynecologist's relationships with other physicians,
nurses, and health care professionals should reflect fairness,
honesty, and integrity, sharing a mutual respect and concern for the
patient.
The
Obstetrician-gynecologist should consult, refer, or cooperate with
other physicians,
health care professionals and institutions to the extent necessary to serve
the best interests of their patients.

Their are other reasons this paper says is the purpose for all midwives and Md's to particpate in consultation and referral: dialogue between professionals “may be part of a clinician's overall efforts
to maintain current
scientific and professional knowledge or may arise in response to the
needs of a particular patient".  (gee this might mean accepting the desires of women who seem 'trendy and fashionable who want safe out of hospital birth with the midwife of their choice).

“Although
consultation usually is requested in an efficient manner that
expedites patient
care,
situations occur in which the relationship between practitioners or
institutions and practitioners results in an inefficient, less than
collegial consultative practice that may NOT be in the best interest
of the patient. (One would think tattletales and fighting over
where a women chooses to birth can fall in this category).

The purposes for
consulting with one another and referrals are many, ACOG goes to on
to say:

“Typically, a
patient first seeks care from her primary care provider, who should
be aware that
the
patients needs may go beyond his or her education, training or
expertise, or experience
(Midwives
are specialists in normal birth, in an expected normal vaginal
birth). Various levels of consultation may be needed to make correct
diagnosis, provide technical expertise, and recommend a course of
action. Occasionally, consultation and referral may be indicated when
a patients request for care (read that as “I would like to birth
at home, with a midwife of my choice) is in conflict with her
primary caregivers' recommendations or preferences. I believe this
must go both ways to offer liberal options in birth.

In all...these
types of consultation, the interests of the patient must be paramount
(I guess this
could
include ' trendy and fashionable' as an acceptable reason why a woman
would want to
birth
with a midwife or at home). ACOG's says in regard to 'ethical
collaborations':
"Welfare
of patient should be central, the patient should be fully informed
about the
need
for consultation and participate in the selection of the consultant
(what's this? Respect
for
Autonomy??). The patient should have access to adequate consultation regardless of her
medical condition,
social status, (fashionable celebrities), or financial situation. Practitioners
must disclose to patients any pertinent actual or potential conflict
of interest that
is involved in a consultation relationship; including financial
incentives or penalties
or
restrictive guidelines.In
addition, both practitioners with primary clinical responsibilities
MUST respect the rights
of the patient and also the rights of their respective professional
colleagues".

To that end,
let's stop the tattletale monopoly on midwives, start learning from one
another and working together to provide citizens with options. Thie 21st century is hardly the age of nor is it appropriate for any vestige of the malleus
maleficarum to exist. Stop the witch hunt against midwifery in the
state of New York and elsewhere.

Links:

http://www.childbirthconnection.org/article.asp?ck=10465

http://www.acog.org/from_home/publications/ethics/co365.pdf

http://www.nacpm.org/

http://www.malleusmaleficarum.org/