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Sunday, April 20, 2008
Interesting &/or Important Documents
of Community Midwives
A professional organization
British Medical Journal 2005;330:1416 (18 June), doi:10.1136/bmj.330.7505.1416
Outcomes of planned home births with certified professional midwives: large prospective study in North America
by Kenneth C Johnson, senior epidemiologist, Betty-Anne Daviss, project manager
Editor's Note: Many of the LMs in California were participants in this study and contributed statistics from our own home birth practices.
BMJ March 13, 2006 Press Release:
Most popular study published in 2005 was Ken Johnson's paper on Planned Home Birth
ACOG Policy Statements on Midwifery & PHB Feb. 2006
The Myth of the Ideal Cesarean Section Rate:
American Journal of Obstetrics & Gynecology 2005
Excerpts from this article, page 935 & 936, paragraph #4
Europe, better perinatal outcomes are achieved with lower cesarean rates and less spend on healthy care. In those countries, midwives manage most low-risk pregnancies, with obstetricians acting as consultants. How did procedure-oriented specialists (referring to obstetricians) come to perform midwifery and well-woman care in the ? US
Paragraph #6: Although trained midwives provide safe obstetrics care, with lower cesareans sections rates, they attend only 7% of births in the
– working mostly in environment where they don’t complete economically with doctors. US
Page 936, paragraph #1: In truth the average obstetrician-gynecologist compares poorly to the family practitioner in the breadth of her training for primary care, and there is little office obstetrics and gynecology that cannot be performed competently by midlevel practitioners. In teaching hospitals, the reduced work schedule of residents is creating service needs that can only be addressed by in-hospital personnel.
Because, by training and inclination, obstetricians spend little time and support during labor – why not phase out the generalist (non-perinatologist obstetricians) altogether?
A self-regulated midwifery profession, working in collaborative practice with consulting perinatologists, would appear to provide a better model for obstetric care [actually for midwifery in the historical sense of the term i.e., non surgical maternity care to healthy childbearing women]
Cesarean Section Delivery Rates and Pregnancy Outcomes:
2005 WHO Global Survey in Latin America ~ Lancet
Antenatal Fear of Childbirth and its association with subsequent
Cesarean Sections and experience of childbirth ~ Sweden: BJOG 2006
Karen Ehrlich's Letter to Local Hospital"s Grand Rounds Committee on BMJ study
The Journal of the American College of Obstetricians & Gynecologists ~ 2002
Biased & Misleading
"Outcomes of Planned Home Births in Washington State"
1. Letter to Editor / Op Ed & Press Release 2. ACOG letter MBC
3. Synopsis /Comments 4. Comprehensive Review
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