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Bibliographical entry (without author) : | Planned home birth: the professional responsibility response. American Journal of Obstetrics & Gynecology. Volume 208, Issue 1, January, pages 31-38 |
Author(s) : | A. Chervenak, Laurence B. McCullough, Robert L. Brent, Malcolm I. Levene, Birgit Arabin |
Year of publication : | 2013 |
URL(s) : | http://www.ajog.org/article/S0002-9378(12)01074-5/… |
Résumé (français) : | Cet article concerne la recrudescence et les nouveaux supports aux accouchements à domiciles planifiés sous la surveillance d’une sage-femme aux Etats-Unis, ainsi que les autres pays développés, dans le contexte de la responsabilité professionnelle. |
Abstract (English) : | This article addresses the recrudescence of and new support for midwife-supervised planned home birth in the United States and the other developed countries in the context of professional responsibility. Advocates of planned home birth have emphasized patient safety, patient satisfaction, cost effectiveness, and respect for women’s rights. We provide a critical evaluation of each of these claims and identify professionally appropriate responses of obstetricians and other concerned physicians to planned home birth. We start with patient safety and show that planned home birth has unnecessary, preventable, irremediable increased risk of harm for pregnant, fetal, and neonatal patients. We document that the persistently high rates of emergency transport undermines patient safety and satisfaction, the raison d’etre of planned home birth, and that a comprehensive analysis undermines claims about the cost-effectiveness of planned home birth. We then argue that obstetricians and other concerned physicians should understand, identify, and correct the root causes of the recrudescence of planned home birth; respond to expressions of interest in planned home birth by women with evidence-based recommendations against it; refuse to participate in planned home birth; but still provide excellent and compassionate emergency obstetric care to women transported from planned home birth. We explain why obstetricians should not participate in or refer to randomized clinical trials of planned home vs planned hospital birth. We call on obstetricians, other concerned physicians, midwives and other obstetric providers, and their professional associations not to support planned home birth when there are safe and compassionate hospital-based alternatives and to advocate for a safe home-birth-like experience in the hospital. |
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Comments : | Critical comments: |
Argument (français) : | Nous appelons les obstétriciens, les autres médecins concernés, les sages-femmes, et autres professionnels de l’obstétrique, ainsi que leurs associations professionnelles à ne pas supporter l’accouchement à domicile alors même qu’il existe des alternatives hospitalières sécuritaires et respectueuses, et de plaider pour une expérience sécuritaire « comme à la maison » à l’hôpital. |
Argument (English): | We call on obstetricians, other concerned physicians, midwives and other obstetric providers, and their professional associations not to support planned home birth when there are safe and compassionate hospital-based alternatives and to advocate for a safe home-birth-like experience in the hospital. |
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Keywords : | ➡ place of birth ; homebirth ; planned homebirth ; public health |
Author of this record : | Bernard Bel — 28 Dec 2012 |
Discussion (display only in English) | ||
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