Humor will not be tolerated!! -Portia

I don't mean to be disagreeable, but my experiences don't back up (what I think is) your position at all. I thought I had been educated on birth. I'd read a lot of things about "trusting your body" and "trusting the process" of birth, etc. I was completely at the mercy of the information I got from my midwives and nurses for my first labor. (Once I knew how *I* labored, it was much easier and I felt more confident and empowered for my second. But that's not how it goes for a first labor)

If all I'd had to go on was what the nurse in the birth class taught, and the things I had read, I would have been at home "trusting the process" But I'd had a midwife mention at an appointment as I was getting closer to the end the different reasons to call them. I knew my water broke. And my first instinct was to laugh. And then more fluid came out and I laughed more. Then I freaked out about how I had dirty dishes in the sink. And then I went and washed them. I'd like to think that I'm some calm, rational person when it's time for action. But I'm not. I'm kind of giddy and anxious and I worry about dirty dishes at inappropriate times.

I needed someone competent to tell me exactly what to do because I wasn't really thinking straight. (Kind of like how we teach stop, drop, and roll when something catches fire, but people's first response is usually to flail or run or do everything but stop, drop, and roll). I don't put a lot of stock in instincts in and of themselves.

I'm sorry to drudge up such an old thread, but I saw this today and had to post it here.

The Journal of Midwifery and Women’s Health just published a paper called "Formulating Evidence-Based Guidelines for Certified Nurse-Midwives and Certified Midwives Attending Home Births." In this paper, the authors reviewed home birth safety standards from "five countries with provincially or nationally promulgated home birth midwifery guidelines" (Australia, Canada, the Netherlands, New Zealand, and the UK).

The authors of the study wrote:"Published guidelines of these countries were then reviewed for common themes. The following criteria for planning a home birth emerged: determination of low-risk pregnancy, informed consent, hospital transfer if complications arise, singleton pregnancy, fetus in the cephalic presentation, no history of previous cesarean birth, and term pregnancy.

After collection, review, and summary of these international guidelines, the primary author synthesized the information into draft home birth guidelines that could be used by US CNMs/CMs. The resulting 10-page document (see Supporting Information: Appendix S1) includes recommendations about licensure, physician collaboration, hospital transports, informed consent, documentation, client screening, equipment, medications, birth assistants, routine care of the mother and newborn, and emergency care of the mother and newborn."

In a nutshell, they compiled agreed-upon standards of safety from five different countries with established standards of care, for use at homebirths in the US by CNMs and other midwives.

After this (again, I emphasize, internationally agreed upon) set of safety standards for home birth was composed, "Fifteen American Midwifery Certification Board, Inc. (AMCB)-certified home birth midwives who participate in the American College of Nurse-Midwives (ACNM) home birth electronic mailing list considered the use of such a document in their practices and reviewed and commented on the guidelines."

They rejected them.

The CNMs rejected the internationally agreed upon safety standards for homebirth.

Why? I quote, from the paper, "The primary concern expressed was that an adoption of national guidelines could compromise provider autonomy."

The home birth midwives cared more about their own autonomy than patient safety. Their main concern is autonomy - not safety.