CIMS (kickass) response to The Today Show

Sept. 22, 2009

Dear Producers of The Today Show,

The Coalition for Improving Maternity Services (CIMS) and the undersigned
organizations are disappointed with The Today Show's misrepresentation of
midwives and home birth that aired on Sept. 11, in a segment titled "The
Perils of Midwifery," later changed to "The Perils of Home Birth." This
biased and sensational segment inaccurately implied that hospitals are the
safest place to give birth even for low-risk women and mischaracterized
women who choose a home birth with a midwife as "hedonistic," going so far
as to suggest that these women are putting their birth experiences above the
safety of their babies. Neither could be further from the truth.

Unfortunately, The Today Show did not do its homework on the evidence
regarding the safety of home birth and midwifery care. The segment featured
an obstetrician who presented only the American College of Obstetricians and
Gynecologists' (ACOG) position in opposition to home birth, but it did not
make any attempt to present the different viewpoints held by the many
organizations that are committed to improving the quality of maternity care
in the US. We are deeply saddened that the show did not take the opportunity
to note that both CIMS and The National Perinatal Association respect the
rights of women to choose home births and midwifery care, and that the
respected Cochrane Collaboration recommends midwifery care because it
results in excellent outcomes.

There is no evidence to support the ACOG position that hospital birth for
low-risk women is safer than giving birth with midwives at home. What the
research does show is that the routine use of medical interventions in
childbirth without medical necessity can cause more harm than good, while
also inflating the cost of childbirth. However, the current health system
design offers little incentive for physicians and hospitals to improve
access to maternity care practices that have been proven to maximize
maternal and infant health.

"Birth is safest when midwives and doctors work together respectfully,
communicate well, and when a transfer from home to hospital is needed, it is
appropriately handled," says Ruth Wilf, CNM, PhD, a member of the CIMS
Leadership Team.

That is why the national health services of countries such as Britain,
Ireland, Canada, and the Netherlands support home birth. In those countries,
midwives are respected and integrated into the maternity care system. They
work collaboratively with physicians in or out of the hospital, and they are
not the target of modern day witch hunts. These countries have better
outcomes for mothers and babies than the US.

Childbirth is the leading reason for admission to US hospitals, and
hospitalization is the most costly health care component. Combined hospital
charges for birthing women and newborns ($75,187,000,000 in 2004) far exceed
charges for any other condition. In 2004, fully 27% of hospital charges to
Medicaid and 16% of charges to private insurance were for birthing women and
newborns, the most expensive conditions for both payers. The burden on
public budgets, taxpayers and employers is considerable.

As US birth outcomes continue to worsen, it should come as no surprise to
The Today Show that childbearing women are seeking alternatives to standard
maternity care. After all, American women and babies are paying the highest
price of all-their health-for these unnecessary interventions, which include
increasing rates of elective inductions of labor and cesarean sections
without medical indication.

To the detriment of childbearing families, the segment "The Perils of
Midwifery" totally disregarded the evidence. Although the reporters
acknowledged that research shows home birth for low-risk women is safe, that
message was overshadowed by many negative messages, leaving viewers with a
biased perception of midwifery care and home birth. CIMS makes these points
not to promote the interests of any particular profession, but rather to
raise a strong voice in support of maternity care practices that promote the
health and well-being of mothers and babies.

One of the ten Institute of Medicine recommendations for improving health
care is to provide consumers with evidence-based information in order to
help them make informed decisions. The Institute recommends that decisions
be made by consumers, not solely by health care providers. The Institute
maintains that transparency and true choice are essential to improving
health care. We remain hopeful that the medical community will soon
recognize the rights of childbearing women when it comes to their choices in
childbirth and will respect and support these choices in the interest of the
best possible continuity and coordination of care for all.

We urge The Today Show to provide childbearing women with fair and accurate
coverage of this important issue by giving equal time to midwives, public
health professionals, researchers of evidence- based maternity care, and
especially to parents who have made choices about different models of care
and places of birth.

Sincerely,
Coalition for Improving Maternity Services
Academy of Certified Birth Educators
Alaska Birth Network
Alaska Family Health and Birth Center
American Association of Birth Centers
American College of Community Midwives
American College of Nurse-Midwives
Bay Area Birth Information
Birth Network of Santa Cruz County
Birth Works International
Birthing From Within, LLC
BirthNet
BirthNetwork National
BirthNetwork of Idaho Falls
BirthNetwork of NW Arkansas
Choices in Childbirth
Citizens for Midwifery
DONA International
Doulas Association of Southern California
Evansville BirthNetwork
Harmony Birth & Family
Idaho Midwifery Council
Idahoans for Midwives
InJoy Birth and Parenting Education
International Childbirth Education Association
International MotherBaby Childbirth Organization
Lamaze International
Madison Birth Center
Midwives Alliance of North America
Motherbaby International Film Festival
Nashville BirthNetwork
National Association of Certified Professional Midwives
North American Registry of Midwives
Oklahoma BirthNetwork
Perinatal Education Associates, Inc.
Reading Birth & Women's Center
Rochester Area Birth Network
Sage Femme
The Big Push for Midwives Campaign
The Tatia Oden French Memorial Foundation
Triangle Birth Network
Truckee Meadows BirthNetwork

About Us
The Coalition for Improving Maternity Services (CIMS) is a coalition of
individuals and national organizations with concern for the care and
wellbeing of mothers, babies, and families. Our mission is to promote a
wellness model of maternity care that will improve birth outcomes and
substantially reduce costs. The CIMS Mother-Friendly Childbirth Initiative
is an evidence-based mother-, baby-, and family- friendly model of care
which focuses on prevention and wellness as the alternatives to high-cost
screening, diagnosis, and treatment programs.

References:
1. The Perils of Home Births,
http://www.msnbc.msn.com/id/21134540/vp/32795933#32795933
2. Birth Can Safely Take Place at Home and in Birthing Centers,
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2409129&blobtype=pdf
3. Offers All Birthing Mothers Unrestricted Access to Birth Companions,
Labor Support, Professional Midwifery Care,
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2409134&blobtype=pdf
4. ACOG Place of Birth Policies Limit Women's Choices Without Justification
and Contrary to the Evidence,
http://childbirthconnection.com/article.aspClickedLink=790&ck=10465&area=27
5. Ratifiers and Endorsers of The Mother-Friendly Childbirth Initiative,
http://www.motherfriendly.org/ratifiers.php
6. Choice of Birth Setting,
http://www.nationalperinatal.org/advocacy/pdf/Choice-of-Birth-Setting.pdf
7. Position Statement on Midwifery,
http://www.nationalperinatal.org/advocacy/pdf/Midwifery.pdf
8. Midwife-led versus other models of care for childbearing women,
http://cochrane.org/reviews/en/ab004667.html
9. Evidence-Based Maternity Care: What It Is And What It Can Achieve,
http://childbirthconnection.com/pdfs/evidence-based-maternity-care.pdf
10. Lamaze Healthy Birth Practices,
http://www.lamaze.org/ChildbirthProfessionals/ResourcesforProfessionals/Care
PracticePapers/tabid/90/Default.aspx
11. Millennium Development Goals Indicators, United Nations,
http://mdgs.un.org/unsd/mdg/Data.aspx
12. National Vital Statistics System, Birth Data,
http://www.cdc.gov/nchs/births.htm
13. Induction By Request,
http://www.marchofdimes.com/prematurity/21239_20203.asp
14. Cesarean Birth By Request,
http://www.marchofdimes.com/prematurity/21239_19673.asp
15. Crossing the Quality Chasm: A New Health System for the 21st Century,
http://www.iom.edu/CMS/8089/5432.aspx
16. The Mother-Friendly Childbirth Initiative,
http://www.motherfriendly.org/mfci.php

Coalition for Improving Maternity Services
1500 Sunday Drive, Suite 102
Raleigh, NC 27607

Tel: 919-863-9482
Fax: 919-787-4916

www.MotherFriendly.org