Home Birth Summit

I just came home from the Home Birth Summit. It was 2 1/2 exhausting but rewarding days of dialogue, discussion, and consensus-building. I was thrilled to be in a room with all of the key stakeholders in home birth and to have honest, open conversations about such a normally divisive issue.

At the end of the Summit, we (meaning all 80 of us delegates) came to consensus on nine key points. We're waiting back for the written report, but in the meantime here are 8 of the 9 main topics. I am totally blanking on the ninth!:

• Role that liability and (fear of) litigation play in increasing costs, decreasing access, restricting collaboration and narrowing women's childbearing choices
• Importance of childbearing women's autonomy and shared decision-making
• Linked data collection and sharing
• Need for collaboration between providers and a system to enable safe, seamless & respectful transfers of care
• Involving consumers in physician & midwife organizations 
• Need to address midwifery licensure in all 50 states, including dialogue on CPM core competencies, working towards licensing DEMs (most likely CPMs, perhaps expanding CM credential) in all 50 states, & eliminating CNM practice barriers
• Addressing inequalities in maternity care (access, affordability, outcomes, etc.), especially for poor, rural, & minority women
• Valuing both physiological birth and the timely & appropriate use of evidence-based interventions

The English professor in me was wincing at times; when you're writing these kind of statements by committee, the language tends to get stilted and overly wordy...but I just had to take a few breaths and let that pass.

I was thrilled that we accomplished so much in so little time. What we did at the Summit was huge. For example, we had the president-elect of FIGO and the immediate past president of ACOG hammering things out with the president of MANA and an epidemiology professor and a malpractice insurer and a direct-entry midwife. (Remember, of course, that all stakeholders attended on their own, not as representatives of their organizations.)

And of course, we had some fun along with all of our work. We had a running joke going about the disappearance of pubic hair in obstetrics (one of those "you had to be there" moments). We also met last night to share birth stories. I showed the video of Inga's birth and I was so honored that such a mixed group got to see and talk about it.

One of my favorite activities was when each stakeholder group created a Proud/Sorry list: 3 things they were proud of and 3 things they were sorry for. Jill of The Unnecesarean and I immediately turned to each other and said, "We are sorry for fanning the flames of divisiveness through anti-OB and anti-hospital rhetoric." That became #1 on our Sorry list.

Over the years I've been blogging, I've matured a lot in my rhetoric and understanding of birth and breastfeeding. I find myself more willing to embrace other viewpoints, less strident in my advocacy for home birth or natural birth (although I still feel passionately about it), and more eager to engage in true dialogue with those groups typically cast as the enemy. Repeat after me: Doctors are not the enemy. Hospitals are not the enemy. (If anyone or anything is--and I think almost everyone at the Summit would agree--it is our malpractice/litigation system.)

The OB group's Proud/Sorry list--which stretched far beyond three items in both categories--was particularly touching. It's too bad we don't have more opportunities for this kind of sharing and conversation. I think we'd find we have so many common goals and that the stereotypes just don't hold up.

I better stop now before I start singing Kumbaya and getting all touchy-feely on you.