The Big Push For Midwives: ACOG Wants to Keep Women Hungry in Labor

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I hate copying and pasting entire press releases, boilerplate and all, but this one is full of great quotes and writing a new post wouldn’t do it justice. It’s from The Big Push for Midwives, so please go there, click around and read liberally.

I had to scroll up to the top to make sure that The Big Push didn’t link to the satirical newspaper, The Onion, instead of the ACOG web site when I read this:

“Allowing laboring women more than a plastic cup of ice is going to be welcome news for many,” Dr. Barth said. “As for the continued restriction on food, the reality is that eating is the last thing most women are going to want to do since nausea and vomiting during labor is quite common.”

Dr. Barth needs to define “many.” I’m also waiting for Reality Rounds to come around and call a “Code Bullshit” on Barth’s paternalistic embarrassment of a statement that “the reality is that eating is the last thing most women are going to want to do [in labor].” How would he ever arrive at that conclusion if he’s never allowed women to eat in labor in the first place?

Dr. Barth’s hospital, Massachusetts General in Boston, sections 32.7 percent of its patients.


Here is the press release:


Physician Group Pulls the Plug on Women’s Autonomy

Issues Policy Statement About What Women in Labor Will be “Allowed” to Eat and Drink


WASHINGTON, D.C. (August 25, 2009)—Displaying a stunning lack of regard for patient autonomy, the American College of Obstetricians and Gynecologists (ACOG) issued a statement this week declaring that the group will “allow” laboring women to drink “modest amounts” of clear fluids during labor while continuing to prohibit access to solid food.

“Once again ACOG has issued a position statement with little regard for the evidence or for the ability of women to make decisions for themselves,” said Susan Jenkins, Legal Counsel for The Big Push for Midwives Campaign. “It’s insulting that ACOG actually believes that laboring women should be grateful that they will now be ‘allowed’ to have more than just ice chips, when we have long known how vital nutritional sustenance is to mothers and babies not only during pregnancy, but during labor as well.”

Hospitals routinely adopt ACOG position statements as standard policy governing the treatment of pregnant and laboring women, despite the fact that a number of the organization’s position statements do not acknowledge all of the risks and benefits associated with common procedures.

“ACOG is asking laboring women to do the physical equivalent of a marathon on the power of a ‘modest’ amount of clear liquid,” said Sabrina McIntyre, mother of two. “Thanks but no thanks. I’ll stick with my midwife and her wisdom of keeping up my physical stamina for such a monumental event.”

Policies restricting food and liquid intake date from an era when laboring women were routinely given general anesthesia and risked aspirating food into the lungs. Modern anesthetic techniques have virtually eliminated this risk, which is further reduced by the fact that only a tiny minority of laboring women, even among those who deliver via cesarean section, actually receive general anesthesia.

“The women in my birth center eat when they are hungry and drink when they are thirsty, all without asking for ACOG’s permission first,” said Elizabeth Allemann, MD. “Women deserve to be fully informed about what the evidence actually shows, and it’s time that the medical profession abandoned policies based on the outdated and paternalistic idea that patients should play no role whatsoever in the decision-making process.”

The Big Push for Midwives Campaign represents thousands of grassroots advocates in the United States who support expanding access to Certified Professional Midwives and out-of-hospital maternity care. The mission of The Big Push includes educating national policymakers about the reduced costs and improved outcomes associated with out-of-hospital birth and advocating for including the services of Certified Professional Midwives in health care reform.


Related post:

Eating During Childbirth? Yes, You CAN, Says BMJ!


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