Recommendations from the Home Birth Consensus Summit Released This Week:

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By Elan McAllister

I recently had the great good fortune to travel to Virginia and participate in the Home Birth Consensus Summit. The Summit brought together multidisciplinary stakeholders from across the maternity care system including midwives, consumers, obstetricians, insurers, policy makers, consumer advocates, pediatricians, family practice doctors, nurses, researchers, neonatologists, ethicists and hospital administrators. I have to say that the Summit far surpassed my expectations. I was so impressed by the dedication of all in attendance to work together toward finding common ground over an issue that has traditionally been deeply contentious. We all shared an understanding that, like it or not, home birth is a reality and we collectively share the responsibility to make it as safe as possible for the families who choose it. By the end of the three days we were able to find consensus over 9 common ground beliefs. Action plans for shifting these beliefs into practical reality are in development. We have a long way to go, there are still deep divides over this issue, but this was a beautiful, hope-inspiring first step toward change. I am deeply grateful to the organizers who made this happen and encourage you to support this work in anyway that you can.

Here are the 9 Statements from the Home BIrth Consensus Summit

The following statements reflect the areas of consensus that were achieved by the individuals who participated in the Home Birth Consensus Summit at Airlie Center in Warrenton, Virginia from October 20-22, 2011. These statements do not represent the position of any organization or institution affiliated with those individuals.

STATEMENT 1
We uphold the autonomy of all childbearing women.

All childbearing women, in all maternity care settings, should receive respectful, woman-centered care. This care should include opportunities for a shared decision-making process to help each woman make the choices that are right for her. Shared decision making includes mutual sharing of information about benefits and harms of the range of care options, respect for the woman’s autonomy to make decisions in accordance with her values and preferences, and freedom from
coercion or punishment for her choices.

STATEMENT 2

We believe that collaboration within an integrated maternity care system is essential for optimal mother-baby outcomes. All women and families planning a home or birth center birth have a right to respectful, safe, and seamless consultation, referral, transport and transfer of care when necessary. When ongoing inter-professional dialogue and cooperation occur, everyone benefits.

STATEMENT 3

We are committed to an equitable maternity care system without disparities in access, delivery of care, or outcomes. This system provides culturally appropriate and affordable care in all settings, in a manner that is acceptable to all communities.

We are committed to an equitable educational system without disparities in access to affordable, culturally appropriate, and acceptable maternity care provider education for all communities.

STATEMENT 4

It is our goal that all health professionals who provide maternity care in home and birth center settings have a license that is based on national certification that includes defined competencies and standards for education and practice.

We believe that guidelines should:

– allow for independent practice,
– facilitate communication between providers and across care settings,
– encourage professional responsibility and accountability, and
– include mechanisms for risk assessment.

STATEMENT 5

We believe that increased participation by consumers in multi-stakeholder initiatives is essential to improving maternity care, including the development of high quality home birth services within an integrated maternity care system.

STATEMENT 6

Effective communication and collaboration across all disciplines caring for mothers and babies are essential for optimal outcomes across all settings.

To achieve this, we believe that all health professional students and practitioners who are involved in maternity and newborn care must learn about each other’s disciplines, and about maternity and health care in all settings.

STATEMENT 7

We are committed to improving the current medical liability system, which fails to justly serve society, families, and health care providers and contributes to:
– inadequate resources to support birth injured children and mothers;
– unsustainable health care and litigation costs paid by all;
– a hostile health care work environment;
– inadequate access to home birth and birth center birth within an integrated health care system;
and,
– restricted choices in pregnancy and birth.

STATEMENT 8

We envision a compulsory process for the collection of patient (individual) level data on key process and outcome measures in all birth settings. These data would be linked to other data systems, used to inform quality improvement, and would thus enhance the evidence basis for care.

STATEMENT 9

We recognize and affirm the value of physiologic birth for women, babies, families and society and the value of appropriate interventions based on the best available evidence to achieve optimal outcomes for mothers and babies.

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