In the usa at least more women are not choosing home deliveries. The 2005 CDC national vital statistics report on births gives the out of hospital (birth center and home birth) rate as 1% and says this has been stable “over the past several decades”. See page 18, “place of delivery” of http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_06.pdf

From the same report we can see the numbers for midwives: a peak in 2002 at 8.1%, falling to 7.9% by 2005.

So I would say “more and more women are choosing home deliveries and midwives” is false for the usa.

World wide, I would guess it is also false, as the world’s population is becoming more urban and historically that has meant a heavy shift from home births to hospital births, but I don’t have data on this.

They have chosen to take a philosophical position on healthcare that is contradicted by facts about patient welfare. They “Care about the quality of patients’ deliveries” and are “Concerned about the welfare” of teh babbys. They obviously don’t want to “Improve the quality of patients’ deliveries.” or “Maximize the welfare” of the as yet unborn child; they want to control it and provide mediocore care.

I can’t fault them morally for that. I fully support the right of doctors to control their practice and what services they are willing to provide, for any reason. However, people have a right to choose doctors who perform the procedures they want. In this case, choose another doctor.

If all of the doctors that you can find refuse the same procedure, then you do not have the right to have a doctor perform that procedure. Their right to control their actions is the controlling factor. Conversely, you have the right to refuse any medical care, including lifesaving care, based on your right to control your own actions.

A few small exceptions are left for such things as discrimination and mentally unsound patients, and the law varies from morality in places, but the Aspen Women’s Center seems to have gotten something right: “We will not provide these services, and this is how you get somewhere that will.” Ideally, they should say so in a less “If you ask about this, we will give you to evil, mean strangers who use questioned practices.” manner. Or, you know, catch up with current medical research. Because I seriously doubt that there is a real philosophical objection to the practices listed.

Decisions concerning intervention in birth look different with the value of hindsight, and perhaps we are inclined to err on the side of caution with regard to birth. Emotions run high, and with the potential of major morbidity and mortality for the infant on the cards, most parents would fold at the first whiff of danger. Perhaps this illustrates the importance of high quality postgraduate medical training, with obstetricians who are effective communicators more than anything else.

In the United Kingdom we have the advantage of a hundred years of maternal mortality studies, and it’s obvious that the rising medical intervention is the price we pay for the decreases we make in maternal deaths. 31% is certainly an average much higher than we see in the UK. 25% seems to be the most oft-quoted average; although obviously this depends on the individual units. It does; however, have to be weighed against the fact that we used to see 65 women per year die of obstructed labour, which would be unheard of in current times.

All of us [doctors] have to justify our decisions, whether that is to a person’s family or to court in the event of litigation. Performing medical intervention is not without risk, and we must be prepared to justify performing and witholding intervention.

You have to recognize that doctors are human; they make mistakes, and not everything they do is in your best interests. Take c-sections for example. For the doctor, it’s quick and easy birth. For the woman, it’s fraught with complications – there’s always a risk when you cut someone open, and the recovery takes much longer. I’m not saying that c-sections shouldn’t be done, merely that they are done when they are not needed.

Doctors are seeing a lot of patients. They’re not thinking about your comfort or your emotional needs when your giving birth, even though a situation of high stress can promote complications and difficulties in the birthing process.

An overburdened medical system is resulting in assembly line medicine – treat them like patients, not people, and get them out as soon as possible. If the doctors could put you on a conveyor belt, attach you to machines that would do the job for them, and merely sit behind a window and press buttons, you bet they would.

The result of assembly line medicine is the dehumanization of the patient. Patient has illness. Treat the illness. Send the patient home.

This formula, already problematic, is still more problematic when you take something like pregnancy which is not an illness at all. Pregnancy can come with complications that do require a doctor’s presence, but the doctor is not the one giving birth. The pregnant woman is the one who is doing the work. The focus should be ensuring that her working conditions are optimal, not the doctor’s. For example, it doesn’t make sense for a woman to give birth on her back, because then she’s working against gravity, but being on her back gives the doctor better access, so that’s the norm.

http://nolongerquivering.com/2009/07/24/vyckies-story-part-20-though-he-slay-me-again/

Regarding the first point, I’m imagining a statement to the effect of “we don’t actually recommend any of this, but if you truly feel you must, at least these people won’t actually hurt you.” Wouldn’t that actually be better for everyone? They keep the patient, the patient is safe and her wishes are reasonably accommodated (which maybe goes to the second point), and they untrained midwives are starved of victims.

[Disclosure: I'm not a doctor, nor have I been pregnant. And I know nothing of the "Bradley Method." It seems perfectly sensible to refuse to do that. Not without reams of waivers, anyway.]