Welcome to the ACNM Library. You can search for ACNM resources—including position statements, issue briefs, fact sheets, and more—by keyword or category. Please note that state guidance documents are among members-only resources and will not appear as a searchable category or in search results unless you are logged in. In order to view a complete listing of library contents in the drop-down “Category” menu, you must first be logged in to the ACNM site. (Member log-in is located at the upper right hand corner of the page.)
For best results when printing documents from the ACNM Library,
select "Fit to Printable Area" from your printer's page scaling
ACOG Committee Opinion on Planned Home Birth: Opening the Door to Collaborative Care
ACNM welcomes ACOG’s shift from an “absolute no” on home birth to the recognition of a woman’s right to make informed decisions about birth setting
In a January 20, 2011 press release, the American College of Obstetricians and Gynecologists (ACOG) announced that its Committee on Obstetric Practice has issued a new Committee Opinion on Planned Home Birth.1 This new statement replaces ACOG’s sharply worded 2007 policy which declared that “ACOG does not support programs or individuals that advocate for or who provide home births.”2
The 2011 Committee Opinion strikes a different tone. “Although ACOG’s Committee on Obstetric Practice believes that hospitals and birthing centers are the safest setting for birth it respects the right of women to make a medically informed decision.” ACOG also urges the development of integrated systems of care to achieve favorable home birth outcomes. Unfortunately, ACOG’s opinion relies heavily on a widely‐criticized and very flawed 2010 meta‐analysis to support their assertion that birth is less safe when it occurs at home.3‐6 Despite this, the document adopts a more respectful tone about women’s choice of birth setting and for the first time ACOG has acknowledged that some women are appropriate candidates for home birth. It is a small step towards future civil discourse.
ACNM agrees that there is a critical need to develop integrated systems of care that promote the best health for women and their newborns regardless of birth setting. “The door is open to explore how collaborative relationships and integrated systems of care can be developed to support women in their childbirth choices,” states ACNM President Holly Powell Kennedy, CNM, PhD, FACNM, FAAN. “However, creating a new dialogue that reverses decades of past beliefs, attitudes, and thorny discourse does not happen overnight. We must start with the respectful belief that all maternity care providers truly want the best possible outcomes for women and their infants.”
Upcoming Summit Offers Unprecedented Opportunity for Dialogue
ACNM views the 2011 ACOG Committee Opinion as a crack in ACOG’s long‐standing negative stance on home birth. “We can focus on the negative aspects of this committee opinion, or we can seize this opportunity to redefine the discussion,” said Kennedy. “Beliefs and values about how to accomplish those outcomes are culturally steeped, experientially‐based, and stem partially from professional training and socialization. Moving to a place of mutual understanding and agreement will require that we all use midwifery skills: patience with process, respect, listening, knowledge, presence, and strong leadership. ACNM is committed to working collegially with all health professionals involved in maternity care to clarify, define, and advocate for the best care practices for women in all birth settings.”
# # #
With roots dating to 1929, the American College of Nurse‐Midwives (ACNM) is the oldest women's health care organization in the U.S. ACNM is the professional association that represents Certified Nurse‐Midwives (CNMs) and Certified Midwives (CMs) in the United States. ACNM provides research, administers and promotes continuing education programs, establishes clinical practice standards, and liaisons with state and federal agencies and members of Congress. In 2008, the number of births attended by CNMs and CMs reached a record high of 317,626, representing 11.1% of all vaginal births, and 7.5% of all births. CNMs and CMs attend births in hospitals (96.1%) freestanding birth centers (2.1%) and at home (1.7%).
1. Planned Home Birth. Committee Opinion #476. American College of Obstetricians and Gynecologists. Obstet Gynecol 2011;117:425‐8. Available at http://www.acog.org/from_home/publications/press_releases/nr01‐20‐11.cfm (accessed February 2, 2011).