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An Open Letter to ACOG

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Posted by MANA Community Manager on April 10th, 2014

The American Congress of Obstetricians and Gynecologists recently released a joint statement with the Society of Maternal-Fetal Medicine on ways to reduce primary cesareans. As a part of our Cesarean Awareness Month efforts, we wanted to share with the MANA community our open letter to ACOG. We welcome your comments.

Dr. Jeanne Conry, President
Dr. Hal Lawrence, Executive Director
American Congress of Obstetricians and Gynecologists

Dear Drs. Conry and Lawrence,

On behalf of the Midwives Alliance, I am writing to congratulate you for the strong commitment to high quality maternity care that ACOG has demonstrated by developing and disseminating the Joint Statement by the American Congress of Obstetricians and Gynecologists and the Society of Maternal-Fetal Medicine, Safe Prevention of the Primary Cesarean Delivery.

In recent studies and commentaries regarding causes for the escalating rate among low-risk patients, experts suggested the increase in cesarean sections was due to maternal health issues, such as gestational diabetes and obesity, fetal issues, such as malpresentation and multiple gestation, as well as malpractice concerns affecting hospital policies and practitioners. However, this new position statement by the nation's maternal and fetal health experts suggests that modification of certain maternity care practices could in fact reduce primary surgical deliveries. The World Health Organization called for the elimination of unnecessary cesarean sections as early as 1996, yet until recently there were few resources to assist maternity care providers in achieving this goal. This new joint statement provides a critical, evidence-based and actionable guideline for both health care providers and consumers. The emphasis placed on accounting for patient preference when making these complex decisions is reflective of the value that ACOG places on patient oriented outcomes.

As you may be aware, in May 2012, MANA, ACNM, and NACPM issued a joint statement entitled Supporting Healthy Normal Physiologic Birth That statement provides a complementary evidence-based guideline for practitioners who seek to facilitate normal physiologic birth and limit obstetric interventions to those that are necessary and evidence-based. We look forward to future opportunities to collaborate across disciplines to endorse evidence-based best practices in maternity care.

I wanted you to know that MANA publicly endorses the Joint Statement on the Safe Prevention of the Primary Cesarean. We are committed to working together—physicians, nurses, midwives, hospital personnel—to strive for an integrated maternal and child health system that provides high quality care for all women and infants in the U.S.

Thank you again for your leadership and vision.

Marinah V. Farrell, President
Midwives Alliance

Marinah V. Farrell is the president of the Midwives Alliance of North America. Politics and traditional medicine is what led Marinah to midwifery, and she has a firm commitment to both political activism and birth work. Marinah has been the president of various non-profit boards, has worked in waterbirth centers and medical facilities for international NGOs, free-standing birth centers in the U.S, and has been the owner of a long standing homebirth practice. Marinah also works with various local grassroots organizations in Arizona such as the Phoenix Allies for Community Health, a free clinic in downtown Phoenix, and assists in collective endeavors with other grassroots groups. Marinah is focused on the issue of lack of access to midwives and the profession of midwifery in communities where health disparities are overwhelming, as well as training in cultural safety.

Thoughts? Comments? Please add them here.

MANA's Open Letter to ACOG

Thank you, MANA, for this supportive and collaborative letter!

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