The first planning meeting for what would ultimately become the three Homebirth Consensus Summits was held in 2009 in response to a rising homebirth rate in the US. While women demanded choices in birthplace, the increasing disagreements and rhetoric surrounding place of birth and qualifications of providers did nothing to meet their expectations of choice and quality maternity care. The vision was to find common grounds of agreement to replace inter-professional conflict, and begin a productive dialogue that would ultimately improve maternal and newborn care for families choosing homebirth.

The 9 stakeholder groups identified in the planning stage for the Summits were:  

• Home Birth Consumers (parents and potential parents considering this option)  
• Consumer Representatives (including doulas, childbirth educators, childbirth and women’s health care reform and information agencies)
• Home Birth Midwives (CPM, CNM, LM, CM, traditional, etc.)
• Maternal-Child Health Collaborating Providers (including paediatrics, labor and delivery nurses, neonatal care providers, CNMs who facilitate access for hospital admission or consultation)
• Obstetricians and OB Family Practice Physicians
• Leaders with expertise in Health Care Models, Systems, and Hospital Administration
• Insurance (liability and payors)
• Health Policy, Legislators, Regulators, and Ethicists
• Public Health, Research, and Education

National leaders with historically opposing views from a cross-section of the maternity care system were invited to participate in the initial 2011 Homebirth Summit which provided a structured setting to begin working toward the common goal of improved experience and outcomes for women and families. Although attendees came as individuals, not as representatives of organizations, Midwife Alliance leadership was well represented. MANA board and staff members at the Summits have included past presidents Jill Breen and Geradine Simkins, current president Marinah Farrell, vice president Sarita Bennet, board member Colleen Donovan-Batson, communications staff member Jeanette McCulloch as well as Melissa Cheyney, MANA Division of Research Chair; and Saraswathi Vedam, Senior Advisor for the MANA Division of Research.

The Common Ground Vision Statements were the result of the 2011 Homebirth Summit. Since the initial summit, task forces have continued to work together on initiatives to address issues named in the Statements, such as accessibility, collaboration and licensure, and have followed up with Homebirth Summits in 2013 and 2014.

The Common Ground Statements

These common ground principles are intended to provide a foundation for continued dialogue and collaboration across sectors, as we work together towards a common goal of improving maternal and newborn care for families choosing home birth.

Autonomy & Choice
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.

Interprofessional Collaboration & Communication
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.

Reduction in Health Disparities & Equity in Access to Care
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.

Regulation & Licensure of Home Birth Providers
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.

Consumer Engagement & Advocacy
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.

Interprofessional Education
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.

Liability Reform
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 healthcare and litigation costs paid by all;
• A hostile healthcare work environment;
• Inadequate access to home birth and birth center birth within an integrated health care system; and,
• Restricted choices in pregnancy and birth.

Liability Reform – Addendum April 2013
In addition to addressing the current system and its shortcomings, some of our main aspirations for the future include:

• Ensure equity in coverage across populations that is non-discriminatory, and
• Reduce the threat of litigation as a driver of delivery of maternity care.

Research, Data Collection & Knowledge Translation
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.

Physiologic Birth
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.

To read more about the Homebirth Summits, click here.
For printable Statements, click here.