APHA
Back to Annual Meeting
 		APHA 2006 APHA
Back to Annual Meeting
APHA Scientific Session and Event Listing
Session: Options for Childbirth: A Fundamental Woman's Right
3412.0: Monday, November 06, 2006: 4:30 PM-6:00 PM
Oral
Options for Childbirth: A Fundamental Woman's Right
This session will adress a number of issues related to women's options in childbirth. Freestanding birth centers (FBCs) offer prenatal and childbirth services outside hospital settings where nurse-midwives are the primary providers for women with low-risk pregnancies. Although previous research provides evidence supporting the safety of FBCs, critiques of methodological procedures question the validity of these claims because of potential effects of hidden bias common in observational studies. The purpose of this study is to assess safety by testing whether FBCs, compared to hospital-based services, produce comparable pregnancy outcomes. Data are obtained through Tennessee birth and death certificates from 1990-2002. The original interpretation of the Term Breech Trial, published in the Lancet in October 2000, suggested that planned caesarean section is better than planned vaginal birth for the term fetus in the breech presentation. The investigators were so certain of their findings, and so concerned about the dangers posed by continuing to offer women vaginal births, they stopped the trial short at 2088 enrollments of the proposed trial of 2800. Background: C-section delivery is the most common major surgery in U.S. hospitals. Massachusetts has among the nation's highest rates; almost 1 in 3 deliveries occur via C-section and the rate has increased 57% over the last 5 years. Some C-section deliveries, particularly among primiparous low risk women may be unnecessary.
Learning Objectives: 1. Identify factors associated with elevated Cesarean rates for lowest risk women 2. Identify 3 key methodological problems with published home birth research 3.Take home tools with which to approach local health care professionals and change public opinion in order to turn the breech issue around. 4. Integrate results about the safety of freestanding birth centers into current and future maternal health policy discussions.
Organizer(s):Barbara Levin, MD, MPH
Carol A. Nelson, LM, CPM
Ceclila Wachdorf, CNM, PhD
Moderator(s):Barbara Levin, MD, MPH
4:30 PMIntroductory Remarks
4:35 PMCesarean rates among low risk women in Massachusetts  [ Recorded presentation ]
Isabel A. Cáceres, MMath, Bruce B. Cohen, PhD, Malena Hood, MPH, Wanda Barfield, MD, MPH, James K. West, PhD, Brooke A. Kinniburgh, MPH
4:50 PMA systematic review of the literature on safety of home birth, 1995-2005: Assessing the quality and impact of the evidence  [ Recorded presentation ]
Saraswathi Vedam, MSN, CNM, Deren E. Bader, CPM, DrPH
5:05 PMAssessing safety of freestanding birth centers in Tennessee using propensity score analysis  [ Recorded presentation ]
Heather A. Davidson, PhD
5:20 PMDisturbing developments in evidence-based obstetrics: Can the breech issue be turned around?
Kenneth C. Johnson, PhD, Betty-Anne Daviss, MSc, RM
5:35 PMDiscussion
See individual abstracts for presenting author's disclosure statement and author's information.
Organized by:Maternal and Child Health
Endorsed by:APHA-Committee on Women's Rights; Population, Family Planning, and Reproductive Health; Public Health Nursing; Socialist Caucus; Women's Caucus

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA