[Congressional Record Volume 157, Number 175 (Wednesday, November 16, 2011)]
[House]
[Pages H7634-H7635]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      HOME BIRTH CONSENSUS SUMMIT

  The SPEAKER pro tempore. The Chair recognizes the gentlewoman from 
California (Ms. Roybal-Allard) for 5 minutes.
  Ms. ROYBAL-ALLARD. Mr. Speaker, I rise to recognize an event of 
critical importance to all current and future childbearing families in 
this country.
  For 3 days in October, a national summit of maternity care 
stakeholders met in Warrenton, Virginia, to discuss the status of home 
birth within the greater context of maternity care in the United 
States. That meeting marked the first time a multidisciplinary group of 
maternity care providers, consumers, and industry leaders came together 
to determine what the U.S. maternity care system could do to make home 
birth the safest and most positive experience possible for moms and 
babies.
  Given the significant controversy over the appropriateness of home 
birth within the groups represented at the summit, the fact that this 
conversation took place at all is historic. The goal of the meeting was 
not to debate the rightness or wrongness of home birth, but rather to 
discuss the support, care, consultation, collaboration, and referrals 
necessary to protect moms and babies in all birth settings.
  According to CDC's most recent figures, in 2008, approximately 28,500 
home births took place in the United States. While this number 
represents less than 1 percent of all births in our country, the last 
available statistics tell us that between 2004 and 2008, the number of 
women giving birth at home increased by 22 percent.

                              {time}  1050

  Without compromising quality of care, women want and expect to have 
choices for childbirth, including birth setting. Women and families are 
ill-served when maternity care professionals allow conflict between 
disciplines to supersede collaboration. The safety of birth in all 
settings must be the utmost priority.
  The delegates who met in Virginia were charged with finding common 
ground to move the issue of safe home birth beyond professional 
differences and toward consensus building. The result of their effort 
was a consensus document released on November 1 of this year. This 
important document sets out nine essential statements of agreement 
about the ideal system to promote the safest and most positive birth 
outcomes across all birth settings.
  While I will be submitting the entire document into the Record, I 
want to highlight the following key points agreed upon by all of the 
delegates at the summit:
  First, all childbearing women in all maternity care settings should 
receive respectful, women-centered care, including opportunities for 
shared decisionmaking to help each woman make the choices that are 
right for her;
  Second, physiological birth is valuable for women, babies, families, 
and society, and appropriate intervention should be based on the best 
available evidence to achieve optimal outcomes for mothers and babies;
  Third, collaboration within an integrated maternity care system is 
essential for optimal outcomes, and when necessary, all women and 
families planning a birth center or home birth have a right to a 
respectful, safe, and seamless consultation, referral, transport, and 
transfer of care;
  Fourth, all health professionals who provide maternity care in all 
settings should have a license that is based on national certification 
that includes defined competencies and standards for education and 
practice; and
  Fifth, in order to foster effective communication and collaboration 
across all maternity disciplines, all students and practitioners 
involved in maternity and newborn care must learn about each other's 
disciplines and maternity care in all settings.
  Additionally, the consensus document calls for medical liability 
system

[[Page H7635]]

reform, a compulsory process with collection of patient data in all 
birth settings, the elimination of disparities of care, and increased 
consumer participation.
  The Home Birth Consensus Summit document is an important first step 
in protecting and supporting all childbearing families across all birth 
settings, but the discussion must not stop there. I encourage all 
professional organizations representing providers of maternity care and 
newborn care and all childbirth advocacy groups to affirm the consensus 
statement and commit to working together toward its realization. 
Mothers and babies in this country deserve nothing less.

                      Home Birth Consensus Summit

                          October 20-22, 2011

                        Common Ground Statements

       The following statements reflect the areas of consensus 
     that were achieved by the individuals who participated in the 
     Home Birth Consensus Summit at Airlie Center in Warrenton, 
     Virginia, from October 20-22, 2011. These statements do not 
     represent the position of any organization or institution 
     affiliated with those individuals.


                              STATEMENT 1

       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.


                              STATEMENT 2

       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.


                              STATEMENT 3

       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.


                              STATEMENT 4

       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.


                              STATEMENT 5

       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.


                              STATEMENT 6

       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.


                              STATEMENT 7

       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 health care and litigation costs paid by all; a 
     hostile health care work environment; inadequate access to 
     home birth and birth center birth within an integrated health 
     care system; and, restricted choices in pregnancy and birth.


                              STATEMENT 8

       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.


                              STATEMENT 9

       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.

                          ____________________