Updated Saturday February 19, 2011 07:26 PM

Consortium for the
vidence-based practice of Obstetrics

The primary purpose of maternity care 
is to p
reserve the health of already 
healthy mothers
and babies

Sister Sites

American College of Community Midwives 

(2) California College of Midwives
(3) HealthCare_2.0.com

(4) NormalBirth.Org


                                                  New Email addresses ~     


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Attention: We are upgrading our computer system & will be off-line  starting
March 28th, 2010

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Most Recent Posted  2.22.06

Hospital Birth Disaster

The 2-minute scoop

Flat Earth Obstetrics

Problem Statement

Reading time 15 minutes

Position Paper ~ May 9, Mothers' Day, 2004  
Reading time 25 min

C.E.O White Paper 2004 Reading time 35 min

(1) Scientific Literature on medical & physiological management  

(2) Historical Background Material ~How normal birth became a surgical procedure

Shortcut to CS photos
& citation directory


he C.E.O web site provides an opportunity for dialogue   between childbearing women and obstetricians and between obstetricians and other providers of childbirth services. The goal of C.E.O. is to promote public debate on improving our national maternity care policy. 

CEO also provides information on evidenced-based birth care for healthy women with normal pregnancies. Information on the CEO web site provides background information to protect the ethical and constitutional rights of competent  adult women to have control over the  manner and circumstances of pregnancy  and normal birth.

 ~ Consortium for the Evidence-base practice of Obstetrics 

is dedicated to bringing science-based 
maternity care
to all childbearing women and promoting public debate on our national maternity care policy    
hosts two organizations 

CEO for is for consumers
and childbirth professionals.

Cytotec // maternal-fetal death

The goal of CEO & A_CEO is national maternity care policy reform that would:

  (a) End the routine use of potentially-harmful obstetrical practices
(b) Establish a single, science- based or ‘physiological’ model of childbirth as the universal
standard for all practitioners providing care to healthy women w/ normal pregnancies


Medicine Gone Mad ~ 
The Death of Normal Birth 
Tesla Presentation 
June 2006 

Mar 06 ~ San Francisco State University's Holistic Health Program – Future Health Conference 2006

April 06 ~ Info for Bloggers
Midwife Controversy 


** A popular Michigan hospital is remodeling its maternity wing. It is building operating rooms, in anticipation of a 50% CS rate by the time the  new unit opens in 2011.

Read more about the 29.1% Cesarean section rate for 2004 and the annual 14.6 Billion dollar bill for CS in 2003 in the race to see who can be first to put normal birth on the list of 'extinct' forms of biology

Action Plan & mailing address f

A_CEO -- for physicians who provide obstetrical services

Contact Us  //  Membership

~ Consortium for the Evidence-base practice of Obstetrics ~
CEO is dedicated to bringing science-based maternity care to all childbearing women
  and promoting public debate on our national maternity care policy    

~ A_CEO ~ The American College of Evidence-based Obstetrics ~
For physicians who wish to
re-establish the scientific foundation of their profession
 and reclaim their expertise in the use of physiological management for normal birth


C.E.O. White Paper 2004 ~ an in-depth exploration of the issues & a plan for rehabilitating obstetrical care for healthy women 


Physiological:  to be "..in accord with, or characteristic of, the normal functioning of a living organism”

 (Stedman’s Medical Dictionary definition of “physiological” – 1995)

Physiological management is the evidenced-based model of maternity care. It is associated with the lowest rate of maternal and perinatal mortality, is protective of the mother's pelvic floor, has the best psychological outcomes and the highest rate of breastfed babies. Dependence on physiological principles results in the fewest number of medical interventions, lowest rates of anesthetic use, obstetrical complications, episiotomy, instrumental deliveries, Cesarean surgery, post-operative complications and delayed or downstream complications in future pregnancies. Physiological management is both safe and cost-effective.

Conventional obstetrics as applied to healthy women (i.e. "flat earth" obstetrics) is the opposite of evidence-based, physiological management. Its associated with a high level of medical interventions, obstetrical complications, anesthetic use, instrumental deliveries, Cesarean surgery and post-operative complications including emergency hysterectomy, delayed complications such as stress incontinence and pelvic organ prolapse, downstream complications in future pregnancies, long-term psychological problems such as postpartum depression, lower rates of breastfeeding and increased asthma in babies born by cesarean section. Conventional obstetrics for healthy women is neither safe or cost-effective.  [see  "What Every Pregnant Woman Needs to Know about Cesarean Section", a systemic review of the scientific literature by the Maternity Care Association of NYC available at www.maternityWise.org]

A long over-due and much needed reform of our national health care policy would integrate physiological principles with the best advances in obstetrical medicine to create a single, evidence-based standard for all healthy women. Physiological management should be the foremost standard for all healthy women with normal pregnancies, used by all practitioners (physicians and midwives) and for all birth settings (home, hospital, birth center). This “social model” of normal childbirth includes the appropriate use of obstetrical intervention for complications or at the mother’s request.

Ending Flat Earth Obstetrics

Flat earth obstetrics is a 21st century version of a medical Dark Ages, in which contemporary
 medicine has forgotten or ignored the traditional knowledge base and physiological
principles necessary for normal labor and safe, spontaneous birth.

Flat Earth Obstetrics is the belief that medical and surgical interventions are necessary
 in every normal childbirth, despite evidence that such a policy is harmful. The
 term is derived from the insistence by religious and political leaders during 
the Dark Ages that the earth was flat despite evidence to the contrary. 

The problem with the current form of obstetrical care in the United States is
the uncritical acceptance of an unscientific method  --  the routine use of
interventionist obstetrics for healthy women with normal pregnancies.

Medicalizing normal childbearing in healthy women makes
childbirth unnecessarily and artificially dangerous.

"Obstetrics has been rated as the least scientifically-based specialty in medicine"
[Dr. Ian Chalmers 1987]. 

"... The hallmark of obstetrical quality is the prevention of the rare disaster
  rather than the optimal conduct of the many normal cases"
[Dr. Brody 1981]

Obstetrics is an expert” system that has failed most in the very area
 it was supposed to have the most mastery and expertise --
preserving the health of already healthy mothers and babies

The 2-minute scoop on CEO // A_CEO

"Motherhood ~ 24/7 on the front lines of humanity.
Are you man enough to try it?" -
Maria Shriver

To bring the disturbing facts associated with the medicalization and routine over-treatment (and at times, mistreatment) of healthy women to the attention of the public in order to rehabilitate obstetrical medicine for healthy women by insisting that evidence-based practices become the foremost standard for 21st century maternity care.

Action Plan Action Plan

Reading time 3 minutes (Index page) or total 15 minutes for remainder of document (follow hyperlink @ after last paragraph)

Assume as a given that no one in the obstetrical profession is purposefully making childbirth hard for women. Medicalized childbirth is well intentionedHowever, interventionist obstetrics does not properly acknowledge the normal biology of spontaneous childbearing nor meet the practical needs of healthy women and their babies.  

Problem: The uncritical acceptance of an unscientific premise -- surgical obstetrics for normal childbirth in healthy women with normal pregnancies

A science-based care maternity based on physiological management --  safe, cost-effective and mother-baby-father friendly.
This would result in a single, evidence-based standard for all healthy women used by all maternity care providers -- family practice physicians, obstetricians, and professional midwives.

Physiological: …"..in accord with, or characteristic of, the normal functioning of a living organism
(Stedman’s Medical Dictionary definition of “physiological” – 1995)

The scientific basis for physiological management of  pregnancy and normal childbirth is supported by a consensus of the scientific literature. Physiological management is actually protective for both mothers and babies, reducing the episiotomy / operative delivery rate (and associated complications), from approximately 72% to approximately 5% with an identical, or even slightly improved perinatal mortality rate. It is efficacious -- that is, both safe and cost effective.

   "In the first place, do no harm..." ~ bringing the Hippocratic Oath into the 21st Century

In order to bring science-based maternity care to all childbearing women, we must bring an end to "flat earth obstetrics". True mastery in normal childbirth services means bringing about a good outcome without introducing any unnecessary harm. Our present system of obstetrics for normal childbirth does not do well in this regard. The scientific literature -- vital statistics records, textbooks and published research -- all make it clear that routine obstetrical interventions and conducting normal birth as a surgical procedure are more dangerous for healthy women than the use of normal or 'physiological' principles.

For the last century, an unscientific form of Interventionist obstetrics has dominated maternity care in the United States, to the detriment of childbearing women and the taxpaying public. In spite of spending more money that any other country in the world, the United States is 30th in maternal mortality and 22nd in perinatal mortality. The five countries with the best outcomes spend only a fraction of the money we do. They all have national maternity care policies that depend on physiological management.

Over the last hundred years organized medicine has purposefully dismantled the infrastructure for providing physiologically-based maternity care and replaced it with interventionist obstetrics. Medical and surgical procedures originally intended to treat life-threatening complications are routinely used on healthy women with normal pregnancies, without having been proven safe or more effective than physiological management. This unregulated medical experiment introduces artificial risk and serious complications. In the last three decades the medicalization of childbirth has expanded exponentially. Institutional memory of "normal" childbirth is now absent for obstetricians, the nursing profession and medical educators.

Defensive medicine rules the day. This creates an asymmetrical burden of risk that falls unfairly on the childbearing woman, in which the mother is exposed to the actual pain and potential harm of medical and surgical interventions in order to reduce the risk of litigation for the obstetrician. Premature and/or artificial termination of normal pregnancy through induction of labor, surgical incisions, instruments or cesarean section has become the statistical norm. Childbirth for healthy women in 21st century America is typically accompanied by the routine use of continuous electronic monitoring (93%), inducing or speeding up labor with artificial hormones (63%), epidural anesthesia (63%), episiotomy, instrumental delivery and/or cesarean surgery (72%). 

Obstetrical medicine rejects out of hand the "social" model of childbirth used world-wide to the great advantage of childbearing families. While publicly promoting itself as virtuous beyond compare, the obstetrical profession is frequently disrespectful and dismissive of the concerns of childbearing women and their families. It does not provide truly informed consent and resorts to threats of legal force if parents do not quickly comply with obstetrical advice for risky medical and surgical interventions that frequently turn out to be unwarranted.

Click here to continue reading this document and learn more about the C.E.O. Action Plan ... 

Table of Contents ~  links to major documents // Position Papers 

(1) C.E.O White Paper 2004 Reading time 35 min
Printer-Friendly PDF Version White Paper 2004

(3) Problem Statement  
(document begins  immediately above) 
Reading time approx. 20 minutes
(2) Position Paper ~ May 9, Mothers' Day, 2004  
Reading time 25 min
6) table of contents for the Scientific Literature
on medical and physiological management

 Contact Information


To become a member of the Consortium, or a "designated ambassador",
email names & other information to the above e-dress

Printer-friendly PDF for Info and request for CEO / A_CEO membership

Non-PDF Printable Info and request for membership in CEO / A_CEO





Archive of Letters to
Maria Shriver   

4) Action Plan, instructions and mailing address for
Maria Shriver Total reading time approx. 15 minutes

(5) Archive of letters to California First Lady
Maria Shriver   

The Bottom Line ~ Five minute short-cut for busy people Form Letter

Non-PDF Printable copy ~ abbreviated Instructions & Address
for letters

Works in Progress
Book #1, Chapter One
Book #1, Chapter Two

Book #2Chapter One

Book #2 Chapter Two