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Tanya Cawthorne: ACOG’s Home Birth Counseling Checklist

Tanya Cawthorne/LinkedIn

Sep 11, 2026, 17:00

Tanya Cawthorne: ACOG’s Home Birth Counseling Checklist

Tanya Cawthorne, Editorial Board Member at the Journal of Perinatal Education at Lamaze International, shared on LinkedIn:

“The idea behind this infographic started with a checklist produced by ACOG (American College of Obstetricians and Gynecologists) designed to ‘counsel’ women considering home birth.

But it also raises a much bigger question: how is evidence communicated to women when they make decisions about their maternity care?

Evidence can inform choice, but the way evidence is framed matters.

Relative risk without absolute risk, emotive references to death and brain injury, selective emphasis on the risks of one option while minimising the risks of another, and presenting medical intervention only as protective can all profoundly influence how a woman perceives her choices.

That isn’t neutral counselling.

When risk communication is designed to instil fear or steer a woman towards the decision her care provider considers safest, it can cross the line from informed consent into coercion.

So I took the original statements and put the counter-evidence alongside them.

This isn’t about arguing that home birth is risk-free, or that hospital birth is inherently unsafe.

There is no risk-free place to give birth. It is about recognising that women deserve balanced, contextualised evidence – including absolute risks, benefits, harms, uncertainties and reasonable alternatives – without fear being used as a tool of persuasion.

Because informed choice only means something when women are genuinely supported to make a choice.

Evidence should inform women. It should not be weaponised to undermine their autonomy.

PS I have popped the original ACOG ‘checklist’ too.”

Tanya Cawthorne: ACOG’s Home Birth Counseling Checklist