Midwifery Legislation

In current news, my home state (Illinois) is in the midst of a long, bitter battle to enable the licensing of certified midwives--a type of legislation that exists in 21 other states at the time of this writing. Homebirth has been shown in multiple studies to be safe for low-risk women, but politics and profit are limiting the choice of women to have a safe birth at home. This is because there are very, very few nurse-midwives (the only legal midwives in Illinois, who mostly practice in hospitals) and/or doctors who attend homebirth in Illinois--between 5-10 in the Chicago area (a city of almost 3 million residents). Licensing midwives will enable highly trained attendants, skilled in homebirth care, to provide alternatives for women who wish to have a low-intervention birth at home.

This is important, because it's not that doctors or nurse-midwives are incapable of attending a homebirth. It's because malpractice insurance is impractically high for doctors who attend births at home, and laws inhibit the practice of nurse-midwives, thanks to the requirement of a written collaborative agreement.

According to this press release by The Big Push for Midwives, there is a clear COST issue in the politics of censoring homebirth. In fact, Consumer Reports, citing a well-circulated publication by Sakala & Corry via Childbirth Connection, often referred to as the Milbank Report ("Evidence-Based Maternity Care: What It Is and What It Can Achieve") stated that induction of labor, use of epidural anesthesia, excessive cesarean surgery, use of electronic fetal monitors (which have never been shown to improve outcomes in any valid study), rupturing membranes, and episiotomy are being used too often, to the detriment of womens' and babies' health!

"The reasons for this overuse might have more to do with profit and liability issues than with optimal care, the report points out. Hospitals and care providers can increase their insurance reimbursements by administering costly high-tech interventions rather than just watching, waiting, and shepherding the natural process of childbirth."

According to the same Consumer reports article, underused and higher-touch modalities such as vitamins, use of midwife or family physician (not an obstetrician), continuous support in labor, use of various positions (and general mobility) in labor, increased availability of VBAC (vaginal birth after cesarean, rather than a repeat cesarean), and immediate skin-to-skin contact of mother and newborn are effective in improving outcomes.

To learn more about midwifery, including the distinctions of the different classes of midwives and how they are different, see: http://cfmidwifery.org/midwifery/faq.aspx .

Please find out if midwifery is legislated in your state. If not, urge your state legislators to support it, if they would like to get your vote in November.