Home-birth Advocates Press Pro-midwife Campaign
Nationally, a group called the Big Push for Midwives marked President Barack Obamas inauguration with an e-mail campaign urging him to ensure that midwives who specialize in home births are included in deliberations on federal health care reform.
“Were at a tipping point now,” said Katherine Prown, the Big Push campaign manager. “Home births are still only a small part of the total, but its poised for growth.”
The campaign seeks to emphasize that in this time of economic crisis, home births can be a safe, satisfying and moneysaving option for many women. But it runs into adamant opposition from the American Medical Association and the American College of Obstetricians and Gynecologists.
“Childbirth decisions should not be dictated or influenced by whats fashionable, trendy, or the latest cause celebre,” the obstetricians policy statement says. “Despite the rosy picture painted by home birth advocates, a seemingly normal labor and delivery can quickly become life-threatening for both the mother and baby.”
According to the latest federal data, there were only about 25,000 home births nationally in 2006 – most of them assisted by midwives – out of nearly 4.3 million total births.
Midwife-attended home births increased by 27 percent between 1996 and 2006. Home-birth advocates believe the numbers will rise as more states amend their laws to accommodate the practice, which they contend is at least as safe as hospital births for healthy women with low-risk pregnancies.
One of the strengths of the state-by-state campaign is its diversity, Prown said.
“Were one of the few movements thats succeeded in bringing together pro-life and pro-choice activists, liberal feminists and Christian conservatives,” she said. “In every state we manage to recruit Republican and Democratic co-sponsors who normally would never be on the same bill together.”
The states are now evenly split on legal recognition of certified professional midwives (CPMs) – those who lack nursing degrees and who account for most midwife-assisted home births.
Half the states have procedures allowing CPMs to practice legally – including five which have taken such steps since 2005. The other 25 states lack such procedures and CPMs are subject to prosecution for practicing medicine without a license.
Depending on legislative decisions, the balance could shift this year. Among the battlegrounds:
-In Idaho, advocates who failed previously to get a voluntary licensing bill through the legislature are back with a mandatory licensing bill. State Rep. Janice McGeachin, R-Idaho Falls, says the changes helped persuade the state boards of nursing and pharmacy to drop their opposition. The Idaho Medical Association, which fought the earlier version, has expressed respect for the changes in the bill and is deliberating on whether further changes might produce a version it could accept.
-In Illinois, advocates also are back with a new version of a licensing bill that failed in 2007. Rep. Julie Hamos, D-Evanston, says it toughens qualification standards for CPMs – changes that prompted the Illinois Nurses Association to drop its opposition. The Illinois State Medical Society remains opposed.
“There are many in the legislature who feel a need to have this option – they need to be educated,” said Dr. Shastri Swaminathan, the societys president. “Were in strong opposition to licensing midwives who dont have the medical training to provide safe home births.”
Cost is a major element in the debate. A routine hospital birth often can cost $8,000 to $10,000, with higher bills for cesarean section deliveries that now account for 31 percent of U.S. births.
Midwives fees for home births are often less than a third of the hospital cost, in part because the mothers generally dont receive epidural anesthesia or various other medical interventions at home.
Source: nymid