Midwives seek state sanction | NEWS | Asheville CITIZEN

For two Fairview women, the births of their first children couldn't have gone more differently. Full Story
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Lorax

Hendersonville, NC

#1 Feb 24, 2008
There is a middle ground not really fleshed out in this article - midwives in hospitals. I gave birth at Mission Hospital surrounded by my husband, 2 children, a midwife, a nurse, and 2 friends who were there to support my children. Instead of using Mission's wonderfully large birthing tub, I was encouraged to labor in whatever positions felt most comfortable to me. I delivered standing up, catching and cradling my son as he entered this world in a dimly lit, quiet environment...it was a very rewarding experience. I highly recommend the caring wonderful midwives at MAHEC. I was able to deliver naturally and with my family close at hand. Had I needed additional medical care, I would have been where it was available. My point being that birth doesn't have to be one way or another, there is a middle ground flourishing in Asheville.
Sandy

United States

#2 Feb 24, 2008
Well said Lorax. I also delivered my son in a calm, comfortable, healthy enviornment at Mission Hospital with the MAHEC midwives. He did not breathe immediately after birth and I was very relieved to have additional medical care readily available. I couldn't have asked for a better birth experience and greatly appreciated the middle ground offered by the wonderful midwives of MAHEC.
Dell

AOL

#3 Feb 24, 2008
I apprenticed with a lay midwife in Georgia approximately 15 years ago, just before that state outlawed lay midwifery and forced midwives to either get a nursing degree or go underground.

Statistics show that babies born at home have a much lower rate of infant mortality than babies born in hospitals, and that mothers have a significantly lower rate of c-sections. Women who give birth in their own homes have a lower rate of infection than those who give birth in hospitals.

Of course the medical establishment is against it - it's taking millions of dollars out of their pockets! The first thing they do to defend their position is instill fear.

Women have been giving birth at home since time began. Lay midwives have been around just as long. Let us seek to educate and certify our lay midwives so they can do the job the public wants from them.
Wow

United States

#4 Feb 24, 2008
Dell wrote:
I apprenticed with a lay midwife in Georgia approximately 15 years ago, just before that state outlawed lay midwifery and forced midwives to either get a nursing degree or go underground.
Statistics show that babies born at home have a much lower rate of infant mortality than babies born in hospitals, and that mothers have a significantly lower rate of c-sections. Women who give birth in their own homes have a lower rate of infection than those who give birth in hospitals.
Of course the medical establishment is against it - it's taking millions of dollars out of their pockets! The first thing they do to defend their position is instill fear.
Women have been giving birth at home since time began. Lay midwives have been around just as long. Let us seek to educate and certify our lay midwives so they can do the job the public wants from them.
Can you post a link to the statistics? Thanks.
Nancy Koerber

United States

#5 Feb 24, 2008
Mission Hospitals offers many options for flexibility if parents choose that option. But some parents want to birth at home. NC does not prohibit homebirths, but unlike most other states, does not provide a licensing mechanism for CPMs who are specifically trained to attend homebirths. The most recent one was published in the British Medical Journal-CPM2000 Study on Homebirth.
This study looked at over 5000 homebirths conducted in North America in the year 2000.
All the studies that have ever been done on homebirth agree that with low-risk pregnancies and trained attendants, homebirths are just as safe as hospital deliveries.
Midwives apply risk screening principles to potential homebirth clients so that typically women who will more likely face challenges in birth are attended in the hospital setting. Emergency transport plans are in place for every birth. CPMs are trained to handle emergencies that are likely to occur until transport to the hospital can occur.
Just Me

Candler, NC

#6 Feb 24, 2008
For years abortions have been performed underground.....the big issues in the enviornment of which the birth occurs isn't so much the "QUALIFIED OR NON-QUALIFIED" ...it's ;mostly become whose dictating the control of the monies!! Hard fact !

Make the choices available in the open. There's risk factors and committments to everything,,,not everyone has the privledges of insurance coverage or lots of cash.

Put some safe-guards in place. If one's mature enough to conceive a child, pre-educate people without sugar coating the realities about all the cost factors in giving birth (the physical, finanical,emotional and energies it takes to the responsiblities of life and to our society)

If a baby decides to make it's entrance into this world as the womanis working OUT IN THE FIELDS or on the way to the hospital,,guess what? Somebody missed out.

Why take away any joys or pleasures for a woman to decide in her child's birthing process? Does anyone really have a choice in these matters?

When my Grandmother was having children,,,it was SUGGESTED to have at least 8 (to work the fields and help keep the standard of a families survival...not wants and more wants )

When my Mother had children,,,the Doctor said,,, "Have one more for me (we're 4)"

When I had children (2) it was "Are you sure you want your tubes tied at the C-Section ?"

So where's the fine line?
Russ

AOL

#7 Feb 24, 2008
Thank you, Jordan, and Citizen Times for your article. For women choosing to birth out of hospital, access to care and normalcy, are of critical importance.

This is not that complicated.

- Planned home birth, attended by a Certified Professional Midwife, is a safe choice for healthy women. This model can be evaluated as safer than planned hospital birth with a 5x reduction in C-section.
- North Carolina has poor access to maternity care, poor maternal health and poor outcomes. Increasing access to the Midwives Model of Care is an easy step toward addressing this.
- North Carolina is surrounded by states that license CPMs (SC, TN and VA). More and more states are licensing CPMs and after decades of experience, no state is regretting their decision.
- The women choosing to birth at home deserve access to care and deserve normalcy when a transfer of care is needed. It is wrong how North Carolina marginalizes this community.

In concept, all we need to do is craft a few pieces of paper and have the General Assembly vote Aye. We are late. This is not that complicated. The North Carolina Medical Society is standing in the way of maternal health, access to care and a woman’s right of self-determination.

Russ Fawcett
Legislative Chair
The North Carolina Friends of Midwives
wnc resident for peace

United States

#8 Feb 24, 2008
I had my baby at home with Nancy, Jan and Jenn in attendance. Thanks be!!

I support home birth 100% if that's what the family chooses.
alice

Lincolnton, NC

#9 Feb 24, 2008
The right to give birth at home is a very important one.

Women who choose homebirth feel that the miniscule risk of an emergency situation occurring that cannot be managed by the midwives or after transfer to a hospital is far less likely than the risk of complications occurring due to overzealous obstetric interventions. Obstetrician mindsets about pregnancy and birth are a hindrance to women’s attempts at natural, unnecessary-intervention-free experiences by their very nature.

Even if you have a CNM attend your birth at a hospital, you’re subjected to hospital protocol. The midwife has to follow the backup OB’s directives when attending births at a hospital, or risk losing her hospital privileges and/or licensure.
Shannon

Greenville, NC

#10 Feb 24, 2008
I have two daughters: one born in a hospital w/a CNM and the other born at home with a CPM.

Hospital birth with a CNM is not always a middle ground. The cascade of interventions starts with something as seemingly innocuous as an external fetal monitor.

Birth need not be a medical event.

Why is the government creating a monopoly for obstetricians? Consumers should be able to choose where to spend their dollars.
Shannon

Greenville, NC

#11 Feb 24, 2008
I have two daughters: one born in a hospital w/a CNM and the other born at home with a CPM.

Hospital birth with a CNM is not always a middle ground. The cascade of interventions starts with something as seemingly innocuous as an external fetal monitor.

Birth need not be a medical event.

Why is the government creating a monopoly for obstetricians? Consumers should be able to choose where to spend their dollars.
Susan

Albuquerque, NM

#12 Feb 25, 2008
In New Mexico, where I live, midwifery has never been illegal and midwives, both CNMs and CPMs, are legal and licensed by the State Department of Health. Midwives deliver over 35% of all babies in this state, have excellent outcome statistics, and have improved Women's access to prenatal care. The nearby states of Texas, Arizona, and Colorado also license midwives, regardless of whether the midwife has a nursing degree or not, as do many other states and most other nations.
It is erroneous to claim that midwifery is the practice of medicine, as at least one physician implies in this article. Organized medicine always tries to make this claim, but midwifery existed long before physicians invented the specialty of obstetrics. Since then, medical doctors have attempted to take over the entire field of childbirth, treating it as if it were a disease or emergency instead of a normal life process. Modern-day midwives provide safe, high quality care. Women and families should not be denied legal access to this care simply in order to perpetuate medicine's monopoly.
Susan M. Jenkins
National Birth Policy Coalition
Jenny

Harrisburg, NC

#13 Feb 25, 2008
Thank you for your comments Shannon and Susan!

Like Shannon, I birthed my daughter with a CNM in a local hospital and my son at home with a CPM. The birth with my son was more difficult, but my midwife's knowledge of simple labor positions was enough to help maneuver my son into place. Had I been in the hospital, I am quite sure it would have been much more of an ordeal! For the record, I tore with my daughter, I did not with my son.

I realize this is only personal anecdote, but the fact remains, birth can and does have it's complications - and CPMs are skilled at assisting clients through those, be it simple positioning or transport options. In hindsight, I strongly feel that for my son's birth home was the safest option.
Evelyn Walker

Charlotte, NC

#14 Feb 25, 2008
I've had homebirths with a non-nurse midwife and the care is amazingly thorough. She asked about my stress level and nutrition throughout my pregnancy. She KNOWS ME, and thus she knows what's normal for me and what's abnormal. The assembly line hospital birth system is a constant stream of strangers. Even a nurse-midwife can't observe one laboring mom for 12 uninterrupted hours.

One great advantage that homebirth midwives have over hospital based providers is that they can tell a mom that she is too risky for her practice. Doctors are prepared to handle worse case scenarios, midwives are prepared to spot worst case scenarios. Even better, midwives know the woman well enough to spot problems before they become emergencies.
It is amazing how few emergencies occur in full-term births without induction drugs or pain drugs.
Elizabeth

Clermont, FL

#15 Feb 26, 2008
Home births are so wonderful and remarkably safe. Please legalize Midwives in NC!
NannyforaMidwife

Waxhaw, NC

#16 Feb 26, 2008
Women and their famililes are going to choose to birth their babies at home no matter what the good doctor thinks. Let's make sure that NC keeps up with the times and licenses the only profession trained to handle women birthing at home; The Certified Professional Midwife! Doing this ensures the safest option for those who wish to birth at home. Women deserve options, so not licensing these fine care providers makes absolutely no sense!
Michelle

Leland, NC

#17 Feb 27, 2008
Thank you for publishing this article. Hopefully legislation will change in NC empowering women to make choices about their births and legally allowing who they choose to attend their birth.
rachael

Bennington, VT

#18 Feb 29, 2008
Lorax wrote:
There is a middle ground not really fleshed out in this article - midwives in hospitals. I gave birth at Mission Hospital surrounded by my husband, 2 children, a midwife, a nurse, and 2 friends who were there to support my children. Instead of using Mission's wonderfully large birthing tub, I was encouraged to labor in whatever positions felt most comfortable to me. I delivered standing up, catching and cradling my son as he entered this world in a dimly lit, quiet environment...it was a very rewarding experience. I highly recommend the caring wonderful midwives at MAHEC. I was able to deliver naturally and with my family close at hand. Had I needed additional medical care, I would have been where it was available. My point being that birth doesn't have to be one way or another, there is a middle ground flourishing in Asheville.
Giving birth in a hospital, even naturally, can not be compared to giving birth at home where you are in control of the birth. If a woman wants to give birth at home, that should be her legal right and the midwives who attend her should have the ability to be licensed. If we only allow midwives to attend women at the hospital, we are making the legal statement that legally women should not have the choice of homebirth.
luna

Bennington, VT

#19 Feb 29, 2008
Certified Professional Midwives are just that... professionals. They undergo a long training period and have taken the extensive and challenging NARM exam. I have heard some doctors say that CPM's are better trained in birth than they and some nurses are!

Medical care for women who need it is very important, and that is why CPM's need to be certified - so they can obtain concurrent medical care for their clients who develop complications without fear of liability.

It is the parents' choice of where to birth, it's the midwife's job to attend them and help guide them safely through the process. People will have homebirths no matter if CPM's are allowed legal recognition in NC, but if they don't allow this legislation there will be many more births unassisted by a midwife. This will put families at needless risk.
Laurie

United States

#20 Mar 2, 2008
I have had 4 homebirths. Much of the problems that doctors talk about are actually results of bad nutrition and/or interventions. I also had 5 hospital births. The difference is phenominal, and our oldest daughter had now had 4 homebirths. THose women certified and having apprenticed are a God-send to women, whose bodies already know how to birth if they area allowed and encouraged to.

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