[utahliz]

I have a nursing school classmate who is in a CNM program now, and apprenticed as a home birth midwife before nursing school to see the other end of the spectrum, which is closer to where she really hoped to be able to practice--offering the option of minimal intervention to the women who want it that way. She said that OB/GYN's will not back up CNM's who attend home births, and the malpractice insurance companies require not attending home births. Of the hundreds of home births she attended--including primips and VBAC's, they were all successful deliveries at home or they went to the hospital in plenty of time when things took a turn. After having a mismanaged hospital labor that resulted in a placental abruption and ruptured uterus, I was very frustrated to find out in nursing school just how badly mismanaged my labor was. I think midwives ought to be the norm, OB/GYN's step in if there is a serious problem, and deliveries would be safer and less invasive.

[CNM2B]

If you haven't already, you should definitely read "Born in the USA" by Marsden Wagner, MD. He is an obstetrician and speaks to the safety of midwives and has really compelling data to support just what you are saying in your post. I read this book and was SHOCKED--it made me even more committed to becoming a CNM.

[CEG]

I wanted to add my .02 to the rest about unassisted childbirth ("UC"). Many of these women choose this route and also make a point to "UP"- unassisted pregnancy- where they monitor their blood pressure, baby's position, urine, blood sugar, etc. Most of these women are extremely well-informed and monitor their health and baby's health carefully. It is simply based on the premise that someone is "healthy until proven otherwise" as opposed to the medical prenatal care model that seems more like "there has to be something wrong with you or baby, let's find it!" Although I wouldn't UP/UC I certainly respect those who make the informed decision.

I also second (third? fourth?) the recommendation for Marsden Wagner's Born in the USA. I was lucky enough to hear him speak at a conference last year and he has a wonderful perspective as a former WHO director. He also expressed his sympathy that I am from Illinois (a terrible state for healthy birth).

It seems to all boil down to $$$$ and ACOG is no help. They are basically running wild promoting the financial and legal interests of their members (which many OBs choose NOT to be) without regard for women or babies.

Sorry, I am on a pre-coffee rant this morning!

[SueBee RN-BSN]

And what dose does Bush say "malpractice is keeping OB's from practicing their love with women in America", or something very close to the quote. So, now a damaged baby/mother can only get a half a million dollars to pay for his/her life-time medical services needs, that will run out in less than a year. Then where does the medical services come from?
A doctor here in Missouri forced a laboring woman to leave the hospital because she refused to hand over total control to him. She wanted to walk, and refused pitocin. The baby was doing fine, and there no need for medical intervention. The woman delivered in her home, uneducated in home birth. This goes on all to often. I've tried to get the media to report this, and they refuse. The parents have signed their privacy rights over to the media, so the story can be released. The media will not give a reason why they refuse, but they just did a story on midwives in Missouri. I believe they were put in their place by local doctors groups, if you know what I mean. I work in litigation now, not nursing. I changed careers because I refuse to carry out, or be forced to carry out doctors orders that harm patients.

Most nurses do not know the legal system very well, and because of this lack of knowledge, nurses are taken advantage of all the time. I remember when I first started studying law, I could not believe have much stuff hospitals and doctors get away with.
I would advise all nurses to take legal courses in into to law, business law, health care law just to name a few. If more nurses did this, the profession would "know how" to pull together. It's the "know how" that is keeping nurses apart.