Which states are CNMs permitted to do homebirths? - page 3

I am a pre-nursing student with the long-time goal of becoming a midwife. Since I love homebirth and believe that it is ultimately best for many women/families, I would like to know if anyone knows... Read More

  1. Visit  Red Kryptonite profile page
    2
    As to the original topic, CNMs can attend home births in Arizona, and last year the law finally got changed so they and LMs can attend VBACs at home!

    I am aware of two birth centers run by CNMs in the Phoenix area, with one being a combo practice that also attends home births.
  2. Visit  klone profile page
    0
    Quote from Red Kryptonite
    As to the original topic, CNMs can attend home births in Arizona, and last year the law finally got changed so they and LMs can attend VBACs at home!

    I am aware of two birth centers run by CNMs in the Phoenix area, with one being a combo practice that also attends home births.
    Are you aware of any CNMs up in Prescott? When we lived there and I had my last child, there were no good options for a homebirth provider. So I opted to have him in the hospital, but as an L&D nurse there, I was luckily able to dictate my care and choose my provider and staff.

    (and as it turned out, it was best that he was born in the hospital, because he came at 36 weeks and had to be flown down to Phoenix for a week in the NICU for RDS).
  3. Visit  klone profile page
    4
    Quote from adoRNo2b2015
    There's quite a few lay midwives that attend births at home. these "midwives" are not even. nurses , they have just taken some courses on midwifery but are not licensed or certified. there's on CNM in a county close to ours who has shown up a few times to our unit saying that she was working under dr such and such and of course dr such and such denied that information and it turned out the CNM was backed up by a dentist from her county. not sure how a dentist can be a CNM's back up. some of them try crazy things like VBAC at home with no physician present, etc, it is crazy what some of these people are allowed to do. have you seen Born in the Wild?
    that show should be cancelled! All this deliveries in the middle of nowhere with temperatures below zero. what would these people do in the even of a shoulder dystocia,
    a prolapsed cord? OMG! I can't begin to imagine!!!!! we have some midwives who are wonderful and work under one of our OB/GYN" but they would absolutely not do home births.
    I disagree with a lot of things that you've written here.

    Large studies conducted in Europe prove the safety of homebirth for low-risk women.

    In the US, the biggest safety risk comes from lack of support and collaboration between midwives and physicians/hospitals.
    mamagui, Elvish, AspiringNurseMW, and 1 other like this.
  4. Visit  Not_A_Hat_Person profile page
    1
    In the UK and Netherlands, all midwives are the equivalent of CNMs. In the US, non-nurse midwives have wide variations in education and training. That's only one of the many, many differences between systems.
    queenanneslace likes this.
  5. Visit  queenanneslace profile page
    1
    Quote from Red Kryptonite
    .

    Planned home birth with a trained attendant is as safe or safer than hospital birth. Even safer for VBACs I'd contend, due to hospitals' refusal to stop using pitocin and even misoprostol on women with uterine scars.
    citation?
    Luckyyou likes this.
  6. Visit  klone profile page
    0
    Quote from Not_A_Hat_Person
    In the UK and Netherlands, all midwives are the equivalent of CNMs. In the US, non-nurse midwives have wide variations in education and training. That's only one of the many, many differences between systems.
    And I do believe there should be standardization and certification for midwives.
  7. Visit  klone profile page
    0
    Cheyney, M., Bovbjerg, M., Everson, C., Gordon, W., Hannibal, D. and Vedam, S. (2014), Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009. Journal of Midwifery & Women’s Health, 59: 17–27. doi: 10.1111/jmwh.12172
  8. Visit  klone profile page
    1
    Here's a different study

    Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study | The BMJ

    There are many more, but I'm at work so I can't spend a ton of time on it. I might post more this weekend.
    AspiringNurseMW likes this.
  9. Visit  queenanneslace profile page
    0
    403 Forbidden

    I encourage everyone who cites this study claiming it shows evidence of parity of outcomes between hospital birth and out-of-hospital birth to actually read the study.

    But I was asking specifically about the claim that VBAC and other higher risk births are safer at home.

    The Cheney study demonstrates higher risk of neonatal mortality with higher risk deliveries occurring in the out-of-hospital setting (VBAC and breech specifically).
  10. Visit  queenanneslace profile page
    0
  11. Visit  Red Kryptonite profile page
    1
    Quote from queenanneslace
    But I was asking specifically about the claim that VBAC and other higher risk births are safer at home.
    I made no assertion about any other type of higher risk birth other than VBAC.

    Unfortunately home VBAC is not a well-studied topic. I'll see if I can find some European resources where they undoubtedly have more experience and better collaboration between midwives and OBs instead of the adversarial relationship that exists here in the US.

    Frankly, I think most of the risk in VBAC comes from the hospital environment. My second birth, had I had the sense to stay home instead of going to the hospital, would not have been a failed VBAC.

    Anyway, here's an excellent, well-cited article to start with: Homebirth after Cesarean: The Myth and the Reality - by Amy V. Haas
    AspiringNurseMW likes this.
  12. Visit  klone profile page
    2
    I will say that my second child, who was born at home with two CPMs, I KNOW would have been a C/S if she had been born in the hospital.
    vintagemother and Red Kryptonite like this.
  13. Visit  queenanneslace profile page
    0
    Quote from Red Kryptonite
    I made no assertion about any other type of higher risk birth other than VBAC.

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    "Planned home birth with a trained attendant is as safe or safer than hospital birth. Even safer for VBACs I'd contend, due to hospitals' refusal to stop using pitocin and even misoprostol on women with uterine scars."

    VBAC is safer in an out of hospital setting? Any evidence that this is true? What are the other higher risk births that increase risk in out-of-hospital settings?

    The BMJ birth center study shows nulliparity to be a risk factor that increases rate of perinatal injury and death.

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