Which states are CNMs permitted to do homebirths?

Specialties Ob/Gyn

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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 where to find a list of states where homebirth by nurse-midwives is legal. Anyone?

Specializes in OB.
CNMs can do homebirths in Florida.

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.

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Specializes in hospice.
crazy things like VBAC at home with no physician present, etc, it is crazy what some of these people are allowed to do.

I had a HBA2C with a licensed midwife (not CNM) and would do it again. The medical model of birth failed me twice, and stole my births from me. I sure as hell wasn't giving them a third chance.

After my two unnecessary cesareans, I had three unmedicated natural births with babies as big or bigger than the ones I was told my body couldn't birth. After the planned home birth, I had my 4th in a hospital with a CNM due to moving to a different state where laws were different. I planned to do that again with my 5th, but she was in a hurry and ended up being born into her Daddy's hands in my bathroom.

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.

Don't fool yourself that hospitals don't pose their own whole set of risks to birthing mothers and their babies. Each venue has its risks and benefits. At least home birthing mothers are usually educated as to what those are.

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Specializes in hospice.

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! :up:

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.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
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! :up:

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).

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
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.

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Specializes in Geriatrics, Home Health.

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.

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Specializes in Nurse-Midwife.
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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.

citation?

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
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.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

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

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

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.

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Specializes in Nurse-Midwife.

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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).

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