Which states are CNMs permitted to do homebirths?

  1. 0 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?
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  3. Visit  moonredlife profile page

    About moonredlife

    From 'Omaha, NE'; Joined May '10; Posts: 11.

    21 Comments so far...

  4. Visit  klone profile page
    0
    The problem with doing a homebirth as a CNM is that you must have physician collaboration. Most physicians would not collaborate on homebirths. I think you will find that very few CNMs do homebirths - most homebirths are attended by CPMs or DEMs.

    You might have better luck asking in the CNM forum. There are several threads on this topic there.

    I'm pretty sure that in IL, it's illegal for a CNM to attend a homebirth. That's the only state I know about, though. I know it's legal in CO and AZ, but for the aforementioned reasons, it just doesnt' happen too often. Most of the time, when you have a woman who wants a birth outside of a hospital that's attended by a CNM, she would go to a FSBC.
  5. Visit  mochamonster profile page
    0
    I know in Texas they can attend home births.
  6. Visit  GooeyRN profile page
    0
    go to mothering.com. There is an area in the forum section for home births. Many of the women on this site have home births, and may be able to assist you. Good luck!
  7. Visit  CEG profile page
    0
    Quote from klone
    .

    I'm pretty sure that in IL, it's illegal for a CNM to attend a homebirth. That's the only state I know about, though. .
    It's definitely legal in IL- I had a CNM attended homebirth there a year ago! And two of my CNM friends own homebirth practices there. MANA has a summary here: http://mana.org/laws.html that mostly addresses CPM/CM but has info about CNMs as well. Basically the restrictions on homebirth practice come from collaborative agreement requirements, not from the laws themselves.
  8. Visit  Nire83 profile page
    0
    New York is one...

    I had a homebirth in Mass and used a CPM
  9. Visit  SwampCat profile page
    0
    It's legal in CT though I think there is only one CNM group in the whole state that will do it.
  10. Visit  natnat122 profile page
    0
    Legal in NY!
  11. Visit  melmarie23 profile page
    0
    Legal in NH. And contrary to what an above poster said, they do not need physician oversight to attend home births in that state.
  12. Visit  monkeybug profile page
    1
    Not in Alabama, for sure. It is illegal for midwives, period, regardless of education, to attend a homebirth. Alabama has a very strong physicians' lobby. Who cares if some women have a 2 hour trip one way to get to a hospital that delivers, that's the "safe" way to do it!
    WantToBeMidwife likes this.
  13. Visit  klone profile page
    0
    Quote from melmarie23
    Legal in NH. And contrary to what an above poster said, they do not need physician oversight to attend home births in that state.
    Not physician oversight, but collaboration. Such as, do you have an accepting physician if you need to transport? I know many midwives just take them (or dump them, sadly) at the ER, but it's much safer and better for the family if she has a collaborative agreement with a physician who has privileges somewhere.
  14. Visit  CEG profile page
    0
    Quote from klone
    Not physician oversight, but collaboration. Such as, do you have an accepting physician if you need to transport? I know many midwives just take them (or dump them, sadly) at the ER, but it's much safer and better for the family if she has a collaborative agreement with a physician who has privileges somewhere.
    Some states require collaboration and some don't. It seems safer to require this but it really doesn't accomplish a lot other than restrict practice. My state law requires a physician in the state, so they could be 4-5 hours away and still meet the requirement but are surely no help in an emergency. In a non-emergency situation I am not going to refer my patient to them, I am going to send them to someone local. (For the record, I work in an academic medical center, I'm not a homebirth midwife). Even if I have a local doc, if I have a true emergency I am going to get the closest/fastest option, not wait for my doc to show up.

    A family practice doc is not required to have a collaborating cardiologist or ENT in order to see patients for BP management or sore throats. The scope of practice in OB is the same as for a CNM or family practice doc. The same principles should apply.

    Ideally, there is a local hospital with 24 hour in house anesthesia and OB. I wouldn't consider a transfer anywhere else in an emergency. Ideally, transfer wouldn't be hostile and midwives would not have to "dump" their patients for fear of prosecution or harassment. An Emergency room is hardly in a position to be upset about receiving an emergency in any case.
  15. Visit  queenanneslace profile page
    1
    There are few states where it is legally prohibited for CNMs to attend OOH birth. Nebraska comes to mind as one. Was it North Carolina where it just got real ugly for CNMs working OOH? This year? I think so.

    There are many other states where it is not prohibited by law, but the requirements for a written collaborative agreement with a physician or mandatory malpractice insurance equivalent to what an obstetrician must carry creates barriers to OOH CNM practice.

    Not legally prohibited. Just financially and/or collaboratively difficult.

    Of the CNM practices that were independent (either in hospital or OOH) - they usually had a collaborative relationship with an OB in private practice. And finding an OB in private practice is becoming rarer and rarer. Group practices of physicians don't want to sign on as collaborators for CNMs in private practice. It creates an difficult situation for CNMs.

    And it all gets confusing with the laws that do and don't apply to CPMs and DEMs because the public often does not understand the distinction between the different types of midwives.

    To obtain a license in my state, CNMs require a written collaborative agreement with a physician. CPMs do not.

    A family practice doc is not required to have a collaborating cardiologist or ENT in order to see patients for BP management or sore throats. The scope of practice in OB is the same as for a CNM or family practice doc. The same principles should apply.
    Whole-heartedly agree.
    WantToBeMidwife likes this.


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