Home Births w/o CNM or doctor-

fergus51 · Aug 15, 2007

I would MUCH prefer homebirths be attended by a skilled person. It scares me that people would risk doing anything else, but if they want a messed up kid at the end I can't do anything about it.

Jolie, BSN · Aug 15, 2007

I'm writing form Missouri. We have women giving birth in their homes w/o professional help. These women have had bad experiences in Missouri hospitals. Midwives will be jailed if they attend a home birth in Missouri. The story was on a St. Louis local news station (KMOV). The story showed a couple giving birth in their home. The couple did their research, and the father delivered the baby.
This is dangerous, and awful-
I guess the OB/GYN's of this state would rather keep the baby delivering turf than to let CNM's practice to their full extent, thus endangering women and babies.

Can you post a link to an article? I am not certain that this is what it seems on the surface. Some states have outlawed the practice of direct-entry (or lay) midwifery, making it illegal for a lay midwife to provide care to a pregnant woman or attend a delivery. In these states, some lay midwives continue to practice "underground", but face criminal charges if they are discovered.

I am unaware of any state that has made it illegal for certified nurse midwives (CNMs) to practice in the home setting. Many choose not to do so due to liability issues and lack of physician back-up, but I am not aware of any legisation prohibiting it.

SueBee RN-BSN · Aug 16, 2007

Jolie,

Here is a link. No CNM's can be found to help women in the St. Louis area. The CNM's work as WHNP.

http://www.kmov.com/localnews/stories/kmov_localnews_070808_midwives.150236a5.html

elkpark · Aug 16, 2007

From the article: "Doctors groups claim that allowing unlicensed midwives to practice medicine could jeopardize patients and put doctors who cooperate with them at risk of professional discipline."

Sounds like the legislation is related to lay, unregulated midwives. If CNMs in the area choose not to assist with home births (and I can easily think of several reasons why they might make that choice), that is their professional choice/right to do so. But the article doesn't say anything about legislation against CNMs (or anything about CNMs not being available). I'm with Jolie -- is there perhaps more to the story than this? Often members of the media have difficulty differentiating between lay midwives and CNMs and don't realize there's a v. significant difference between the two, and write reports in which it's hard to tell which group they're talking about.

SueBee RN-BSN · Aug 16, 2007

"Often members of the media have difficulty differentiating between lay midwives and CNMs and don't realize there's a v. significant difference between the two, and write reports in which it's hard to tell which group they're talking about."

CNM are "not allowed" to practice beyond a WHNP, due to competition for ($$$$$) with OB's. This is what I have been told by the local CNM's I have spoken with. In my quest to network with CNM's, some have refused to speak with me about the porfession, questioning my motives, and wondering if I was a reporter. This reaction speaks volumes to me. My only interest was a career in midwifery. The media confusing lay midwives with CNM may be just what the doctor ordered, if you get my drift.

All I can say is that St. Louis is one nurse haten town for RN's and APN's of all types. I will not work here. The nurses, of all types, have refused to come together and force a change for their patients, and themselves.

I spoke with a midwife about the issue, a midwife across the river in Illinois, and she gave my the name of a book that I must put down often due to my anger toward the medical establishment.

"Born in the U.S.A." by Marsden Wagner, MD., MS. I hope you that are reading this topic on this fourm take the time to read this book, if your interested in womens health.

Despite the fact that many families are not willing to deliver their babies in St. Louis local hospitals, the CNM has his/her hands tied.

KellNY, RN · Aug 26, 2007

Just wanted to note that there is a large following of Free Birth (or Unassisted Childbirth). It is not always awful and dangerous, and many if not most of the women who make this decision do so in an educated and informed manner.

I do agree, though, that no woman should have a UC for the sole reason that she cannot find a qualified homebirth attendant. That not only goes against the whole spirit of UCing, but is a sad example of what has happened to childbirth "management" in this country.

SueBee RN-BSN · Aug 26, 2007

There has also been a sharp rise in deaths of mothers due to medical intervention that is not needed, and c-sections done because of this medical intervention. Midwives are the ones who should be attending births, and caring for women in this country. If a doctor is needed the midwife can call one in on the case. Our health services in this country is very broken. I will no longer use the word health care, as there is very little caring going on, it's just health services. Or medical services, as all to many times there is nothing healthy about the word health in health services.

*Bethany* · Oct 21, 2007

Unassisted Childbirth, also known as UC, is not as "awful or dangerous" as it sounds. I'm sure many people have the misconception that UC is the equivalent of a teenage girl giving birth in the bathroom on her prom night... but UC parents for the most part, educate themselves thoroughly, and are prepared to handle some degree of complications. They are smart, know what to expect, know what kind of complications *may* occur, and have an action plan on what to do *if* something didn't go according to plan.

moodyred01 · Nov 2, 2007

Just wanted to note that there is a large following of Free Birth (or Unassisted Childbirth). It is not always awful and dangerous, and many if not most of the women who make this decision do so in an educated and informed manner.
I do agree, though, that no woman should have a UC for the sole reason that she cannot find a qualified homebirth attendant. That not only goes against the whole spirit of UCing, but is a sad example of what has happened to childbirth "management" in this country.

Well said. ITA.

utahliz · Nov 2, 2007

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 · Nov 3, 2007

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.