IL looking to "Legalize" Midwives - what do you think?

[traumaRUs, MSN, APRN]

Published March 20, 2016 in Peoria Journal Star

SPRINGFIELD — Mishra Keller skirted a state law when she chose to deliver her second child at home with the help of a midwife, given that the trained birthing professionals have been barred from practicing since 1987 in Illinois.

Keller, a holistic health coach in Evanston, disagrees with the state's stance, saying that midwives are a good resource.” With the right training, they can help people have positive outcomes,” Keller said.

State Rep. Robyn Gabel agrees, and is making her second attempt in a year to get the Home Birth Safety Act to the House floor — and hopefully into law. The act would issue licenses to midwives for the first time since 1963 and legalize the practice, which she says is needed give women more delivery options. But its passage is uncertain in the General Assembly, and the proposal is still staunchly opposed by doctors, who say there are possible risks to mothers and babies that could arise during at-home births.

​What do think about this?

[LibraSunCNM, BSN, MSN, CNM]

Hmmm I'm confused by this. Are they talking about legalizing certified professional midwives? Certified nurse midwives have already been around in IL for quite some time. I do believe I've heard it's illegal for a CNM attend a homebirth, but they are certainly already licensed.

[traumaRUs, MSN, APRN]

Yes, CPM. As you stated, CNMs are already fully licensed and credentialed.

[cayenne06, MSN, CNM]

I do not feel that CPMs should be recognized with licensure at this point. This is coming from a CPM (turned CNM) who used to practice in state where I was licensed and able to receive medicaid and private insruance reimbursement.

Right now, CPM education is woefully unstandardized and the requirements for entry to practice do not meet the minimum guidelines issued by the International Confederation of Midwives. Many CPMs are highly skilled and competent, but the CPM credential itself in no way guarantees that.

I support women's access to safe home birth- I had my own two kids at home and did homebirth for years. I really hope the direct entry midwifery community mobilizes to create a stronger base for entry to practice. I hope to see CNMs/CPMs/CMs unify so we can all just be midwives. But as it stands currently, I only support licensure for direct entry midwives if the state creates requirements above and beyond those required by NARM. Licensure confers legitimacy to the public, and it is not in the public's best interest to legitimize a profession that does not hold itself to the generally recognized minimum requirements for competent midwifery practice. I still hold my CPM cert, and it greatly pains me to speak out against a qualification that I worked so hard to obtain. But I feel very strongly about this.

[AspiringNurseMW]

The problem arises when CNMs are not allowed to attend homebirths or require a practice agreement with an OB thus making it almost impossible to attend homebirths.

Then if CPMs are not legalized, what recourses do women have if they want to homebirth?

This is what drives some to freebirth. But I agree with cayenne06 that the bar for licensure should be raised.

[cayenne06, MSN, CNM]

The problem arises when CNMs are not allowed to attend homebirths or require a practice agreement with an OB thus making it almost impossible to attend homebirths.

Then if CPMs are not legalized, what recourses do women have if they want to homebirth?

This is what drives some to freebirth. But I agree with cayenne06 that the bar for licensure should be raised.

Agreed. The lack of integration within the mainstream health system decreases the safety of US homebirth dramatically, compared with countries that have seamless transfer/collaboration from the home to the hospital.

[Maevish, ASN, RN]

I do not feel that CPMs should be recognized with licensure at this point. This is coming from a CPM (turned CNM) who used to practice in state where I was licensed and able to receive medicaid and private insruance reimbursement.

Right now, CPM education is woefully unstandardized and the requirements for entry to practice do not meet the minimum guidelines issued by the International Confederation of Midwives. Many CPMs are highly skilled and competent, but the CPM credential itself in no way guarantees that.

I support women's access to safe home birth- I had my own two kids at home and did homebirth for years. I really hope the direct entry midwifery community mobilizes to create a stronger base for entry to practice. I hope to see CNMs/CPMs/CMs unify so we can all just be midwives. But as it stands currently, I only support licensure for direct entry midwives if the state creates requirements above and beyond those required by NARM. Licensure confers legitimacy to the public, and it is not in the public's best interest to legitimize a profession that does not hold itself to the generally recognized minimum requirements for competent midwifery practice. I still hold my CPM cert, and it greatly pains me to speak out against a qualification that I worked so hard to obtain. But I feel very strongly about this.

PREACH, sister!! I'm with you...there are just too many stories and deaths related to uncertified "professionals" not using their brains (or not being trained well enough) while doing their job. Bad outcomes can happen with a CNM or in hospital, but I believe and see that it's far less likely to be from the basic things that are missed by those uncertified practitioners.

I also believe that, if they're not moving in that direction legally, either more training or more sensitivity training needs to be done so mothers aren't shamed for not feeling comfortable and wanting to call for help/EMS. A mother's gut instinct is present from early on and they need to be told to trust it. You can't do much about those women (like my sister-in-law) who would do it all over again even with a poor or fatal outcome, but it may help some.

xo