Is there a reason why most CNMs don't do homebirths?

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Specializes in Nurse Leader specializing in Labor & Delivery.

Is it liability/insurance, or something different?

I've made the decision to go back to school to get my CNM. As a former homebirther myself, the idea of attending homebirths appeals to me, but it seems very rare that CNMs attend homebirths - they seem to usually be CPMs or DEMs.

Just wondering if someone could shed some light into it for me.

Thanks in advance,

Kerry

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Specializes in Ante-Intra-Postpartum, Post Gyne.

Yes it is a liability issue. Its hard enough for a midwife to get let alone that will cover one that does home birth (notice that on the NSO application it takes everyone but CNMs and CRNA)

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Specializes in Nurse Leader specializing in Labor & Delivery.

I wonder what homebirth midwives do for , then?

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in NY they can get it, but most od the harcore CNM's choose not to carry it

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Specializes in Emergency Department.

It's not that "hardcore CNMs" (or any midwives like me for that matter) choose not to carry it, we can't afford it! My CNM friends have educational debt and get it paid off easier in the hospital setting.

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No, I am talking about the experienced, long out of school, long out of the hospital, very successful hb midwives in my area who are probably inching their way to 500,000 gross annually choosing not to have it. they are the same ones choosing not to have a written practice agreement or hospital privileges. those three things seem to go hand in hand and create certain obligations on the mw's part that some of them simply choose to operate without. but that's in my area--different places are different.

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Specializes in Emergency Department.

Hard to say without knowing your area. The ones who are in my area who don't do home birth never have. The ones who'd like to wouldn't risk the politics of making the move. And then there is the nice reason of making a bigger impact with midwifery care to women in hospitals than at home. There are plenty of CPMs to serve that small population. But to answer the insurance question there are those who believe you are a target for litigation when you carry the policy. No insurance, no lawsuit.

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It's not legal in my state. . .incidentally, I've asked two "more progressive" family medicine MDs I know if they'd consider attending a homebirth if I have another child (they both do housecalls for other medical issues, both deliver babies). Both said it was "too much of a risk."

Ugh.

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what area is this?

how does this crazy law read?

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In my area of the world, there aren't any docs that will back the CNM.

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It's not legal in my state. . .incidentally, I've asked two "more progressive" family medicine MDs I know if they'd consider attending a homebirth if I have another child (they both do housecalls for other medical issues, both deliver babies). Both said it was "too much of a risk."

Ugh.

Homebirth isn't illegal anywhere. You can't legislate place of birth. Otherwise we would have to throw those women who deliver by the side of the road in jail along with the planned homebirthers.

There may be legislation that does not allow CNMs to attend homebirths... although as I understand it that is usually not the case. Typically it is local politics and the availability of backup docs that determines this.

Rarely do the state boards restrict where or how an MD can practice so I am guess that your MDs are indicating the "medical risks" rather than the legal ones.

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