Lay Midwives?

ChristineN, BSN, RN · Jan 17, 2006

In some states they are required to be licensed, while other states do not regulate them at all, and in other states it is considered an illegal profession equivalant to "practicing medicine without a license." I have personally known a few lay midwives and found them to be competant of their field. I actually considered a career as a lay midwife, but opted for the path of C.N.M. as I can move to states where C.P.M. is illegal and still practice. :)

hippienurse · Jan 17, 2006

I know alot of CPM in Washington state. They go thru extensive training, alot of the pre-reqs are exactly the same as nursing. The rest of the coursework is related direcly to training in labor and delivery, along with all types of perinatal care. I, personally, would not labor and deliver at home. But I do know these women (the ones I know) are very well trained and have a unique passion and intution when it comes to birthing babies. Personally I am taking the path to become a CNM because I want to work in the hospital and birth center. In Washington a CPM can only do home births.

judyblueeyes · Jan 19, 2006

In my area, lay midwives are glorified birth junkies- not all that helpful and just want to 'be there'.

midwife2b · Jan 20, 2006

I live in an area where homebirth is not supported. There are "underground" midwives who provide services for these families and for the most part things go well.

One lady just got credentialed as a CPM; while not legally recognized here, at least she has demonstrated competency to somebody!

We do have one OB who will provide prenatal care to women who want a homebirth. If complications arise at least the patient has somebody who will help them. That is so muich safer than those ladies who have NOBODY as a backup!

SeekingNur · Jan 20, 2006

I've had three homebirths with CPMs, the last birth just over a month ago. They were fabulous, empowering experiences. The CPM that assisted in the delivery of my last two children has over 20 years experience as well as her certification, and a rather impressive education. She delivers breeches with ease and "problem" births with ease. She is knowledgeable, respectful and damned good at what she does. I love CPMs.

I live in a state where professional "lay" midwifery is legal and regulated. My first birth was in an alegal state.

SeekingNur · Jan 20, 2006

In my area, lay midwives are glorified birth junkies- not all that helpful and just want to 'be there'.

what state do you live in?

matchstickxx · Jan 20, 2006

The calls and e-mails started circulating last week, with growing urgency. Jennifer Louisa Williams, 54, a certified professional midwife working since 1989 in Central and Southern Indiana, had been arrested.

The case is tragic enough without charges being filed.

Williams -- an experienced practitioner who has delivered 1,500 babies -- was hired by a Shelby County minister and his wife to assist with the birth of their baby at home in June. The child was full-term, but his heartbeat stopped in the birth canal. Williams acted quickly, but the little boy was born not breathing. He later was pronounced dead at Johnson Memorial Hospital in Franklin.

Link to full story...I hope...

http://www.indystar.com/apps/pbcs.dll/article?AID=/20060119/COLUMNISTS02/601190472&SearchID=73233074707345

Aneroo, LPN · Jan 20, 2006

The calls and e-mails started circulating last week, with growing urgency. Jennifer Louisa Williams, 54, a certified professional midwife working since 1989 in Central and Southern Indiana, had been arrested.
The case is tragic enough without charges being filed.
Williams -- an experienced practitioner who has delivered 1,500 babies -- was hired by a Shelby County minister and his wife to assist with the birth of their baby at home in June. The child was full-term, but his heartbeat stopped in the birth canal. Williams acted quickly, but the little boy was born not breathing. He later was pronounced dead at Johnson Memorial Hospital in Franklin.
Link to full story...I hope...
http://www.indystar.com/apps/pbcs.dll/article?AID=/20060119/COLUMNISTS02/601190472&SearchID=73233074707345

That's so sad- However, I do agree with the decision to prosecute her. She knew she did not have the go ahead to be practicing as a midwife. Just because you have the skills to do something doesn't mean jack- I could have went thru nursing school, jumped thru all their hoops, and still not be a nurse. I could have easily found some old lady who needed home health but couldn't afford a nurse and have done the same thing (practice without a license). Weird analogy, but that's how I see it.

However, I am torn between whether or not the family could/should sue. They knew the risks beforehand (risks of a home birth with a non-licensed person). However, they lost their child, and if they can prove anything (just because this person was not licensed) they could probably win.

What a tragic case...

matchstickxx · Jan 20, 2006

I think there needs to be some way to regulate midwives. Not all people who present themselves as midwives are competent. Of course, not every poor homebirth outcome is a result of using a midwife. Hospital deliveries can have devestating outcomes too.

Aside from word of mouth, how's a mom to know if a midwife is competent or if they just been lucky that nothing bad has happened yet. A friend of mine had a home birth with an unlicensed midwife. The midwife had an "apprentice" with her who would be a midwife after she accompanied/ assisted her trainer on 100 deliveries. This was many years ago before I was even in nursing school. At the time I thought 100 deliveries sounded like a lot, but now I realize it really isn't that many.

SmilingBluEyes · Jan 20, 2006

Horrible case. But if it was against the law for her to practice midwifery without an RN license prior (as it said in the article), she appears not to have much to stand on. Tragic all around. She knowingly broke the law and took a huge risk; there will be a price to pay, despite the death being NOT of her fault or doing.

SmilingBluEyes · Jan 20, 2006

I think there needs to be some way to regulate midwives. Not all people who present themselves as midwives are competent. Of course, not every poor homebirth outcome is a result of using a midwife. Hospital deliveries can have devestating outcomes too.
Aside from word of mouth, how's a mom to know if a midwife is competent or if they just been lucky that nothing bad has happened yet. A friend of mine had a home birth with an unlicensed midwife. The midwife had an "apprentice" with her who would be a midwife after she accompanied/ assisted her trainer on 100 deliveries. This was many years ago before I was even in nursing school. At the time I thought 100 deliveries sounded like a lot, but now I realize it really isn't that many.

I have to agree. The case in point is in that article. If the law that a midwife must hold RN credential prior is considered unfair or unreasonable, the onus is on the community to change the law. It's not for midwives to practice outside of it. Regulation IS in order, so homebirthing is safer and families are sure of whom they are hiring to officiate at these momentous home birth occasions.