Midwives without nursing degrees risk prosecution

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Specializes in Telemetry, Med-Surg.
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Specializes in Ante-Intra-Postpartum, Post Gyne.

I feel sorry for the women in your state. Do they allow LM or CPM? If not your state is doing a serious disservice to women

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Specializes in Telemetry, Med-Surg.
I feel sorry for the women in your state. Do they allow LM or CPM? If not your state is doing a serious disservice to women

From the article, "The midwife is part of an illegal underground network in Missouri and Illinois helping women have babies at home. The two states are among 13 that prohibit or outlaw midwives without nursing degrees."

I have not considered becoming a nurse midwife, but I wonder why there are not more of them here since MO requires the nursing degrees. It's looks like plenty of women are getting around this requirement, however.

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Specializes in ER/ICU, CCL, EP.

I guess I do not know enough about the CPM certification to make an informed decision about this issue.

I am also a MO resident, I wanted a home birth and didn't have one because of the possibility of complications. I wonder if I made the right choice sometimes, as midwives seem to have great outcomes.

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Specializes in Community, OB, Nursery.

It is also illegal in my state for CPMs to deliver babies, but I know that they do it anyway. I have a good friend who did it this way for baby #1, and is planning the same thing for baby #2, due this spring.

The silly thing is, it's not illegal for women to have their babies at home, just illegal for CPMs to attend the birth. Tell me how much sense that makes.

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Wow, that was a pretty amazing article. I thought it was pretty pro-homebirth and more importantly it included lots of evidence, which is often lacking in pro-natural childbirth articles.

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Specializes in Community, OB, Nursery.

Agree with you, CEG. I'm glad they included those stats. I'm not sure how people can infer that homebirth is any less safe when crunching the numbers.

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Specializes in geriatrics, L&D, newborns.

I had my second child at home attended by a CNM. This was in MD. The first had been born in the hospital under last minute general anesthesia. The two experiences were as different as night and day. If I had had a third child, it would have been at home. The complications with delivery are most often caused by interference with the birthing process by "professionals".

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It is also illegal in my state for CPMs to deliver babies, but I know that they do it anyway. I have a good friend who did it this way for baby #1, and is planning the same thing for baby #2, due this spring.

The silly thing is, it's not illegal for women to have their babies at home, just illegal for CPMs to attend the birth. Tell me how much sense that makes.

It's exactly the same logic as the anti-choice people use -- if you notice, the proposed laws to criminalize abortion always involve penalties for the docs providing the abortions but not for the women who make the decision to terminate the pregnancy. It's because the activists & legislators realize they would lose a lot of public support if they start talking about throwing lots of young women in prison ... :)

I'm not saying there's any other connection between the anti-midwifery people and anti-choice people -- just that the logic in constructing the laws is the same.

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Specializes in ICU, currently in Anesthesia School.
It's exactly the same logic as the anti-choice people use -- if you notice, the proposed laws to criminalize abortion always involve penalties for the docs providing the abortions but not for the women who make the decision to terminate the pregnancy. It's because the activists & legislators realize they would lose a lot of public support if they start talking about throwing lots of young women in prison ... :)

I'm not saying there's any other connection between the anti-midwifery people and anti-choice people -- just that the logic in constructing the laws is the same.

Not sure how you make the leap from homebirth to abortion- The logic is not the same in regards to these very separate issues. "Therapeutic" Abortion is a surgical procedure, Birth (whether preterm, spontaneous abortion, or other physiologic cause) is a natural process. The laws regarding them must be thought out differently as one is totally planned ("Therapeutic") and the other (Birth) may or may not be. If one was to outlaw homebirths, then the women who were trying to get to a hospital birth and had the baby in the cab would be imprisioned- makes no sense. As for your comment in regards to trying to equate MO laws on UNLICENSED/UNCERTIFIED people being criminally culpable for attending home births to attempts by some groups to criminalize licensed physicians who perform a legal surgical procedure- I again can't see the reasoning- apples to oranges.

Now, back to topic- I think the home birth movement is great, I would prefer some standard in caregiving however. I can see how requiring a CNM/CPM could help outcomes, and honestly, I think the 13 states that require strictly CNM would benefit from allowing CPM's to practice.

I think my problem with the unlicensed/uncertified people as sole attendants in the home births comes from the fact that they may not be able to recognize problems before they develop into disasters- in which case, why pay these people at all? My grandma would do just as good a job, and do it for free. If you are willing to take the time to apprentice and then charge for your services, why not develop the physiologic underpinnings of your actions? Then become certified to allow for some verification of your knowledge as set forth in a certification standard. This way the women you serve will have an assurance that the care they receive is of good quality.

To the OP- thanks for the thought provoking article.

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Not sure how you make the leap from homebirth to abortion- The logic is not the same in regards to these very separate issues. "Therapeutic" Abortion is a surgical procedure, Birth (whether preterm, spontaneous abortion, or other physiologic cause) is a natural process. The laws regarding them must be thought out differently as one is totally planned ("Therapeutic") and the other (Birth) may or may not be. If one was to outlaw homebirths, then the women who were trying to get to a hospital birth and had the baby in the cab would be imprisioned- makes no sense. As for your comment in regards to trying to equate MO laws on UNLICENSED/UNCERTIFIED people being criminally culpable for attending home births to attempts by some groups to criminalize licensed physicians who perform a legal surgical procedure- I again can't see the reasoning- apples to oranges.

Now, back to topic- I think the home birth movement is great, I would prefer some standard in caregiving however. I can see how requiring a CNM/CPM could help outcomes, and honestly, I think the 13 states that require strictly CNM would benefit from allowing CPM's to practice.

I think my problem with the unlicensed/uncertified people as sole attendants in the home births comes from the fact that they may not be able to recognize problems before they develop into disasters- in which case, why pay these people at all? My grandma would do just as good a job, and do it for free. If you are willing to take the time to apprentice and then charge for your services, why not develop the physiologic underpinnings of your actions? Then become certified to allow for some verification of your knowledge as set forth in a certification standard. This way the women you serve will have an assurance that the care they receive is of good quality.

To the OP- thanks for the thought provoking article.

I purposely made a point of saying that I wasn't drawing any other connection between the groups beside the logic in constructing the (proposed) laws criminalizing the providers of the procedures but not the women who make the decision to have the procedure.

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You know, we do so much high risk where I work- we're the only place with a NICU to support these babies for at least 2 hours in every direction. So perhaps we may be a little jaded where home birth is concerned. But please understand that our only professional experiences involve home births that have either failed (ie: infected and C/P for 6 hours before she made it to our door) or never even got off the ground (ie: laboring for 3 days, ruptured X2 days and unable to void s cath X24 hours). Both cases ended up in C/S but it was the hospital's fault that they didn't get the birth they wanted. I wholly support a woman's right to deliver where she will; but I wish that people would realize the primary goal is a HEALTHY mom and a HEALTHY baby. The lay midwifery community has a responsibility to their patients and their babies to know when to come in for help, and not let fearmongering and pride get in the way of safe patient care.

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