States Respond To Increasing Demand For Midwives, Home Births

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An increasing number of pregnant women are eschewing hospital deliveries for home births, prompting some states to consider legislation to license midwives who assist in home deliveries, the New York Times reports.

The number of home births in the U.S. rose by 5% from 2004 to 2005 and held steady at 25,000 in 2006 ... Women who opt for home births cite several reasons, such as religious beliefs or a desire to avoid a caesarean section ... medical interventions have increased significantly in the past 20 years, including interventions in low-risk pregnancies ...

Midwifery advocates argue that recent figures showing an increase in the U.S. maternal mortality rate supports their position that a majority of c-sections are unnecessary and possibly dangerous. However, some physicians and medical groups argue that home births carry higher risks than hospital births ...

The issue of how to regulate midwives is playing out in Illinois, where the state Legislature is considering a bill (HB 226) that would license direct-entry midwives ... Illinois law considers legal home births to be those attended by a physician or a nurse midwife ...

... Licensed home-birth attendants work in only seven of Illinois' 102 counties, leaving a majority of the state home births unattended or attended illegally by someone whose license and education are unregulated ... women often register home births as "unassisted" to avoid scrutiny of their midwives.

Supporters of the Home Birth Safety Act ... argue that it strengthens and protects pregnant women and their infants from untrained practitioners. It also allows midwives to practice openly and transport pregnant women to hospitals in emergency cases without fear of reprisal or arrest. Opponents of the measure -- including ACOG, the Illinois State Medical Society and the American Medical Association -- argue that home births are riskier than births in medical settings.

Illinois' midwifery organizations are cautiously optimistic that the measure will pass. Rachel Dolan Wickersham, president of the Coalition for Illinois Midwifery and vice president of the Illinois Council of Certified Professional Midwives, said medical groups' opposition to the measure is "about power and control." She added, "These women are going to have babies at home," adding, "Why would anyone want to keep the situation so that the person attending them has no regulated training or is afraid to transport them to a hospital in an emergency?" ...

Melissa Maimann, Essential Birth Consulting 0400 418 448