Home birth article

[Rae_1478]

I LIKE delivering in the hospital. Personal preference. But I read this and just shook my head. How in the world did any baby ever survive before birthing in hospitals became normal? It's almost like doctor's don't get the phrase 'mother's instinct' or something. Anyway, enjoy (or be disgusted, your choice )

http://vitals.nbcnews.com/_news/2013...idelines?lite=

[kellyowens]

Not to step on toes but it always amazed me that women's "choice" extended to abortion but not where and with whom a woman births her baby

It's good to hear the aap make the statement that women should have a choice...even though they don't endorse that choice . I agree. I think there needs to be more focus on educating and equipping midwives as well as more drs willing to provide back up. Maybe, eventually midwifery will be legal in all states so women can choose competent care-providers who support their birth choices.

It's a step in the right direction

[Smplyme89]

Not to step on toes but it always amazed me that women's "choice" extended to abortion but not where and with whom a woman births her baby

It's good to hear the aap make the statement that women should have a choice...even though they don't endorse that choice . I agree. I think there needs to be more focus on educating and equipping midwives as well as more drs willing to provide back up. Maybe, eventually midwifery will be legal in all states so women can choose competent care-providers who support their birth choices.

It's a step in the right direction

I agree. It is really fascinated that there are so many restrictions on where a woman chooses to give birth. As a VBAC mom I can give birth at home (I'm in Florida), but I can not give birth in a birth center Suuure we'll pretend like that makes all kinds of sense

[MaryJane]

It's nice they can say that a women who chooses to give birth at home should have a trained, certified midwife and another midwife for the baby and back up care in place, but in many states those conditions are impossible since midwifery is heavily prosecuted, doctors refuse to offer back up care, and the number of midwives is small. In my state, midwives are not licensed and if they attend homebirths they can be prosecuted. That said, there are doctors who support homebirth and are willing to backup homebirth midwives many of who are practicing illegally. That doesn't mean they aren't certified and competent. They are. Many of them are even licensed in other states. And most have apprentices or assistants who are trained and certified in neonatal resuscitation. Jennifer Margulis who they mentioned in the article is a facebook friend of mine and very active in the birth community, and she just released a new book. I will probably download it to the kindle and read it soon.

[MaryJane]

Forgot to say that Jennifer's book is called Business of Baby.

[sammilynn]

It's nice they can say that a women who chooses to give birth at home should have a trained, certified midwife and another midwife for the baby and back up care in place, but in many states those conditions are impossible since midwifery is heavily prosecuted, doctors refuse to offer back up care, and the number of midwives is small. In my state, midwives are not licensed and if they attend homebirths they can be prosecuted. That said, there are doctors who support homebirth and are willing to backup homebirth midwives many of who are practicing illegally. That doesn't mean they aren't certified and competent. They are. Many of them are even licensed in other states. And most have apprentices or assistants who are trained and certified in neonatal resuscitation. Jennifer Margulis who they mentioned in the article is a facebook friend of mine and very active in the birth community, and she just released a new book. I will probably download it to the kindle and read it soon.

This is our state... in fact they are working on making it legal but they want to make them get a nursing degree AND have an OB in practice with them plus all of the other various insurances they will need so rather then charging by person and helping the mother get what birth they wanted Home birth fees will skyrocket and insurance may not even cover it. My MW friends are trying to get the bill NOT to pass because they said they rather risk it then have birth be degraded and hurt the moms. Also all of my MW friends are CPR certified for both adults, children and neonates, are first aid certified and one is certified with oxytocin. They all carry oxygen tanks and are herbally ready for anything. Most around here have to be to be safe.

[MaryJane]

This is our state... in fact they are working on making it legal but they want to make them get a nursing degree AND have an OB in practice with them plus all of the other various insurances they will need so rather then charging by person and helping the mother get what birth they wanted Home birth fees will skyrocket and insurance may not even cover it. My MW friends are trying to get the bill NOT to pass because they said they rather risk it then have birth be degraded and hurt the moms. Also all of my MW friends are CPR certified for both adults, children and neonates, are first aid certified and one is certified with oxytocin. They all carry oxygen tanks and are herbally ready for anything. Most around here have to be to be safe.

Yeah, there are a lot of midwives against licensing because in some states where they license midwives they place so many restrictions on their practice that most women can't even qualify for homebirth. CNM can attend homebirths here legally with OB backup, but CPMs pass the same certifying tests that CNMs pass. If doctors and midwives would work together to serve women and provide more options then they could achieve so much. In our area, the ob/gyns who support homebirth midwives do it under the radar, but one of them is the chief of obstetrics at one of the hospitals and he is supporting the creation of a birth center. Will be the 2nd one in the entire state. When they support midwives and work with them everyone is safer.

[sammilynn]

Yeah, there are a lot of midwives against licensing because in some states where they license midwives they place so many restrictions on their practice that most women can't even qualify for homebirth. CNM can attend homebirths here legally with OB backup, but CPMs pass the same certifying tests that CNMs pass. If doctors and midwives would work together to serve women and provide more options then they could achieve so much. In our area, the ob/gyns who support homebirth midwives do it under the radar, but one of them is the chief of obstetrics at one of the hospitals and he is supporting the creation of a birth center. Will be the 2nd one in the entire state. When they support midwives and work with them everyone is safer.

Yeah its bad here and I watched one go to jail for being in a home birth where the baby had difficulties breathing and they transferred to the hospital, and the hospital turned them in. My OB is against home birth but knows the only reason she is seeing me is out of respect for my husbands fears. Most hospitals and OBs around here are against it. But in my area if you want a VBAC you have to do home birth or travel because 3 out of the 4 in a 45 min radius are Banned from VBACs.

[MaryJane]

Yeah its bad here and I watched one go to jail for being in a home birth where the baby had difficulties breathing and they transferred to the hospital, and the hospital turned them in. My OB is against home birth but knows the only reason she is seeing me is out of respect for my husbands fears. Most hospitals and OBs around here are against it. But in my area if you want a VBAC you have to do home birth or travel because 3 out of the 4 in a 45 min radius are Banned from VBACs.

That's crazy. I don't know how they can say they ban VBACs. They can't force an adult to have surgery if they don't want it. The policy of turning in homebirth transfers is one of the things that makes homebirth less safe. If a midwife knows she has hospital support then she's much more likely to transfer early on. Not saying it should matter, but they shouldn't have to worry about prosecution for doing what's right. Alternatively, when they tell women they can't have VBACs they force women who refuse to have unnecessary surgery to take the added risk of birthing without a good care provider. I know women who choose to VBAC at home unassisted rather than go to the hospital for a repeat section. It's really very scary and absolutely maddening. This is why I struggle with becoming a CPM or a CNM. I want to affect change, but I also want to be able to attend homebirths and not be limited by hospital policies and routines. The really good CNM we had here who was fighting for change from the inside out, who was offering women the options they wanted in the hospital was forced to resign for not going along to get along in that system and now she does homebirths only. But when the supportive doctors retire it's going to be up in the air if she can even do that legally. I can't even stand the thought of being in L&D as a nurse and having to follow protocols that have been proved to be outdated and potentially harmful.

[sammilynn]

That's crazy. I don't know how they can say they ban VBACs. They can't force an adult to have surgery if they don't want it. The policy of turning in homebirth transfers is one of the things that makes homebirth less safe. If a midwife knows she has hospital support then she's much more likely to transfer early on. Not saying it should matter, but they shouldn't have to worry about prosecution for doing what's right. Alternatively, when they tell women they can't have VBACs they force women who refuse to have unnecessary surgery to take the added risk of birthing without a good care provider. I know women who choose to VBAC at home unassisted rather than go to the hospital for a repeat section. It's really very scary and absolutely maddening. This is why I struggle with becoming a CPM or a CNM. I want to affect change, but I also want to be able to attend homebirths and not be limited by hospital policies and routines. The really good CNM we had here who was fighting for change from the inside out, who was offering women the options they wanted in the hospital was forced to resign for not going along to get along in that system and now she does homebirths only. But when the supportive doctors retire it's going to be up in the air if she can even do that legally. I can't even stand the thought of being in L&D as a nurse and having to follow protocols that have been proved to be outdated and potentially harmful.

I completely agree and I just got word that the bill passed.

[Smplyme89]

Yeah its bad here and I watched one go to jail for being in a home birth where the baby had difficulties breathing and they transferred to the hospital, and the hospital turned them in. My OB is against home birth but knows the only reason she is seeing me is out of respect for my husbands fears. Most hospitals and OBs around here are against it. But in my area if you want a VBAC you have to do home birth or travel because 3 out of the 4 in a 45 min radius are Banned from VBACs.

That's how it is here as well The closest hospital that 'allows' VBACs is over an hour away. It's quite frustrating.

[Rae_1478]

I'm still curious how women ever gave birth to healthy babies before! Without ANY trained help other than maybe relatives or neighbors who had given birth themselves before. This is definitely a case of state-over-regulation.

I like my hospital, but my state DOES allow the option of home births. The choice is there.

[Smplyme89]

I'm still curious how women ever gave birth to healthy babies before! Without ANY trained help other than maybe relatives or neighbors who had given birth themselves before. This is definitely a case of state-over-regulation.

I like my hospital, but my state DOES allow the option of home births. The choice is there.

Yes a hundred times over. Having a choice and being treated as competent individuals who are capable of making such a deiciosn.

[lilya003]

It is not entirely about regulation - it is about money, and the regulation we are subject to is the result of businesses making money off the birth/baby industry lobbying for all those regulations. The dollar is the deciding factor that limits our ability to decide for ourselves. (Although, for the record, I would never consider having a baby outside of a hospital, but that is my choice and I think others should be able to decide for themselves.)

[pants]

I just got word today that in NC a bill was moved out of committee onto the senate floor to decriminalize CPM's. So basically they can not criminally prosecute them, though there is still no path for licensure. Which is ideal for the CPM's here. They want to provide midwife services without fear of being put in jail. Another bill for CPM's is still in committee that would provide a path of licensure for CPM's. But the medical lobbyists are fighting hard against that one. At least it looks favorable that this year CPM's can provide midwifery care without criminal punishment. (right now it's a literal witch hunt for CPM's. Every transfer to a hospital has resulted in a CPM getting put into jail.)

CNM's can attend homebirths BUT they have to have doctor sign off on their charts and have malpractice insurance if they backup CNM's. So most docs dont do this because of the cost AND risk for them. How unfair would that be for a doctor, who can't legally attend homebirth, to be sued because of something that happened at a birth he wasn't at just because he signed off on a chart. Most docs are for COLLABORATIVE practice where they can collaborate on homebirths but not be ultimately responsible for them. There is a separate bill is to allow CNM's autonomous work and collaborative doctor status. I'm not sure the status of that bill. I believe that they have a good chance of this going through.

Since I used a CPM i'm more interested in the CPM bills.

[Smplyme89]

I just got word today that in NC a bill was moved out of committee onto the senate floor to decriminalize CPM's. So basically they can not criminally prosecute them, though there is still no path for licensure. Which is ideal for the CPM's here. They want to provide midwife services without fear of being put in jail. Another bill for CPM's is still in committee that would provide a path of licensure for CPM's. But the medical lobbyists are fighting hard against that one. At least it looks favorable that this year CPM's can provide midwifery care without criminal punishment. (right now it's a literal witch hunt for CPM's. Every transfer to a hospital has resulted in a CPM getting put into jail.)

CNM's can attend homebirths BUT they have to have doctor sign off on their charts and have malpractice insurance if they backup CNM's. So most docs dont do this because of the cost AND risk for them. How unfair would that be for a doctor, who can't legally attend homebirth, to be sued because of something that happened at a birth he wasn't at just because he signed off on a chart. Most docs are for COLLABORATIVE practice where they can collaborate on homebirths but not be ultimately responsible for them. There is a separate bill is to allow CNM's autonomous work and collaborative doctor status. I'm not sure the status of that bill. I believe that they have a good chance of this going through.

Since I used a CPM i'm more interested in the CPM bills.

That to me just shows how awesome they are. Even the risk of going to jail doesn't keep them from taking care of their mamas I hope the bill passes