Contrast these homebirth news stories!

I have followed homebirth legislation news in Utah and South Dakota with interest and concern.  I don’t want Montana getting any stupid ideas. 

UtahI blogged about their nonsense recently.  Yesterday, the Utah Senate voted to restrict homebirth practices.  The bill was supposed to have been a compromise, but what resulted was something restrictive and punitive.  Women will be forced to attempt VBACs in hospitals or on their own.  Were this the case in my state, I would have an overwhelminly large chance at “failure” since my hospital’s VBAC rate is a pitiful <1%.  They only had 16 successful VBACs at the hospital in 2006.  Utah legislators have chosen a path that makes homebirth less safe.  To search for Senate Bill 93, click here.

South DakotaI also blogged about their homebirth “situation,” and it appears that both the SD House and Senate have approved a homebirth bill. 

The bill would require midwives to become registered nurses, get master’s degrees in nursing, and pass additional tests. Certified nurse midwives wanting to attend home births would need approval of both the Nursing board and the Board of Medical Examiners.

Allowing certified nurse midwives to attend home births in South Dakota would be allowed on a trial basis until 2013.  (click here for source article)

My concern is that CNMs were previously required to have OB back-up, and evidently no OBs were agreeing to provide back-up services.  What will be different?  And I’m not sure that having a Masters Degree makes anyone particularly qualified to attend labor.  Shouldn’t these homebirth midwives have assisted on “x” number of births before they become licensed?  Why is it always about the piece of paper??

Also, the bill states that CNMs will be able to attend homebirths “under certain circumstances” but doesn’t clarify what those circumstances may be.  I suppose we must find the Board guidelines to find more clear language.  To read the bill, click here.

Homebirth in South Dakota

South Dakota isn’t particularly close to me here in Western MT.  However, SD is a neighboring state, and I have relatives who live in that state, so birth news from SD is important to me!

SD is working on legislation that will allow women to birth at home with assistance of certified nurse midwives (CNM). 

Current laws require South Dakota’s Certified Nurse Midwives to have a signed collaborative agreement with a physician as a pre-requisite to practice.  However, South Dakota’s physicians have failed to cooperate with any Certified Nurse Midwife for homebirth.
 
The South Dakota Chapter of the American College of Nurse Midwives supports the measure and provided testimony on Wednesday citing the safety of low risk mothers who have planned home births with Certified Nurse Midwives.

I don’t believe that Montana allows CNMs to attend homebirths.  I do know that doctors who used to provide back-up support for direct entry midwives (different certification and oversight than CNMs) in my community no longer do.  I like the language in the article – “. . . physicians have failed to cooperate . . .” – indeed!

Jeanne Prentice is a CNM from South Dakota that currently attends homebirths in Wyoming. 

Prentice is alarmed at the growing number of mothers who are choosing to deliver without any help at home because they fear what may be forced on them in the hospital delivery setting.

Indeed, many of us know well enough that hospital delivery can be interventive.  Women are not in a position of power with regard to their bodies, their babies, and their birth plans.  I am not talking about balking at medically-necessary intervention.  However, very little of what goes on in labor and deliver is NECESSARY.  Women are subject to a number of routine procedures and protocols upon entrance to to the hospital.  Women are resisting, and I believe this has caused 2 things:

  1. Care providers, especially medical providers, insurance companies, and other medical institutions are becoming more restrictive, more interventive, and less woman-centered.  This is evidenced by declining maternal-infant outcomes, increased cesarean deliveries, increased PTSD & PPD, and declining VBAC rates.
  2. Out-of-hospital birth is on the rise.  Women and finally starting to realize (I know I am) that their chances of having a good and safe childbirth experience are declining in hospitals.  Women are learning and owning the benefits of natural physiologic childbirth, when possible, and insisting on finding care providers who will enable that.