I have followed homebirth legislation news in Utah and South Dakota with interest and concern. I don’t want Montana getting any stupid ideas.
Utah – I 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 Dakota – I 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.
The bill would put new limits on direct-entry midwives, who are licensed and attend home births. By defining a “normal” birth, it bans them from administering to women with a host of medical conditions, from diabetes to hypertension.
They also would be stopped from assisting women whose babies are breech or who want a vaginal birth after a previous cesarean section (VBAC).
How is it that people who never see “normal” birth (a term that is easily usurped and unfortunately true of augmented birth in this day and age) are able to determine normalcy. If they can determine “normal”, then perhaps they should start overtly forcing more women into induction, augmentation, and other interventions. Medically-managed labor & delivery is certainly most common in a hospital setting. In fact, why don’t we just get rid of the mother’s (and other vested persons’) desires altogether? Many – if not most – OBs are contemptuous towards mothers with birth plans anyway.
I can tell you that “normal” should equate to “natural”, but it doesn’t any more. And really the only venue for assuring natural birth is home. Sure “natural” might not happen for everyone. I’m not even trying to suggest that all women should give birth at home. But these restrictions . . . why not ensure that direct-entry midwives are well-trained for breech, twin, and VBAC scenarios. How do you ensure this? By keeping it legal and supporting midwives who feel confident in their skill level with breech, twin, and VBAC labor. Just as an OB should know if s/he is the appropriate person to deliver a breech baby or perform an amniocentesis (and lemme tell you, some simply are NOT), so should a CNM or direct-entry midwife.
I’ve written about “normal” and “natural” before – click here to read!