Please Help Advocate for Midwifery, Home and Birth Center Birth!

As many of you are aware, midwifery and out-of hospital birth are enjoyed by only a small minority of American women.

Although research shows that giving birth in home and birth center settings is safe, there have been some recent developments that threaten the birthing choices available to women and families desiring midwifery and out-of-hospital care. Here are some current issues that concern us.

The American Medical Association and Home Birth

The American Medical Association (AMA) recently issued Resolution #239 to develop laws regarding oversight and control of midwifery licensure and scope of practice. This especially threatens Certified Professional Midwives (CPMs), but has the potential to threaten all types of midwives, including Certified Nurse Midwives (CNMs).

The AMA also issued Resolution #205, which supports crafting laws limiting births to hospital, hospital-based birth centers or accredited free-standing birth centers (like Madison Birth Center). This Resolution is critical of home birth and aims to restrict the rights of women and families about the choices available to them.

Although we agree that there are safety parameters required in every birth setting, we at the Madison Birth Center oppose the concept of physician groups deciding (and legislating) either the scope of practice of midwives or the choice about where families give birth. We suppport the ethical concept of autonomy and informed choice for families about where and with whom they give birth.

[Read more here about home birth]

Elective Cesareans

The National Institutes of Health (NIH) convened a panel on March 27-29, 2006 to hear testimony about the trend toward "elective cesareans." These so-call "maternal request" cesareans are performed when there is no medical reason or need for intervention.

The NIH panel findings were widely reported, often quoting the chair of the panel stating "We don't believe [cesarean sections] should be discouraged or encouraged." Many groups responded to this coverage with calls for more accurate reporting, including the American College of Nurse-Midwives.

What wasn't reported was that overall, the panel results strongly favored vaginal birth over cesarean birth. In fact, the main conclusion of the review was:

"Without clear, compelling and well-supported justification for cesarean section or assisted vaginal birth, a spontaneous vaginal birth that minimizes use of interventions that may be injurious to mothers and babies is the safest way for women to give birth and babies to be born."

[Read more here about elective cesareans]