Home Birth.
In seeking physiologic childbirth, more women are turning to the Midwives Model of Care in freestanding birth centers and homes.
Certified Professional Midwives (CPMs) are the gold standard when it comes to out-of-hospital care. They are uniquely required to undergo clinical training out-of-hospital. They are trained to screen candidates, conduct resuscitation, administer medication, and follow emergency management and transfer protocol. Unlike Nurse Midwives, they do not care for women who have been given induced labor or epidural medication.
33 states have updated their laws to recognize CPMs, and no state has ever rescinded its licensure law. Licensure for CPMs allows regulation and accountability for professional midwives, and protection for consumers and back-up medical personnel.
Why did we work to get Alabama to legalize CPMs?
In 2010, the European Court of Human Rights held that women are the ones with legal authority to make the decisions of childbirth, and that the state cannot use the force of law to take away their freedoms. We believe the same rights apply in Alabama.
Out-of-hospital birth is a safe option for some women. Respected institutions such as The American Public Health Association and World Health Organization have passed resolutions supporting “the expansion of legally regulated and nationally certified direct-entry midwives to serve low-risk clients desiring out-of-hospital maternity care services.”
Natural birth, intervening only when necessary, is important to some women. At 35.5%, AL has the sixth highest cesarean rate in the U.S. (CDC, 2010) Midwifery care for low-risk pregnancy has been associated with reduced rates of many birth interventions.
Access to care is a serious issue in rural Alabama. Today, just 17 out of 54 designated-rural Alabama counties have hospitals with labor & delivery wards. CPMs residing in rural communities could provide lifesaving, affordable prenatal counseling and testing in a mother's home, at the mother's convenience. CPMs are well trained to refer clients to medical services if complications arise during the pregnancy and can attend to low-risk deliveries at birth centers located near hospital back-up.
Health care costs are high and on the rise. Not every birthing mother needs a surgeon. It would be a wise use of resources to triage a mother based on risk status and in doing so, reduce superfluous and costly interventions. For this to work, a respectful and collaborative relationship, with hospital transfer plan in place, must exist between providers.
Last but not least, this is common sense emergency preparedness. The CPM is uniquely trained in out-of-hospital birth, making them ideal first responders in the event of a situation that makes it unsafe or not feasible for women to give birth in hospital.
