Home birth is a safe alternative for many women



By Sarah Wittekind



I am absolutely dismayed by Dr. Burke’s statements regarding home birth in Indiana. Not only are his opinions slanted, but many of his assertions are simply untrue.

Burke attempts to speak for all ISMA members, yet I know from personal experience that there are physicians in the state who support planned home birth for low-risk women who are attended by a Certified Professional Midwife (CPM). I feel that the difficulty in finding physicians who will serve as back-up for a planned home birth should a woman need to transfer to hospital has more to do with Indiana’s legislation and insurance issues than the safety of home birth.

In June 2005, the British Medical Journal published an extremely thorough study that would hold up to the stiffest scientific scrutiny. The study group was comprised of 5,418 women who expected to have CPM-attended home births at the onset of labor. The study found that 12.1 percent of women who intended to birth at home at the onset of labor transferred to hospital. It also showed that medical interventions like epidurals (4.7 percent), episiotomies (2.1 percent), forceps delivery (1.0 percent), vacuum extraction (0.6 percent) and C-sections occurred much less frequently in the study group than in low-risk hospital births in the US. The conclusion: planned home birth for low-risk moms attended by a CPM results in fewer medical interventions, higher maternal satisfaction for mom and similar rates of intrapartum and neonatal mortality when compared to planned hospital birth for low-risk moms here in the U.S.

In 41 states, CPMs can practice without fear of being criminalized. Twenty-four states provide a mechanism through which these professionals can be licensed. CPMs are highly trained individuals who have received a credential from the North American Registry of Midwives. NARM is the leading certification agency for direct entry (non-nurse) midwives in the U.S., and all or part of the NARM certification process is used for the basis of licensure in the states that license direct-entry midwives.

CPMs are professionals who, after receiving their credential, are qualified to provide prenatal, intrapartum and postpartum care for mother and baby. They participate in mandatory peer reviews and ongoing learning opportunities in order to maintain their certification. (They recertify every three years.) NARM’s legally defensible certification process includes, among other things, clinical training which ensures competency in real-world situations.

So if home birth is safe and CPMs are well-trained, what’s the problem? Here in Indiana, the problem is the law. Since 1993, midwives and home birth consumers have been working to pass legislation which would, among other things, allow for the licensure of CPMs. Repeatedly, the legislation has been proposed and supported by legislators who are also medical professions (like nurses and physicians.) Twice, the legislation has passed the House of Representatives by wide margins, however, it hasn’t made progress in the Senate because Sen. Patricia Miller (R-Ind) pigeon-holes it because she doesn’t support it. Sen. Miller is notorious among professionals like chiropractors and nurse practitioners. She even proposed legislation that would require people seeking reproductive therapy to first be married and second receive “permission” from the state to procreate. She doesn’t appear to be a senator for the people; she seems to ensure passage of her own agenda, and while that’s frustrating to those of us who want to affect change, it hasn’t stopped us from trying.

Home birth isn’t for everyone, but to say that nobody should birth outside of a hospital is ridiculous! Even worse, implying that a parent wouldn’t have suffered the loss of a child had she simply been in hospital is cruel and unfair. How many doctors can say that they’ve experienced one stillbirth in over 1,500 births? Dr. Burke was not in Jennifer Williams’ shoes, nor did he even attend the birth, so he cannot say that things would have turned out differently had the mother labored and delivered in a hospital. None of us can.

It’s important that we as parents make informed choices. Indiana should not be allowed to dictate where and how we birth our babies under the guise of “protecting us.” It’s time for Indiana to join the 21st century (and the majority of states in the U.S.) by making direct-entry midwifery legal.

Sarah Wittekind is a Columbus resident.

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