the state

– of local midwives & matt. by vastate
Wednesday, 21 January 2009, 14:15
Filed under: -of health, -of jhumphrey, -of kiddos, -of localism

there is some fascinating discussion over on hburg news regarding “Delegate Matt Lohr [introducing] two bills to the House of Delegates that may limit the practices of Certified Professional Midwives.”

check it out here.

it has to do with the fact that a lot of antagonism between local health care providers may be creating an unsafe environment for the age-old practice of giving birth.


it has to do with the fact that local health care providers are spending an awful lot of time lobbying lawmakers instead of lobbying each other.

i don’t know much about matt lohr,


but i do know that he is not a women’s health care professional.  what’s up with the nurse-midwives and the licensed midwives and the certified practical midwives and the lay midwives firmly aligning themselves against one another with the help of folks who really don’t know much about birth?  here is where i’m coming from…

not that the seattle system for childbirth is perfect by any means…but i know i felt completely safe and supported in a well-honed network of inter-connected health care professionals when i had my out-of-hospital birth in 2006.

my licensed midwives at seattle home maternity (hi marge, suzy, and heather!)


either helped to found or were professionally trained at seattle midwifery school.


they were (and are) part of a fairly supportive network (30-years in the making) making homebirth and birth center birth very safe for the healthy pregnant woman and her baby (like myself and eli).  i felt confident in their ability to provide a seamless and supported transfer to a local hospital if necessary.


i knew and trusted the nurses, nurse-midwives, and doctors whose care i would have received had i required a transfer.  i knew they would have accepted me and provided excellent care without question or judgement because they had a good relationship with my homebirth midwives.

the OB/GYNs and hospital nurse-midwives in the area trusted the professional practice and judgement of most (there were exceptions, as with any group of providers) of the licensed midwives.  i believe this had to do with a conservative attitude towards risk factors on the part of the respected homebirth midwives in the area.  they had developed and gained the trust of the medical community due to their repeated good decision making regarding who are and are not appropriate homebirth candidates.

at this point in time, i’m sad and slightly ashamed to say, living in harrisonburg,  if i have a second baby, i don’t know where that baby would be born.  i so desperately want to say “homebirth all the way!”  but, i’m scared.  i’m scared that a broken system is not a safe system.  i’m scared of having to find my own Rhogam.  i’m scared that if i had to transfer, the experience might not be so great.  i’m scared that my nurse-midwife friends might think me reckless.  i’m scared my homebirth midwife friends don’t have the support they need to provide safe care.  i feel so torn.

most healthcare professionals will resent efforts to limit their practice through law.  this undermines a necessary trust that healthcare professionals will follow guidelines put in place by their various professional organizations.  (ACNM, ACOG, MANA) if they fail to do so, they are and should be held accountable.

acnm1 acoglogo701 manalogo

so, i ask the harrisonburg community of women’s healthcare providers:  why can’t you talk to each other?  here are my suggestions. humble as they may be.  i want discussion.  i acknowledge that i know much less than some regarding the topic, but that said:

maybe the hospital nurses, nurse-midwives, and OB/GYNs could ask “how can we make homebirth transfers better, safer?” i understand on a visceral level (i’m a labor & delivery nurse, remember?) the need to protect your practice and the intense fear of being thrown into a scary situation with a patient you do not know and to whom you have not provided care.  but the fact is that ignoring or turning away or attempting to supress the reality of homebirth in the area isn’t going to make your job easier or birth safer.

maybe the homebirth midwives could acknowledge that a little conservatism is needed in this political climate.  homebirth is safe for healthy moms and babes.  but not all women should be having homebirths.  you and your practice will gain much needed support if you choose wisely and practice with exceptional care regarding your patient population. this may mean disappointing some people.  this may mean that you turn away some women who desperately desire homebirth.  but maybe it’s worth it in the long run?

i truly believe that most everyone involved (OBs, CNMs, LMs, CPMs, women) has a similar goal of providing excellent maternity care for women.

but women  are telling you that they want options. they want options in the hospital.  they want options at home.  these options can be very safe.   what is not safe is a fragmented system. so let’s fix it, already…



6 Comments so far
Leave a comment

Yes, and yes and yes!

Comment by Susan Ellenwood

amen sister beautifully put

Comment by melody

Great article. Maybe midwives need to make sure that birth statistics are out there where everyone can find them and be better educated to the actual safety that midwifery brings to the birth experience. Lack of knowledge and fear are what drives the Matt Lohrs of the world. Perhaps we should go visit him and bring him up to date…

Comment by Barbra

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