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Licensure needed for midwives

Why would a woman decide to give birth in a hotel? Recently, I saw a report on WGN. The midwife called 911 because the mother needed additional treatment after the birth of a healthy baby.

As a labor delivery nurse who has worked both in the hospital and the home, I have some thoughts.

In Illinois, certified nurse midwives can attend home births with a doctor backing up their practice. But most CNMs have learned the medical model of birth and practice in the hospital.

In the medical model of birth, the attendant manages the birth process, sometimes aggressively. It includes electronic fetal monitoring, induced or stimulated labor, artificial rupture of membranes, pain control with narcotics and/or epidural anesthesia. All of these interventions have some risk and may lead to more interventions.

It is illegal for a certified professional midwife to attend births in Illinois (but legal in neighboring states). CPMs learn to support normal birth through study and apprentice learning. The physiological model of birth allows labor to progress without intervention. The baby's heart rate is monitored intermittently by Doppler. The mother receives nourishment. Pain is a signal that helps direct both the mother and midwife.

Some women want a birth without interventions, and will work hard to find a midwife. Perhaps the hotel was a meeting place for midwife and client that lived a distance from each other.

The midwives in Illinois have lobbied for licensure of CPMs. Licensure would set standards for CPMs. It would ensure that the midwife was qualified to attend births.

Pediatricians are against home birth. In my experience infants had less blood sugar and temperature problems in home birth than what I saw in the hospital.

The Illinois legislature should act on licensure for CPMs.

Carol Van Der Woude

Hoffman Estates

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