Lawmakers Seek to Make Home Birth Midwifery Legal in Kentucky

home birth midwifery legal

The Kentucky Home Birth Coalition has been working with state lawmakers to draft legislation to allow home birth midwifery in their state.

I have many friends who have delivered their babies at home, and I have friends who have been forced by law to deliver their babies not at home, as they desired. And I have friends who had had a safe home birth with their first baby or two, but then were forced by a law change to go to a hospital for their next baby — one of these friends ended up delivering just inside the front doors of the hospital, and another friend didn’t even make it to the hospital, delivering in the back seat of the car on the way. Particularly for mothers who have had successful, safe home births before, these situations bring to light the absurdity that a law would dictate where a woman with a low-risk pregnancy can have birth.

If not for the many advocacy groups around the country, home births would likely be completely off the table of possibilities in the United States in the face of the lobbying power of conventional medicine. Advocacy groups, like the Kentucky Home Birth Coalition, not only work to protect where home birth is currently allowed but also to expand the practice to give women more choice of where to deliver.

The Kentucky Home Birth Coalition has been working with state lawmakers, Sen. Tom Buford, R-Nicholasville, and Rep. Russell Webber, R-Sheperdsville, to draft legislation to allow home birth midwifery in their state. The potential legislation was discussed December 14 in the state’s Interim Joint Committee on Health and Welfare of 2016.

The controversy began almost immediately, with opposition voiced that a midwife is not the same as a physician and that, if an emergency arose, the woman could not receive immediate emergency care as she would need to be transported to a hospital, which may not have a working relationship with the practicing midwife.

There is a widespread belief that home birth midwives are a group of uneducated women who refuse to work with the rest of the health care system and who are unqualified to know what constitutes as a safe or unsafe birth setting, when actuality, these assumptions are not at all based in fact. What is also not based in fact is the opinion that women who choose home birth are naive or rebellious against convention. Women on both sides — whether the expectant mother or the midwife — are making informed decisions.

Professionally trained midwives are required to have certain educational requirements, credentials, and scope of practice — just like any health care provider. Midwives know when a pregnancy is low-risk or not, when a labor is going smoothly or not, and whether a delivery at home is advisable or not. I know friends who were hopeful for a home birth, only to have their midwife send them to a hospital for tranverse or breech positioning, hypertension, or another early warning sign of a high-risk situation. A certified home birth midwife isn’t going to compromise her professional ethics.

I didn’t have a home birth with any of my children, because I didn’t have low-risk pregnancies. But oh, the many stories of the many friends who’ve had a home birth is enough to convince me that if I could’ve, I would’ve had my babies at home! That, and the experience of having my regular, 1-minute-apart contractions nearly stop as soon as I reached the hospital — with its sterile smell, unfamiliar rooms, and frequent check-ins by nurses I didn’t know — convince me that the comfort of home probably definitely has an advantage over hospital births for low-risk pregnancies of women who desire a home birth.

I don’t have anything against women wanting to have a hospital birth, but I do believe that women should be allowed to make an informed choice, and if it is a low-risk pregnancy and there is a qualified home birth midwife available, she should be allowed to practice home birth if an expectant mother requests to do so — and that it is unethical for obstetrics to not support this childbirth option simply on the basis of arguments that likely otherwise have a working solution, given just a little teamwork and problem-solving.

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