Midwife-attended births are at an all-time high in the US. In 2009, Certified Nurse Midwives (CNMs) attended 11.8% of vaginal births. Overall, midwives attended 8.1% of all births in the US in 2009. Between 1989 and 2002, midwife-attended births more than doubled in the US and have grown steadily since.
Midwife-attended births have better outcomes. When the Cochrane Library reviewed 11 scientific trials involving 12,276 women, no difference was found between midwife-attended hospital births and traditional hospital deliveries in terms of newborn death. It was found, however, that women who gave birth in the hospital with a midwife were:
More likely to have a spontaneous vaginal birth.
More likely to have high perceptions of control.
More likely to initiate breastfeeding.
Less likely to use analgesia or anesthesia.
Less likely to have an episiotomy.
Less likely to require forceps or vacuum extraction.
More likely to have infants requiring shorter hospital stays.
NEW MEXICO HAS HIGHEST RATE
New Mexico has the most midwife-attended births (24%) in the US. As a result, we also have one of the lowest cesarean rates. (23%). New Mexico has a rich tradition of midwifery; midwives have been protected by law since statehood in 1912. In 1963, however, New Mexico ceased granting licenses and only older traditional Pateras continued to practice.
In 1978, during a Department of Health, Environment and Social Services reorganization, an effort was initiated to outlaw traditional midwifery in New Mexico all together. Two self-taught midwives, Elizabeth Gilmore and Tish Demmin, heard about the effort from a doctor friend and organized resistance. New Mexico is a poor, rural state where midwifery is essential as all do not have access to a hospital.
Families from all over the state showed up at the public hearing that was intended to shut down traditional midwifery and rallied for a new law instead. The eventual result was that New Mexico became one of the first states to legalize what was then called “lay midwifery” and went on to demonstrate an exemplary model of care by state licensed midwives.
I served on the New Mexico State Midwifery Advisory Board with Elizabeth Gilmore in the mid-eighties at a time when the law was still controversial and we had to continue to make the case for midwifery at every public hearing.
POWER OF THE PEOPLE
Reflecting on this history and the fact that midwifery is now so well established and accepted again in New Mexico, I’m proud of the work that regular people have done. New Mexico has a good regulatory model that other states have copied and many people worked together to make this happen. We had to learn how the licensing process worked, how to present data, how to work with an adversary and how to be political, but I recommend these skills to any of you who want to improve your state midwifery legislation.
As midwifery increases in popularity, find out about your state midwifery laws. Start a Citizens for Midwifery group to work for better legislation. We did it in New Mexico. Not only do we have the highest rate of midwife-attended births in the US, but we also have the highest rate of homebirth: 10%! You can do it too!
For information on state laws for direct-entry midwives.
For grassroots organizing and advocacy tools, see Citizens for Midwifery.
For information on Certified Professional Midwives. see The National Association of Certified Professional Midwives.
For information on Certified Midwives and Certified Nurse Midwives see The American College of Nurse Midwives.
Tags: American College of Nurse Midwives. National Association of Certified Professional Midwives, Certified Nurse Midwives, Certified Professional Midwives, cesarean birth, Citizens for Midwifery, Elizabeth Gilmore, licensed midwives, Makeda Kamara, midwifery-attended births, midwives, New Mexico, New Mexico State Midwifery Advisory Board, pateras, Tish Demmin