Can anyone point me to a resource online or even just advise here regarding the laws about home birthing in MD? My hubby and his ex did a home birth 10 years ago in MD and I see so many mama's here talking about it, yet a friend nurse at Upper Chesapeake in Bel Air just told me they are illegal in MD. What is the truth?
Home Birthing Laws in MD?
I had a home birth in 09. As far as I know, it's perfectly legal with a CNM but not with a CPM or LM. I think MD doesn't have a state license for CPM or LM's and that's why? Not sure about that part. My midwife practice is based in VA but does MD births too. There's also Evelyn Mulhan (sp?) who is a CNM I think and has a practice based in MD, and that's legal from what I know.
Oh, and I don't think the actual HB is the illegal part - it's the provider illegally providing services, I think. So you're not in trouble, the MW is, if they're not practicing legally.
Ay yi yi! IT annoys me when people spread stupid myths! I too was also told by my sorta-Bradley teacher that HB was illegal in MD! And she, as a childbirth educator, REALLY is someone who ought to have known better!!!!!!!!!!!!
Yes - exactly, it is ALWAYS LEGAL FOR YOU - you can give birth wherever you darn well please! It is the MW who would be in trouble if she is unlicensed. ("Practicing nursing without a license" is the crime.) Only CNMs (nurse midwives) are legal to practice midwifery (anywhere) in Maryland. Evelyn Mulhan is, I'm fairly certain, the only CNM who would attend HBs in Harford county.
Direct entry MWs (CPMs) are illegal in Maryland. You can google CPM and find sites with this data. Some states have no policy at all -either way- regarding them, so they are "alegal", whereas they are perfectly legal in other states, and outright illegal in others. It's so stupid! Karen Webster is a CPM and actually licensed (totally legal) in Virginia, but she is illegal here in MD.
Now, at first I was freaked about the idea of using some illegal, underground, renegade midwife! Ha! Seemed odd to me. But the more I learned about maternity care in America, the more comfortable I became. Reading the book, 'Born in the USA" really helped. Karen Webster's illegal status in Maryland is absolutely no reflection whatsoever on her actual competence, skill, and education as an exceptional maternity care provider! On the contrary, I respect her practice of 'civil disobedience' to do what she feels is right & continue to provide this great service to us MD women!
Also, the climate in the state matters greatly. There have been witch-hunts at times in other states. And there have been some parents harassed by child protective services (i.e. you are "endangering" your child by using an illegal MW.) But thankfully none of that is going on in Maryland right now. As a matter of fact, Karen Webster doesn't even bother to "hide"- she has that public website up!
AND... most importantly... if you needed to transfer, Upper Ches would be your transfer hospital anyway and at least 2 of the CNMs there are very friendly to HB - and have considered becoming HB MWs themselves! I'm currently seeing them for a small degree of 'back-up' care. They know Karen Webster & they are totally supportive! (Although they told me some of the docs might give them a hard time, so they didn't put it down in my file, that's all.)
Feel free to PM me for more details. You're also likely to meet other HB mamas at the Harford County Birthing circle. The 1st meeting had several women who were clients of KW and several who had been clients of KC (who prefers anonymity). So you can ask more Qs of others who've BTDT.
But if you believe you don't need to be in a hospital, I wouldn't let the Maryland laws give you any reason to hesitate pursuing HB. As a matter of fact, if you're considering it, call KW ASAP! She only takes, I believe, 6 births per month & she does fill up & have to turn people away. It doesn't hurt to go chat with her & see how you & your DH feel. (She really is fantastic!!)
I had my son at Upper Ches, & it was a decent experience, but in hindsight I do think I ought to have just started out with HB in the first place. (Probably would have if I'd learned more earlier.) There was simply no reason to have gone to the hospital. & I hated being stuck there 48 hours! (Was GBS+, no time for antibiotics, & that was policy. I decided not to fight & try to leave "AMA".)
There are also other great reasons for a first-timer to HB - there was a great thread on that maybe a month ago on "birth & beyond" I could dig up if you like. For one thing, first-timers take longer to labor & birth, & hospitals aren't generally very patient with longer durations, making it particularly advantageous for a first-timer to be at home!
Everything that MegBoz said but also wanted to add:
You're probably also going to hear a lot of nonsense about pregnant women being required by law to do any range of procedures from fetal heart tone checks in labor to screening for STDs. These are also crazy myths meant to frighten you into compliance, there are no such laws requiring you to do anything you don't want to do. Now, there are some MWs out there (even HB MWs!) who don't seem to mind if their personal standard of practice is confused for law. It's simply another wonderful reason to know your rights and be crystal clear on what you want and expect from your maternity care provider.
For more options in MWs, perhaps you could check out PA as well? I don't know anything about HB in PA, just throwing the idea out there.
As stated above, homebirth is 100% legal in Maryland, but only Certified Nurse Midwives may legally attend homebirths here. I don't belive that other types of midwives have been prosecuted here in years (decades?), though, and there are lobbying groups working to bring those caregivers into the legal fold. So the climate for CPMs is not too bad right now.
My midwife used to be a CNM but let her certification lapse because the state she used to live in (California) didn't distinguish between CNMs and CPMs in any meaningful way. Since moving to Maryland, she's been in the process of recertifying as a CNM. I don't know whether that's complete or not, but she lives in Cockeysville and I'm pretty sure she serves Harford County. She's told me her CNM certification will be official "soon" (I know she passed the exam), which is great for me because my insurance only covers homebirth with a CNM. Otherwise, I wouldn't care.
I haven't given birth yet, but she's been absolutely wonderful so far. PM me if you want her name and contact info!
(I don't want to publically post her name without her express permission, given her pending status change.)
It is the fundamental right of any parent to birth where you choose. Birth in the woods, birth in your tub, birth in your car, birth on the moon! :) Oh, and that hospital place too, if you must. :)
Maryland is behind the times. We are one of ten states that actually say it is outright illegal to practice homebirth midwifery unless the midwife is certified by the ACNM as a CNM. Well, fortunately, our CPMs who have been around for many, many years have not been deterred by this ridiculous law. CPMs still practice here and they will continue to do so. It is our hope that one day the legislation will be changed to regulate CPMs as many other states already do including our neighboring state Virginia and above us, Pennsylvania isn't expressly legal but it isn't illegal either. In Pennsylvania, the courts there ruled that the Board of Physicians (why them who knows as they have no right to decide what midwifery laws state) are to write regulations for the many CPMs working in PA and have been for decades!!
One day, Maryland will get with it but not without the consumer voice. You the parent must act and help with groups trying to educate about CPMs and hopefully one day have litigation to push through and pass to legalize our CPMs, too.
Visit www.MarylandMidwives.com for more info.
I don't know whether that's complete or not, but she lives in Cockeysville and I'm pretty sure she serves Harford County. She's told me her CNM certification will be official "soon" (I know she passed the exam), which is great for me because my insurance only covers homebirth with a CNM. Otherwise, I wouldn't care.
Oh, that's where I live...that is so exciting! Does she do well-woman exams? My insurance randomly assigned me an ob/gyn but I don't want to go to anyone but a MW if I can help it. Plus, the baby-making bug is hitting me hard right now and how wonderful to have a MW so close...my midwives when I had our son were an hour away (though absolutely worth it -- they exceeded my expectations in every way possible).
Actually, midwives do not have to be CNMs. In Maryland, only CNMs have legal status but we have CPMs and lay midwives here and in every state in the United States despite the laws. The laws need to change to give more women access to the care they are seeking, but homebirth midwives certainly do not have to be CNMs.
Yup - and you can usually even get insurance coverage for CPMs despite their "illegal" status in Maryland! Not only am I getting coverage for Karen Webster, CPM - I have an "exception" letter to get coverage at the in-network rate! :D
Check with your insurance! Do not assume anything!
Even if you have BCBS- there are 10 bazillion BCBS plans and they are all different.
My BCBS plan covers homebirth but ONLY with CNMs. And they have an explicit "no gap exception" policy for homebirth with out-of-network CNMs or CPMs. So I'm getting partial out-of-network coverage for my out-of-network CNM. Better than nothing.
(My one ultrasound was with an in-network radiologist, though, so that was covered 100% despite being ordered by a CPM. If I had any labs, it would be the same situation.)
I went to see KW and you're right, she rocks! Loved her. Anyway, hubby and I are struggling with the idea of KW's costs and potentially doing the "abbreviated care" with SOG and their global care costs. Double costs? Ouchie. Anyway...how did you manage that? And how did you get the exception letter? Feel free to PM me instead of replying to this thread if you like.