Advice on states that allow HBAC

[howeberry]

I'm wondering if anyone knows where to locate a list of states that allow HBAC, if such a list exists.

We'll be TTC in about a year or so, and DH & I are entertaining the idea of leaving NJ for someplace with more space and less hustle-bustle/keeping up with the Jones' feel. It's just too darn stressful here! Primary places we're thinking is WA (where I grew up), CO, or MT. Maybe VT, NH, ME or MA, although less likely. In the end, it depends on where DH can find work. He currently has a great job in Princeton, NJ, so relocating closer to his office is also likely, but that doesn't help with the desire for less stress.

For a little background: My baby boy was born by C-Section in December for water leaking. My membranes ruptured due to failed Castro Oil induction, three days later my midwives insisted on a medical induction (12 hours of Cervidil, followed by 10 hours of Pit) which failed to efface and/or dilate. After no progress, I was out of options.

I'd LOVE the opportunity to home birth. It's honestly something I've wanted to do since I learned it could be done 10 years ago. With my first/last pregnancy I failed to do enough research in the beginning and wrongly believed my OB would let me have a natural birth. (Afterall, it would be in MY best interest, right?) I switched to a midwifery practice at 36 weeks and hoped for a HB. I blame my inevitable C-section on my OB's lack of nutritional counseling.

To get to the point, it is illegal in NJ to HBAC. They will let you try for a VBAC in a hospital, and where I live, the options really aren't bad for this. If we do end up moving out of state, I'd love to find one that meets this little requirement of mine.

Thanks for listening and any advice you may have to offer!

[LisaSedai]

Well it's illegal here in Alabama to regular (not even VBAC) home birth with a midwife but I've heard there are underground midwives who will attend home births, you just have to find them clandestinely. Maybe a post in the tribes area or birth professionals area could give you more information or checking out the ICAN website to see if there are chapters in the states you are thinking of moving to.

Good luck!!.

[akind1]

I think anywhere out west - CO, WA, etc may be more homebirth, and possibly HBAC, friendly. I know SC (not on your list!) is not HBAC friendly at all, though thankfully CPM's are legal here, VBAC mamas aren't considered low enough risk for them to attend at home. NC only recognizes CNM's and the majority of those practice out of hospital based practices. . . there are CPM's, etc in NC but they have to practice under the radar so to speak.

I agree, check out Finding Your Tribe, and maybe the ICAN site. It says something that my state doesn't even have an active ICAN chapter.

[AlexisT]

States I know about:

It's not illegal in NY, but not all midwives will do it. Maybe this has increased since the abolition of mandatory practice agreements.

It is not illegal in PA, but I do not know of a single CNM in the state who has a practice agreement permitting HBAC. CPMs are not licensed. Some will do it. Some will not. Apparently, the midwives in my area are more conservative than outsiders expect after hearing about how much the Amish/Mennonite community prefers to home birth; I've heard of women in this area who had difficulty finding a midwife to take them, though perhaps there were complications to their case they didn't mention.

WA does not outlaw HBAC exactly. It's not covered by the state malpractice pool and Medicaid won't pay for it; I don't know if it creates additional complications for LMs who do it. But as a result, many Washington LMs will not do HBAC.

FL does not outlaw HBAC but requires the LM to consult with an OB for sign off and you can be risked out for other things.

[ablepearl]

It is not illegal in ANY state in the U.S. to HBAC, even in NJ.  It is though, illegal for a licensed midwife to attend your HBAC in NJ and other states where it is seen as illegal.  In some states DOCTORS can attend a VBAC, but the MW can't.  If you stay in NJ there is a great group of midwives that attend VBAC patients at a hospital in Trenton.  The hospital is kind of 'eh' but the midwives are really great and have an awesome success rate.

You can also consider hiring a traveling midwife to come to you and allow you to HBAC.  I wanted to do this, but we live in AK now and it is too expensive since you normally have to pay the airfare too.  I would say join the ICAN yahoo list and contact the ICAN chapters in the areas you are considering moving to so you can get more info on the birth climate there.

[Right of Passage]

Like it's been said it's not illegal to birth where you want, what's illegal is you choosing the attendant you want.

I'm in CO, I've HBAC'd(UBAC'd). You can find the VBAC information on page 15 http://www.dora.state.co.us/midwives/Rules.pdf  On  

[AlexisT]

Originally Posted by ablepearl 

It is not illegal in ANY state in the U.S. to HBAC, even in NJ.  It is though, illegal for a licensed midwife to attend your HBAC in NJ and other states where it is seen as illegal.  In some states DOCTORS can attend a VBAC, but the MW can't.  If you stay in NJ there is a great group of midwives that attend VBAC patients at a hospital in Trenton.  The hospital is kind of 'eh' but the midwives are really great and have an awesome success rate.

You can also consider hiring a traveling midwife to come to you and allow you to HBAC.  I wanted to do this, but we live in AK now and it is too expensive since you normally have to pay the airfare too.  I would say join the ICAN yahoo list and contact the ICAN chapters in the areas you are considering moving to so you can get more info on the birth climate there.

Legally (AIUI) they would still be bound by the state's laws where the birth took place and would be taking the same risk as a local midwife who chose to break the law. Her chances of getting caught are lower, but it's a risk she may or may not be willing to take on.

[howeberry]

Very clever wording..

Originally Posted by Right of Passage 

it's not illegal to birth where you want, what's illegal is you choosing the attendant you want.

I tried reaching out to my local ICAN group here and got no response. If we do pick up and move I'll post in the Tribes forum specific to where we'll be relocating. Thought it'd be better to post here first.

Remembering a convo with my midwives, it sounded like they would attend a HBAC in PA, but I'm not interested in moving to birth there. It's interesting what you say about WA, AlexisT, I can't help be amused by the restrictions without outright banning it. And from what I've read, CO is pretty relaxed about them.

Where ever we end up, I'd be interested in a CNM, but that's just my preference.

Thank you all for the incite.

[dlm194]

Originally Posted by howeberry 

I tried reaching out to my local ICAN group here and got no response. If we do pick up and move I'll post in the Tribes forum specific to where we'll be relocating. Thought it'd be better to post here first.

Remembering a convo with my midwives, it sounded like they would attend a HBAC in PA, but I'm not interested in moving to birth there. It's interesting what you say about WA, AlexisT, I can't help be amused by the restrictions without outright banning it. And from what I've read, CO is pretty relaxed about them.

Where ever we end up, I'd be interested in a CNM, but that's just my preference.

Thank you all for the incite.

I'm not sure who you contacted but the Morris leader was out of the country for a while.  However, Greater Essex, Someset and Monmouth all have available leaders.  You could try emailing any of them and you should get a response.  Finding an CNM for an HBAC is probably going to be difficult.  Most homebirth midwives are CPMs and the few CNMs that attend homebirths also have hospital privileges that they cannot risk. 

I guess a traveling midwife would be subject to the same laws as the state where she is attending but what can that state do to her if they don't hold her license?  Midwives who do not follow the laws of the state can have their licenses revoked but that doesn't mean they lose their skills.  I don't think NJ could revoke the license of a midwife in another state. 

I'm not trying to convince you to stay in NJ (I'm not from NJ either) but if you moved near Princeton, there are a lot more rural options.  North Jersey scares me!  Much too crowded.  LOL!

[roadfamily6now]

Originally Posted by ablepearl 

It is not illegal in ANY state in the U.S. to HBAC, even in NJ.  It is though, illegal for a licensed midwife to attend your HBAC in NJ and other states where it is seen as illegal.  In some states DOCTORS can attend a VBAC, but the MW can't.  If you stay in NJ there is a great group of midwives that attend VBAC patients at a hospital in Trenton.  The hospital is kind of 'eh' but the midwives are really great and have an awesome success rate.

You can also consider hiring a traveling midwife to come to you and allow you to HBAC.  I wanted to do this, but we live in AK now and it is too expensive since you normally have to pay the airfare too.  I would say join the ICAN yahoo list and contact the ICAN chapters in the areas you are considering moving to so you can get more info on the birth climate there.

I was going to say the same thing. You can have a homebirth ANYWHERE you want. It's not illegal.  But the regulations on Midwives in the states vary.

I too live in Alaska.