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-   -   Petition for Safer Home Birth (https://www.mothering.com/forum/20-homebirth/1498154-petition-safer-home-birth.html)

pillowy 04-06-2015 01:42 PM

Petition for Safer Home Birth
 
Hi everyone! I haven't been around in a while, but I just saw this shared on Facebook and I think it's a really great thing. It's a petition to state legislators to help make home birth safer and to standardize midwifery laws across the states: https://www.change.org/p/state-legis...me-birth-safer

It includes things like requiring midwives to have malpractice insurance, which I know from my friend's experience is really important to cover unexpected medical expenses for home birth families.

Anyway, I wanted to share it because I thought it was great!

pixieprincss 04-06-2015 10:48 PM

I'm sorry that your friend had a scary experience. While I am glad that this petition brings you peace, I want to share a different perspective. I've seen this language before and it was used to try to prevent CPMs from practicing in favor of only allowing CNMs (who often practice very differently). The phrasing about getting rid of NARM is a particular red flag about the aims of this petition. Why does CPM vs. CNM matter? In my state, for example, a CNM can only work under the supervision of an OB and not with their own autonomy. While that doesn't have to mean a different style of care, it certainly can. The homebirth CNMs in my area practice very differently than CPMS. For example, not allowing water birth. Additionally, the cost of carrying malpractice could very well make CPM midwife fees even more daunting than what they are now, which is frequently 100% out-of-pocket for anyone who doesn't have out-of-network insurance benefits. Right now, phrasing almost identical to what is in this link is being used to try to shut down an emerging bill in Maryland that would finally expand the extremely limited birth rights that these women have. While CNM home births are allowed in MD, almost none offer this service, which means home birth is not a true option. Expanding to allow CPMs, who are ready and waiting both in MD as well as neighboring DC and VA, will actually allow people to legally live out what should be a basic right.

funfunkyfantastic 04-10-2015 08:43 PM

@pixieprincss I didn't see the language that pointed to only allowing certified nurse midwives. Could you quote it for me? I'm curious now. There aren't very many CNMs in my area, in fact there are only 2 that practice who do homebirths, and I live near a major city. Most CNMs in my area only do hospital births. The majority of midwives in my state are just CMs or CPMs. Most go to the midwifery school in Seattle, which from what I hear has rather strict guidelines to finish the program. Two of the 3 midwives I see are Naturopathic midwives, which I see as a bit of a bonus, because not only are they Naturopathic doctors, but they have gone through the midwifery program as well. I sure hope what they're trying to pass doesn't take away from the great midwifery care we have in my state. There are so many midwives here that it was rather hard to choose one. I'd rather have the multitude of midwives I have to choose from now than having only 2 options (one of which I rather disliked... she was my midwife last time.)

Jenabear 04-11-2015 05:02 PM

I think the first sentence of this petition was a red flag for me being, "despite the increased risk of morbidity and mortality at out-of-hospital births" as that's not true. Below is an excerpt from an article by Chris Kresser - full story here. I suspect that petition is the medical system's attempt to try and capitalize on the situation by putting home birthing into their realm of control.

Quote:

Another myth bites the dust: hospital birth is not safer than home birth

In the Netherlands, where 1/3 of babies born at home under care of midwife, outcomes for first babies are equivalent to those of babies born to low-risk women in the hospital, and outcomes of second or subsequent babies are even better.

A UK analysis found that birth at home or in small family practice units is safer than birth in an obstetric hospital for mothers and babies in all categories of risk.

Other studies have shown that modern obstetric interventions have made birth more dangerous, not safer.

In fact, in terms of outcomes for mothers & babies, studies show that planned home birth has perinatal mortality levels (the numbers of babies dying around the time of birth) at least as good as – and often better than – hospital figures, with lower rates of complications and interventions.

A landmark study by Johnson and Daviss in 2005 examined over 5,000 U.S. and Canadian women intending to deliver at home under midwife. They found equivalent perinatal mortality to hospital birth, but with rates of intervention that were up to ten times lower, compared with low-risk women birthing in a hospital. The rates of induction, IV drip, episiotomy, and forceps were each less than 10% at home, and only 3.7% of women required a cesarean (c-section).

Other studies have shown that women who plan home birth have around a 70-80% chance of giving birth without intervention. And because of low use of drugs, home-born babies are more alert and in better condition than those born in the hospital.

Contrast this with the 2002 and 2006 Listening to Mothers surveys which examined 3,000 births in conventional settings. They found “virtually no natural childbirth” in either survey.

Other studies have shown that women who plan home birth have around a 70-80% chance of giving birth without intervention. And because of low use of drugs, home-born babies are more alert and in better condition than those born in the hospital.

Contrast this with the 2002 and 2006 Listening to Mothers surveys which examined 3,000 births in conventional settings. They found “virtually no natural childbirth” in either survey.

A landmark study by Johnson and Daviss in 2005 examined over 5,000 U.S. and Canadian women intending to deliver at home under midwife. They found equivalent perinatal mortality to hospital birth, but with rates of intervention that were up to ten times lower, compared with low-risk women birthing in a hospital. The rates of induction, IV drip, episiotomy, and forceps were each less than 10% at home, and only 3.7% of women required a cesarean (c-section).

In the 2006 survey, around 50% of women were artificially induced; almost 75% had an epidural; and 33% gave birth by c-section.

Finally, in a review of the safety of home birth by the esteemed Cochrane collaboration, the study author states:

There is no strong evidence to favour either home or hospital birth for selected low-risk pregnant women. In countries where it is possible to establish a home birth service backed up by a modern hospital system, all low-risk women should be offered the possibility of considering a planned home birth…

I agree with the author’s conclusion that hospital birth is no safer than home birth. But if you consider the statistics above which suggest that having a natural, undisturbed birth in a hospital setting is exceedingly difficult, I would argue that there is strong evidence to favor a home birth.

moregreenforlessgreen 05-28-2015 11:22 PM

Quote:

Originally Posted by funfunkyfantastic (Post 18667106)
@pixieprincss I didn't see the language that pointed to only allowing certified nurse midwives.

This is what Point 2 is all about. AAP and ACOG don't support CPMs just CNMs. The dis about NARM in the last sentence of that point is a direct attack on CPMs (see coordinating footnote).


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