Restrictive Laws on Home births


#1

I was researching home births and midwifery. It appears, generally, that our culture is becoming more accepting of homebirths. I noticed that my state has one of the most restrictive set of laws against home births. It is prohibited by
statute, judicial interpretation, stricture and practice. Midwifery is also strictly prohibited.

Are there posters who have input on working with the legal system to birth at home? Obviously this isn’t an immediate issue for me :stuck_out_tongue: but I found it to be sad information.


#2

Midwifery is illegal in your state?! That’s really sad. I had no idea that it could even be prohibited – how in the world could anyone possibly come up with a good reason to make it illegal??

I was born in CA almost twenty years ago, at home, with the assistance of a midwife. All of my siblings have been born with the assistance of midwives in Texas. There haven’t been any legal issues at all that I know of, though insurance doesn’t necessarily like midwives.


#3

Missouri?


#4

From Wikipedia:

"No state prosecutes mothers for giving birth outside of a hospital. However, midwives who assist at such births may be prosecuted in some areas.

In the early and mid 1900s, physicians pushed to have midwifery banned throughout the United States. Childbirth became very clinical with the mother generally subdued with leather straps and ether. In 37 states it is once again legal to acquire the services of a midwife. Many midwives continue to attend mothers in states where it is illegal, while efforts are underway to change the law.

Practicing as a direct-entry midwife is still (as of May 2006) illegal under certain circumstances in Washington, D.C. and the following states: Alabama, Georgia, Hawaii, Illinois, Indiana, Iowa, Kentucky, Maryland, Missouri, North Carolina, South Dakota and Wyoming.[12] However, Certified Nurse Midwives can legally practice in these areas.

People wishing to have a midwife-assisted home birth in the United States should always research the applicable laws in their home state."

This means you can have a homebirth with a midwife attending, but it has to be a medically trained midwife, such as a nurse-midwife, as opposed to a doula.


#5

In Missouri direct entry midwives (“lay midwives”) are illegal. Nurse midwives can practice, but must have a doctor present AT ALL TIMES. As a result, homebirths here are attended by “underground” midwives willing to risk fines and/or jail to help parents. There is one birth center, in Columbia, MO, staffed by 2 nurse midwives and a family practitioner, who admits that her mandated presence at all prenatal appts. and births is ridiculous and seriously hinders the practice. There was bill introduced that would have allowed lay midwives to practice, but of course the medical lobby is blocking it (I’m not sure the status of the bill at this time). The only other option you have if you want a home birth is to find an Ob that will do it (a friend of mine actually did, but she ended up miscarrying :frowning: ). It makes me so mad! This same group (the ob/gyns) are claiming that they are concerned for the mothers and children, that midwives aren’t “safe”, yet they are all for giving mothers the “choice” to abort their unborn children :mad: You wanna kill your baby by abortion? Fine, they consider that part of good “reproductive medicine”, even in abortion clinics that are less regulated than vets offices, but you wish to decide where, how and w/ who you want to give birth? Then they start looking out for the “health and safety” of the mother and child. Yeah, right :rolleyes: It’s all about money. Sigh. This state is so incredibly backwards about so many things.

In Christ,

Ellen


#6

Well, God willing, perhaps no children will come along until we complete med school. :thumbsup:


#7

I live in KY, where it’s not necessarily illegal to birth at home…the state just no longer licenses “lay midwives” (I hate that term. Most CPM (certified professional midwives) have gone through extensive training and a rigorous selection process. “Lay” makes it sound like they woke up one day and decided to catch babies). The state doesn’t allow anyone who isn’t “licensed” to practice medicine…thus, CPMs are illegal. CNMs are, as far as I know, allowed to do homebirths…at least, ours did :thumbsup:

That being said, I know a BUNCH of CPMs right here in Lexington who catch babies all the time. It’s one of those “if everything goes ok, we won’t prosecute, but if someone decides to complain, we’ll prosecute for practicing medicine without a license.” Annoying.


#8

Nurse midwives can practice, but must have a doctor present AT ALL TIMES.

Just to claify…
CNMs are Advanced Practice Nurses and are not required to be under direct supervision of a physician but are in Collaborative Practice Arrangements. Non-nurse midwives must have a physician present.

Home births are legal but may not be attended my non-nurse midwives.


#9

wyoming has outlawed midwifery. very sad, considering that esther morris championed the right to vote for women in wyoming and she was a midwife. most couples/moms who want to have a home birth come to montana. i tried a home birth, but darn baby girl decided to come breech!


#10

from my midwives website:

mountainmidwives.com/Wyoming.htm
Since then, and without informing any of the midwives, the Medical Board persuaded the legislature to remove the midwives’ exemption - entirely - from the Medical Practices Act. This leaves no law addressing midwifery. In other states, such as South Dakota, which similarly have no midwifery law, midwives are prosecuted and sent to jail for practicing medicine.

Wyoming families must continue to educate their communities and their legislators about the safety and need for home birth attended by competent and licensed midwives. As it stands now, there is no accountability for the very few midwives who practice in Wyoming. This is dangerous for the mothers, the babies and the midwives.


#11

Hi Autumn. Did you read the 2 part report in the Post Dispatch a few weeks ago about midwives in MO? The CNM’s from Columbia (the one’s w/ the birth center) stated that the dr. had to be present at all the prenatal appts, and had to physically be the one that “caught” the babies at delivery, so the CNM’s had to work around her schedule (I can’t remember the doc’s name, she was a family practitioner, though, and had her own practice outside of helping the midwives). The “lay” midwives in the report were completely underground, and faced prosecution if caught. It didn’t indicate that they were allowed to practice at all, w/ or w/o a doctor.

Either way, I really hope that bill passes. “Feminists” and pro family people have united in favor of it, it’s just the ob/gyn lobby that’s opposed to it and trying to block it.

In Christ,

Ellen


#12

Hi Autumn. Did you read the 2 part report in the Post Dispatch a few weeks ago about midwives in MO? The CNM’s from Columbia (the one’s w/ the birth center) stated that the dr. had to be present at all the prenatal appts, and had to physically be the one that “caught” the babies at delivery, so the CNM’s had to work around her schedule (I can’t remember the doc’s name, she was a family practitioner, though, and had her own practice outside of helping the midwives). The “lay” midwives in the report were completely underground, and faced prosecution if caught. It didn’t indicate that they were allowed to practice at all, w/ or w/o a doctor.

Hi Ellen! Those were not CNMs.

It’s also the only place where non-nurse midwives can legally care for women. The reason: The center’s director is a family physician who must oversee the midwives’ nearly every move Source

CNMs do not require direct supervision per the APN Rule, which I think I have it memorized :whacky:.


#13

Wikipedia has a nice treatent about this topic. However, remember that Wikipedia should not be considered a completely reliable source.

en.wikipedia.org/wiki/Midwifery


#14

that the dr. had to be present at all the prenatal appts

Silly. That is a slap in the face to non-nurse midwives. NPs can see prenatal patients without supervision.


#15

So how come we don’t have them in Missouri? And what’s the difference b/t the midwives at the birth center and the “underground” ones? Are they the same, and the ones at the birth center are just choosing to follow (the incredibly restrictive ridulous) law? I’m totally confused now (whoda thunk it? :whacky: ).

That brings up another question (the thread about paying child care workers “under the table” made me think of this): As a Catholic, in Missouri, would it be immoral to use an “underground” lay midwife, since it’s against the law?

In Christ,

Ellen


#16

So how come we don’t have them in Missouri?

Our law is too restrictive.

And what’s the difference b/t the midwives at the birth center and the “underground” ones? Are they the same, and the ones at the birth center are just choosing to follow (the incredibly restrictive ridulous) law?

I believe you are correct. The midwives at the center and those underground are “direct-entry” midwives (DEM), which includes Certified Professional Midwife (CPW), Certified Midwife, lay midwife , and Licensed Midwife (LM). The ones at the center are CPMs.

MO is not midwife friendly. There are only 92 CNMs, which may be related in part to the lack of acceptance by physicians. As a MO APRN familiar with the challenges and struggles of MO APRNs, I can imagine what DEMs are facing.

As a Catholic, in Missouri, would it be immoral to use an “underground” lay midwife, since it’s against the law?

Good question.

Too bad we don’t have a birth center in STL.


#17

Quote:
As a Catholic, in Missouri, would it be immoral to use an “underground” lay midwife, since it’s against the law?

Does anyone know where I can find an answer to this question?
I read in the Catechism that breaking the law would be allowable if it otherwise is “contrary to the demands of moral order.”

I’ve had one c/s, 3 home VBAC’s and then one hospital VBAC due to a the baby having a heart defect. Now I am expecting a healthy baby, but the state no longer allows VBAC’s at home. I am so disappointed. I am full of “I want” but I promised God “thy will be done” so if it is immoral to use an illegal midwife I won’t. I will be very disappointed though. I think I have justification because the prenatal and postpartum care is much more thorough with my midwife. She knows way more about natural birth than my OB, but my OB knows way more about complicated births. (He does all the triplets and quads in town.) I had no problem trusting him with my problem child, but frankly I bore him with my normality. He forgot about me in just 3 weeks.

Sorry for the life story, birth gets my tongue wagging. I need to decide before my next appointment, so if there is another forum that would know the morality of this question, I would appreciate it.

The issues on my side are: 1. better healthcare for mom and baby, 2. I’m not breaking the law, the midwife is, and 3. the law is in a study committee to be changed, but the new law wouldn’t go into effect until a year after the baby is born.

Thanks!
Evelyn (and this is my first post)


#18

Hey Evelyn! Welcome to Catholic Answers! I recommend the parenting forum. The link is at the top of the family forum page. It is very active and I think you’ll find the resources and support you are looking for.:slight_smile:


#19

back when I was pregnant with #2 and hoping for VBAC, i first went with a well-regarded midwifery practice in my area. When I was about 18 weeks along, the head midwife came to me in tears and told me that they couldn’t be my caregivers, that the hospital where they had privileges had decided that Midwives could not oversee VBAC births. Reason? The hospital policy dictated that any VBAC birth needed to have an OB on call, just in case…and the OBs didn’t like hanging around waiting for a birth they might not be needed for (translation: not get paid for!). :mad: I was so mad that I determined to never deliver at that hospital.

I eventually found an excellent OB with a 90% VBAC success rate…and delivered my next two babies with him, in a hospital, with great success. :thumbsup:

That said, i have a good friend who is a nurse, who has had all three of her girls at home. Even a 10 pounder :eek: ! She has a midwife at each one. She is in Virginia, where the laws are iffy…midwifery is not illegal, but it is not “legal”, either. :shrug:


#20

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