Two questions that are facing our nation and our state could be connected. Should our tax dollars go to Planned Parenthood? Will Illinois certify Professional Midwives (CPMs) to provide home birth care? A number of states do recognize CPMs, but not all. In some states they can bill medicaid for home birth care.
In the United States we have three designations for midwives: Direct Entry who are apprentice trained; Certified Professional Midwives who have taken courses, are apprentice trained and certified; Certified Nurse Midwives who have completed a masters program in midwifery and almost exclusively practice in the hospital or in birth centers. Hospital birth and home birth are different and require different approaches to care. CPMs are skilled in attending home birth.
In the past I have written about my experience with home birth. After working in hospital labor delivery units for many years—beginning at Hutzel Hospital in Detroit in 1972—I made the surprising decision to sign on to a home birth practice (never thought I would do this). For four years I took weekend call as the birth nurse, attending women in labor, in their home. A doctor or a CNM came for the birth. This practice closed and attendants for home birth in Illinois are very few.
I attended 66 labors, 61 of which birth took place at home, 5 were transferred to the hospital. Through this experience my understanding of birth expanded. I was consistently attending women all the way through labor, birth and recovery.
All of the skills that I had taught as a Lamaze instructor were easier to include in the home setting. Women were more intuitive about working with their body. Interventions were fewer.
It was very important to carefully observe the progress of labor and recognize risk factors. An observant birth attendant could tell when transfer to the hospital was advisable. Unlike the hospital, where the use of medications, surgical rupture of membranes, a stationary position in bed and anesthesia pumps could set off a sudden emergency, problems became apparent gradually in the home. There was enough time to make a transfer to the hospital. Certification of professional midwives at the state level could insure that midwives had the skills necessary for home birth.
What maternity care needs is a good communicating system between home birth attendants and hospital staff. Fear of a negative reception at the hospital sometimes leads to a delay in transfer to the hospital. Receiving a home birth patient in crisis can upset hospital staff– but on the other hand they are equipped to handle emergencies. The fear of lawsuits hovers over doctors.
But we should solve this. Midwives are focused on women’s health. They have more opportunities to teach and provide hands on care for women. Doctors are often balancing a very full schedule with minimal time with the patient, I learned so much about the women I attended by seeing them in their home setting. Midwives will bring the cost of maternity care down and improve the establishment of successful breastfeeding.
Instead of putting tax dollars to work at Planned Parenthood, let’s use the money to invest in health clinics and to increase midwifery services. CNMs that primarily work in the hospital could do a rotation in home birth, learning from CPMs. CPMs could do a rotation in the hospital with CNMs. The legislature could work on tort reform and relieve doctors from the constant fear of lawsuits.
What can we do to move this forward?
- Call or e-mail your Senators and House Rep., asking them to defund Planned Parenthood.
- If you live in Illinois call or e-mail your House Rep. and ask him to support the House Bill, HB 4341.
- You may also want to visit the website of Women Speak for Themselves. Not all women think that the government should provide funding for abortion.