Those who believe midwives should practice without government interference and those who support governmental regulation of midwifery.
If you speak to a supporter of midwife autonomy, you will likely hear about the age-old tradition of midwives practicing independent of regulation. These supporters also worry about regulations keeping midwives from attending VBACs, twin and triplet births, breech births and pregnancies that exceed 42 weeks. Worries include requiring a back-up ob, midwives having to purchase malpractice insurance and phasing out direct-entry midwives, among other concerns.
I get these issues. Really, I do. As long as informed consent is practiced every step of the way, I believe a woman and her midwife should be the only ones to decide if she risks out of a homebirth. I also appreciate that midwives have traditionally practiced free of regulation and that concerns of regulation will limit, rather than expand, a midwife's ability to work with women and babies and I chose a direct-entry midwife to attend Liza's birth. So yeah. I understand the worries.
But, I am a firm supporter of governmental regulation of midwifery:
1. My home state of Mississippi has no law on the books about midwifery. Yet, every surrounding state has midwifery laws. Therefore, Mississippi has become a safe-haven for midwives with bad outcomes in other states. This is not obviously not safe for mamas or babies.
2. In Mississippi, anybody can advertise midwifery services, regardless of experience or training. Attend some births......catch some babies.....does not a midwife make.
3. As the poorest state with the worst neonatal outcomes and the lowest rates of prenatal care and breastfeeding, giving women more access to midwifery care makes a lot of sense in regards to mother friendly/baby friendly care and in regards to a financially viable way to improve healthcare to women in rural areas of the state with little to no access to ob/gyns.
4. States with birth laws in favor of midwives and homebirths have large numbers of midwives. Finding an experienced midwife with positive outcomes is a good thing but having the ability to interview multiple midwives to find an experienced midwife with positive outcomes who also meshes with your family dynamics is a great thing.
5. Currently in Mississippi, face-to-face interviews and word-of-mouth is the only way to validate a midwife's birth outcome history. The ability to log-in to a database to check for filed grievances against a midwife helps keep women and babies safe.
So, yeah. I am firmly planted in the pro-regulation camp. And, that's why I am dedicating my time and service as a board member of Mississippi Friends of Midwives.
Interested in learning more or making a donation to an important cause?
Check out www.msfriendsofmidwives.com for more details!
Are you a supporter of government regulated midwifery?
What are the birth laws like in your state?