An article in the New York Times on September 23, 2010, covered Illinois’ struggle to legalize home birth midwives.
The bill’s supporters say it toughens standards and protects pregnant women and fetuses from untrained practitioners, while allowing qualified midwives to practice openly and to transport emergency cases to hospitals without fear of reprisal or arrest. (Women often register home births as “unassisted” to protect their midwives.)
State Representative Robyn Gabel, Democrat of Evanston, is the bill’s chief sponsor. “It’s an uphill battle in the House,” Ms. Gabel said.
That the bill has made it this far is testament to the midwifery community’s newfound political acumen and its first lobbyist, hired by the Coalition for Illinois Midwifery in 2006.
The bill’s opponents, including the American College of Obstetrics and Gynecology, the Illinois State Medical Society and the American Medical Association, argue that home births are inherently more dangerous than births in medically supervised settings. Also resisting the bill, though more quietly, are members of rural midwifery groups that have operated under the radar and off the grid for years, and would prefer to remain that way.
“We just don’t think home is a safe environment for delivery,” said Dr. Jacques Abramowicz, co-director of the Fetal and Neonatal Medicine Center at Rush University Medical Center and a Fellow of the American College of Obstetrics and Gynecology. “Childbirth is very dynamic, and it can be a very dangerous process. In the vast majority of cases, nothing happens. However, if an emergency occurs, it happens very fast — in two, three, four minutes.”
The article also cites wanting to avoid a cesarean as a reason that some women opt for home birth. Rush University Medical Center’s cesarean rate in 2008 was 43.4%.
The senate bill has not gone unnoticed by the Illinois State Medical Society, whose “Grassroots Action Center” posted the following dramatic web alert:
Opposition to Licensure of Midwives
DANGEROUS MIDWIVES BILL WILL LIKELY BE CALLED IN NEXT WEEK’S VETO SESSION
A PHONE CALL TO YOUR STATE REPRESENTATIVE TODAY IS CRITICAL TO STOPPING THIS BILL!
House Floor Amendment 1 (HFA1) to Senate Bill 3712 (SB 3712 would license midwives and allow them to provide unsupervised home birthing services.
THIS IS AN EXTREMELY DANGEROUS BILL AND MUST BE STOPPED!
HFA1 to SB 3712 is an extremely dangerous bill that would allow the least trained individuals to independently provide one of the most critical services to Illinois women.
These midwives are significantly different from certified nurse midwives. Certified midwives do not consider obstetrical care medical; nor do they consider themselves medical providers. Yet HFA 1 to SB 3712 would allow these midwives to take histories, perform physicals, provide prenatal care, dispense drugs, treat hemorrhages and other emergencies, and treat the infant and woman postpartum. All of these responsibilities are medical in nature and should only be performed by the professionals who are adequately trained to do so.
Under HFA 1 to SB 3712 , midwives would be able to dispense and administer drugs. Yet, the bill only requires midwives to complete minimal training in pharmacology. Their assumption that this prepares them to prescribe dangerous drugs will prove to be life threatening to some mothers and their babies.
The majority of a midwife’s training is an apprenticeship program that only requires that a candidate attend a certain number of home births with a preceptor – someone already “recognized” as a midwife. Proposals for licensure require only that individuals receive minimal education in science and first aid, be credentialed as a certified midwife and be in good standing with the North American Registry of Midwives.
PLEASE CLICK ON THE “TAKE ACTION” BUTTON BELOW TO CONTACT YOUR STATE REPRESENTATIVE (LISTED BELOW) IMMEDIATELY AND URGE A “NO!” VOTE ON HFA1 TO SB 3712!
Other critics of the Home Birth Safety Act are concerned that the bill excludes primary VBACs from the home birth midwifery scope of practice and that the bill will change nothing for women who have had a previous cesarean and wish to give birth at home.