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Monday
Nov152010

Illinois' Home Birth Safety Act (SB 3712)

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By Jill—Unnecesarean

 

The Home Birth Safety Act is likely to be called to the floor on Wednesday, November 17, 2010, according to Illinois Families for Midwifery.

 

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:

Click to enlarge 

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.

 

 

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  • Response
    Thanks to the Unnecessarean for pointing out that the Illinois Home Birth Safety Act (SB 3712) is most likely being called to the floor Wednesday - tomorrow! We've had four home births here in Illinois, and we may (believe it or not) have more children someday, so this bill directly affects ...

Reader Comments (26)

"However, if an emergency occurs, it happens very fast — in two, three, four minutes.”

Ergo, for God's sake, don't let mothers make their own informed decisions about where/how to birth their own babies!

November 16, 2010 | Unregistered CommenterKK

I think I am at a point where I don't think legislation is going to "fix" anything or make it "safer". Proof of this is the pointed exclusion of lay midwives from the discussion. I don't know that midwives becoming more "political" is really going to help women have more choices. It may create the appearance of choice for some while greatly decreasing the choices for others. An example of this is the exclusion of primary VBACs. So mothers who haven't had a cesarean and want to birth at home think this is the greatest law ever, support it, get it passed. Now moms who want a HBAC are prevented from accessing homebirth care because the registered midwives aren't allowed to attend them. Further, if these moms seeks care from an unregistered midwife or birth unassisted, they are potentially at greater risk for having their child removed from their home because they are now outside a stated law.

My point, is that common sense cannot be regulated. Having a baby at home is common sense.

November 16, 2010 | Unregistered CommenterVanessa Manz

Can somebody use the same exact wording about midwives hurting women and their babies by giving them drugs and turn it around for OBs? Because god knows it's the truth. I read it that way in my head and it was fantastic!

November 16, 2010 | Unregistered CommenterCaitlin

"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"

I'm sorry, but how is taking a history "medical in nature"? And the prenatal care that I received at the ob office could have been taught in a weekend to any person with half a brain (weight check, blood pressure, etc.) Talk about control freaks!

November 16, 2010 | Unregistered CommenterSara

Vanessa, I see what you're saying but I think this can be an important step. If I understand correctly, currently ALL homebirth in IL is technically illegal. What is that MLK, jr quote? "It may be true that the law cannot make a man love me, but it can keep him from lynching me, and I think that's pretty important." So, yes, the law won't make these anti-homebirth groups embrace it and use common sense, but it can start the ball rolling and hopefully access will only increase with time. Maybe there are some awesome midwives who would be open to starting a homebirth practice if it became a legal option. Maybe there are mothers who would consider homebirth if it was legal.

Well, good luck to IL. That insulting alarmist language on the 'grassroots' site is really something. Did some PR dude get paid the big bucks to come up with that?

November 16, 2010 | Unregistered CommenterAnother Rachel

After all, in the end it's all about power and control.

November 16, 2010 | Unregistered CommenterHeather

Holy cow, the "dangerous drugs" being considered for use are oxygen, IV fluids (lactated Ringer's = water with electrolytes), and methergen and pitocin for emergency postpartum hemorrhage. No one would blink if a paramedic gave these things to a woman transporting to a hospital. Also vitamin K and Rhogam. Wow.

The bill does exclude first time home VBACs:

[The CPM must consult with a doctor for:]
10 (T) History of any prior uterine incision. A woman
11 who has had a previous low transverse cesarean section
12 (LTCS) with a subsequent vaginal birth may be
13 considered for home birth. A woman with a prior LTCS
14 and no subsequent vaginal birth after cesarean or other
15 uterine surgeries, may be managed antepartally with
16 consultation, but will be transferred to the
17 consultant's care for delivery.

Also must consult with a physician (but not necessarily refer for delivery) with breech babies:

18 (U) Lie other than vertex at term.

And twins:

19 (V) Multiple gestation.

Heather, could you please be more specific? Who is trying to dominate and control whom?

November 16, 2010 | Registered CommenterJill

Another Rachel,

You shouldn't say that "all homebirth is technically illegal." For anyone to represent herself as a midwife and assist at a homebirth is illegal. It isn't illegal for a mother to give birth on her own. Not saying this is advisable, but it is what I eventually did.

In general,
As someone whose first baby was delivered by C section, I would have been excluded by this new law. And now there are a lot more women in this situation than ever before. But is that really a good reason to oppose the law? I think getting people used to the idea of non medical midwives and home birth would over time change attitudes enough for further changes to be possible.

And it would still be possible for women who do not want to be limited by this law to operate in the same way they have been doing. At least I think it would. If it wouldn't, someone explain why.

It seems odd to me that a window is left open for home breech delivery, but not for a first VBAC. The skill of the practitioner doesn't make all that much difference to the integrity of the uterine incision, as long as one isn't stressing it with labor augmentation. (Am I wrong about this?) But it makes a great difference with breech birth. In practice thought, the way things are now, the woman with a breech is just going to be told she has to come in and have a section.

I think it would be a good think on the whole if this law passes.

Susan Peterson

November 16, 2010 | Unregistered CommenterSusan Peterson
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