Friday, November 28, 2008

Frequently Asked Questions about midwifery in Illinois (under development)

(Scroll down for answer)
1) Can you refer me to a midwife?
2) Are midwives legal in Illinois?
3) Didn't women used to die in childbirth/hasn't modern obstetrics made birth safer?


1) Can you refer me to a midwife for a home birth?

This, by far, is our most frequently asked question! We know that the interest in home birth, and the demand for midwifery services, is rising around the country, including in Illinois. We do not refer to midwives. We suggest you check with the Illinois Chapter of the American College of Nurse-midwives for a listing of home birth nurse-midwives. Due to their legal status, we do not distribute contact information for any direct-entry midwives.

2) Are midwives legal in Illinois?

Yes, and no. This is a complicated subject to address, in part because there are two basic types of midwives in the United States. There are nurse-midwives who almost always practice in the hospital, and professional midwives, or "direct-entry midwives" who are trained specifically for out-of-hospital  birth, such as at home, and have a much smaller scope of practice than nurse-midwives. Certified nurse-wives have authority to prescribe many medications in all 50 states. Certified Professional Midwives hold licensure* in 24 states, primarily to attend normal birth for healthy women.

*Exact term varies by state; licensure is used in a generic sense to mean recognized by the state to practice midwifery. Examples of titled used by different states include: Licensed, Registered, and Documented.

Illinois only recognizes certified nurse-midwives. Ample evidence exists supporting legal recognition of certified professional midwives.

3) Didn't women used to die in childbirth?       (or)
    Hasn't modern obstetrics made birth safer?

The single most important factor in improving childbirth outcomes is the sum of various public health improvements and changes in lifestyle. Clean drinking and sanitary waste disposal, steady food supply and vitamins, and the invention of antibiotics are responsible for the vast majority of improvement that have made childbirth safer than any procedure. And the countries which use modern obstetrics the least, have the best outcomes. 

We are grateful for obstetrics when it is necessary, but as applied today, it has gone far beyond the realm of safety net (such as it exists in Europe), and has crossed the line, ignoring a large body of evidence that babies are healthier when they experience a physiological normal birth (where the mother is undisturbed and gives birth in her own time so long as everything is progressing normally). Failure to respect physiological childbirth and allow births to unfold in their own time, has resulted in many American mothers and babies at greater risk for injury, infection and maybe even death.

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