Meg,CNM | Indy Week

Member since May 31, 2008




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Re: “Midwives seek autonomy in N.C.

As a CNM practicing for 28 years,15 in NC,I have followed this topic with great interest.I have attended birth in the home,birth center and hospital and my preference is in-hospital birthing center where women can birth normally but have timely access to whatever level of care they or the baby might need. Many women who are "high risk" can deliver "normally".Many women who are "low risk" need interventions.Families who desire home birth should be able to choose that option and be able to have the assistance of a licenced health care professional(CPM,CNM,MD) who can easily access other levels of consultation and care when necessary.This just seems like common sense. But even if we make home birth safer and easier by improving support systems it will not significantly address basic situations such as access to health care,economic status,poor nutrition and obesity, etc. that contribute to poor perinatal outcomes. For most women in need of health care home birth is not even on the radar scope. What saddens me beyond belief is that the majority of women who will deliver in the hospital setting are subjected to common non evidence based practices such as continuous EFM,IV fluids and oral nutrition restriction,inability to ambulate,restrictions on support people,etc that do lead to abnormal labor and further interventions.I worked with a pioneering OB 30 years ago who said" if women want to deliver at home why don't we make the hospital like home?" When reading about and talking to families comparing their home and birthing center experiences to the common L&D unit and from my personal practice in attending birth in all of these settings I can see why many prefer the out of hospital experience.We have a 25-40% C-section rate in many communities and this is an alarming statistic contributing more to perinatal morbidity and mortality than home birth practiced by trained,conscientious,licensed and regulated professionals.I have seen home birth attended by midwives with varying degrees of training and experience and would much prefer to see it practiced by individuals who must show evidence of a basic level of training to be licenced. MegCNM

Posted by Meg,CNM on 05/31/2008 at 5:54 PM

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