“I`ve spoken to several [women] who would rather give birth at home without anyone than be forced to go to the hospital without the support they need,” said Kaycee Cavender, ABC`s director of strategic initiatives. Currently, Alabama`s 15 licensed midwives serve 41 of Alabama`s 67 counties, according to ALMA data. Many of those counties are rural and lack obstetric services, Reeder said. What if we changed our minds? Childbirth works best when the mother feels safe and comfortable. For some, the place where they feel safest is the hospital. If at some point you decide you want to change your plans for a home birth or if you are not comfortable with my care, I want you to feel free to make the choice that works best for you. I hope that if you are not satisfied with my care, you will tell me so that we can sort things out. If we can`t agree, the North American Registry of Midwives has a complaint process that you can contact. (For more information, please contact the North American Registry of Midwives, 5257 Rosestone Drive, Lilburn, GA 30047. Or call 888-842-4784.) Birmingham`s Chandler Harris gave birth to her daughter at home earlier this month, accompanied by one of these newly licensed midwives. She said she never considered a home birth with a midwife until she learned early last year that Alabama had legalized the practice. In 1976, the Alabama legislature quietly amended the law governing the practice of midwives. Their changes made nurse midwives the only legally recognized midwives in the state.
Until 1984, all existing midwives who cared for families in their communities and homes could not renew their licenses and were forced to retire by the state. However, the Ministry of Health, the agency responsible for ending midwifery, then referred mothers to local midwives in parts of the state, leaving families and midwives unaware of this change in the law. They continue to give birth at home or visit moms at home. Until the state started arresting midwives. Is home birth safe? A number of studies show the safety of home birth for low-risk women and a healthy pregnancy. The New England Journal of Medicine published a study in December 2015 showing that there is no increased risk for low-risk mothers giving birth at home than if they were in hospital. The Journal of Midwifery and Women`s Health published a study based on data from the Midwives Alliance of North America Statistics Project showing that home births are a valid option for women. This companion article explains how the data was collected.
The British Medical Journal published a study showing a lower incidence of home birth procedures with certified professional midwives. Here is a link to a list of medical literature showing the safety of home birth. Another great resource for understanding the data and why doctors and nurses choose to give birth at home is the film Why Not Home. The Why Not Home discussion guide is also very helpful. Rebekah Myrick, left, a certified professional midwife, stands with members of the new Alabama State Council of Midwives after being approved for a midwifery license. Alabama issued midwifery licenses on Jan. 18, 2019, after a 2017 state law legalized the practice of licensed lay midwives. Last January, the state`s Department of Midwives granted Alabama`s first home midwifery licenses since 1976. This month, Alabama authorized 15 home-delivered midwives, according to ALMA. Alabama last granted a midwifery license in 1976. Since then, it has been illegal to practice midwives without a license, effectively banning lay midwives in the state. Alabama women could choose to give birth at home, but births could not legally be accompanied by a midwife or other professional.
It`s a dramatization that comes home for many pregnant women across the country, as hospitals rampant and families have to make tough decisions. I am not sure, but I read somewhere that a midwife was arrested for assisting in a home birth. “I told my husband, and honestly, he looked at me like I was crazy,” said Harris, who gave birth in the hospital with her firstborn. “But he did his research and realized that if you`re low-risk and healthy, home can be just as safe as a hospital. So we thought, let`s try it. While CPM practices from home, certified nurse midwives in Alabama operate exclusively in hospitals. And although they have never been banned from working in the state, they are prohibited from running independent private practices without a cooperation agreement with a doctor. I wonder what would happen if you (or someone) “accidentally” had a baby at home? I don`t know how they could punish you for not going to the hospital. I don`t like it at all. This seems to make miscarriages illegal/punishable. Less than half of the state`s 67 counties have provider hospitals, and only 17 of the 54 rural counties have hospitals that provide obstetric services. However, there are no stand-alone birth centres – facilities that provide a family environment and are separate from hospitals where CPMs, NJCs and doctors can manage care, often with the help of a doula.
Who can give birth at home with your office? In short, low-risk women carrying a single baby upside down with no pre-existing or current complications or history of caesarean section. Pregnancy is a normal physiological process and most pregnant women can have a healthy pregnancy without complications. Midwives use antenatal care to continually assess and assess risk status. Many risks can be reduced or avoided by a good diet and a healthy lifestyle. Women who have any of the following conditions would not be good candidates for home birth: insulin-dependent diabetes, severe preeclampsia, chronic high blood pressure, gestational diabetes, which requires medication to control, and premature birth. “Being able to come home and serve these women and do what I want to do is my passion and my calling from God is amazing,” Myrick said. Nine newly licensed midwives gave birth to 98 babies in 26 Alabama counties last year, according to data compiled this month by the Alabama Midwives Alliance (ALMA), a group representing professional midwives at home. Today, mothers who choose to give birth outside of the hospital must cross state borders to legally give birth with a midwife, find a midwife willing to risk prosecution by helping them at home, or give birth at home without assistance.
The state claims that the law protects mothers and babies. The Alabama Birth Coalition and parents affected by this misguided law disagree vehemently. In the coming weeks, we`ll be publishing articles about how parents are affected by Alabama`s Midwifery Act. We need to make that clear. Our campaign is not about home births, but about access to medical care in all areas. The fact that inhibitions of home birth are illegal is just one symptom of a much larger problem. Here are some of the measures that make it a reality. Our dominant standard of maternity care has given a caesarean section rate of 36.1%, with rates ranging from 18.9% to 67.2% depending on the hospital where you give birth. Caesarean section significantly increases the risks for mothers – three times the risk of maternal death – as well as for babies and future pregnancies. Evidence supports a caesarean section rate of 15-20%. Our standard of care resulted in an infant mortality rate of 9.2, higher than any state except Mississippi.
Evidence suggests that 74 percent of women who offered vaginal delivery after a C-section will succeed, but the Alabama standard of care gave a VBAC rate of just 3.3 percent. The Alabama standard of care offers parents no birthing centers and only 20 licensed nurse midwives statewide, two options that significantly reduce the risk of C-section and other unnecessary procedures. Only about half of licensed licensees are allowed to participate in births. According to a health and human services report, Alabama practices NJCs in the worst work environment in all 50 states. In hospitals, it is common for Alabama mothers without medical indication to experience artificial induction or intensification of labor, electronic fetal monitoring, restriction of diet and alcohol consumption during labor, or pushing into past positions.