Why Is ACOG So Scared of Midwives?

Christie Haskell

Certified Nurse-Midwives are allowed to practice in hospitals, and often you will see them, not the obstetrician, unless there is an emergency. But there's another type of midwife, the Certified Professional Midwife (CPM), who specializes in out-of-hospital care.

Evidence shows that hospital birth isn't necessary for normal, healthy, low-risk pregnancies, and many women have home births or deliver in a birthing center. A CPM is the most-trained and ideal person to attend you during birth.

The problem is, they aren't legal in 23 states.

The American College of Obstetricians and Gynecologists (ACOG) has been the biggest obstacle for people pushing for legislation to make Certified Professional Midwives legal in all states. They often use studies that are considered "junk science," claiming that home birth or birth center births are just "trendy" or even going so far as to say that moms who choose home birth are uneducated "bad moms," says The Big Push for Midwives.

Even though 23 states don't have legal CPMs, 27 do, and they also are working to make them legal in Puerto Rico and Guam. The results in states with CPMs are nothing but good, so there isn't much of a leg to stand on in trying to keep them illegal in other states.

Whether you think home births are safe or not, one thing stands true: Some women are going to birth out of the hospital no matter what kind of assistants are available to them. By depriving them of trained, skilled professionals, you aren't stopping their choice, you're making their choice less safe.

Having a CPM attend your birth comes with a major benefit to taxpayers and states as well -- lower c-section rates, and lower complications result in big savings. Washington reported a savings of $2.7 million after just 2 years of use of CPMs. The Department of Health also found that over 87 percent of the time, transfer to a hospital is not required for moms or babies birthing outside the hospital with constant one-on-one care from a CPM. The majority of transfers to hospitals also weren't emergencies, but were mainly maternal exhaustion. Overall, these women and babies receive lower rates of costly medical interventions -- less electronic fetal monitoring, fewer episiotomies, lower rates of vacuum extraction and c-section -- with the end result comparable to those of low-risk hospital births.

Yes, there is always going to be the exception. Hospitals are important and needed for some births, but not all. In fact, it's common that the reason a woman was in distress in the first place is directly related to the hospital environment. If anyone is worried about possible complications, realize that CPMs know, just like your hospital nurse, when things just aren't going right, and they call the hospital ahead of time to let them know what's going on, so by the time you get there, they're ready. Generally speaking, it takes just as much time for them to prepare whether you're at the hospital to start or not.

So the Big Push for Midwives has a major thumbs up from me. I had originally searched for a midwife or birthing center with my daughter, but hit obstacle after obstacle and finally gave up ... a choice that ended up leaving me with a very traumatic birth. So I definitely understand the importance of availability of midwives, TRAINED midwives, for birthing centers or hospitals, and I fully support them.

I just wish everyone would, especially you, ACOG.

Do you think CPMs should be made legal in all states?


Image via Andrea Salcedo

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