I recently found a fantastic website called The Mommy Blawg that chronicles the intersection of mommyhood and the law. Her latest post discusses recent midwifery legislation in Alabama, Idaho, Maryland, Missouri, New Hampshire, North Carolina, Ohio, and South Dakota.
She links to another great website: “The Big Push For Midwives, launched on January 24, is a coordinated campaign to advocate for regulation and licensure of Certified Professional Midwives (CPMs) in all 50 states and the District of Columbia. The website includes a page with links to news articles related to midwifery-related legislative efforts, and a map of states [which I've copied below] where licensure is available or where legislation is pending. Licensure is currently available to CPMs in 22 states.”
There is also a page on The Big Push for Midwives website that lists birth resources for the following states: Alabama, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Maine, Michigan, Missouri, Nebraska, Nevada, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Dakota, West Virginia, and Wyoming. (Might be a good place to look if you want a VBAC and are looking for a VBAC supportive provider.)
The relevance of CPM licensure to VBAC moms? More legal options.
No state prosecutes mothers for giving birth outside of a hospital. However, midwives who assist at such births may be prosecuted in some areas.
In the early and mid 1900s, physicians pushed to have midwifery banned throughout the United States. Childbirth became very clinical with the mother generally subdued with leather straps and ether. In 37 states it is once again legal to acquire the services of a midwife. Many midwives continue to attend mothers in states where it is illegal, while efforts are underway to change the law.
Practicing as a direct-entry midwife is still (as of May 2006) illegal under certain circumstances in Washington, D.C. and the following states: Alabama, Georgia, Hawaii, Illinois, Indiana, Iowa, Kentucky, Maryland, Missouri, North Carolina, South Dakota and Wyoming. However, Certified Nurse Midwives can legally practice in these areas.
People wishing to have a midwife-assisted home birth in the United States should always research the applicable laws in their home state.
I know homebirth sounds like a radical thing, but I have heard story after story of women who would have never considered a homebirth until they started looking for a VBAC supportive OB only to find none and then felt trapped, out of options, and scared. And so now these women, who would have been quite happy to birth in a hospital, are hiring midwives, regardless of wether it’s legal in their state, and having a homebirth VBAC rather than face the alternative, an unwanted, unnecessary repeat cesarean in a ‘VBAC ban’ hospital.
I hope this is going to be one of the factors that swings the conventional wisdom back to supporting VBAC because when enough women start birthing at home and that an impact is felt in hospital revenues, hospital administrators and OBs might start paying attention. Unfortunately, by the time that happens, it might be ‘to late’ for the hospitals. Enough women would have experienced the joy, peace, privacy, and safety of homebirth to never want a hospital birth again.