An article was published in the St. Louis Post-Dispatch about midwives, which are illegal in Missouri. Well, in a way.
After almost 20 years of legislative debate, midwifery was legalized in Missouri last summer, when Sen. John Loudon, R-Chesterfield, inserted a vague clause into a larger bill. A circuit county judge, however, ruled that legislative procedures were not followed and struck down the law, which has been sent to the Missouri Supreme Court on appeal.What form would this licensure take? This article is pushing midwifery as a "health freedom" and "female empowerment" issue, but by using a midwife rather than a doctor you're essentially allowing someone with no medical training to perform medicine. No license can fix that.
Whatever the outcome, midwife advocates and doctors promise another showdown this legislative session over a more comprehensive bill that would license and regulate midwives.
Now that the necessity has lifted, when everyone can have access to a trained doctor in a hospital, why does this practice continue?
Midwifery is a tradition that goes back centuries, whereby women support each other through pregnancy, birth and early infancy. Much of that tradition was born out of necessity, when there were few doctors and even fewer hospitals.
A few statistics on the sidebar of the article provide a bit of evidence about the safety of midwife births relative to hospital births. For instance, "Infant death rate was 1.7 per 1,000, consistent with low-risk births at hospitals." Is this the low-risk death rate or the overall death rate? And how does a midwife assess risk, given that they monitored the fetal heart rate in less than ten percent of cases?
Medical intervention rates for planned home births with midwives were consistently less than those of low-risk births in hospital.I should hope so! Again, midwives have no formal medical training. Yet despite this fact, they perform episiotomies and C-sections in 2.1 and 3.7 percent of cases, respectively. That's surgery!
And why is it a virtue to minimize intervention? I would much rather have a professional intervene in the birth of my child if it was recommended to me than to refuse that intervention or, worse yet, never have it recommended in the first place.
While 99 percent of all births in the U.S. occur in hospitals, states need to recognize that some parents are going to choose home birth, said Katie Prown, a midwife advocate who helped draft legislation that legalized midwifery in Wisconsin and Virginia. "So what can we do to make it safe?"Either train the midwives in actual medicine or incentivize real doctors to perform home births.
Doctors say a system already exists for women to have a home birth in Missouri and Illinois: Midwives with a nursing degrees. But non-nurse midwives say they only want training in pregnancy and home birth, not nursing degrees with hospital training.Tough. You've got to walk before you can run, and basic medicine will, hopefully, give you the skills you need to keep patients alive.
My favorite quote comes from a doctor, who doesn't buy the "freedome of choice" argument.
While there are few other options for non-hospital births, direct-entry [aka untrained, non-nursing-or-medical degreed] midwives shouldn't be allowed to practice just so that a mother can have a child at home, said Goldman, an obstetrician for the past 33 years.I guess sometimes empowerment and the myth of "natural births" trump the safety of a newborn child.
"So what should we do? Dumb down the process so you have a choice?" he said. "What about the fetus' choice?"
- Thanks to Bing at Happy Jihad's House of Pancakes for the link. He's got a lot more there about this story and others related to it.