Midwives seek state license for home births

Alliance fights for qualified midwives, study shows home births are increasing.

Jennifer Hall had both of her children at home using a midwife. Katie, 4, and Daniel, 17 months. This photo was shot where she gave birth to Daniel in his nursery in their Fairborn house.

Jim Witmer/Dayton Daily News Jennifer Hall had both of her children at home using a midwife. Katie, 4, and Daniel, 17 months. This photo was shot where she gave birth to Daniel in his nursery in their Fairborn house.

ENLARGE PHOTO

Jim Witmer/Staff photo Midwives Devon Horsman(L) and April Kline meet to plan lobbying efforts to have licensing in Ohio for their profession.

ENLARGE PHOTO

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By Meredith Moss, Staff Writer Updated 6:58 AM Tuesday, July 6, 2010

An increasing number of women are opting to deliver babies at home, but the practice is unregulated in Ohio because the state doesn’t license home midwives.

In May, under the banners of Ohio Families for Safe Birth and Ohio Midwives Alliance, 40 men, women and children from the Miami Valley joined with 300 others to rally at the Ohio State House and meet with legislators to push for a bill that would license and recognize Certified Professional Midwives. Twenty-six states now recognize that credential.

“We’re trying to make sure a consumer has access to qualified midwives to help them in their home birth,” said Devon Horsman of Kettering, a certified professional midwife who serves as legislative chair for the Ohio Midwives Alliance.

A report released in March by the National Center for Health Statistics studying two-year periods show there was a 3.5 percent increase in the number of home births from 2003-04 to 2005-06 in the U.S. In Ohio, 1,888 babies were born at home from 2005-2006.

Dayton physician Evangeline Andarsio, a delegate for the Ohio State Medical Association, said her organization would have to review any potential legislation before taking a stand on the issue “but would most likely be opposed to the legislation to license midwives in Ohio.”

“It’s safest for the health of the mother and the baby to be in a medical facility with immediate access to qualified medical professionals equipped with lifesaving medical equipment,” she said.

Horsman cites a 2005 study published in the British Journal of Medicine that found out-of-hospital births to be as safe for low-risk women as a hospital birth when attended by a qualified midwife.

Jennifer Hall of Fairborn was born at home 29 years ago and has carried on that tradition with her two children. She said her own research convinced her there would be less intervention and less likelihood of a Caesarian section at home.

Pregnant women wishing to gain information about a home birth option and those who are qualified to perform it will have a harder time finding what they’re looking for in the state of Ohio.

National statistics show that a greater number of women are having babies at home, but the practice is unregulated in Ohio because the state doesn’t license home midwives.

The only midwives currently recognized by the state are Certified Nurse Midwives who attend nursing schools and collaborate with physicians and hospitals.

According to the National Center for Health Statistics, 95 percent of midwife deliveries in Ohio in 2006 occurred in hospitals.

Finding an experienced midwife for her first child’s birth was easy for Jennifer Hall.

She and her husband were living in New Mexico at the time, so they just opened the phone book and looked under “midwives.” They found and interviewed someone they liked and ultimately had a positive home birthing experience.

It wasn’t that simple the next time around when the family was living in Fairborn.

“Around here, you had to know the right people in order to find a good midwife,” Hall explained. “It was about finding a friend who knew a friend. And because in this state we don’t have licensure, you don’t really know what you’re getting into, and it’s really hard to determine if someone has the level of experience you want.”

That level of experience is offered, she said, by a Certified Professional Midwife who has received both educational and clinical training in an out-of-hospital setting in keeping with the standards of the North American Registry of Midwives (NARM).

Devon Horsman of Kettering has those credentials and now serves as chair for the Ohio Midwives Alliance. The group is actively seeking sponsors for a bill that will recognize the CPM designation.

“Home births are happening, it’s not something people are seeking permission to do,” Horsman said. “We believe that nationally the tide is moving in this direction, more than half the states now recognize Certified Professional Midwives and the number of families having their babies at home has been increasing significantly.”

Across the nation 49,438 babies were born at home in 2005 and 2006 combined. In Ohio, 1,888 were born at home in the same two-year time period.

The reasons families want to give birth at home, Horsman said, may be religious, cultural or economic. The cost of a midwife in the Miami Valley may range from $1,500 to $2,000 and includes prenatal visits, the birth itself and follow-up checkups. The fees are not covered by insurance.

“I really think that people want to know what all their options are and then make the decision that’s best for their family,” Horsman said.

The American Medical Association and the Ohio State Medical Association are among the organizations that take issue with the idea of licensure for midwives in a home setting. They do support Certified Nurse Midwives who work in collaboration with an obstetrician in a hospital.

Jeff Smith, director of government relations for the Ohio State Medical Association, said obstetricians have specific education, residency requirements, training and experience that prepare them for a delivery of a baby in every type of situation.

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