Many pregnant women in New York City recently lost access to legal home birth.
New York City! The epicenter of finance, art, entertainment, commerce and culture. MY city. The place, just five months ago, that I gave birth to my daughter at home.
To practice in New York, home birth midwives are required to obtain a written practice agreement (WPA) from a physician willing to back them in the event of complication. Many of NYC’s midwives that attend the 600 homebirths in NYC each year obtained their WPA from a doctor at St. Vincent’s Hospital Manhattan, which closed earlier this month.
The midwives of the estimated 50 women planning to home birth in the coming weeks have a choice: risk losing their license or abandon the woman in their care.
This has me wondering why, and who benefits from the loss of legal home birth?
And if this is happening in NYC, a global city known for dictating trends, what does this mean for women all over the United States? The world?
Currently, 14 states, plus the District of Columbia, authorize midwifery practice without a required written practice agreement: Alaska, Arizona, Connecticut, Idaho, Iowa, Maine, Minnesota, New Hampshire, New Mexico, Oregon, Rhode Island, Washington, Wyoming, and New Jersey (pending). (1)
This means in 36 states in this country, highly educated and licensed woman’s health care providers, with thousands of hours of collective experience, are either required to have a doctor’s permission to treat their patients, or are only legally allowed to practice in hospitals.
Recently proposed legislation was defeated in Alabama last month whose aim was to establish a State Board of Midwifery, licensing lay midwives who currently assist the homebirthing women of the state. Similar legislation is currently in debate in Ohio.
In Illinois, progress (!!) was made weeks ago when the Homebirth Safety Act passed the House committee, bringing midwives in IL one step closer to the licensed care of birthing women.
And yet in New York, the Midwifery Modernization Act proposes to eliminate the written practice agreement completely.
In these times of dramatically rising rates of cesarean section, maternal death, and low infant birth weight, women need access to the midwifery model of care, which is shown to significantly lower risk of obstetric interventions and adverse outcomes (including augmentation of labor, electronic fetal monitoring, epidural analgesia, assisted vaginal delivery, cesarean section, hemorrhage, and infection). (2)
What pregnant women don’t need, is to be an afterthought in the battle for control, placed in order of importance after malpractice insurance costs and increasing profits.
I am sure the doctors and hospitals that refused to issue temporary WPAs to midwives in NYC over the last weeks would feign regard for patient safety as a reason. I suspect it has at least a little to do with eliminating competition and a fear of lawsuits. For if patient safety were truly a consideration, would they not enable women in the final weeks of pregnancy to remain with their care provider?
While there is no law prohibiting home birth, there is also no specific law in place protecting it.
A good place to start protecting our midwives and ourselves is by seeking a community, (like Bring Birth Home!) that truly supports birthing women and their right to make rational, informed, un-coerced choices HOWEVER they choose to birth.
Email, call…even better, VISIT legislators in support of bills that would eliminate Written Practice Agreements and establish State Boards of Midwifery in states without license. In fact, as soon as I finish writing this up, my home birthed baby and I are off to meet our state Assemblyman.
We DO make an impact; during the wake of the St. Vincent’s closing, Choices in Childbirth reported the Health Department in NY had never received more calls regarding one issue!
Most importantly, keep telling the stories to anyone that will listen.
Our beautiful homebirth stories, the stars of which shine a brand-new-to-the-world little light on the legal issues surrounding homebirth.
For more information on how you can help in the states mentioned above, visit: