The Truth About The Home Birth Safety Act

The Truth about HB 226 The Home Birth Safety Act A publication of the Coalition for Illinois Midwifery

INTRODUCTION: Each year, 800 - 1000 Illinois women, including some from the Amish, Latin Mass Catholic, Orthodox Jewish, and other communities, choose to have a home birth for deeply-felt reasons. In most states, a licensed midwife could assist in these home births, but it is illegal in Illinois to assist in a home birth unless a midwife is also a nurse and practices with a physician. Thus, only about 4 of Illinois' 102 counties have a licensed home birth provider, and even in those counties, the demand for homebirth far surpasses the number of providers. As a result, an underground industry of unlicensed midwives currently serves Illinois mothers creating an unsafe situation. HB 226 would license certified professional midwives, as 26 other states already do, to regulate this market and protect Illinois moms who choose home birth, and their babies. Over the past few months the Illinois State Medical Society (ISMS), and other sub-specialty private physician professional groups, distributed materials that we believe misrepresent the facts about HB 226 and about the midwives who would be licensed for home birth by HB 226. These Physicians groups offer many false criticisms but absolutely no viable solution. What is their answer to the home birth crisis that Illinois women must face every day? This document was produced to set the record straight about our solution, HB 226, the Midwifery Licensure Act.

Claim

"These midwives are significantly different from certified nurse midwives."

The Facts

In terms of providing care beyond maternity care, yes. But when it comes to providing maternity care throughout prenatal, intrapartum and postpartum period, CPMs have nearly identical training to nurse-midwives with special attention paid to out-of-hospital techniques. This training along with the required additional background education has received the approval of the ISAPN and INA.

Claim

ISMS supports the collaborative relationship that currently exists between physicians and certified nurse-midwives."

The Facts

Illinois OB/GYNs support only the inclusion of the provision requiring written collaboration, not the real-life practice of providing homebirth collaborative care. As a group, they do NOT support homebirth or homebirth providers, including homebirth nurse-midwives, in spite of the statute requiring that nurse-midwives secure written and signed agreement with a physician. Nationally, ACOG has officially turned its back on the home birth population, stating, “Although ACOG acknowledges a woman's right to make informed decisions regarding her delivery, ACOG does not support programs or individuals that advocate for or who provide out-of-hospital births.” (American College of Obstetricians and Gynecologists Executive Board. (2006). "ACOG Statement of Policy on Out of Hospital Births in The United States". October 2006. www.acog.org)

Coalition for Illinois MIdwifery

Truth About HB 226, pg. 2

Claim

"Midwives are asking to ‘prescribe dangerous drugs.’”

The Facts

There is absolutely no prescriptive authority in this bill. Licensed midwives will be allowed to carry and dispense only a tiny number of medications, and only as strictly regulated in the statute. The medications section in the bill was written in collaboration with the Illinois Society for Advanced Practice Nursing.

Claim

“These midwives will not be prepared to deal with emergencies.”

The Facts

As loving parents, we strongly agree licensed midwives should be prepared to deal with emergencies. That is why HB 226 would only license nationally certified midwives whose training includes continuous hands-on, one-on-one care throughout labor to anticipate potential problems and help prevent them or deal with them as they emerge. National rates of emergency transfer of care during labor or right after the birth, for Certified Professional Midwives, were only 3%, and good outcomes were achieved in the majority of instances. The fact is CPMs are trained in the same way as nurse-midwives to identify complications and call for transport. CPMs are educated to carry oxygen and drugs for possible hemorrhage just like nurse-midwives, and are also trained in CPR and Neonatal resuscitation including use of oxygen, just like nurse-midwives (often attending these specialty classes taught by the American Academy of Pediatrics and American Heart Association instructors, together with nurse-midwives.)

Claim

"Passing HB 226 bill is comparable to ... lowering the standards for a licensed obstetrician.”

The Facts

Licensed midwives would NOT be practicing obstetrics but professional midwifery -- an entirely different profession for which licensed midwives under the statute would be fully prepared. Licensed midwives would not perform hundreds of complicated medical procedures (like surgical treatment for fibroids, screening for breast cancer or prescribing literally hundreds and hundreds of truly dangerous drugs) for which OB/GYNs must be prepared. Physicians and nurse midwives almost uniformly DO NOT attend homebirth. Far too often it is neighbors, church ladies and friends who deliver babies at home in Illinois. Passing HB 226 bill is not about lowering standards; it will increase current “standards” from the the level of a neighbor, friend or church lady to a nationally certified, welltrained midwife who could could legally practice in 26 other states.

Coalition for Illinois MIdwifery

Claim The Facts

Truth About HB 226, pg. 3

"Substituting under-trained, unsupervised individuals for physicians and advance practice nurses increases the risk to mother and child." This would only be true of doctors and advanced practice nurses were actually attending home birth. They are not -- in Illinois, nor anywhere in the country, with very few individual exceptions. In fact more than 80% of Illinois has NEVER had licensed home birth providers. The truth is that HB 226 will “substitute” nationally certified, highly skilled individuals for uncertified women calling themselves midwives, friends, grandmothers and church ladies (who are not MDs, APNs or CPMs). This will immediately increase the safety for mother and child.

Claim

“These midwives just see 40 births and then get ‘certified’.”

The Facts

During her education, a student CPM observes hundreds of births. First as a labor support person during dozens of births. Then, the student CPM moves on to the role of assistant midwife. Finally, after a year or two, having observed hundreds of pre- and post-natal exams and births, and advancing in her education thoroughly enough to qualify, does the student CPM begin to assume primary care (but still supervised). It is this in this role as “primary midwife” during which the 75 prenatal exams, 40 births, 40 post partum maternal exams, and 40 newborn exam requirements are met, after which the student CPM qualifies to sit the 8 hour national board exam. This is nearly identical to the number of births and prenatal exams required for nursemidwives and family practice physicians.

Illinois home birth mothers and babies deserve licensed midwives who practice with transparency, oversight and accountability. Vote YES on HB 226. Contact Colette Bernhard !773" 504-8442 or Vicki Johnson !815" 262-2235 for more information.