I am so discouraged by the beliefs of some of my fellow midwifery students. Many of them do not believe in homebirths, VBAC’s, non-nurse midwives (such as CM’s or CPM’s), or other non-interventional childbirth. They think all births should occur in a hospital with sophisticated monitoring equipment and capabilities. What in the world are they doing in midwifery then?
One of the discussions in class led to the topic of litigation. The things coming out of some of their mouths were just repetitious dogma of ACOG and malpractice insurers. Some were saying how risky VBAC’s are, others saying so many things can go wrong at home. There were some actually accusing CM’s and CPM’s of not having a scope of practice and over stepping their boundaries by practicing medicine. Huh?
I posed the question of perception. Has the risk of uterine rupture increased with VBAC recently? No. Well, let me answer that with yes. It will increase when women who are VBAC-ing are given misoprostil. Here’s a thought: don’t give women misoprostil. Don’t mess with their labor. Again, what has changed that suddenly makes VBAC’s the devil’s labor?
The "things can go wrong at home" argument just doesn’t fly with me for reasons to not homebirth. Sure, put a high risk mother (for instance a woman with preeclampsia) in her home to labor and birth and you are asking for trouble. Put a low risk, healthy mom in her home to labor and birth and most of the time you will see a wonderful event. On the flip side, put a low risk woman in a hospital to labor and birth and watch the intervention rate sky rocket and her chance for a c-section at 30% (or higher depending on the hospital).
The other thing that bothered me was the misunderstanding of what non-nurse midwives are capable of. They are trained, skilled labor attendants. They are taught to watch for signs of possible trouble, and know their limitations (sound familiar? So do CNM’s!) and when to refer. I had no idea that there was such animosity towards what is commonly called “lay” midwives. And for the record, I don’t like the term “lay”. It doesn’t give the general public the right perception of who they are and the training and certification they have received. It makes them sound like they are a group of hippie women with armpit hair and hemp necklaces who decided to birth some babies out in a field.