There are over 800 licensed midwives in the State of New York — that’s more than any other state in the country. And about 10 percent of those midwives can’t practice because they don’t have a written practice agreement (WPA) with an obstetrician. When St. Vincent’s Hospital in Manhattan closed recently, seven of New York City’s 13 homebirth midwives lost their WPA’s and therefore their “permission” to practice. They are currently seeking new WPA, but many obstetricians aren’t willing to sign them.
Right now there is a bill called the Midwifery Modernization Act awaiting decision in Albany. The bill would remove the WPA requirement for New York midwives (though still provide that practicing midwives have a relationship with an obstetrician in case of emergency). Though it flew through the Assembly and Senate committees and seemed to be on the fast track to a legislative “yes,” last week the American Congress of Obstetricians and Gynecologists issued a memorandum in contest. An article in the New York Times reports that the memo “challenged the safety of midwife-attended births and suggested that the bill was a ploy to allow midwives to expand their turf and directly compete with doctors. ‘While this legislation does not intend to extend a midwife’s scope of practice, it has the ability to pave the way for midwives to open their own independent birthing centers,’ it said.” Say what? Really? And what’s so wrong with that? While New York State does not have any independent birth centers, 33 other states do — that’s over 60 percent of the country. But this isn’t just about birth centers — it’s about the fact that midwives are essentially forced to obtain permission from their self-proclaimed competitors to work. Can you imagine if — despite having earned all necessary degrees, certifications, and with requisite experience — you still had to find someone else who does what you do and get them to sign a waiver so that you could go to work?
Statistically, homebirths are as safe (if not safer) than hospital births, though they now only account for around one percent of all births in the US. With C-section and induction rates racing to staggering heights as more and more hospitals fall prey to the pressures of insurance and pharmaceutical companies, there has been a revival in the homebirth movement, one which will be swiftly squashed with misinformation like that doled out by the ACOG. Though many obstetric practices have incorporated midwives, and hospitals (like Rhinebeck’s Northern Dutchess) have distinguished their labor and delivery units as birth centers with progressive policies and more woman-centered care, the attitude towards homebirths, independent birth centers, midwives, and natural childbirth — as exhibited by the ACOG — is unfair and undeserved.
Passing of the Midwife Modernization Act would certainly change maternal (and infant) care here in New York, and would act as a huge show of faith in the efficacy of the midwifery model, which has just gotten a bad rap from big business. And big business has no place in childbirth, if you ask me.
I’ll step off my soapbox now…
For more information…
on the Midwife Modernization Act, visit the NYS Association of Licensed Midwives
on independent birth centers, visit the American Association of Birth Centers
on homebirth midwives in New York, visit www.nyhomebirth.com