By Kirsten Scharnberg
...in Missouri, where the Kerr baby was born in a carefully planned home birth, the experienced midwife hired to oversee the delivery was committing a Class C felony.
Even as midwifery grows increasingly popular nationwide, with an estimated 40,000 babies born outside hospitals last year, a handful of states remain severely restrictive of the profession. In nine states, including Illinois, Iowa and Indiana, some forms of midwifery are illegal, though not a felony. Missouri, the only state where midwives can be charged as felons, has long been the most hostile to the practice of midwifery, though hundreds of families like the Kerrs rely on an underground network of midwives who quietly operate outside the law.
At issue for states distrustful of midwifery is the credentialing and training of the midwives delivering babies, particularly in home births like the Kerrs'. "Lay midwives," unlicensed practitioners whose training usually consists of self-study and who have no state or national certification, are allowed to practice in a few places in America. Missouri and the nine other states go further, outlawing "certified professional midwives," practitioners who are nationally certified through the Midwives Registry in a highly selective process that takes three to five years of study, including one year of clinic practice and an eight-hour written exam.
All 50 states allow "certified nurse-midwives" to practice. These are midwives who are registered nurses, or nurse practitioners, who work under the supervision of doctors, almost always in a hospital. Millions of babies -- more than 300,000 per year in recent years, according to the American College of Nurse Midwives -- have been born in hospitals under the direction of these nurse-midwives.
But midwife-assisted home births are the ones that spark much heated debate. The American College of Obstetricians and Gynecologists has said it "strongly opposes" home births. Opponents of midwifery often point to hazards that can accompany childbirth, such as a compressed umbilical cord or the need for an emergency Caesarean delivery. They often cite statistics that complications arise in up to 1 in 10 births.
Despite the illegality of having babies at home with a midwife's help, a significant number of women in Missouri are doing it anyway, a reality that mirrors the growing popularity of home births nationwide.
She said many women choose home births with midwives to limit hospital pressure to use drugs for pain or to have a Caesarean; to have a more intimate, controlled and personal birth; or due to religious beliefs that keep them away from hospitals.
"The bottom line is that there is no more important or personal experience than giving birth," she said. "We believe we should have the right to choose to do that in the way that's best for us."
"If something goes wrong in the hospital, the attitude from everyone is, 'Oh, that's so sad, but sometimes tragedies do occur with childbirth,'" said Ivy White, a Missouri midwife. "But if something happens during a home birth, the attitude is, 'What were you thinking to try to do this on your own? How could you have been so irresponsible about the life of your child?'"
Midwifery advocates often cite what they see as the biggest irony of anti-midwife laws like the one in Missouri: that a good Samaritan who helps a woman deliver her baby on the side of a road or in a taxi cab is not subject to prosecution, but that a trained midwife who helps a woman carefully plan her out-of-hospital birth is. In one high-profile Missouri case, sheriff's deputies who had gotten word of a delivery by a midwife raided the home shortly after the healthy baby was born, confiscating bloody sheets and a video of the birth as evidence.
I can think of few women's issues more important than our health care. And for many of us, when, how, and if we give birth is central to that health care. The continued resistance to not only birth control in the sense of our controlling IF we have children, but HOW we have them, is only one more example of a largely white male establishment knowing better what is good for us, than we ourselves.
In the face of stories like this one, I can only ask once more, what is so threatening? Why is it so hard for people in general to "think outside the box"?