General Question

Minute_And_A_Huff's avatar

Should midwifery be legal?

Asked by Minute_And_A_Huff (588points) September 4th, 2010

Time magazine has an article on the movement to legalize midwifery. What are your thoughts on it? For it? Against it?

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33 Answers

faye's avatar

I’m for it. Big but, two of my babies would have died if I wasn’t in hospital. I am prochoice, though. I don’t approve of having to go home a few hours after giving birth.

aprilsimnel's avatar

One of my good friends is a doula. I feel there should be a choice for expectant mothers, as long as there’s an organization maintaining proper training and standards, like any other profession

wundayatta's avatar

It’s legal where I live. We had a midwife deliver both my children.

Oh. That article was about home birth, not midwifery. Well, home birth is legal here, too. The midwife across the street had both her kids at home.

rangerr's avatar

In a previous question about at-home births, I said that I thought the entire thing was crazy and that I’d never do it, but I wasn’t against people choosing to do it.

Now, I’m completely for it. and would definitely take that route with my future children.

After being in the house during two at-home births one of which went perfectly, the other had a slight shoulder dystocia issue, I’ve seen how prepared midwives are they had all the monitors/equipment that would be needed if something went wrong and how relaxed the mothers are compared to mothers I’ve seen in the hospital.

I see no reason why it should be illegal.

MissAnthrope's avatar

It’s illegal?

Minute_And_A_Huff's avatar

@MissAnthrope “Today, just 27 states license or regulate so-called direct-entry midwives—or certified professional midwives (CPMs)—whose level of training has met national standards for attending planned home births. In the 23 states that lack licensing laws, midwife-attended births are illegal, and midwives may be arrested and prosecuted on charges of practicing medicine or nursing without a license. (Unlike CPMs, certified nurse midwives, or CNMs, who are trained nurses, may legally assist home births in any state. But in practice, they rarely do, since most of them work in hospitals.)”

Read more

MissAnthrope's avatar

@Minute_And_A_Huff – Huh. I had no idea! I’m a California girl and it’s fairly common here. In fact, one of my oldest friends has become a doula. I totally support midwifery. As long as the midwife is well-trained, knowledgeable, and responsible (especially when it comes to packing it in due to crisis). I think it’s a very valid choice, perhaps not for everyone, but I think it should be available.

Thammuz's avatar

Personally i think it should be legal but people shouldn’t prefer it. Hospitals are much better equipped and sanitized, it just makes sense for both the baby’s and the mother’s safety to go to a hospital.

Then again i know of the abysmal situation of healthcare in the US so i’m not surprised there still are people who opt for giving birth at home.

ragingloli's avatar

It should be legal. But it should also be legally required for a midwife to have professional training.
German law requires a 3 year training connected to a hospital and passing a state exam, to become a midwife.

Trillian's avatar

For. One of my best friend is a nurse-midwife. She is a licensed practical nurse practitioner.

GeorgeGee's avatar

I think it is positively evil that doctors formed what is effectively a monopoly on health care that locks out anyone else and ensures that they can hold your health hostage as they raise rates to whatever they care to charge. Think about this: Any 8 year old diabetic kid can be taught to give themselves an insulin injection. So why do we have to go to doctors at all for something like a flu shot? Surely ministers, boy scout leaders, pool life guards and others could handle flu shots, and yes midwives can handle births. I think they should be required to complete basic certification on birth and hygiene, but that’s not medical school.

MyNewtBoobs's avatar

@GeorgeGee It’s more lawmakers and insurance companies that have done that than doctors.

Thammuz's avatar

@GeorgeGee that’s what you get without public health care.

GeorgeGee's avatar

Actually @papayalily, it was a conscious decision to form the American Medical Association in order to create a medical monopoly by actively lobbying congress. Yes congress made the laws, but the idea came from the doctors themselves and they pushed for the legislation since 1847, actively trying to squeeze out midwives, pharmacists, chiropractors, and anyone else involved in health and wellness. You can read about it in “Nursing, Physician Control, and the Medical Monopoly” by Group & Roberts here:

iamthemob's avatar

Hospital births are only necessary if the child is in distress – this is something that midwives take into account (if they know what they’re doing) when assisting with a birth. Of course, as ragingloli suggests, there need to be some form of certification requirements. But people were giving birth outside the hospital regularly pretty much up until well into the last century.

And although infant mortality is a scary thing to hear about – it’s not necessarily associated with still births. Developing world communities where home births are the norm suffer higher rates due not to the act of birth but also postnatal nutrition issues, diseases, etc.

There’s good stuff on the business of being born.

iamthemob's avatar

This thread is awesome! So much new information….

laureth's avatar

Here’s a .pdf that compares and contrasts some home vs hospital birth issues.

Here’s something interesting. Our so-called modern method of “legs-in-the-stirrups-up-on-a-table” birth in hospitals comes from a point in history when Louis XIV commanded that a “viewing table” be constructed so he could better see the birth of one of his mistress’ children. Of course since he was the king, it became the “au courant” thing to do among the elite and eventually made its way into the accepted norm.

It may have royally turned on ol’ Louie, but that doesn’t mean it’s comfortable, or medically necessary.

MyNewtBoobs's avatar

@laureth Is there a more comfortable position? If you aren’t do that position, what should you be doing?

Response moderated (Off-Topic)
laureth's avatar

@papayalily – Traditionally and instinctively, squatting is the best position for childbirth. It’s a posture that helps expel things from the lower abdomen.

This may be TMI, but it’s also the best position for pooping. The usual “sitting on the toilet” position doesn’t lend itself to completely getting rid of everything, to put it nicely.

MyNewtBoobs's avatar

@laureth But isn’t sitting on the toilet with your legs apart much like squatting, but much more comfortable?
Is the back position more comfortable than the squatting for child birth? I mean, isn’t there a reason squats are included in many a workout routine?

laureth's avatar

Personally, I’d say that squatting is to sitting what sitting is to laying down. The angle is different, the position is different, and the muscles are different.

As for “is the laying on the back position more comfortable for childbirth,” let me quote from the site I just linked to:

Up to the late 1960’s, the standard position for childbirth was the lithotomy position, where the mother lie flat on her back with her feet tied to and held up by stirrups.

The lithotomy position was an ergonomic nightmare for both mother and baby. No other position could be worse than this position for childbirth. It was said that the lithotomy position originated from a command by French king Louis XIV, who wanted to see one of his mistresses giving birth.

Women hated this position because they could not exercise any control over the birth of their baby. On her back and with her legs up in the air, she cannot move much. The pressure of the baby’s head on her back and tailbone can be very painful.

Also the poor mother has to push her baby ‘uphill’ against the force of gravity. This requires her to strain and push harder and longer. Additionally, in this position, the size of her birth canal can be reduced by up to 30%. As a result, during delivery, the baby is used as a “wedge” to force open the narrowed birth canal.

This causes great pain and distress for the mother, and prolongs her labor. Despite valiant efforts, many women – with the laws of physics and biology stacked against them – become exhausted and could not give birth easily.

Seek's avatar

I do not believe the government has the right to dictate where a woman is allowed to give birth, and who must be present at the event.

I support homebirth, nurse-midwives, midwives, doulas, and unassisted delivery, 100%. Choosing where and how to bring your child into the world is a very personal decision.

@laureth I ended up with an induced hospital delivery, against all plans. After 28 hours I caved and asked for an epidural – which did nothing to kill the pain, but everything to destroy the sensation in my legs. Hour 37 I started to push – laying on my back, of course. 2½ hours later, I managed to use a bar and a sheet to pull myself into a sort of squat. Only then did my son (who had shoulder dystocia) descend enough to be delivered.

MyNewtBoobs's avatar

I support a woman’s right to give birth however she wants, except maybe directly into a volcano. However, I do believe that if someone calls themselves a midwife or doula or asks for payment in general for their services in assisting with the birth, there should be licensing and regulation and oversight and requirements. But then you’re free to get your sister or neighbor or whomever to help without those restrictions, or do it alone. I also believe in people butting the hell out of others decisions.

Minute_And_A_Huff's avatar

@laureth Wait, it turned him on? It wasn’t just some sort of “who’s my heir” thing? He was aroused by this? or did I take that too literally?

Nullo's avatar

@Minute_And_A_Huff There are some odd paraphilias out there.

laureth's avatar

@Minute_And_A_Huff – Here’s a more detailed article about the history of birthing positions.

While the rest of it is certainly enlightening, I’m bringing it here for this quote:

Some scholars claim that the change in birthing position was a perverted caprice of King Louis XIV (1638–1715). ...Since Louis XIV reportedly enjoyed watching women give birth, he became frustrated by the obscured view of birth when it occurred on a birthing stool, and promoted the new reclining position.

In “academic paper” language, that’s about as close to “Louis got off on watching birth” as you can get. ;)

Minute_And_A_Huff's avatar

@laureth So then was he playing with himself during this?

SMJESQ's avatar

As a result of the AMA anti-midwife actions discussed above, midwifery became illegal in most states of the US during the last century. The TIME article on home birth provides information about a national campaign that has developed to advocate for licensing and regulation of qualified Certified Professional Midwives to have been specifically trained in home birth and who specialize in caring for women in childbirth in the home and in freestanding birth centers. The Big Push for Midwives Campaign was created by state consumer groups who were working with their local midwives to change state laws and wanted to develop a national source of mutual support for their efforts. Here’ s a link to a page from their website showing where midwives can practice legally and where efforts are underway to achieve legal status:

We’re on facebook too. Come visit us and become a fan.
Susan Jenkins
The Big Push for Midwives Campaign

wilma's avatar

I had no idea that midwifery was not legal everywhere in the U.S.

Deitzee's avatar

I am from a state that has jailed skilled midwives for assisting home birth families. We are working to get the laws of our state changed, but it is an uphill battle. The Medical Lobby is very powerful and very good at defending their turf…all in the name of safety. The Big Push for Midwives mentioned above has been a huge help to our state organizations. If you are interested in helping states that are trying to make things better for families who choose to give birth out of hospital, The Big Push would be a great organization to support. If you live in one of the illegal states, please find your state organization and support them as well.

laureth's avatar

@Minute_And_A_Huff – Luckily, I wasn’t there to see. :P

Minute_And_A_Huff's avatar

@laureth I’m honestly torn between my feelings of disgust and my interest in knowing the truth. There’s a small part of me that wants to go back in time and see.

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