One of my former students-turned-Bradley-Instructor asked me a question this week on Facebook, in light of all the midwifery issues going on in NY.
If Donna Ryan was forced to have a hospital birth, or an unassisted birth, which would she pick? This was my answer.
First, there are many things to consider. I believe in prenatal care. If you choose unassisted birth, you are likely choosing no prenatal care. A Licensed Midwife evaluates each woman and pregnancy and determines if she is a good candidate for homebirth. Most women are.
I know everyone thinks my answer will be a resounding "Yes, go unassisted!" It's not that simple. I believe in having a good midwife at your side, no matter where you are giving birth. Women have the right to a midwife and they have the right to birth where they feel safest. For many women, this is at home, and for many, it is in the hospital. Educate yourself and make the best decision for you and your family.
As far as what is happening in NYC, the problem is that they are shutting down the hospital where most of the out-of-hospital midwives have backup from an OB. In order to be a LM in NYC, you have to have an OB back you up. St. Vincent was a very midwife-friendly hospital, and they have shut their doors. The midwives cannot practice, legally, without that backup. So, they either need to find other OBs to back them, not practice anymore, or do it illegally.
One of my friends birthed a baby at home in ID before it was legal for midwives to practice openly. (It is legal for them to practice in ID now.) There are still a number of states where homebirth is illegal, but midwifery is alive and well. You know the risks as a midwife, but also as a consumer. I just talked with a local midwife this week who is originally from Missouri, where homebirth is illegal. She would love to go home, but she said she's not ready to deal with the risks of practicing illegally. The state of TX has some great laws in place for out-of-hospital midwives.
So my point is, that a woman doesn't really need to be forced into the hospital if she doesn't want to be there. She also doesn't have to choose an unassisted birth as her only other option. I've known women who have jumped state lines. There are midwives that are willing to risk their own hide so that women have access to homebirth.
I will never tell a woman I think she should have her baby unassisted. That is a risky position for me, as a childbirth educator. I do not give medical advice, but I think my opinion is weighed pretty heavily by a lot of my students. If you know me, you know that I am so NOT a fear monger (trust your body, trust in birth), but I've seen strange things happen in labor, birth, and immediate postpartum. Things that I would want a midwife attending to. I know women who have had unassisted births and everything was great, actually with all of them. And I do believe that it will be fine most of the time. I still like to see a midwife by all womens' side, no matter where they are giving birth, and whether they are practicing legally or illegally.
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