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Looking at the risks of home birth: be careful what midwife you use, P.2

Last time, we began looking at some of the risks of electing for a home birth, particularly at the role the midwife has to play in these risks. As we noted, lack of training really sets a certain type of midwife apart from midwives who go through more rigorous training.

The general risks of using a C.P.M, the lesser educated type of midwife, can be seen in the loose approach to ethics and the lack of safety standards taken by the Midwives Alliance of North American, the agency that certifies them.  Going with a C.P.M. might not be a problem in low-risk pregnancies, though even then couple should be very cautious, but for women at high risk, it is unwise to do so. 

Aside from lack of training, another risk factor with C.P.M.s is that it is illegal for them to practice in many states. In the state of New York, C.P.M.s may practice, but only after they become a licensed midwife. Earning a C.P.M. certification is not a direct route to licensure in New York. Rather, C.P.M.s in this state must demonstrate their credentials to the New York State Board of Midwifery. According to the New York State Education Department, Midwives must have the equivalent of a master’s degree, attend an accredited midwifery school, pass a certification exam, and have some training in newborn health, primary care, well-woman car, family planning and pharmacology.

Despite these requirements, some midwives slip through the cracks and practice outside the law, both in New York and other states. This can lead to situations where something goes wrong and the midwife fails to seek timely help for fear of punishment. This can naturally lead to situations where the midwife is punished even more severely, sometimes even facing criminal charges.

In our next post, we’ll take a look at the issue of malpractice for midwives who practice within the rules and regulations established by the state.

Sources:

The New York Times, “Why Is American Home Birth So Dangerous?,” Amy Tuteur, April 30, 2016.

Office of the Professions, “Midwifery—Questions & Answers,” Accessed May 18, 2016. 

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