Homebirth Midwives Aren’t Too Hard to Find
Midwives are highly skilled professionals in the realm of normal birth. Although it’s common for current generations to think that all babies are born in a hospital with obstetricians (OB’s), the preferred attendant around the world for normal birth is still the midwife. Of the top 50+ countries around the world that have the BEST outcomes for mothers and babies, ALL of them use midwives for the majority of their maternity care, and save their OB's for the truly complicated situations.
Sad fact: The USA is NOT in the top 50 for best maternal OR infant mortality, nor do we use midwives for the majority of our maternity care. We use OB’s, and also spend more money per/birth than ANY other country while also getting appalling outcomes. (Many American’s health care assumptions would be rocked to know that Cuba and Serbia, for instance, save more mothers and babies than USA does.). Our higher rate of complications and poor outcomes is a known consequence of unnecessarily medicalizing birth. It makes even more sense when you hear the Triple-Crown-winning horse rancher talk about it (see my blog, 'Safer Birth In a Barn’).
Midwives are experts on normal birth process (which is the majority of births), and OB's are experts on high risk births (a smaller percentage). Being a skillful midwife includes knowing how to recognize and reduce risks. Unfortunately, OB’s often increase risks to their patients by routinely apply their high-risk skills to low-risk mothers.
Don’t forget, obstetrics is a surgical specialty with an emphasis on identifying and managing maternal complications and performing surgery. It’s quite rare for an OB resident to sit with a normally laboring mother from beginning to end, which is typically a great source of education in the midwife tradition. If you would like your care provider to recognize variations of normal in your pregnancy and birth journey, they MUST be experienced in ‘normal’. It’s often assumed, but not at all accurate, that specialists in complications will also (by default) be specialists in normal birth.
If you wish to birth at home with a professional attendant, in the US this generally means with a midwife.
Midwife (commonly also called Direct Entry Midwife, Lay Midwife, or Traditional Midwife)
Licensed Midwife (LM, often State regulated)
Certified Professional Midwife (CPM)
Certified Nurse Midwife (CNM)
CNM’s may attend homebirths, though this varies by state; their licensing generally requires a formal relationship with an physican which may or may not be available. Occasionally a family practice doctor will also do home births, at least in the recent past. It's common, though, that even physicians who philosophically support homebirth are prohibited by their malpractice insurance or hospital contract from providing meaningful support in an out-of-hospital setting.
So how does one find a midwife, if you're the first in your circle to consider such a thing? Depending on the health care politics of your area, it could be super easy, or a big challenge! You could start by looking on-line; consider searching:
The name of your state (or neighboring state), plus words like midwife, CPM, LM, CNM, birth, natural childbirth or homebirth.
Your state (or neighboring state) for its professional midwife organizations; one national organization is MANA.
Related words - because they often lead to like-minded people, people in the childbearing stage of life, people who know the natural health or homebirth community, or stories about people who've accomplished what you are interested in. These words/groups include traditional midwife, lay midwife, direct-entry midwife, free birthing, breastfeeding groups, mommy groups, Hike It Baby groups, baby-wearing groups such as Wrap Your Baby or through one of my favorite wraps Erobaby, natural mama groups, holistic mamas, La Leche League or breastfeeding support groups.
Amish or Mennonite communities commonly utilize homebirth midwives, if you live nearby.
Facebook - use similar words to find local groups sharing info and passions on natural birth.
Look into homebirth friendly publications such as Pathways to Wellness, Mothering, or Midwifery Today
Keep in mind that many experienced and highly-qualified midwives may not be on-line, or care to develop a on-line presence. They may just busy in their practice (really good ones often are), or not be tech savvy or politically active. If your state is hostile to midwives, or for instance, to vaginal breech birth, those skilled providers may be purposefully low-key or hidden for the safety of themselves and their clients. These gems may be found more by word-of-mouth, so look to unearth these connections by reaching out to groups locally or on-line that are likely to have clients, patients, customers and members friendly to natural birth.
Essentially - be curious, explore, make friends, reach out, follow leads. Don't hesitate to open up conversations at your local health food store, food co-op, childbirth education class, natural baby store, holistic dentist, food co-ops, postpartum exercise and support groups. And most of all, ask all the questions you need of those you interview! Trust your gut and your baby. It's never too late to make a change, really.