Provide more options for child-birthingPublished 6:38pm Thursday, February 13, 2014
Senate Bill 99 or so-called SB99 concerns the licensing and certification of Professional Midwives in Alabama. Certified Professional Midwives, Licensed Nurse Midwives and several other designations apply to trained and professional midwives who have passed appropriate exams and are approved by the state to assist women with deliveries of newborns either in the hospital setting or in the home setting.
Midwives have existed for thousands of years and for most of our history were the only help that women delivering babies had. Much of the world, including much of the industrialized world , still relies on the services of midwives. Our neighboring states of Tennessee and Mississippi have seen fit to license and certify professional midwives.
Currently multiple professional medical societies in Alabama including the Medical Association of the State of Alabama(MASA) have vehemently opposed the licensing and certification of midwives.
The stated reason for opposing this legislation is that they are trying to protect the health of women and babies. There is strong evidence to the contrary that when midwives are integrated into the healthcare system, infant mortality and morbidity decrease, medical costs decrease, C-section rates decrease, and there is better and earlier access to education and care for pregnant women.
Alabama has the sixth highest cesarean section rate in the U.S. at nearly 36%. There are 36 counties without obstetrical service. This causes some mothers to drive up to two hours to deliver at an in-state hospital.
We have the highest infant mortality rate in the nation. In Alabama our infant mortality rate is 9.2/1000 births while the national rate is 6.2/1000. The rate in Europe where midwifery is common is 4.6/1000 births.
If our state were to sanction the training, licensing and certification of midwives, just as with Licensed Nurse Practitioners, our citizens would be the beneficiaries. Incorporation of obstetricians in the training, testing, and certification would make the entire process more credible.
Also, integration and coordination of midwife services with currently practicing obstetricians can only improve the delivery of health care and childbirth services for women in our state. I cannot see any downside for the practicing obstetricians.
Truth is, they are much better at handling complicated deliveries than the normal ones. Let them be at the top of the pyramid and get referrals from midwives for the complicated deliveries. Let them manage and deliver the complicated pregnancies. That is really what they spend the most time doing in their training. Let women with normal pregnancies decide from whom and in what setting to receive their help with delivery.
If women want to get prenatal care from an obstetrician and deliver in a hospital they should be able to do so. But if they want services from a licensed, certified midwife, that should not be prohibited.
As a physician, I want the highest quality of healthcare for the citizens of this state. As a citizen, I strongly believe in the rights of the individual to make personal decisions.
We need to give women options for delivery services which include state regulated and certified midwifery.
I strongly recommend that each of you call your state senator and representative and voice your opinion concerning this important issue.