I read a great article written by Dr. Michael Flanagan, addressing Alabama’s proposed legalizing of direct entry midwifery. He makes several concise arguments about why lay midwives are not adequate birth attendants in emergency situations.
Complications of labor can include, but are not limited to, a baby getting stuck in the birth canal, tangling of the umbilical cord around the baby’s neck, bleeding, infection, or even unexpected immaturity of the newborn’s lungs. These dangers are possible even in the most state-of-the-art facility, but at least the infant and mother have the best possible chance of survival. I have personally participated in urgent and emergent care that required quick decisions by the physicians and nurses to save the life of the unborn child and mother. The same cannot be said for a birth that is planned for the home and attended by a lay midwife. Instead, you will have a well-meaning, but woefully undertrained and underprepared individual and a false sense of security for the parents. When a planned home birth takes a turn for the worse, the time spent in an ambulance ride to the ER can mean the difference between life and death.
Dr Flanagan is talking about births that just unexpectedly go wrong, and the problems associated with that. He cannot even begin to understand the negligence associated with unlicensed home birth practitioners, they take high risk pregnancies if there is no oversight preventing it. Home birth midwives in Utah, for instance, regularly attend breech births, vbacs, and twin births (or shockingly, a combination of the above risk factors). There have been fatal results. Dr Flanagan continues:
There will always be babies born spontaneously in elevators, taxi cabs and parking lots. Most of these deliveries will likely be fine, given the law of averages.
This is true, and this is exactly why midwives can claim their practices are safe. Midwives also deliver far fewer babies per year than a obstetrician or a nurse midwife working in a maternity unit, and so they can claim to have worked for many years without a death, or they can choose to see the deaths they have attended as unavoidable because of their ignorance of obstetric interventions. They scoff at the idea that they have attended so many non-lethal births out of sheer luck, but its the absolute truth. Midwives take credit for good outcomes and deny responsibility for bad outcomes- its an abhorrent model of patient care. Dr Flanagan continues:
However, if the State of Alabama passes a law legalizing lay midwifery, it sends a message to the public that this practice is safe. This idea could not be farther from the truth.
I cannot speak for other states that have unfortunately legalized this dangerous practice. Perhaps no one spoke up against it.
Plenty of people speak up against it. Several physicians have spoken to me about the danger of home birth midwifery, the disasters they encounter at their work because of incompetence. A legislator in Utah told me in confidence that they believe most of the legislators in our state would rather not have home birth midwifery allowed legally, but the midwives are very organized and have friends in high places. They are willing to pour as much money as needed into their cause to make it happen- after all, if the practice is outlawed, they are out of a job (or risk prison). They have much more to lose than the average citizen (who will not choose home birth), so they understandably put more effort towards keeping their job legal. Midwives have a weird habit of teaching classes on activism as part of required courses in their midwifery school. They know they desperately need unity to keep the sham going because home birth midwifery cannot stand on its own merits.
If anyone from Alabama is reading this- please, please contact your representative and tell them that you don’t want the state to endorse this practice. If citizens of Alabama fail to stop this action you will be in the same position as Utah’s citizens- watching helplessly as tragedy after tragedy unfolds before our eyes, fighting against a status quo of legal unlicensed midwives practicing without any oversight or required training. Every community values its children, and this is a very serious threat to their well being.