As many of our readers know, both of my children were born at home. I live in California, and one of my midwives was licensed. I did receive parallel care from a medical doctor, although I am not sure if this was legally required by the state. After my babies were born, my midwives requested we tell the authorities when applying for birth certificates that the home birth was “unplanned”. Even though California law protects a women’s right to chose a home birth and mandates insurance companies reimburse midwifery fees, there is still the feeling that home birth midwives are outlaws practicing medicine without a medical degree. Unfortunately, New York City midwives have now joined the outlaw ranks.
In New York, home birth midwives can practice legally if they have the backing of a hospital. There are only 13 home birth midwives in New York City, a shockingly low number for the size of the city, and seven of these midwives had the backing of St. Vincent’s Hospital Manhattan. Due to bankruptcy, the hospital is closing, and the NYC midwives have been unable to obtain the legal backing they need from another medical facility. The New York Times explains:
The loss of that 25-year relationship with a sympathetic hospital has left some home-birth midwives not only fighting for the legal viability of their practice but having to justify their very existence. Officials at several hospitals said this week that while they were friendly to midwives, they were skeptical of the safety of home births and were concerned about the malpractice implications of taking over their clients in emergencies…
The 13 midwives attend about 600 births a year, and about 50 of their clients expect to deliver in the next month.
To them and their clients, having the option of a home birth is an affirmation of their reproductive rights. It is also a reaction against the highly medicalized climate of hospital births, which, they say, has contributed to a Caesarean-section rate of more than 1 in 3 births in New York City, Westchester County and Long Island combined, with some hospitals having rates above 40 percent. While the ideal rate of Caesarean sections is disputed, the World Health Organization has suggested 15 percent.
A mother has never been prosecuted for having a home birth in the United States, but the midwives could face legal ramifications if they practice without the “written practice agreements”. There is a movement in Albany to remove this requirement, as 15 other states allow home birth midwifery without the backing of a medical facility or doctor. SB 1479 in California states:
The midwifery model of care is an important option within comprehensive health care for women and their families and should be a choice made available to all women who are appropriate for and interested in home birth.
Until the law changes in New York state, Albany should grant NYC midwives clemency to continue to serve their clients and give women the choice they deserve.
Hillary Boucher says
Thanks so much for covering this important health care issue in my home state. I live in Central New York and unfortunately these issues are not only related to NYC. Women all over New York State are unable to attain the excellent care of midwives in hospitals, birthing centers and in the home setting.
We’ve created a home base for New York citizens to gather, be counted and take action at FreeOurMidwives.org. We were lobbying for legislation that would remove the barrier of the written practice agreement and give families all over New York better access to midwives in April in Albany. Legislators have specifically asked to hear from New York citizens. If you live in New York please come and subscribe to http://www.freeourmidwives.org. We can create a long term solution to this problem by joining our voices and acting strategically.
Thank you for posting this article. It is a sad thing to read. I delivered my children at home over twenty years ago and it was a fight then. I was hoping things had changed. I guess not. My thoughts of progress and success, protection and appreciation go out to those brave angelic midwives!
Nicole T says
I’m in NY, and hope to have another child at some point in the next couple of years. This worries me, greatly. It was extremely difficult trying to get my insurance company to cover my birthing center experience (they didn’t and I had to find other health insurance) . Now, that center has had to move all births into the hospital, and I’ll be looking into home-birth next time around.
Rev. Criss Ittermann says
Miriam Schwartzchild, one of the home-birth midwives in NYC most often quoted in articles on the topic of St. Vincent’s closure, was my midwife for both of my home-births. I refused to have a child any other way, with the exception of pre-natal care indicating that there will be complications or definite risk to me and/or my baby. Before choosing to home-birth I read several midwifery manuals — so one cannot say I was unaware of potential risks, complications, or reasons to transport to the hospital. I actually considered becoming a midwife.
Both of my home-birth experiences limited my risk of infection by being in my home environment, eliminated the possibility of impatient doctor meddling and doctor-imposed deadlines, allowed more people to attend my birth (whomever I felt comfortable with, including my 2.5yr old daughter at my 2nd home birth), allowed me to sleep, eat, rock, walk, etc. whenever I wanted, and –this one really gets me– allowed me to hold my child immediately after birth and making sure the baby took a breath (wet & squiggly while the midwife dealt with recording the time, clamping the umbilical cord, and whatever other fussy-stuff she had to do immediately post-partum). Then the midwife did the APGAR test, then handed the baby back to me for a first feeding — which helps with the delivery of the placenta.
A couple days ago I heard about a woman who died an hour after childbirth and had never gotten to see or hold her baby. They’ve been whisking babies away from mothers immediately after birth and doing APGAR tests, eye wash, circumcision (sometimes whether you want them to or not), and often within 2 hours of birth they give the dreaded Hep-B injection — all during the baby’s most precious awake & aware period after birth. This is a BONDING MOMENT…the baby needs to be with Mommy and maybe Daddy. Instead the baby gets to be aware through being handled by strangers, cut, poked, prodded, stinging eyes, etc. Welcome to your first experience of the waking world — and how is that experience going to help you feel about the world? Our first most impressionable moment is one of suffering rather than comfort, and people wonder why the (mental, emotional, ethical) health of our nation is declining?
Yesterday a dear friend of mine just sent me a photo of her daughter and newborn granddaughter. They’re in the hospital — it’s the FIRST TIME my friend’s daughter gets to look at her newborn. The newborn is being held up over a small gurney by a woman (nurse? midwife?), and off in the distance 5-10 feet away is the mother with a look of astonishment on her face. Thank goodness they’re healthy.
However, it makes me ANGRY. It’s a great photo — but this is the first time you get to look at your baby?!? With the exception of the person who catches the baby, who has the right to be handling YOUR child before you even get to say hello? I’m hopping mad, which is why I started researching the loss of legal practice of my beloved midwife in NYC. This is an abomination.
When a woman and her fetus are healthy, let her choose how, when and where to give birth. Period. I did the right thing and had an experienced very responsible nurse-practitioner midwife at both of my births. DO NOT CRIMINALIZE HER.