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.