The Illinois Home Birth Safety Act - vote tomorrow?

Thanks to the Unnecessarean for pointing out that the Illinois Home Birth Safety Act (SB 3712) is most likely being called to the floor Wednesday - tomorrow! This bill establishes the recognition of certified professional midwives. 27 US states have CPMs.

Midwives are illegal in states in red.
Image credit: Surachit.

We've had four home births here in Illinois, and we may (believe it or not) have more children someday, so this bill directly affects us. Here's what I think.

I generally support this bill because I think it makes sense. The home is a safe place to have a normal, non-high-risk birth. Normal women can give birth without a physician's manipulation; so it makes sense to allow an educated, informed woman to choose to do so. Hospitals have been repeatedly shown to be not very safe or accomodating places to give birth. On the other hand, these midwives already practice and do good for the community. They've been through extensive training and are often already registered, but they cannot legally perform these services in Illinois (though they can in neighboring states!). By legalizing the practice of home midwives, you're helping women make the legitimate choice to birth at home (which is already their right!) and enabling them to hire a compassionate, knowledgeable birth expert to assist them.

On the other hand, these same midwives are now going to be subject to possibly unnecessary restrictions. For instance, this decade's obstetric community (and the insurance companies who write their paychecks) have swung back to a more paranoid view of breech births and vaginal births after cesareans, with little evidence to do so and while other countries are progressively moving forward on allowing these births to proceed nonsurgically. This law would not allow midwives to attend first-time VBACs, though they can attend subsequent VBACs - so women must try to find a VBAC-friendly obstetrician (good luck with that). Midwives would also have to refer breech presentations to an obstetrician for "consultation" - and what obstetrician is going to approve a home breech birth, when he or she knows that no insurance company would allow them to attend one in the hospital?  Home midwives already attend HBACs (home birth after cesarean) and breech births successfully; but they would be disallowed under this new law.

There are other issues, like the fact that your very good (albiet illegal) midwife might not be registered how the state wants them to be; they might not have a general Associate's degree (a relatively arbitrary requirement in addition to all their midwifery training); they might be subject to more stringent reprimands and actions by the midwifery board than an obstetrician would be by the medical board (i.e. women complain all the time about obstetricians and nothing happens to them, but the first complaint by a woman against a CPM would probably be handled severely.)

But generally, I think that the bill is a good one, or at least a step in the right direction.

See also my summary of the Illinois Home Birth Safety Act.