Detroit News Examines Debate Over Certified Professional Midwives' Qualifications

Main Category: Nursing / Midwifery
Also Included In: Pregnancy / Obstetrics;  Public Health
Article Date: 31 Jul 2008 - 8:00 PDT

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The Detroit News on Tuesday examined the debate between the medical community and home birth advocates over where women should give birth and who is best qualified to perform deliveries. According to CDC's National Center for Health Statistics, about 1% of births annually are performed outside of hospitals.

The American Medical Association last month issued a statement that said the "safest setting for labor, delivery and the immediate postpartum period is in the hospital, or a birthing center within a hospital complex." AMA and the American College of Obstetricians and Gynecologists also have said a hospital is the safest place to give birth because medical staff are readily available if complications arise. The groups also have said that physicians and certified nurse midwives, who have formal nursing certification, are the most appropriate professionals to oversee deliveries. Certified nurse-midwives are licensed in all states and most often practice in hospitals or medical centers.

However, many home birth advocates have said that formal nursing certification is not necessary for a midwife to oversee home births and that certified professional midwives, who do not have nursing certification, are able to oversee births successfully. About one-half of states license CPMs, although many midwife advocates are calling for universal licensure of CPMs to expand birthing options for women. Many medical groups have said CPMs, who must deliver 40 infants to be certified, do not have enough training to handle complications.

Steffany Hedenkamp, communications coordinator for The Big Push for Midwives Campaign, said medical groups' efforts to limit CPMs are "anti-competitive," adding, "With this integration of [CPMs] we see increased access to care." Erin Tracy, an ob-gyn at Massachusetts General Hospital, said the 40 deliveries CPMs are required to oversee is "less than ... interns do in one month," adding, "You need more of a medical background to understand medical complications" (Detroit News, 7/29).

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