LETTERS: Kentucky Mothers Fighting for Home Birth
The Kentucky Home Birth Coalition (KHBC) is lobbying for senate bill 85 and house bill 578, which would require home birth midwifery (a.k.a., a certified professional midwife) to be licensed by the state and to create a regulatory board thereof.
According to the North American Registry of Midwives (NARM), a home birth midwife is a "knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by [NARM]."
The KHBC argues that licensing home birth midwives "is the best way to ensure that those families who choose out-of-hospital birth will have access to quality maternity care."
Home Birth in Kentucky
Up until the early 1900s, out-of-hospital deliveries were the norm. Starting around the 1920s, hospitals slowly but surely expanded their services. According to a slew of studies conducted by medical organizations, like the American College of Obstetricians and Gynecologists and the British Journal of Obstetrics and Gynaecology, the risks of planned home births are low with trained midwives.
Randomized, controlled trials are the standards in research methodology, and as such, results in most studies have bad conclusions. But the trials do not omit unplanned pregnancies or other situations that lead to inconclusive outcomes.
Yet, according to federal statistics, Kentucky and neighboring Indiana home birth rates are over one percent, higher than the national standard. Many women opt for home births, for varying reasons. Such as religious or spiritual reasons, health reasons, financial reasons, and sometimes for political ones.
Aundria Radmacher, a Louisville midwife who has attended hundreds of births since 2008, states, "The largest portion in my practice of professions are teachers and nurses...I’ve had ER doctors, lawyers, college professors and teenage moms." If home births are so dangerous, then it would not be in demand by people in "esteemed" professions. As opposed to the poor and the hippies that also partake in this practice.
Mothers who choose to have planned home births go through steps to secure the safety and efficiency of delivery. Often times this is despite government interference. Access to certain equipment and medication are regulated by the state, thus limiting options for practitioners of home birth.
Instead of forcing regulations on this industry, the state can simply get out of the way. Currently, the state of Kentucky regulates the practice of today's standard midwifery. The state mandates these midwives have permits, are supervised, and further regulated.
The hospital-setting midwifery regulated by the state is expensive in both cost and price. Meanwhile, the home birth alternative is less costly and less pricey.
Though the KHBC is not seeking to heavily regulate home birth midwifery, the coalition and its allied legislators seek to grow government. The problems home birth are associated with largely come from the legal protections extended only to the standard midwives. Such as creating a regulatory board, defining standards, using the US Midwifery Education, Regulation, and Association (US MERA) credential as licensure criteria, and access to equipment and medication.
A new regulatory board is unneeded - the Board of Nursing could fulfill this demand. Which could also promote the standards from NARM or other reputable sources. The board can certify, without a licensing mandate, home birth midwives. The state could reduce both government and spending by allowing the free market to supply the demand of resources.
Currently, SB 85 is waiting in the Senate Licensing, Occupations, & Administrative Regulations Committee, with sixteen sponsors and co-sponsors (eight Republicans and eight Democrats). While HB 578 is in the House Health & Welfare Committee, with five sponsors and co-sponsors (three Republicans and two Democrats).
The KHBC are well-intentioned, but they are what free-market economist Milton Friedman called "do-gooders doing harm." Increasing government will invite trouble - such as the regulations being written by big business lurking in the shadows.
Home birther and maternity entrepreneur Baby Bradford asks, "Where do you feel safe? You need to feel safe in your birth so you can relax and allow yourself to go to that animal & innate state of a mothers work." Government has no business being the mothers of society.