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Pregnancy is Not an Illness

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Pregnancy is Not an Illness

If you are an expectant mother in the state of Alabama and looking to give birth at home, you are on your own. Literally. If a midwife assists you in your birth, she/he could be prosecuted under current Alabama law. One of only 9 states that bar Certified Professional Midwives from practicing, Alabama forces many of its mothers to visit neighboring states if they are looking for a non-hospital birth experience.

Why Midwives Should Be An Option

2011 Walk for Midwives at Big Spring Park

If you are one of those mothers who couldn’t wait for the sweet relief of an epidural, you may be saying to yourself, “What’s the big deal? Isn’t it safer for everyone if people give birth in a hospital?” The reality is that hospitals are wonderful alternatives to home birth for moms who are high-risk or who are just looking for the security and peace of mind a hospital brings to them. However, most women don’t need help giving birth and the more intervention is available to them, the more intervention occurs. This has led to a C-section rate of 34%, more than double that recommended by the World Health Organization. While you can use a Certified Nurse Midwife in a hospital setting in Alabama, so few CNMs practice in Alabama that they are not a valid option for most women here and that still leaves out women searching for an out-of-hospital birth experience.  This is why Alabama needs Certified Professional Midwives so badly.  According to a recent report from the Centers for Disease Control, home births have increased more than 18% in Alabama over the past few years.  Last year, Huntsville’s Walk For Midwives had 55 people.  This year 115 were in attendance.  And walks took place all over the state.  Obviously, the public is demanding the option of a care provider trained in out-of-hospital birth and CPMs are the answer.

As someone who has used two Certified Nurse Midwives and three different OB/GYNS in my lifetime, I can attest that while I had wonderful OBs, the midwife model of care suited my needs and wishes much better than the medical model most OB/GYNs practice. In Florida and in North Carolina I was lucky enough to find wonderful CNMs who practiced inside an OB/GYN clinic and who I saw before, during, and after giving birth to my daughter. Their care was extremely similar to the care I received from my gynecologist with a couple of exceptions. First, they focused on natural alternatives whenever possible, always trying to err on the side of caution when it came to optional tests/care. Second, they talked to me A LOT more and listened just as much. We talked not just about how much weight I was gaining or how big the baby was getting but also how I was doing. How I was feeling about the experience. How it was affecting my relationship with my husband and how I was dealing with the stress of juggling work and pregnancy.


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How You Can Help

Regardless of whether or not a home birth is for you, it should be an option for those who desire it. These women aren’t “crazy” or backwards, they are convinced by medical studies that show that women under CPM care are:

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  • Ten times less likely to be induced.
  • Six times less likely to have the labor stimulated with oxytocin.
  • Twenty times less likely to have their baby pulled out with a vacuum.
  • Six times less likely to need a cesarean section.
  • Nine times less likely to have breastfeeding fail in the weeks after the birth.

To find out more about the movement to improve access to evidence-based maternity care options for women, families and communities in Alabama visit the Alabama Birth Coalition website, and Facebook page and join us next year for the Fourth Annual Walk for Midwives at Big Spring Park!


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See you there!


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View Comments (12)
  • I’m all for hospitals, drugs, and c-sections but I am also all for women having a choice in birthing options! It’s a shame women can’t use a midwife in this state. I truly hope this will change!

  • Thank you, thank you, THANK YOU for bringing this to a new audience! Few people realize how very important this is.

    Many women cannot get to a hospital, can’t afford medical care and end up giving birth at home anyway – alone, uneducated in the topic, terrified. In this situation, many wind up in situations that a trained midwife can easily handle, but can be disastrous without a knowledgable care giver available. This situation, created by unfair legislation in this state, has shed a deceptively negative light on homebirth. Home birth with a CPM is statistically as safe as, or in some studies even safer than, a hospital birth, with a significantly lower risk of uneccessary interventions. Midwives are not just for the crunchy folks, they are a critically needed component of our healthcare system.

    • Ashley – thank you for mentioning something I left out of my piece and honestly didn’t even think about. I never considered the money factor and the idea of being forced to go through birth alone because of archaic laws is horrible. Thanks for bringing that to light as well.

  • This is one of the best, most succinct and well-rounded pieces I’ve read in favor of the CNM option in Alabama. I personally had a scary emergency c-section at 28 weeks so obviously I’m more inclined to head to the hospital just for the safety aspect. But a woman who is having a healthy pregnancy, isn’t high-risk and has done her homework should have the option of a birth with a CNM in a non-hospital setting. And I love the idea of seeing a CNM at an OBGYN clinic. My mom gave birth to me with a CNM (at an Army hospital) and just LOVED her.

    • Thanks Anna. My second CNM (the one in North Carolina) was actually a former Army CNM 🙂

  • There is absolutely no reason this option shouldn’t be available to women in Alabama, except that the medical associations have better lobbyists than the midwives. While I personally wanted all the painkilling drugs and the reassuring hospital setting, I also believe “to each her own.” Women did not generally deliver babies in hospitals until 50 years ago or so. What changed? Money. I have a hard time believing that this law is for the welfare of women–I just don’t believe our state legislators really care that much about how or where we give birth.

  • Jen, I thought that was you at the walk on Saturday! I should’ve introduced myself. Thank you so much for coming and for blogging about this issue; it’s one I’ve been passionate about for 10 years and counting.

    If anyone has questions about using a midwife (how to find one, what to expect, etc.) or how to have a natural birth in a hospital setting, I’d love to help answer them!

  • Jen! What a wonderfully written piece! Thank you, thank you, thank you! I appreciate your time, dedication and support. We loved having you with us on Saturday, and I don’t think you could have expressed our viewpoint any better (and thanks to Ashley for the input about low-income women with few options)! A passerby at the WFM on Saturday asked what the signs were about, and I explained the situation. He said it was “asinine” that AL legislation required CPM’s to be liscensed in the state but then provided no way of becoming liscensed. I really had to agree with him. Thank you for being a voice for the cause and helping us reach a whole new audience. You are amazing!

  • Thank you for your coverage of this issue, which is so important to so many Alabama families. I HATED having to drive to Tennessee just so I could use a Certified Professional Midwife. She was worth the drive though, because her skill kept me from having a C-Section. I loved getting to have a waterbirth with my Certified Professional Midwife, something the local hospitals don’t allow. My prenatal care was amazing too. Wow! 2 hour prenatals vs, 2 hour waits in the OBGYN office. Nothing like someone who you can call 24/7. What OBGYN do you know that would give you their personal cell phone and tell you to call them day or night if you had any concerns whatsoever? If CPMS, CNMs, and OBGYNS worked together we could radically change maternity care for the better in this state. Now is not the time to fight over turf, we need all hands on deck for safe birth!

  • Every woman should have the to right to choose! Thank you, wish I had been aware of the walk this year. New here. I was fortunate to have both my children with a CPM. It was the most wonderful, peaceful experience. Pregnancy and birth are natural, not medical conditions.

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