Friday, November 18, 2011

Part 1: Midwifery in Mississippi

Everything You Ever Wanted To Know about
Mississippi Friends of Midwives

Part 1:
Midwifery in Mississippi
Midwives have been caring for women during pregnancy and birth since the dawn of time, so everyone has heard the term. However, many don’t know how midwives fit into the modern maternity care system or why an organization exists to support midwives.

The broadest definition of a Midwife is a woman who provides health care for women. Laws and practices of midwives vary greatly around the world. Let’s focus on Mississippi.

Much like the rest of the United State, we have two types of midwives working in our state.

Certified Nurse Midwives (CNMs) are Registered Nurses who have continued their education to specialize in nurse midwifery. The vast majority of CNMs have no training or experience attending out of hospital birth. They are required, in MS, to work with supervision from a physician. We have several CNMs in the state. They work closely with Obstetricians and deliver babies in hospitals. In many other states CNMs have more autonomy from physicians and are able to care for women planning a home birth. MS Friends of Midwives agrees that MS families could benefit from improving regulations for CNMs. However, this is not our primary focus.

More and more women in Mississippi (and across the country) are choosing home birth and (for the most part) they are being cared for by direct entry midwives (DEMs). See the data below from the MS Department of Health Vital Statistics Reports

Number of Births attended by a “Granny Midwife” (AKA Direct Entry Midwife)

2010: 62 2007: 40 2004: 43 2001: 33 1998: 21

2009: 61 2006: 47 2003: 41 2000: 28 1997: 11

2008: 46 2005: 36 2002: 35 1999: 31 1996: 15

“Direct entry” simply means NOT a nurse midwife. Generally, the midwife is the primary care provider throughout pregnancy, the labor and delivery, and postpartum care (more about this later). Mississippi law states that midwives are “exempt” from medical practice laws.

Why does MS Friends of Midwives exist?

Mississippi Friends of Midwives is a non-profit organization dedicated to supporting and promoting midwifery as a safe and legal childbirth option for women and families throughout the state of Mississippi. We are a group of consumers and supporters of midwifery, we are not a professional organization for midwives.

There has been an effort by lobbying groups to make direct entry midwifery illegal. In 2010 legislation was passed in the House of Representative (HB695) which would have limited the practice of midwifery to nurse midwives only. This would have made direct entry midwifery illegal and left homebirth families with no legal options for hiring a care provider. This legislation was the catalyst for the “birth” of MS Friends of Midwives. Fortunately, midwives and their clients flooded the capitol with calls and emails and the bill was not brought up for a vote in the Senate.

MS Friends of Midwives supports legislation that would legally recognize direct entry midwives through the process of issuing Licenses. This legislation would require direct entry midwives to obtain the Certified Professional Midwife (CPM) credential from the North American Registry of Midwives (NARM) to provide out-of-hospital maternity care for healthy women experiencing normal pregnancies. NARM certification requires a rigorous educational and training process including a clinical internship that takes a minimum of 3-5 years to complete and a national board exam. Continuing education is a requirement for re-certification.

Licensing provides a mechanism for families choosing home birth to verify their midwife’s credentials. NARM’s grievance process will provide some protection for families from midwives with known unsafe practices.

27 other states legally authorize CPMs to practice—some for more than thirty years—and not a single one of those states has rescinded its program.

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