New York Midwives Lose Right to Deliver Babies at Home
May 16th, 2010
Via: New York Times:
As residents of the world’s consumer capital, New Yorkers can have anything delivered to their door at any time. They can have their hair cut in the living room, have champagne and caviar rushed to them on a whim, enjoy a shiatsu massage in their own bed or invite a clairvoyant to predict their future from Tarot cards laid out on the kitchen table.
But there is one thing that is currently unavailable for delivery to those who live in this most can-do of metropolises. Women can not legally give birth at home in the presence of a trained and experienced midwife.
This city of more than 8 million people, with its reputation for being at the cutting-edge of modern urban living, now lacks a single midwife legally permitted to help women have a baby in their own homes. “It’s pretty shocking that in a city where you can get anything any hour of the day a person cannot give birth at home with a trained practitioner,” said Elan McAllister, president of the New York-based Choices in Childbirth.
The collapse of New York’s legal home birth midwifery services has come as a result of the closure two weeks ago of one of the most progressive hospitals in the city, St Vincent’s in Manhattan. When the bankrupt hospital shut its doors on 30 April the midwives suddenly found themselves without any backing or support.
There are 13 midwives who practise home births in New York, and under a system introduced in 1992 they are all obliged under state law to be approved by a hospital or obstetrician, on top of their professional training.
St Vincent’s was prepared to underwrite their services, but most other doctors and institutions are not, and they now find themselves without the paperwork they need to work lawfully.
Miriam Schwarzschild, one of the 13, is now in the invidious position of either abandoning her clients or operating illegally. “Apparently by taking a woman’s blood pressure I am committing an illegal act,” she said. She has no doubts about what she will do: she will stand by the six to eight women she helps in labour every month, law be damned. She said she intends to “fly under the radar”, but is anxious about what would happen should she be reported to the state authorities. “At any time a nurse or doctor could report me, and once that happens they could go after my licence and shut me down.”
Jitters are spreading among the tiny community of home birth midwives. The rumour has circulated that one of them has already been shopped to the authorities by an obstetrician at a hospital where she transferred one of her clients in need of medical attention.
The crisis of home birth in New York city is an extreme example of a pattern found across America. Fewer than 1% of babies are born at home in the US, and in New York that figure is as low as 0.48% — about 600 babies every year out of 125,000. That compares with a rate of about 30% in the Netherlands.
In much of Europe, midwives play the lead role in assisting most low-risk and healthy women to give birth, handing over to a specialist doctor or surgeon only when conditions demand. In the US, that relationship is reversed.
Obstetricians, who are trained to focus on interventionist methods and often have never even witnessed a natural birth, are in charge of about 92% of all cases. As a body, they are fiercely resistant both to midwives – who under the private medical system in America are their competitors – and to women choosing to remain at home.
Everyday we signs of our eroding rights and now these people choose to take away the most basic and natural of all, how we give birth. Women need to stand up for themselves and protest, protest, protest. Make a noise! Shake the foundations!