Sunday, May 17, 2009

Doctors Vs. Midwives

This is the latest about doctors and midwives in Time magazine. Melissa Cheyney is on the Midwives Alliance Division of Research and is a CPM, researcher.

1 comment:

Steff Hedenkamp said...

Sharing the following Letter to the Editor, which is posted on The Big Push for Midwives Campaign headlines page:


I would like to point to a factual error in Jeffrey Kluger's May 16 article, "Doctors Versus Midwives: The Birth Wars Rage On."

The author states that home births "attended by trained nurse-midwives are no less safe than hospital births . . . providing the midwives are affiliated with a nearby hospital to which the mothers can be brought in case of complications." He then follows with a quote stating that the "'most comprehensive study of this was published in the British Medical Journal in 2005," says Melissa Cheyney, an assistant professor of anthropology at OSU and a practicing midwife herself. "It showed that for low-risk [home] births in the U.S. and Canada, the infant mortality rate was roughly 1.7 per 1,000, or about the same as it is in hospitals.'"

In fact, this study examined the outcomes of all births attended by Certified Professional Midwives (CPMs) in North America during the year 2000, not the outcomes of babies delivered by Certified Nurse-Midwives (CNMs), whose practices are primarily hospital-based. The CPM is the only national midwifery credential in the US that requires specialized training in out-of-hospital settings and that prepares midwives to develop expertise in out-of-hospital birth, and the vast majority of babies born at home and in birth centers are delivered by CPMs. No CNMs participated in the 2005 BMJ study referenced in "Doctors Versus Midwives."

Moreover, the objective of the study was to evaluate the outcomes of CPMs in "jurisdictions where the practice is not well integrated into the healthcare system," (read the study here) not in situations where midwives are affiliated with a nearby hospital. CPMs are not legally authorized to practice in just under half the states. The fact that they produce excellent outcomes in the face of less-than-ideal practice environments in many states is a testament to the rigorous educational and training process required to qualify as a CPM.

In recognition of the need for midwives with expertise in out-of-hospital birth, since publication of the BMJ study, Virginia, Utah, Wisconsin, Missouri, Maine and Idaho have joined the growing number of states that legally authorize CPMs to provide maternity care, with legislation pending in a dozen more states. As CPMs become more fully integrated into our health care system, we see the "Doctors Versus Midwives" wars transform into "Doctors Working With Midwives" partnerships.

To learn more about the contributions of CPMs to our maternity care system, please attend the May 21st Issue Briefing on Out-of-Hospital Maternity Care and Health Care Reform at the Sewall-Belmont House, 144 Constitution Avenue, NE from 8:00 to 9:00 am. Speakers include the authors of the 2005 BMJ study as well as an economist and public health specialist with expertise in the clinical and economic benefits associated with out-of-hospital deliveries under the care of CPMs.

Katherine Prown, PhD
Campaign Manager, The Big Push for Midwives Campaign