Home births are on the rise, and moms have a few choices when it comes to what sort of midwife is present at the birth. The American Academy of Pediatrics has issued a recommendation, however, that leaves many practicing midwives in the dust.
AAP stepping on toes
Midwifery is a time-honored tradition that dates back to the dawn of time. In ancient cultures, women surrounded laboring mothers and helped deliver their children. Obstetricians are a modern development, as are hospital births — but in recent years, home birth is on the rise, as is the use of midwives.
Moms can research and choose from a few different types of midwives to attend their home birth, but the American Academy of Pediatrics has ruffled some feathers with their latest recommendations, which state that only a Certified Nurse Midwife (CNM) should be present at a home birth.
Types of midwives
CNMs are trained registered nurses who usually possess a four-year degree in nursing, and have gone on to take an additional two years of schooling specific to the practice of nurse midwifery. CNMs often have admitting privileges at hospitals and birthing centers and some will also attend a home birth. Certified Professional Midwives (CPMs) are certified through the North American Registry of Midwives and are usually the more common practitioner to attend a birth at home. Lay midwives have received their education and training from other midwives and while they hold no certification, they are usually fully trained in birth and emergency situations.
Some feel that the move is a good one — more similar standards across the board to improve overall quality of care. “I don't see a problem with making things more clear for training and education,” shared Ashley, pregnant with her fourth child. “Most every other profession you need a certification or degree. With everything that could go wrong during a birth, I think some extra education for the people involved makes sense.”
... or reducing access
Other see it as a move to keep births in the hospital and away from home.
"More and more babies are being born at home and the medical industry is obviously not a fan."
“A low-risk pregnancy is not a medical condition,” explained Brittney, whose second child was born at home. “The studies that have been done that show that home birth is just as safe as hospital birth were done on births attended by CPMs or lay midwives. That should be enough to deem this unnecessary. I really think this is just a push to make homebirth less accessible. More and more babies are being born at home and the medical industry is obviously not a fan.”
While it’s a recommendation and not a requirement, many in the midwifery profession are upset that the spotlight is being trained on CNMs, which may insinuate that their training is somehow better than the others. Also, recommendations by the American Academy of Pediatrics do bear weight with the general population. It has been pointed out that the accrediting body for both types of certifications is one and the same (National Commission for Certifying Agencies), so many wonder if there is indeed some agenda leading moms away from birthing at home.
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