Keeping Our Birth Options Open

May 11, 2010

Guest blogger Danielle Brown, like many of our Mama Goose customers, is an impassioned homebirther who is very concerned about the crisis New York state midwives are currently facing. She was kind enough to share important information and her own experiences in this post.


I am not inclined to try to change anyone’s mind about homebirth or midwifery care in their own lives but I won’t waver when it comes to the necessity of birthing options for all women. Our Ithaca area homebirth midwives are losing their written practice agreements because the one physician who was signing them locally is no longer available to do so. Recently, New York City homebirthers lost their access to homebirth midwives as well. While I am aware that this issue isn’t just about homebirth, as a homebirther myself, much of my focus falls on exactly that. In my estimation this issue is wholly about access to care and the disregard for a woman’s right to choose the birth she deems appropriate. The written practice agreement stands as an effective barrier to midwifery care and homebirth care specifically, thereby eliminating those birthing options in areas where licensed midwives are unable to attain them.

 I vividly recall the fear I felt when faced with the possibility of having a hospital birth. While talking with a friend I mentioned this apprehension and she suggested that I look into midwifery care. With that suggestion I realized that what was right for me was to seek out midwifery care and specifically, a homebirth. I knew that I wanted a completely natural birth with no unnecessary intervention and I planned to breastfeed; decisions which lend themselves to homebirth midwifery care. Both of my children were born at home here in New York, each attended by a licensed midwife and although the initial decision to have a homebirth was fear-based, my convictions about my decision continue to grow.

In the United States roughly a third of births occur via c-section, which doesn’t even closely follow the c-section guidelines as laid out by World Health Organization. Women who have had one c-section are often told that they will be denied a vaginal birth [after cesarean] or VBAC, despite the fact that they did not necessarily elect to have the initial c-section. This has led to the existence of sites like The Unnecesarean which, in good company with Pushed by Jennifer Block and the movie The Business of Being Born, observes that midwifery care is part of the solution and a means to move away from the medicalization of birth.

Last year, my children and I attended the homebirth picnic at Taughannock State Park and it was nothing if not delightful. It is rare to have the opportunity to spend time with so many likeminded people, to see so many other women in one place who birthed their children in the same manner as I did. Seeing our midwives and their assistants mingling amongst the families, stopping to chat and see the children they skillfully and lovingly helped to be birthed was an invaluable experience. It was a profound demonstration of the existence of a homebirth community, and in my mind, also served to establish homebirth as a way of life that needs to be preserved for those who wish to choose it.

In the state of New York midwives are required to have a written practice agreement or WPA, signed off on by a practicing OB/GYN or hospital. At this time supporters of midwifery are working to have the WPA requirement removed and a call to action has gone out. The Midwifery Modernization Act or MMA, bill S5007 / A8117, was referred to the Higher Education committees last year and while it is faced with serious opposition from the American Congress of Obstetricians and Gynecologists, they are being countered by a swell of support for the bill by those of us who believe firmly in the autonomy of midwives and wish to see the bill moved out of committee for consideration.

The current educational and licensure requirements for New York midwives are extensive and the track record of midwives as a distinct section of care providers speaks for itself. There is a large body of evidence which establishes that midwifery care is directly connected to better outcomes for mother and baby as well as lower costs, in part due to lower cesarean section rates. Despite this, midwives in New York and 35 other states are not allowed to practice as independent health care providers.

Now is the time for action in New York State; it is our time to take a stand. The depth of my conviction about the issue of midwifery care stems from how I feel about homebirth but moreover it has to do with the desire to choose where, with whom and in what manner I will birth my children. If you believe that women should have birthing options and unrestricted access to midwifery care both in and out of hospital, please read the call to action and take your stand.


Danielle's beautiful son and daughter, born 10-7-07 and 2-22-06, both at home and attended by a licensed midwife.


One Response to “Keeping Our Birth Options Open”

  1. hillary13 Says:

    Great post Danielle, and like you said this legislation is about so much more than homebirth. It’s about professional midwives being able to set up independent practices to provide well-woman care to woman of all ages as well as care to pregnant and expectant mothers (in all birth settings).

    Midwives who practice in hospitals stand to loose their jobs at any moment because they rely on the hospitals and docs to hire them in order to obtain their written practice agreement.

    No matter where you choose to give birth we, as women and community members, need to be supporting each other’s choices. We can all get behind this movement and legislation right now.

    Thanks for highlighting this important women’s health cause and we invite everyone to come and join the consumer movement over at to learn more and gain strength in number.

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