Alabama Midwives Alliance

Imagine that you have arranged a personal meeting with your legislator to request access to licensed home birth midwives. You identified the ways in which licensing and regulation of midwives would benefit you and the community. You then neatly avoided the "selfish mother" trap by answering the question of why you would choose home birth with reasons that center on safety and the well-being of baby. But then your legislator mentions the numerous e-mails from the many reputable physicians in his/her district that desire to defeat any bill involving home birth and midwifery because it is so dangerous. NOW WHAT?

Step One: Remain calm. Expect this kind of opposition. The American Medical Association has pledged to strongly oppose home birth and midwifery and has created the Scope of Practice Partnership (SOPP) to oppose all expansion of practice by nonphysicians. On the surface AMA members will claim it is because of concerns for safety, but in 2008 the Supreme Court in Missouri listened to their arguments and told them safety and protection of patients was not their motive, rather it was economics. Protection of their "turf" under the ruse of representing the health and safety of the patients earned them "Lack of Standing" in their case opposing CPM practice. The case was dismissed and CPMs in Missouri are legal to practice.

Step Two: Remain confident. By their own admission in their own documents to their own members, the American College of Obstetrics and Gynecology "does not defeat this issue on the merits of the debate." They have no solid research with which to defend their position so they instead will grab whatever information looks like it might favor them and try to lead the less-critical thinkers into believing their position is evidence-based. They describe their own efforts as "deft political maneuvering and hardball tactics." Licensing and regulating home birth practice using the CPM credential is based on evidence. The position of truth will eventually see justice. In the meantime, be aware of the hardballs about to fly. (The latest example of these tactics is the now infamous Wax Paper, a meta-analysis yielding poor conclusions regarding infant mortality rates that has been sharply criticized by the international community.)

Step Three: Be prepared. It remains to be seen what scary statistics will be used to generate hysteria this coming year. Be prepared to hear just about anything, but realize that whatever statistics are offered to discredit home birth, they will be numbers taken out of context. ABC will be on the lookout for abuse of "research" during the session, so if you hear a legislator express concern, accurately document the information that is alarming to him/her and then provide that information to ABC. We will then do our best to provide the background needed to correctly interpret the hype, and hopefully provide some means of bridging understanding.