by Ashley Price
Around this time last year I pulled my son out of my body and held him for the first time. My doula wrapped a towel around us, and as my husband was calling the grandparents my midwives watched closely as my baby took his first breath.
As the water of the birth pool chilled I cuddled my new baby, marveling in the fur on his ears and the odd shape of his head. When the placenta was birthed and the cord cut, I handed the baby off to his father, walked to the bathroom and was cleaned up, and then crawled into my bed to nurse my baby for the first time.
My son’s birth was easily the best moment of my life, and while the location was unconventional my choice was perfectly legal. Unfortunately my midwives were committing a felony.
There has been a movement since the mid-90s to license Certified Professional Midwives in Illinois. CPMs are non-nurse midwives whose training and scope of practice is limited to low risk birth. They do not provide well-woman care, treat disease, prescribe drugs, or handle high risk pregnancies. They are trained to recognize, prevent, and if necessary stabilize complications in labor.
The true benefit of CPMs (aside from the fact that they are cheaper and we know that licensing CPMs will save Illinois Medicaid $5 million/year without an increase in homebirth incidence) is that they are specifically trained in out-of-hospital birth. This means that they can resolve complications in a low-technology setting. They are licensed and practice openly in 27 states including Missouri, Wisconsin, New York, Oregon, and Tennessee.
Prenatal care with my homebirth midwife was excellent and evidence-based. Much like at your average OB visit, she measured fundal height, checked heart tones with a doppler, tested my urine for signs of gestational diabetes and pre-eclampsia. We spent an hour at each appointment talking about nutrition, labor concerns, exercises to help my baby stay in a good position, and really anything we want. One of the benefits of homebirth is that there’s never a stranger attending your birth.
While prenatal care is very similar to what a low-risk mom receives in your average OB practice, there are subtle but important differences in labor care. One of the biggest reasons local moms cite for choosing homebirth is that they find certain standard procedures and policies at area hospitals unacceptable.
Many of the details that make hospital birth plans long and tedious are the default for homebirth. The cord isn’t cut until the placenta detaches, newborn procedures are delayed until after the first feeding, and you’re never separated from your infant. My birth plan was exactly 2 lines long: I want a water birth, and please note the exact time he’s born.
It’s an unfortunate fact that in order to get a homebirth I had to find a midwife on the black market. I found her by posting on a message board and hired her based on her stellar reputation, but she wouldn’t accept me as a client until I was vetted and they were confident I wasn’t an “infiltrator” trying to report the midwife.
I frequently get people asking me to find them a midwife, as do many of the C-U residents who have mentioned in public that they homebirth. Finding a healthcare provider based on a friend of a friend knowing someone is insane, but it’s a reality in Illinois. In the past 15 years 16 midwives have been investigated and sanctioned, and 14 of them have left the state.
Just as the midwives fear arrest, the homebirth families fear official harassment. We hear stories of DCFS being called on homebirthers who wind up in the hospital for any reason, including needing stitches, of babies being kept hostage in the NICU unnecessarily, and generally being mistreated. Accordingly homebirthers have a strong incentive to delay a hospital transfer until it becomes clearly necessary, which isn’t exactly safe. I have approached Carle to implement a policy on homebirth transfers, and they have thus far refused to speak with us.
Underground black market maternity care is never safe, but it’s a reality here in this community and throughout the state. The Coalition for Illinois Midwifery yet again introduced the Home Birth Safety Act in the Illinois House, a bill which would integrate CPMs into the healthcare system, making homebirth safer for everyone. Rep. Naomi Jakobsson (D-Urbana) was a chief co-sponsor. Rep. Adam Brown (R-Champaign/St. Joseph/Arcola) voted against it in committee, where it remains.
As homebirth numbers rise (up 29% in 5 years) families in Illinois will continue to lack access to licensed, regulated, safe homebirth care. My homebirth was the best moment of my life, and my midwife by all measures highly trained and skilled, but because of the legal situation in Illinois it was absolutely less safe. Until the law allows Illinois families access to licensed homebirth care, families will continue to have babies at home with unregulated midwives they find in the underground maternity care system.