More Demand for Reform

"With health care reform once again on the national agenda, the American College of Nurse-Midwives has formed a Presidential Task Force on Health Care Reform to educate health policy makers and legislators about the contribution that certified nurse-midwives and certified midwives make to improve the care of women and childbearing families.

"It is generally accepted that the United States can do more to improve the health of all women and their newborn infants and to reduce the disparities in population groups. For nearly 80 years, studies of nurse-midwifery care have repeatedly demonstrated that, in collaboration with obstetrical specialist care, the rates of prematurity, low birth weight babies, and medical interventions such as cesarean section can be reduced and the health and welfare of mothers and babies improved. Furthermore, midwifery care reduces costs to insurers, families and the system as a whole. The women who have been cared for by midwives have a high rate of satisfaction with the care they received, and their collaborating physicians report that it improves their ability to offer more comprehensive care," says ACNM President Eunice K.M. Ernst, CNM, MPH, DSc(HON), FACNM. "With the formation of this task force, ACNM is preparing to ensure that midwifery is included in proposals for health care reform. It is a model of care proven to be part of the solution for improving the health and welfare of mothers and families, while simultaneously reducing costs."

Pregnancy and childbirth are major drivers of rising health care costs in this country. Childbirth remains the number one reason for hospitalization, and childbirth is the most performed procedure performed in America’s hospitals today. In 2003, 4 million hospitalizations for women giving birth accounted for 11 percent of all stays in U.S. community hospitals. The average charge for childbirth was $8,300. The aggregate charge (i.e., national bill) for these hospital stays totaled over $33 billion. The average charges associated with uncomplicated C-sections were $11,500, which is more than $5,000 greater than the mean charge for all routine vaginal deliveries. (Source here)

The ACNM task force is chaired by Marion McCartney, CNM, FACNM. Click here for the full list of task force members. For more information, visit

With roots dating to 1929, the American College of Nurse-Midwives is the oldest women’s health care association in the U.S. ACNM’s mission is to promote the health and well-being of women and newborns within their families and communities through the development and support of the profession of midwifery as practiced by certified nurse-midwives and certified midwives. Midwives believe every individual has the right to safe, satisfying health care with respect for human dignity and cultural variations. More information about ACNM can be found at"

          Do you know what sentence made me the most upset through that whole article?  "Childbirth remains the number one reason for hospitalization, and childbirth is the most performed procedure performed in America’s hospitals today."

          When did childbirth become a procedure that someone else had to perform?  In the course of "The Business of Being Born," there is a Monty Python-esque sketch in which we see a frenzy of doctors in what appears to be an OR.  They’re ordering instruments and drugs and various and sundry things and then the scene cuts to the actual laboring mother.  She asks, "What do I do?"  The doctor replies, "Nothing.  You’re not qualified."  That seems to just about sum up the attitude of the general public about women’s abilities to give birth without medical intervention.  We’re not qualified to do it. 


            "Midwives believe every individual has the right to safe, satisfying health care with respect for human dignity and cultural variations."  Exactly what part of that statement is threatening or sounds un-safe, dirty, or un-natural to you?  That actually sounds far better than typical hospital procedures to me.  Staying in bed, flat on your back, having no food and being monitored constantly just doesn’t seem "welcoming" to me.  While I admit a natural disdain for hospitals because of my personal experiences and my resulting mental associations of them, I still can’t mentally justify birth being a hospital experience for 99% of mothers in the US.  Only 8% of mothers in this country are attended by midwives, with only 1% being home births.  ONE PERCENT. 

          I am so glad to see that there appears to be a rising tide of awareness and outcry for change in our country.  I am glad to see that more and more people are not just accepting what is being handed to them, and that they are demanding to know their options, demanding to have those options, and telling others about those options.

          Below is a list compiled by Jennifer Cheney, who is currently an RN at DePaul’s Midwifery Center, of things you can do to support midwifery.

  •      Visit midwives for well-woman care.  They provide great menopause/post menopausal care, too!
  • Write a letter of thanks, send flowers, etc., to midwives and/or doctors who support midwives.
  • Support groups like VABirthPAC, a midwifery lobbying group in Virginia, who are working hard to create a database of legislator’s stances on birth, and let you know what is going on in the political world of birth.
  • Donate money or ask for donations in lieu of Christmas/other gifts for your favorite midwifery groups: VABirthPAC, Birth Matters, Tidewater,, North American Registry of Midwives.
  • Support the safe motherhood quilt project, which remembers mothers who have died due to childbirth complications and brings awareness to health care issues in birth.  Remember the Mothers
  • Go to major book stores and order books like Ina May’s Guide to Childbirth by Ina May Gaskin, Henci Goer’s The Thinking Woman’s Guide to a Better Birth, or Elizabeth Davis’s Hearts & Hands: A Midwife’s Guide to Pregnancy & Birth.  The stores order one for the customer and then a few more for the shelves!
  • Donate safe birth books, like the ones mentioned above, to your local library.
  • Talk to your local library about setting up a display that supports midwifery and helps educate the public, especially during National Midwifery Week (October 7th – 13th).
  • Be a member or participate with groups like Birth Matters and Citizens for Midwifery.
  • Subscribe to magazines like Mothering.