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New Studies Confirm Safety of Home Birth With Midwives in the U.S.

Posted by Midwives Alliance on January 30th, 2014

by Geradine Simkins, CNM, MSN, Executive Director, Midwives Alliance of North America

In today’s peer-reviewed Journal of Midwifery & Women’s Health (JMWH), a landmark study** confirms that among low-risk women, planned home births result in low rates of interventions without an increase in adverse outcomes for mothers and babies.

This study, which examines nearly 17,000 courses of midwife-led care, is the largest analysis of planned home birth in the U.S. ever published.

The results of this study, and those of its companion article about the development of the MANA Stats registry, confirm the safety and overwhelmingly positive health benefits for low-risk mothers and babies who choose to birth at home with a midwife. At every step of the way, midwives are providing excellent care. This study enables families, providers and policymakers to have a transparent look at the risks and benefits of planned home birth as well as the health benefits of normal physiologic birth.

Of particular note is a cesarean rate of 5.2%, a remarkably low rate when compared to the U.S. national average of 31% for full-term pregnancies. When we consider the well-known health consequences of a cesarean -- not to mention the exponentially higher costs -- this study brings a fresh reminder of the benefits of midwife-led care outside of our overburdened hospital system.

Home birth mothers had much lower rates of interventions in labor. While some interventions are necessary for the safety and health of the mother or baby, many are overused, are lacking scientific evidence of benefit, and even carry their own risks. Cautious and judicious use of intervention results in healthier outcomes and easier recovery, and this is an area in which midwives excel. Women who planned a home birth had fewer episiotomies, pitocin for labor augmentation, and epidurals.

Most importantly, their babies were born healthy and safe. Ninety-seven percent of babies were carried to full-term, they weighed an average of eight pounds at birth, and nearly 98% were being breastfed at the six-week postpartum visit with their midwife. Only 1% of babies required transfer to the hospital after birth, most for non-urgent conditions. Babies born to low-risk mothers had no higher risk of death in labor or the first few weeks of life than those in comparable studies of similarly low-risk pregnancies. 

Importantly, this study also sheds light on factors that may increase risk. These findings are consistent with other research on pregnancy complications, but the numbers of these pregnancies were low in the MANA Stats dataset, making it impossible to make clear recommendations. This article from Citizens for Midwifery contains important information to share with families who are contemplating their birth options and weighing their individual risks and benefits.

This study is critically important at a time when many deeply-flawed and misleading studies about home birth have been receiving media attention. Previous studies have relied on birth certificate data, which only capture the final place of birth (regardless of where a woman intended to give birth). The MANA Stats dataset is based on the gold standard -- the medical record. As a result, this study provides a much-needed look at the outcomes of women who intended to give birth at home (regardless of whether they ultimately transferred to hospital care). The MANA Stats data reflects not only the outcomes of mothers and babies who birthed at home, but also includes those who transferred to the hospital during a planned home birth, resolving a common concern about home birth data.

This study adds to the large and growing body of research that has found that planned home birth with a midwife is not only safe for babies and mothers with low-risk pregnancies, but results in health and cost benefits that reach far beyond one pregnancy. We invite you to share this news in your communities, and join the conversation on our Facebook page, Twitter, and Pinterest

We are grateful to the ongoing support of the Foundation for the Advancement of Midwifery, which has been a major funder of the MANA Statistics Project.

** Note added 12:33 EST when the issue was published:

MANA Statistics Project Update

Posted by MANA Community Manager on January 24th, 2014

We’re incredibly excited to tell you that on January 30th, next Thursday, the much-anticipated outcomes from our MANA Stats 2004-2009 dataset will be publicly released.  

Two articles will be published in the upcoming Journal of Midwifery & Women’s Health: one describes the MANA Stats system and how it works, and the other describes the outcomes of planned home births with midwives between 2004 and 2009.  

The Midwives Alliance is proud of our Division of Research and the amazing MANA Stats system. This is the largest registry of planned home births in the U.S. and one of only two large datasets where normal physiologic birth can be studied, and we thank all of the contributor midwives who have made this possible. We also thank the members of the MANA Division of Research who created the system, continually improved it over the years, and have put quality assurance processes in place to make sure the data are sound.  And finally, we thank the researchers who shepherded these articles down the long road to publication.  We’re looking forward to the important conversations that these articles will generate!

For an in-depth look at what to expect from the articles, check out the post Understanding MANA Stats here.

Watch here for an update next Thursday, when we’ll share with you a summary of the findings, links to the research, and materials to share with women, families and others interested in learning more about home birth.

image credit: www.sweetbirths.com

HUMANizing Birth

Posted by Midwives Alliance on January 16th, 2014

Tell a man that he could possibly have a heart attack when making love. Then tell him that it would be safer for him to come to the hospital and make love while being monitored by a physician. Do you think a doctor coming in to take his blood pressure and monitor his heart every 10 minutes would affect his performance?

This is the question Saraswathi Vedam asks when giving an analogy about women and their birth choices.

In many cases, women birth in an unfamiliar environment and are separated from their loved ones during labor. In an unfamiliar place with unfamiliar people, women are expected to perform at their very best and deliver on someone else’s time.

Even zoo animals do not have to experience such a thing.

But why do so many mothers?

Watch more of Vedam and her talk on HUMANizing Birth here:

Speaker bio:

Saraswathi Vedam, RM, FACNM, MSN, Sci D (h.c.) is Associate Professor of Midwifery at University of British Columbia. She serves as Senior Advisor to the MANA Division of Research, ACNM representative the MANA-ACNM Liaison Council, and Interim Executive Board Member, Canadian Association of Midwifery Educators.

She is also a co-author of two upcoming research articles on the largest dataset on planned home births in the United States. To learn more about the research, click here.

Blog post author bio:

Iola Kostrzewski is a volunteer online community manager for Midwives Alliance of North America. She is a doula and Midwifery student starting in September. She is mom of two boys and creator of Breastfeeding in Color. Her passions in birth pertain to birthing and breastfeeding outcomes within the African American community.

Accepting Abstracts to Speak at MANA 2014!

Posted by Midwives Alliance on January 13th, 2014

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We are pleased to announce the theme for the MANA 2014 Conference October 23-26 in St Louis is:

"The Spirit of Midwifery."

This theme speaks to MANA Conferences as a place where midwives of all types and backgrounds can gather and be nourished and enriched. We hope it resonates for you too and that you will consider submitting a proposal to present a talk, workshop, or poster at MANA 2014. This is an excellent way to share your expertise and knowledge with the midwifery community.

The deadline for submission is February 10, 2014. We are seeking pre-conference workshops (full and half day), breakout sessions, plenary talks, and poster presentations. You may submit your presentation for consideration in more than one category.

The initial abstract form is streamlined and efficient. If your presentation has been selected, you will be notified by early March, and you will then have approximately 4 weeks to complete the more in-depth form necessary for MANA to apply for CEUs from MEAC and ACNM. For details and to submit your proposal, click here.

Thank you!

The MANA 2014 Programming Committee

What Does The Law Say About Midwifery In Your State?

Posted by MANA Community Manager on December 10th, 2013

New State by State Resource Guide provides legal status, connects birth professionals and consumers

In a climate of rapidly expanding consumer demand for home and birth center births, state midwifery laws are changing to adapt to this growing trend for out-of-hospital birth. The United States does not have a comprehensive federal law that regulates the practice of midwifery. Each state determines its own regulation and scope of practice for midwives. While Certified Nurse-Midwives practice legally in all 50 US states, regulation of direct-entry midwives varies widely from state to state.

Check your state at our State By State resource guide to:

  • learn about the current status of midwifery laws in your area

  • connect with the midwifery professional organizations and consumer groups supporting birth options

Direct-entry midwifery (DEM) is a general term used in the United States for a wide range of practitioners who enter the profession of midwifery through routes of education other than nursing. These practitioners include Certified Professional Midwives (CPM)—those holding certificates issued by the North American Registry of Midwives (NARM), Certified Midwives (CM)—those holding certificates issued by the American Midwifery Certification Board (AMCB), as well as Registered Midwives (RM), Licensed Midwives (LM), and other direct-entry midwives practicing in states still in the process of regulating and licensing DEMs.  Most DEMs provide services in birth settings that are outside of medical institutions, primarily freestanding birth centers and private homes. 

For additional resources or changes to our current contacts, please contact the Midwives Alliance at region6@mana.org.