The question of my stance on home birth has been raised by several. I can only assume this question stems from my recent change from seeking out my license as a CPM (Certified Professional Midwife), and seeking out my degree as a CNM (Certified Nurse Midwife).
I most definitely have not changed my stance on home birth. I am still a firm believe in a woman's choice to birth in whatever environment she likes and I plan to support a woman's choice no matter where she plans to birth., providing she meets the requirements to categorize her as 'low risk'. In fact, not only do I support home birth, but I plan to attend them as well. In South Carolina, CNMs do not attend home birth, but attend births only in hospital and freestanding birth centers. However, North Carolina CNMs may attend births at home, a freestanding birth center, or in hospital. My plan is to become licensed as a CNM in both the state of South Carolina, and in North Carolina since I am so close to the state line. This gives me such a wide variety of options for home births, births in a freestanding birth center, as well as hospital births. I have the option of offering out of hospital births to qualified women and having their insurance pay for it as well. As a CNM, I feel like I will be able to reach so many more women than if I were only a CPM. This is another huge reason for my recent decision regarding my education.
Choosing to become a CNM instead of a CPM does not automatically equate me as anti-homebirth. I am not anti-homebirth, but I am pro safe birth. I believe a woman can have a safe, amazing birth experience in a birth center, at home, and even in the hospital. Do I believe that women who choose to birth with a CPM are not choosing 'safe birth'? No, not at all. There are plenty of wonderful, qualified, well-trained CPMs who have a sharp eye and a kind heart. There are also many under-qualified, uneducated, unregulated CPMs that do not provide a safe birthing environment. I am most certainly not anti-CPM, and I never will be. Just because I have decided to go another route does not mean this at all. Do I believe there are women out there who are birthing out of hospital that should not be? Absolutely. Homebirth, I believe, should be reserved for those who are 'low risk'. The term "low risk" is such a variable as everyone has a different opinion on what that means. To most OB's, a VBAC (Vaginal Birth After Cesarean) is not considered to be "low risk". However, to me, because the risk of a complication from a VBAC is less than 1%, I still consider that to be "low risk". Most would agree that issues such as presentations besides vertex (breech, ect.), multiples, and certain maternal conditions are considered "high risk", though many still attend out of hospital births for these women. I can not say I am in 100% agreement with this. I personally believe there should not be an across the board answer, but each situation considered on a case by case basis. I am a firm believer that a women who has had a complication free pregnancy, no known issues with her or her baby, has a baby in a good position, and goes into spontaneous labor is a prime candidate for a home birth. I do not, however, believe a women who is having twins, both of which are breech, and is developing high blood pressure is considered "low risk" and should be birthing at home. Many will agree with me, and many will not. Again, we all have our opinions on what "low risk" means and we all have to make the best decisions for ourselves and our specific situation.
I say all this to clarify that I have not, nor will I ever, be anti-homebirth. I believe home birth is a safe, natural, and beautiful thing with a skilled, qualified attendant and I will be honored to attend many home births in the future.