As a fellow physician, I know that your first concern is for the health and safety of your patients. Every year in Ohio almost 1,000 babies are born at home. In this state, that puts them at unnecessary risk.

Studies have shown that home birth can be safe for low-risk mothers when overseen by qualified midwives who can identify emergent complications and transfer care appropriately. Because the state of Ohio does not license home-birth midwives, families may delay a necessary transfer to the hospital, fearing negative repercussions due to their choice of birthplace and their midwife's legal status. Some women choose to deliver at home unassisted, or with an under-qualified attendant, because of the barriers to accessing maternity care in an out-of-hospital setting. As a result, their safety may be jeopardized if complications develop and hospital care is needed. The current legal climate has created a "black market" of maternity care that is dangerous for mothers and babies.

As an obstetrician, I have been working with families who have chosen home birth since I started into private practice in 1993. The fears expressed in the latest ACOG position paper on home birth are unfounded and I can assure the medical community that these families are not a fringe element choosing that which is "fashionable, trendy or a cause celebre'." This is an intelligent, thoughtful and well-read clientele. They are doctors, nurses, business executives, artists, musicians and, yes, even lawyers. Home birth families cannot be simply painted with one brush. Some have had previous negative interactions with hospitals and are looking for a safe alternative to that which we have come to consider mainstream. Many choose home birth for religious convictions. Others have found comforts in the home setting that may bring on a progress of labor too rapid to allow for a safe transit to the hospital. Whatever their reasons, in our current climate, these families are offered few resources to make informed decisions about care providers and options other than traditional hospital birth. Instead, they are forced to turn to an underground system that is not regulated and (it may surprise you) is not specifically prohibited by law. Something needs to change.

Ohio Physicians for Midwives is a group of doctors who support legislation licensing Certified Professional Midwives in Ohio. We believe women who choose out-of-hospital birth deserve access to care from qualified, licensed professional midwives. The American Public Health Association supports "increased access to midwifery services," and "efforts to increase access to out-of-hospital maternity services... through recognition that legally regulated and nationally certified direct-entry midwives can serve clients desiring safe, planned, out-of-hospital maternity-care services." Licensing Certified Professional Midwives would be a step forward for maternal-child health policy in Ohio, bringing us in line with the practices of other states and nations with excellent perinatal outcomes.

The Certified Professional Midwife (CPM) credential is a national credential for midwives specializing in out-of-hospital birth. It is a legally defensible, competency-based standard recognized by 22 other states. Licensing Certified Professional Midwives protects families by ensuring the care providers they choose have met rigorous criteria for providing maternity care in an out-of-hospital setting. A licensure law would also clearly make midwives responsible for their own acts and omissions and protect receiving physicians in a transfer from vicarious liability. Families, physicians, and midwives all benefit from the integration and regulation of CPMs into mainstream health care. Families planning an out-of-hospital birth receive the best and safest care possible when midwives can work with physicians to consult, collaborate, and, when necessary, transfer care in an efficient and timely manner.

You can help make out-of-hospital birth safer for Ohio families. Please join me in supporting Ohio families' right to make evidence-based maternity-care choices that respect their cultural, philosophical, or religious beliefs. Support licensure for Certified Professional Midwives. Both individuals and organizations are encouraged to join. Just download the Ohio Families for Safe Birth / Ohio Physicians for Midwives Joint CPM Licensure Initiative Endorsement Form (as a PDF or a Word file), fill it out, and mail to:

Regards,

Dr. Daniel Bowen,
Founding Physician, OPFM