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Hope springs anew in Illinois.

On October 7, 1993, the Illinois Citizens Council on Women, one of seven councils established by the Illinois General Assembly to hold hearings on topics of legislative interest, met on The Role of Midwifery in Today's Health Care. The council is composed of eight consumers and eight lawmakers, all women.

Currently the legality of midwifery in Illinois is unclear. In 1991, the Illinois General Assembly thought it had made the practice of lay midwifery in Illinois illegal to, as some legislators believed, make all births safe in Illinois. Many midwives in Illinois believe it is not illegal because the bill that was passed pertains to practicing medicine without a license. Midwives do not feel they are practicing medicine, so the law does not pertain to them. Many attorneys have supported this view.

The Illinois Alliance of Midwives, headed by Yvonne Cryns, has been working since then to try and get midwifery legalized by the passage of the Licensed Midwife Practitioners Act, so far without success. In the most recent step down the road to licensed midwifery in Illinois, both direct-entry and certified nurse midwives were able to present their cases before the Citizens Council on Women, as were midwifery consumer representatives (of which I was one) and two doctors and one attorney from the Illinois State Medical Society. Also present was the director of a free prenatal clinic in Springfield, who appeared to be opposed to midwifery.

The Council on Women was an ideal audience. They were well informed, receptive to what we had to say, and were actually somewhat hostile to the medical community and some of their ridiculous statements. They asked well-informed questions and didn't allow those representing the medical community to sidestep issues.

The midwifery consumer representatives all had varying stories, but they were all along the same lines. We all testified that either through previous negative hospital birth experiences or, in two of our cases, through lots of research, we all turned to midwives for our care and for a home birth experience. Though some of us did mention that it is cost effective, our main emphasis was on our experience. I spoke on the intimacy my husband and I experienced at the birth, the bonding and closeness. For these reasons, we chose an unattended home birth for our son's birth because midwives aren't practicing in our area due to the vagueness of the laws, leaving us with the only other option of a doctor assigned to us at random through Public Aid and our local medical society--something not acceptable to us.

Anne Nicholson Weber, consumer advocate, attorney, childbirth educator, and home birth mom, spoke on the safety and the cost effectiveness of home birth, comparing $1,000 for the average home birth to $5,000 for the average hospital birth. She cited excessive use of ultrasound and external fetal monitors as two ways that the cost of health care is being driven up as much as $1 billion annually, resulting in no better birth statistics and, in fact, an increase in cesarean sections. Weber also pointed out that obstetricians can't give the same quality of care and "labor sit" like midwives do because it isn't cost effective. She said that since birth is a normal, healthy event and not an illness, it is wasteful to use doctors, who are uodertrained in normal birth. She also passed out bound, thick packets of statistics and articles to all members of the council.

Jane Arbuthnot has been practicing obstetrics in Springfield since 1982. She believes the role of CNMs is vital but that doctors should be present at all births because she says that one of every five births has complications. She said doctors are needed to control things like hemorrhage and that such situations were beyond CNMs' abilities. She made large assumptions about what CNMs and direct-entry midwives would do (such as prescribing unnecessary treatments) and said that direct-entry midwives would increase the cost of medical care by using more interventions to make more money. That souoded to us like what many doctors are doing. The council didn't buy it. When one member of the council pointed out that the United States ranks highest in infant mortality in industrialized nations and that all other countries use midwives for their primary care, she said that she wasn't opposed to physician-supervised midwives. When asked why physicians as a general rule don't do home births, she said it was the fault of the trial lawyers. When asked if, for the record, she was saying that doctors dont' do home births because of attorneys, she said yes. The council then told her that physicians aren't going to rural areas and that well-educated midwives could take up the gap there, pointing out they wouldn't be certified if they weren't well trained. The doctor had no response to this.

Midwives described to the council what they do, explaining that they do not deliver babies for high-risk women but only for low-risk women. When asked if this fact skews the statistics, it was pointed out that 95 percent of all babies in this country, whether high or low risk, are delivered by doctors and that the doctors still have poor birth statistics. The midwives were received very favorably and were asked very insightful questions that would increase the council's uoderstanding.

One doctor ended up comparing women to her frieod's racehourses. She said that her frieod woo't even let his racehourses give birth in a stable but sends them to the vet, where the best care is available. One council member told her that her comments were insulting to women. This doctor also stated that one of the greatest concerns in a homebirth is infection and that that is another reason women should give birth in a hospital. Actually, hospitals have the highest infection rates; the low infection rate is one of the many good things about home births. Frightfully enough, this woman is not only a doctor but a teacher of medical studeots.

Democratic Representative Janice Schakowsky thought, after hearing everything, that doctors are clearly needed in high-risk pregnancies but that women needed to have a choice. "Not everyone will take [the midwife-home birth option!. I uoderstand. People who want to will be in hospitals with doctors, but for those who prefer to be at home--prefer to have the kiod of personal care midwives provide--I think it should be an option, yes! With proper protections." Schakowsky expects that the Citizens Council on Women will propose legislation to license midwives this spring. Referring to all the male senators and representatives who have some opposition to midwifery legislation, one of the council members said, "We'll have a talk with the boys."

Another sign of hope is that these hearings received relatively extensive coverage in the media. At least three television stations, the Springfield newpaper, and Illinois Public Radio ran stories. Legal licensed midwifery might be just arouod the corner in Illinois.

Marcee Murray is a mother of two and a

provisionally certified childbirth

educator who expects for be fully

certified any day now. She has a

"conventional degree" in psychology and

also does birth assisting.
COPYRIGHT 1993 Association of Labor Assistants & Childbirth Educators
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1993, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Title Annotation:for licensed midwifery
Author:Murray, Marcee
Publication:Special Delivery
Date:Sep 22, 1993
Previous Article:Reducing the risk of sudden infant death syndrome.
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