Manassas Journal Messenger | New law clears the way for midwives

When Andi Fouse gave birth to her second daughter, Branwen, a year and a half ago, the newborn didn’t breathe right away.

But Fouse didn’t panic this time, like she did after giving birth to now-3-year-old Alexis.

When she delivered Alexis, hospital doctors induced the birth, as Fouse was overdue. But Fouse experienced a painful reaction to the medication used in that process.

Her doula, or a woman who assists another woman during labor, even feared that Fouse’s uterus would rupture.

After Alexis arrived, Fouse worried when doctors took her daughter away for monitoring.

During her second labor, Fouse enjoyed the comfort of her own Bristow home. And she didn’t have a team of doctors swooping her baby away or using medications that caused her pain.

Her midwife immediately gave oxygen to the newborn and monitored her with Fouse lying next to her baby. Just as a precaution, the midwife called 911.

“The midwife comes prepared for all the issues that might come up,” Fouse said. “The [emergency medical technicians] showed up and basically didn’t do anything.”

But Fouse’s midwife delivered Branwen only through a loophole in Virginia law. At the time, the commonwealth didn’t recognize midwifery as a legal practice.

During the 2005 General Assembly session, home birth advocates flooded committee rooms to speak in favor of HB 2038, submitted by Delegate Philip A. Hamilton, R-Newport News, and an identical bill, SB 1259, submitted by Sen. Frederick M. Quayle, R-Chesapeake.

Both the House of Delegates and the Senate approved the bills, and Gov. Mark R. Warner signed them into law, effective July 1.

The bills “Provide for the licensing by the Board of Medicine of those persons who have obtained the certified professional midwife credential to practice midwifery pursuant to regulations adopted by the Board of Medicine.”

The board still needs to establish those regulatory guidelines. But whatever regulations it promulgates, midwives around the state anxiously await the legal ability to practice.

Once the law goes into effect, women like Fouse can also get insurance coverage for the use of a certified professional midwife.

Nokesville resident Sally Holdener has fought for state recognition of midwives with the Virginia Friends of Midwives since early 1997, shortly after the birth of her first son.

The group encouraged legislators to call for a study, which was completed by the General Assembly Joint Commission on Healthcare in 1998, Holdener said.

“They came out with the recommendation that [certified professional midwives] be licensed, but nothing came of it,” Holdener said. “We have had bills every year since. It kept coming up against the Medical Society of Virginia, and they kept bringing in doctors with horror stories.”

The Society continues to oppose licensure of midwives, said spokeswoman Ann Hughes.

“The problem that the medical society has is the access to safe medical care for women who choose an alternative location [for birth],” Hughes said.

Midwives refuse to work with doctors or hospitals, Hughes said.

“We think that knowing there are a number of things that can go wrong during the labor and delivery process, that it is not putting the woman’s health first to not have any type of collaborative relationship with a doctor or a hospital,” Hughes said.

According to Fouse, midwives feel that doctors don’t recognize their legitimacy, and refuse to work with doctors for that reason.

Some doctors might dismiss midwives because certified professional midwives are not trained like nurses who also practice alternative birthing methods, or certified nurse midwives, Hughes said.

“The medical profession does not acknowledge them as they would a nurse midwife, because of the lack of a clearly defined curriculum that needs to be completed for them to hang out their shingle and say that they’re a midwife,” Hughes said.

But home midwives are required to assist in more at-home births than are nurse midwives before practicing on their own, Holdener said.

Gainesville resident Peggy Franklin, who practiced midwifery in Washington state before moving to Prince William County two years ago, went to Seattle Midwifery School for her training.

Franklin had to pass a skills assessment and written test regulated by the North American Registry of Midwives, a national midwife accrediting organization. She has participated in more than 1,500 births during her time as both a nurse midwife and home midwife.

“A lot of people have misconceptions about the safety of birth at home versus hospital,” Franklin said. “Our bodies were made to go through this and throughout all of time many have had their babies at home. It’s only recently that doctors would take care of babies in the hospital.”

Having a natural delivery at home can even be safer than giving birth in a hospital, Franklin said.

Some cite Fouse as an example that would put fears about midwives to rest. In her case, the baby encountered a problem and the midwife handled it in the home.

In October, Fouse plans to be home, delivering her third child, with a newly-licensed midwife. Some women, like those with high-risk pregnancies, might not want to use a midwife, Fouse said.

But she highly recommends a more natural, at-home birth if possible.

“The interventions [in hospitals] that are out there are out there for a reason,” Fouse said. “There are times to use them. It’s just that they get used a little more than necessary.”

Staff writer Sari Krieger can be reached at (703) 878-8062.