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Home birth advocates continue to fight

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By NANCY HICKS / Lincoln Journal Star

Tuesday, Jul 25, 2006 - 12:11:57 am CDT

One mom who believes that Nebraska women should have the option of a safe home birth assured the Nebraska Board of Health Monday that women like her are not wacky.

“We are not a bunch of tree-hugging, Volkswagen-van-driving, stick-it-to-the-establishment lunatics here,” said Autumn Foster Cook of Omaha.

“We are thoughtful, well-educated mothers and fathers who devote great amounts of thought, time and energy to what is best for our children,” she told the board during an afternoon public meeting.

About a dozen other Moms who support the option of home birth (and a few dads) politely showed their support for changing state law, filling the seats in the board’s meeting room at the State Office Building.

When a baby got fussy, the mom quickly left the room so the noise would not be so distracting. But the muffled wails of several infants wafted over the meeting.

The board had also received several hundred postcards from Nebraskans who support the home birth option.

But the show of support didn’t erase board members’ concerns over the safety of babies and their moms.

The board rejected the recommendation that the state’s certified nurse midwives be allowed to help with home deliveries.

They agreed with the representatives of the Nebraska Hospital Association and the Nebraska Medical Association that a hospital setting is best for mothers and children.

“A low-risk pregnancy can become a high-risk pregnancy very quickly,” said Carly Runestad, with the hospital association.

But leaders of the group of Nebraskans formed to support the home birth option said they will not be derailed by the health board decision, which will become a recommendation to the Legislature.

“This just means it will take a little longer,” said Cook, chair of the Nebraska Friends of Midwives.

That group will seek a law change next year and “every year until it passes,” said Cook, who wanted to give birth to her third child at home but was stymied by Nebraska’s law.

Currently women who give birth at home don’t break the law, but any midwife who helps them does.

That leaves women with the choice of an unattended home birth or giving birth in the hospital.

The board’s decision doesn’t remove the problem, said Dr. Daryl Wills, a board member and chiropractor from Gering, and the only board member to vote for liberalizing the home birth law.

“We will still have women who want to give birth at home and want to have someone with skills there to help them,” he said.

The board vote was part of a regulatory process intended to advise the Legislature. It came after a technical review committee also rejected changing the state’s restricted home birth law.

Nebraska’s Chief Medical Officer, Dr. Joann Schaefer, will also make her recommendation in late summer or fall.

The health board’s decision should not stop the discussion over how to improve health care and over creating more collaboration between nurse midwives and doctors, said Linda Lazure, of Omaha, chair of the board.

“Reasonable people can reach reasonable solutions,” she said.

Home births was one of three major issues in the study.

The state board also rejected creating a state licensing process for direct entry midwives, people who are not nurses but have had training and experience in midwifery. Lay midwives can practice legally in more than 30 states.

The board also recommended maintaining current law, which requires certified nurse midwives to have written agreement with a physician to practice in the state.

Reach Nancy Hicks at 473-7250 or nhicks@journalstar.com.


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midwest girl wrote on July 25, 2006 12:38 am:
" Homebirth is a safe and healthy options for many families, and there are many studies that prove this. Of course the individuals on the medical side of things believe that a hospital is the safest. But how "safe" is it when you have at least a 26% chance of having major surgery (a Cesarean section), increasing the woman’s chances of infection, injury to mom and/or baby, problems with breastfeeding and so on. There are also the other medical interventions that are routine in a hospital-induction, restricted movement, constant monitoring and so on all can lead to a c-section and other problems. I have not even mentioned issues that come up after the birth. The state is already throwing up many roadblocks, so as is typical I am sure they will allow homebirths, but will not license anyone to provide care at a homebirth thus making homebirth non-existent. I love NE and miss my hometown, but I am not moving back until I have my last child at home in my new hometown with my competent and caring midwife, a doula and family at my side. We need to remember that labor and birth is not an illness, it is a normal process that women all around the world experience everyday. We need to stop treating birth as a medical event, and teach women to once again trust the birth process. "

 jon wrote on July 25, 2006 4:20 am:
" This is freedom?I thought that Nebraska was all about freedom,justice and the American way. Of course doctors are going to object to home cures for anything.Just as Jiffy Lube objects and expresses major concern for the life of your car.Home oil changes by a non-trained professional are messy and potentially dangerous for the owner and the auto. I would think that staying at home is far safer than the DRIVE to the hospital.Any one of many complications could arise from the drive. I believe that the list of 3500 Nebraska potential terror targets includes hospitals.AAHHHH!!!!Stay home.AL Queda terrorists might get you at the hospital.You may DIE on the drive there. The medical profession wants us to think that birth is a major cause of DEATH!! "

 Lin wrote on July 25, 2006 7:52 am:
" Nebraska has sold out once again to the recommendations of the hospital association and medical association. The fact is Medicine is a money making business, allowing for safe births at home takes the money away from these businesses. Hospitals are no more safe than a playground. Hospitals operate well below safe staffing levels, and nosocomial infections are more of a threat, medications errors are more of a threat and increased risks associated with surgical procedures are of more concern to the safety of the Mother and child. An effective smoke screen is again thrown up with patronizing arguments to ensure the 'business' keeps coming the way of the medical establishment. I am a part of this establishment, have worked in it to this day for over 30 years. There are not safe practices in hospitals and it is always, the patient that pays for these literally and figuratively. I have looked forward to the day I can move from this state ever since I first arrived here. This state is far from progressive and attempts to put strangleholds its population by limiting thier choices under the guise of 'safety' when the truth is the opposite. This is an unfortunate decision. I want to see this state come into the present day, and let go of their unwarranted fears of loss of revenue. This was not an educated decision but rather an manipulative decision. Sad for Nebraska. "

 c.h. wrote on July 25, 2006 7:56 am:
" careful, Nebraska. You may think you're making sure that all babies will be born safely, in hospitals, but in reality you're probably making sure that babies born at home will not be attended by a professional. Women who want to deliver at home feel very, very strongly about it, and when faced with the choice between a hospital, or an un-attended home birth, they almost always choose the latter. If you REALLY want to protect babies, better work with the midwives and moms. "

 safety first wrote on July 25, 2006 8:21 am:
" If you feel the need to have your baby in the comfort of your own home, then get to the hospital early and decorate it like your living room! as a mother, you say you are looking out for the best interests of your new-born child, yet you are completely willing to risk their life just to have your baby on a lazy boy recliner?? obviously i'm exaggerating, but safety should come first and complications can arise. mothers should always feel the most comfortable when having their child, but i think doing it at home is an opportunity for disaster. especially if not everyone is educated or if you dont have the proper cleaning supplies, or if perhaps a perfect baby turns into a very scary birth. you never know, and the hospitals and doctors are not trying to take away your freedom; they are also looking out for the best interests of your child... and you. "

 cm wrote on July 25, 2006 8:57 am:
" once again, it appears that nebraska will ignore those parents who put more thought into their healthcare choices than the average consumer. and we wonder why the brain drain in nebraska? when those of us who make INFORMED choices about the health and welll-being of our families are harrassed for such choices. "

 marysescapades wrote on July 25, 2006 9:09 am:
" What an extreme disappointment! I was watching with great hope and anticipation from SD where we have a similar situation. What is wrong with these people when the truth means nothing to them? What are they afraid of? It boggles my mind that in the face of indisputable facts that home birth with a midwife is a safe and family-friendly option that these people can stand up and deny the option for Nebraska women. This very poor decision on the part of the NE Dept. of Health is a tragedy for the families in Nebraska. "

 E wrote on July 25, 2006 9:20 am:
" If I want to give birth in the comfort of my home then it is no ones business but my own! Childbirth is not a disease or illness, it is a natural process and it should not be forced to happen in a hospital. "

 Travis wrote on July 25, 2006 9:31 am:
" I am a man, so that probably makes me unqualified to comment, but in my parents' generation home births were common. Then again, infant mortality rates were much higher in that era, too. It doesn't take a genius to see that lower infant mortality rates are, in part, due to advanced medical care present for the birth. More power to these women for doing this, but there is no chance that my wife and I would gamble with the life of our child in the first critical moments of life. "

 CAS wrote on July 25, 2006 9:42 am:
" my wife and I looked into Doula and home birthing. I wonder if you work in a hospital because my cousin, an RN, extolls the value of hospital birth. I have a hard time believing that someone who is paid 40,000 a year or as a doctor considerably more has my 'best interests' or my child's in mind. EMTs can deliver a baby on the back of a truck bed so its not exactly a mystical procedure. Ive had the same training as they did and we would be attended by an RN/Midwife-I just wouldn't be paying 1000 a day for bad food and boring basic cable tv and prying medical interns. I fail to see much of the advantage to your logic. Medicine is a profit driven industry and I and others don't feel the need to make their profit bigger for something that has been happening on its own for thousands of years. "

 sodiac wrote on July 25, 2006 10:13 am:
" When a woman shows up at a hospital in labor, she is guaranteed care, even if she is an illegal alien (EMTALA). When a woman in NE is in labor at home, she is guaranteed to have to "go it alone". NE mothers need to file suite against the state for discriminating against them in this access to care issue. NE CNMs have a valid "restraint of trade" issue with their state..... It is time to file the paperwork ladies! Don't mothers have a constitutional right to LL@PUH? And what business does the Hospital association have with this? Are they so concerned about loosing a few bucks? They should not even be involved...it is a conflict of interest! Shame on you Board for your selfish arrogance! You should all loose your licenses for "doing harm"! "

 Another Mom wrote on July 25, 2006 10:15 am:
" Who is HHS to tell moms where they can have their babies, or who can help?? Women know themselves better than a doctor does, and believe me, if they're comfortable having their "low risk" pregnancy end in a home birth, then leave them alone!! Or is this just another way to be sure the hospitals get in on the financial end?! "

 Phil wrote on July 25, 2006 10:32 am:
" So maybe Nebraska should foot the bill for births that occur in hospitals if they are so animant about not allowing home births to occur. It seems logical that in today's society where healthcare charges pretty much what they want- $5,000 to $6,000 for a normal birth-that we should be searching for alternatives to the greedy healthcare industry! "

 ABR wrote on July 25, 2006 10:43 am:
" Of course the representatives of the Nebraska Hospital Association and the Nebraska Medical Association think that a hospital setting is best for mothers and children. They are only going with what is in their best financial interests. No Doctor or representative of a doctor is going to say that it's ok for people to not require their services. This is a huge conflict of interests to ask for their opinion. Something like this requires an independent investigation. "

 DAWG wrote on July 25, 2006 11:32 am:
" Heres another case of the state telling Adults they're not able to make choices for themselves and there families. "

 DD wrote on July 25, 2006 11:33 am:
" I think that Nebraska needs to some checking on states that allow home birth. I agree with CAS, there are just some many people in and out of the rooom at so many times, it's hard to relax in that environment. Someone coming in to check this or that, when all you want to do is sleep and rest. If I could have had the choice of having my child at home I would have because it would have been more comfortable and relaxing and I might not have been so stressed with things. As for the men on the board, try having a child and then make an informed decision. "

 A thinking woman wrote on July 25, 2006 12:10 pm:
" MY biggest concern with the BOH review and with this article is that it fails to point out one major falacy of the judgement. "the show of support didn’t erase board members’ concerns over the safety of babies and their moms." It is precisely safety why I chose to have my 3 children at home. I knew the truth and actual documented facts, facts which were most likely presented to the Board and Technical Review Committee, but they obviously must not have read according to their closing statements. Facts such as: States with higher percentages of midwife attended birth have lower infant mortality rates. Or the study by the CDC that shows your baby is 19% more likely to die in birth if you are attended by a physician than if you are attended by a midwife. In a study by Dr. Lewis Mehl (from Childbirth and Family Research of Berkley) comparing home birth verses hospital birth, he found a huge difference: 4 times more cases of infection in newborns, 3 times more cases of newborns having difficulty beginning breathing, 3 times greater incidence of maternal hemorrhage after birth, and a whopping 5 times more incidences of maternal high blood pressure all in the hospital birth group. Also, in the hospital birth group (about 1,000 patients) there were 30 cases of infant injury including: skull fractures, facial nerve palsy (from forceps), brachial nerve injury, and cephalohematoma, while there were no injuries from the home birth group. Over the last 50 years we have gone from nearly all births taking place in the home to virtually all happening in the hospital, and all this with complete disinterest in the resulting rise in Cesarean and infant mortality rates! In fact: with all of our technology, the United States ranks 28th in the world for least infant deaths. Meaning 27 countries in the world have lower infant mortality rates. We have been getting worse as more births move to the hospital. We were at 12th place in the 1950's, 16th in the 1970's, 23rd in the 1990's, and have now dropped to 28th place. Is this a trend we want to continue? I think those moms who fight for home birth in Nebraska have the best interests of their chidren at heart. I only wish we could say the same for the hospital association. "

 Wake up, Nebraska! wrote on July 25, 2006 2:28 pm:
" Those who support homebirth have done their research and know it is SAFER than hospital birth. It's a shame the Nebraska legislators can't do the same basic research and come to the same conclusion. Regardless, this country was founded on FREEDOM, such as the freedom to choose or refuse medical care for ourselves and our childre, and we have the right to decide where our babies are born. Nebraska will not succeed in preventing homebirth. It can only stick its head in the sand and ignore the truth...but hopefully not much longer. "

 vgarr wrote on July 25, 2006 3:57 pm:
" Is it that the state is soooooooooooo concerned with the health of Mom's and babies, or is it that they simply think they need to have their hands in every pie? Childbirth is not rocket science. Women have been having babies for centuries and centuries. Women have been having babies at home for centuries and centuries. And I've not noticed the human race dying out. Childbirth is not a medical procedure. It's natural. Your body is naturally (and will rid itself of the baby) going to push that baby out whether or not there is a doctor standing at your feet, and you're surrounded by four hospital walls. Good night Nebraska. "

 C Hayes wrote on July 25, 2006 6:51 pm:
" It's sad that Nebraska cannot seem to find their way to joining MOST of America, nor do they seem capable of listening to their constituents. Nebraskan women are going to continue to have births at home, and thankfully, there is nothing the political advocates of medical birth can say about it. I cannot for the life of me figure out how this commitee managed to ignore science in favor of scare tactics. Home birth is as safe, if not SAFER than birth in hospital, and thankfully that knowledge is becoming more widespread. The only people who are likely to tell you otherwise are those that have money riding on the decision, and those who are afraid. Today is a sad day for the birthing rights of women in Nebraska. "

 Sharon wrote on July 25, 2006 7:02 pm:
" This makes no sense at all! It's dangerous for a woman to give birth at home so make it worse by not allowing her to have a skilled person assist her? Even in a hospital setting the health of a child and mother is not guaranteed. What makes more sense? Having a perfectly healthy pregnant woman go to a hospital full of very ill people to deliver her baby or allow her to remain at home where she is comfortable with a skilled midwife to assist her? A midwife would be able to see if something is going wrong and call for help. A woman alone with her husband may not recognize a potentially dangerous situation until it's too late. If a woman is found to be competent enough to choose whether or not to have a child, why is she not found to be competent enough to choose where to give birth to her child? "

 My body, My choice wrote on July 25, 2006 7:18 pm:
" “A low-risk pregnancy can become a high-risk pregnancy very quickly,” said Carly Runestad, with the hospital association. Hey, Carly... It also takes a chunk out of your pocket, huh? It is a disgrace that this country treats pregnant women like cattle instead of individuals. I wonder what NE's c/s rate is? "

 ZAZ wrote on July 25, 2006 7:19 pm:
" There are many points to be made from this article, but what it boils down to *IMO is your own basical rights. What you are allowed to do and what the govt. steps in and says NOPE can't do that. Many say it's a safety issue, with some...Yes, and others it's a $$$$$ issue. I have a very good friend who had an homebirth in NE and wouldn't have had it any other way..well, plus a midwife..Maybe.:o)What is next? "

 Homebirth Supporter wrote on July 25, 2006 8:28 pm:
" From the article:“A low-risk pregnancy can become a high-risk pregnancy very quickly,” said Carly Runestad, with the hospital association." I reply, not usually. But even when an otherwise low risk pregnancy becomes high risk, Certified Nurse Midwives are qualified to assess that risk and make the appropriate referral. Even in states that Licence Non-Nurse Midwives, those midwives are equally as qualified to assess when a low risk pregnancy is moving toward a higher risk one and either take appropriate action to address the problem or refer to a physician who is qualified to address the problem. By disallowing women the option of qualified assistance for birthing out of the hospital (should we mention the inherent risks of birthing in the hospital?) you force a certain segment to go without prenatal care and qualified assistance at their birth. In the current medico-legal climate do Doctors really want to be liable for a woman walking in from a unassisted home birth where something has went wrong that a qualified midwife could have assessed, addresses, or even better, avoided? If the answer is no, then we have two choices. A) change the current course of non-evidence based care within the hospital climate. or B) Create licensure for midwives in Nebraska and ensure that women are receiving the highest quality of midwifery care that NE has to offer. Home birth with a *qualified* provider is just as safe as birthing inside a hospital. It can even be argued that it's safer. Home birth midwifery care is not a "lowest common denominator" type of approach. Hospital birth is. We monitor all women continuously when continuous electronic has never been proven to improve maternal or fetal outcomes. We perform vaginal exams, repeatedly, in women who are GBS+, increasing the likely hood of exposure to their babies, then pump IV antibiotics in them to try to counteract our intrusion, as well as the natural course of the infection. We induce women with drugs that carry their own inherent risk, and increase the risks by performing the inductions before the woman's body and baby are ready, and even worse we begin that process by rupturing her bag of waters which commit her to delivery of this baby and hold her labor (which her body may not even be favorable for) to the Friedman's curve. No big deal, right? If she can't perform for us and "deliver from below" within our pre assigned time window, we'll just step in and "deliver her from above." Then the next time she can save herself all this trouble and just schedule an elective repeat cesarean because we no longer offer the option of vaginal birth after cesarean. ^5 to us! "

 LB wrote on July 25, 2006 10:33 pm:
" Nebraska's ideas on homebirth make it a bigger laughingstock than Kansas' ideas on evolution. At least in Kansas, women are trusted to be intelligent enough to make their own decisions on what is best for them and their babies. Way to go, Nebraska. @@ "

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