New York City has only 13 home birth midwives, and 7 of them are in danger of losing their licenses.
State law requires all home birth midwives to have agreements with obstetricians at nearby hospitals who will back them up and handle medical emergencies with their patients. St. Vincent’s Hospital in Manhattan was the official back-up hospital for more than half of New York City’s midwives until it closed this week.
Now the midwives are having trouble finding a new hospital that will take them in. Obstetricians, it seems, are not eager to sign on for back-up duty.
In most developed countries, having a baby at home with a professional midwife is seen as a safe, healthy, affordable choice for healthy moms with low-risk pregnancies. Here in the U.S. it’s seen as dangerous and subversive. So much so that the American College of Obsetritians and Gynecologists issued a stern warning in 2008 calling home birth “trendy” and dangerous.
In fact, most of the people who have ever lived were born at home. If its a trend, it’s one that’s been around since the Stone Age. It’s also not particularly dangerous: a large scale study of home births in the US found that only 12% transfer to hospitals, and only 3.4% of those transfers are urgent. No maternal deaths have been reported by home birth midwives here, and the infant mortality rate is the same as in a hospital.
So why are New York’s midwives having such a hard time finding back-up doctors? As one put it, midwives are the competition. Of course OBs don’t want to back them. And even a sympathetic OB must worry about liability issues promising to cover for another person’s practice, especially one he or she knows little about.