Regulation and Licensure of Certified Professional Midwives: Beneficial for North Carolina?
Public Deposited- Last Modified
- February 27, 2019
- Creator
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Knight, Suzanne
- Affiliation: Gillings School of Global Public Health, Public Health Leadership Program
- Abstract
- The primary caregiver to women who choose the home setting for birth in the United States is the certified professional midwife. Credentialing is awarded by the North American Registry of Midwives, which is accredited by the National Commission for Certifying Agencies. Certified professional midwives are legally authorized to practice, licensed, and regulated in twenty-six states, including North Carolina’s neighbor states of Virginia, Tennessee and South Carolina. North Carolina stands out in the Southeastern region of the United States as having limited access to licensed and credentialed midwives to serve women who choose midwifery care during the antepartum period, and the home setting for birth. This restricted access has negative implications for both safety and quality care for women who choose this option. The Centers for Disease Control and Prevention (CDC) recently reported accelerating rates of planned home birth in the U.S., with North Carolina experiencing one of the largest relative increases. In a hallmark prospective cohort study done in 2000, it was concluded that planned home birth for low risk women in North America, using certified professional midwives, was associated with lower rates of medical intervention, and very similar intrapartum and neonatal mortality rates (1.7 per 1000) to that of low risk women who delivered in hospitals in the United States (Johnson, K.C. Daviss, B., 2005). This issue can be viewed as two-fold: problem-solving and benefit providing. From the problem solving perspective, by licensing and regulating certified professional midwives, North Carolina can address the access to care issue for women who choose home birth. This will minimize the rates of planned unattended home birth, help manage intrapartum transports in emergency cases, and assure that midwives maintain standards of care. From the benefit providing perspective, licensing certified professional midwives in North Carolina can cultivate a lower cost/high quality option for women that is proven to dramatically reduce rates of cesarean section, minimize planned unattended home births and improve access to maternity care in rural areas (North Carolina Friends of Midwives, 2010). Additionally, home-birth families will have the benefit of knowing that their birth attendant is practicing within guidelines and standards that are regulated, while still allowing for a successful, empowering experience. In this paper the action steps necessary for North Carolina to adopt the licensure of certified professional midwives will be outlined. These recommendations are based on a review of the literature, an analysis of the licensing barriers that were overcome by neighboring states, an assessment of the current licensing and practice guidelines, and finally, an examination of the history of midwifery-including the foundation and development of the current NC midwifery classifications.
- Date of publication
- December 2011
- DOI
- Resource type
- Rights statement
- In Copyright
- Note
- Paper type: Policy
- Track: Leadership
- Advisor
- Steffen, David
- Degree
- Master of Public Health
- Degree granting institution
- University of North Carolina at Chapel Hill
- Graduation year
- 2011
- Language
- Deposit record
- b6f6bdeb-f0b9-4907-a2ad-769b5d2e1080
Relations
- Parents:
This work has no parents.