in seconds that can have devastating results. Being disappointed and having anxiety because you can't afford a midwife to have a home birth is kind of wah wah .

whether in a hospital or a birthing center.. or during a home birth. At a hospital (or a birthing center) support for emergencies may be (should be) close. Most birthing centers I've heard of work in close cooperation with a nearby hospital or OBGYN. I've also read articles (no direct experience) that midwives are also certified and part of that certification is close contact with a physician, just in case things "happen" during birth.

I don't consider midwives, or the reason to want a midwife "wah wah," nor do I consider it "woo, woo"... Women have been helping other women deliver babies for millenia, no men needed or desired, thank you. This woman had 5 pregnancies go awry for whatever reason and came out of the hospital devastated there was no follow up to help her through it, nor through her desire to successfully become a mother. MOTHERS are not held as the most important aspect in today's world. We are only women. ONLY the baby is held up as important. And if there's no baby, no importance. In fact, the more likely the mother is to feel she has failed as a woman, according to today's standards for women. (and thus was it ever)

I had ONE baby. I readily admit she would not have lived had I not been at the hospital with the OB's on call. Things were touch and go for me for days, as well. In fact, in was nearly 3 months later before I could bring my daughter home. But I don't necessarily feel midwives would have been a problem, if they'd been in contact with emergency care, even in my circumstance. I really had no option... not only because this was 40+ years ago, but also because I was military when I gave birth. And I can tell you from personal experience, as good as those OBs were, I didn't really feel supported. In fact, it took two months AFTER I began telling them something was wrong before anyone even listened enough to me to start doing tests on the fetus and amniotic fluid.

I'm all for expanding the role of midwives during pregnancy and birth. If I could have had another child, I personally would have wanted a midwife in close contact with an OB or emergency approved birthing center. But if a pregnancy has preceded successfully for 9 months with no hint of problems, I see no reason not to have a woman-supported birth... be it at home with a doula or at a birthing center. I also feel Insurance should cover midwives as well as death doulas. Not everyone wants their entry and exit from with world to be in accordance with antiseptic hospitals. That's why Hospice was created. But some people have problems with hospice being too associated with a specific hospital or doctor at times. We would prefer to go out on our own terms, and we shouldn't be kept from that because $$$$ and insurance restrictions; both of which favor males over what women, specifically, would want.

They provided prenatal care, attended home births, and provided postnatal care. They had a doctor providing backup if something went wrong during the delivery, meaning the patient would be admitted to the hospital and precious time wouldn't be los6 because the hospital refused to take a report on the patient's condition from a lay midwife (a big problem for them).

The area was underserved in a lot of ways and most people didn't have health insurance. The town finally got an Ob-Gyn NP a few months before I left.

Nurse midwives were originally proposed to fill the gaps in care, but qualifying requires a master's degree, meaning 6-8 years of combined education and specialized training. Most nurse midwives work in hospitals and birthing centers, they can't afford to work anywhere else. It's rare that you find one hanging out a shingle in a semi rural area.

I would love to see certification for lay midwives, something to allow them insurance payments, physician backup, and legal protection within the scope of their practice. I know how important a good midwife is in a lot of areas.

https://narm.org/about/the-cpm-credential/

also there's this https://www.midwife.org/Certified-Professional-Midwife
This site further explains a difference between the certified nurse-midwife and the Certified Professional Midwife, which is more what we are talking about. CPMs enter the profession through various methods, including apprenticeship to another CPM and education. Increasingly they will have an associate degree and may have worked in L&D. They are allowed to practice in 36 states and DC, but insurance may be a problem, of course. Here's their website: https://www.nacpm.org

I have a feeling that CPMs are going to become increasingly important, especially in red states which OB/GYNs are fleeing rapidly and new ones are not coming into. Insurance will have to start ponying up.

Medicalizing normal childbirth and insisting it takes place in a hospital serves few well, especially women in non urban areas where few people have health insurance. Hospitals and stand alone birthing centers are generally far away, so meticulous prenatal care is essential to pick up complications early and avoid having to call for a helicopter to rush a laboring woman in crisis to a hospital.

The midwives I knew did the apprenticeships. They were long on science and short on religion, so their care was superb. I admit I was skeptical of the whole hippie home birth movement until I met them. Then I wasn't skeptical any more.

So yes, bring on the certified lay midwives. They won't replace birthing centers and hospitals for women who need a higher standard of care, but they will be the first line in identifying such women and keeping them safer.