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9 responses to “Homebirth Practice Accreditation”

  1. Megan Barnes

    This is a fantastic rationale for homebirth accreditation! It addresses the main issue that I encounter when discussing homebirth with people–they don’t understand the level of care provided. Most people assume they that homebirth cannot possibly be as safe as hospital birth or they naively think that appropriate preparation for managing unexpected outcomes is unnecessary. You did a great job of addressing all the facets and nuances of the issues–including the common arguments that accreditation will in one way or another be detrimental to the profession. You clearly emphasized why homebirth accreditation is all about increasing safety and best practice–which is what we ALL should want. Lovely!

  2. Tamrha

    This is such a great post! Not only does it detail Dr. Lane’s practice’s beginnings, including the journey to the standard of which the practice currently operates, it looks the the possibilities and potentials of the future of homebirth midwifery, if accreditation was created.

    As a consumer, I want this. Not only for myself but for other women AND their babies. Dr. Lane’s analogy of restaurants and hair salons being closed down for periods of time so that public safety can be ensured is spot on. Food and salon services being the best they can be is important, but so are the birthing environments of our babies and the practices that care for these mother-baby diads.

    This should be a given, but since it is not, I do hope that we can in the near future see a body come together to put these detailed steps into real motion. I look forward to the next post on this subject!

  3. Sarah

    It is fascination to read how BMS has developed through the years. I think this blog makes a good case for accreditation both in terms of consumer protection and practitioner recognition. It’s been fascinating to see the legislative misunderstanding of midwifery in Indiana. Perhaps with accreditation our legislation would be more fact and science driven.

  4. Nicole

    I must admit to smiling at the bit about “nor many midwives like being told what to do,” because I think that’s also a facet of home birth families (sometimes to their detriment; after all, a trained midwife will have knowledge they don’t and they need to listen :).

    Definitely interested in reading more about this and seeing what standards would be considered! Also curious about how such accreditation would be communicated to consumers… is it something that would hold value to them? It should, but how will that value be shared with them?

  5. Anastasia

    This is the most well written piece on homebirth accreditation I have come across! In the medical community, I would expect opposition to this because homebirth is still seen as reckless and unsafe as a blanket statement without taking into consideration provider, practice, and level of care. Therefore, the medical community might say that by giving homebirth accreditation, they would be accepting homebirth as a safe or equally safe way to bring a child into this world and sadly there are still many hospital based providers who disagree with that. This is merely the devil’s advocate that just doesn’t seem to go away.

    However, I completely agree with accreditation of homebirth. Those providers who seek accreditation would be able to stand out from the rest. Similarly, hospitals seek accreditation all the time among facilities and staff to set them apart from the rest. Always asking yourself, why would someone choose to birth with me, or my facility over others? Accreditation gives homebirth more of an appropriate voice among the public as well. There are still so many who don’t understand the difference between a CNM, CPM, and all other lay midwives let alone accreditation. This would be a great step in clearing that up for the public and medical professionals alike as well finally giving a voice to competent and safe homebirth practices that deserve recognition for the outstanding outcomes they have achieved for mothers and babies in their care.

  6. Trish Ross

    I have had a25-year career in corporate training and seven more in midwifery education. I have created certification programs in several fields. I want to contribute to work like you describe.

  7. Chelsey Smith

    From the Believe Midwifery LLC website on the maternity care page “It is easy to claim the glory of beautiful births, but it is the more complicated scenarios that test the character and skill of a midwife.” This is precisely the reason accreditation seems necessary. We need to ensure that midwives are competent in caring for mothers and babies in emergency situations, as well as to provide a safe, sanitary environment in which to practice if the social stigma is going to change. We expect all other health care providers to meet expectations set by their professions, and to assume the cost of licensure and certifications. If midwifery is going to gain credibility in our society, the bar needs to be raised. The Better Business Bureau and Angie’s List are thriving companies because consumers want to hire trusted certified and licensed professionals for the job. Consumers research their options these days. If the general public saw that home birth midwives were accredited by a professional agency, they would have reassurance that their midwife is a credible health care provider.

  8. Sara Snyder

    Hello Penny,

    I enjoyed reading this post. I love your critical thinking and your efforts toward improving home birth practices and standards. You and I spoke about three years ago after my son died in breech delivery in a freestanding birth center in MI. You were the first person who told me about all of the things that should have been evaluated before we attempted vaginal breech delivery outside the hospital. It was that conversation that helped me know how much was missed and ignored before my labor even began.

    Since then, I’ve worked very hard to have conversations with folks in the midwifery community, in a state with no regulation, about improving safety, establishing standards for both education and practice. We developed a website to help families better understand the complexities of hiring a midwife in our state, and doing so safely. There was so much I wish I had known. “Midwife” means a million and one things and it’s so confusing to the consumer. It’s difficult for families to know who they are hiring, and how safety is inevitably impacted. I share your vision for safer options.

    Much of what you wrote her resonated with me. The paragraphs regarding breech delivery outside the hospital were of particular interest. I think the accrediting body doesn’t support it because, as you explained, there are many midwives whose practice skill sets are not qualified to handle such events. We are a living example of the fact that some even mislead to take on high risk deliveries even though they don’t have the skills to safely screen and attend such deliveries. I understood your point that some may be more qualified than others, but I still worry that without an emergency team down the hall, or EFM how it could possibly be as safe as a hospital TOL for vaginal breech.

    At any rate, I wish you well in your endeavors. I always appreciate finding midwives who are fighting for standards for the sake of improving safety and midwifery as an option. From conversations with other midwives with similar thoughts, it seems that sometimes it’s difficult to find like-minded peers within the profession. Keep thinking critically, keep thinking safety. Thank you.

  9. Sara Snyder

    One more thought Penny…wouldn’t it be ideal if a mother planning the birth of a breech baby could opt for hospital TOL with her midwife? What if the HB midwife could have admitting privileges, properly evaluate, and offer the mother a TOL in the hospital with back up right there? That would be dreamy, and so much safer. A more integrated system of care would go such a long way!

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Dr. Penny Lane, nurse-midwife

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