Assisted by a midwife, Heather Barlow of Jacksonville gave birth to her second child in her living room, in a kiddie pool filled with warm water. The midwife let her snack lightly to keep her energy up and helped her maneuver into different positions to relieve her labor pains without medication.
"That birth was like poetry," said Barlow, whose first child was born in a hospital.
But when Barlow went to the county clerk's office afterward, to register her baby's birth, she didn't mention her midwife. That's because, under North Carolina law, even the most experienced midwife, certified by the most respected national midwifery organization, could be arrested for practicing medicine without a license for attending a home birth.
For more than a decade, midwives have been fighting to change the law. This spring they hoped it would happen. A study commission last year appeared to have paved the way for recognizing Certified Professional Midwives, establishing another panel to hash out the details of the certification and licensure. But in April, the medical establishment stepped in and ended the certification debate.
Under current law, again crafted by the guiding hand of the medical lobby, the only midwives allowed to attend births are Certified Nurse Midwives, who must practice with an attending physician. The practical effect: The vast majority of nurse midwives practice only in hospitals or birth centers. Only a handful have made arrangements with doctors to attend home births.
Brooke Atkinson, who lives near Salisbury, said the Medical Society may claim this policy is about patient safety, but she thinks there's more at stake.
"This is about turf, and money, and control," she said.
Atkinson's point is simple: "Some mothers are going to have home births. If doctors are so concerned about safety, shouldn't we regulate the midwives attending those births?"
Atkinson pointed to a recent report from the U.S. Centers for Disease Control and Prevention showing that home births, while still less than 1 percent of all births, are increasing rapidly in North Carolina.
Erin Henry, a Raleigh mother training to be a midwife, noted that Certified Professional Midwives are recognized in 27 states, including Virginia and South Carolina.
She learned from experience how much study and apprenticeship are involved in entering the field. Usually the process takes three to five years of full-time work.
Henry decided to pursue midwifery after giving birth to her second child at home, in a squatting position at the end of her bed. Her midwife, who was also a nurse, risked her license by attending.
To Henry, that doesn't seem right.
"Sometimes I walk by that spot and tell my daughter: That's where you were born!" she said. "That's something that should be celebrated."
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