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ADVANCE Perspective: Nurses

New Home Birth Guidelines Ignite Debate

Published June 14, 2013 3:44 PM by Catlin Nalley
The American Academy of Pediatrics (AAP) recently released a policy statement, published in the May issue of the journal Pediatrics, that offers guidelines for planned home births.

The AAP outlines a number of recommendations, including:

  • There should be at least one person present at the delivery whose primary responsibility is the care of the newborn infant and who has the appropriate training, skills and equipment to perform a full resuscitation of the infant.
  • All medical equipment, and the telephone, should be tested before the delivery, and the weather should be monitored.
  • A previous arrangement needs to be made with a medical facility to ensure a safe and timely transport in the event of an emergency.

While the majority of the guidelines are straightforward, there is one aspect of the AAP's policy statement that has caused controversy among midwives.

According to the AAP, "pediatricians should advise parents who are planning a home birth that AAP and American College of Obstetricians and Gynecologists recommend only midwives who are certified by the American Midwifery Certification Board."

This recommendation, reported TIME, "has upset certified professional midwives, who deliver the majority of babies born at home in this country but are accredited by a different body - the North American Registry of Midwives (NARM)."

Kristi Watterberg, MD, lead author of the AAP's home birth guidelines told TIME that "the AAP is simply echoing a similar recommendation from the American College of Obstetricians and Gynecologists regarding which midwives should attend home births.

Do you support the AAP's guidelines? What would you recommend to your patients?

posted by Catlin Nalley


Being that the American Midwifery Certification Board certifies primarily Certified Nurse Midwives, the vast majority of whom are trained and work in hospital settings, I don't think they are the most qualified to decide which midwives should attend homebirths.  The North American Registery of Midwives is the certifying body for CPM's (Certified Professional Midwives) and in many states, such as mine, they provide testing and certification for Licensed Midwives.  Both of these classifications of midwives are trained to provided care in an out-of-hospital setting.  They, by far, have the most experience and expertise in attending home births and therefore the AAP statement is not a well-informed one based on evidence, but rather a further politicalization of the unfortunate divide between midwives attending home births and midwives attending hospital births.

Corina Fitch, Midwifery - Licensed Midwife, RN, N/A June 15, 2013 8:44 AM
Miami FL

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