By Janelle Boyington, RM, CPM
From the earliest recorded history, midwives have been attending women in birth. In fact the etymology of the very word “midwife” comes from Middle English and means “with women.” Before the 1600s almost all babies in the world were born into the hands of the community midwife. Even in 1910, fifty-percent of the babies born in this country were attended by midwives. However, by 1935 this number had dropped to around ten-percent. The male dominated medical profession pressured states to pass laws against midwifery, restricting the practice of obstetrics to doctors. Unable to become doctors, since universities would not accept women, nursing was left as the only opportunity available to women in the medical field.
In the 1940s almost all births took place in hospitals and midwives in this country were an endangered species; dwindling except in small rural areas where “granny” midwives served families. By the 1950s the medical community practiced for their convenience, under the guise of safety for the mother and child, with assembly line deliveries of babies born to heavily anesthetized women.
Cultural changes took place in the 1960s that led to questioning of authority figures, including the medical community. The idea that anesthetic was not only unneeded but a hazard, along with the powerful feminist movement, led to a resurgence of natural birth and with it, midwives. Due to the laws set in place during the early part of the century, there were many legal obstacles to overcome. These were compounded by resistance from physicians, and their unwillingness to provide medical back-up for home births. In the late 1970s, these issues led traditional midwives to create state and national organizations, which approached legislatures to gain legitimacy through licensure.
In 1982 the Midwives’ Alliance of North America (MANA) was created. Today MANA is on the forefront of midwifery issues in this country and internationally. This member-run organization covers topics ranging from the values and ethics of birth, to the decriminalization of midwifery and national health policy. In 1989 a program called the North American Registry of Midwives (NARM) formed to serve as a “tool to determine whether entry level knowledge has been achieved.” This offers a legally defensible, national standard for certification. Midwives credentialed by NARM are called Certified Professional Midwives.
In 1993, the practice of direct-entry midwifery became legal here in the state of Colorado. This success was spearheaded by the Colorado Midwives Association with other grassroots groups and created a registration process considered equal to licensure. The Colorado Department of Regulatory Agencies sets and maintains the guidelines for practice. The legal stature of traditional midwifery and the rules and regulations surrounding it are part of an evolving process. Incremental change is bringing midwives scope of practice in Colorado to one more in line with that of the other states maintaining laws that regulate midwifery. Colorado is among twenty-five other states with an avenue for midwives to legally provide proven safe care to low risk women and their families.
Part II of this article: Home Birth In Colorado – Safety and Statistics, will be published in two weeks.
Janelle Boyington, RM, CPM is a midwife providing homebirths, well-woman care and lactation services; seeing clients at Stillwater Healing Arts Clinic, here in Lyons.