For centuries giving birth at home was the norm. In the early 1900’s women started going to the hospital to give birth. Eventually, home birth declined from 50% in 1938 to fewer than 1% in 1955, with the interventions and the perceived ease of birth, women felt safer in hospitals.
A conflict between surgeons and midwives arose, as doctors began to assert that their modern scientific techniques were better for mothers and infants than midwifery. As doctors and medical associations pushed for a legal monopoly on obstetrical care, midwifery became outlawed or heavily regulated throughout the United States and Canada. An organized campaign accused midwives of being “incompetent and ignorant.”
Today midwives are recognized as highly trained, specialized birth professionals in “normal” birth. There are two kinds of midwives Certified Professional Midwives (CPM) and Certified Nurse Midwives (CNM). CPM’s attend home births while most CNM’s work in hospitals, some also attend homebirths.
Homebirth Midwifery care is based on the idea the pregnancy and birth are normal physiological process and provides prenatal care with individualized education, counseling, and continuous hands-on assistance during labor and delivery, in addition to, postpartum support while monitoring psychological and social wellbeing.
This type of care is contrast to the medical model that often promotes pregnancy and childbirth as potentially pathological and dangerous.
The midwifery model plays a significant role in Sweden and the Netherlands. In Sweden midwives administer 80 percent of prenatal care and more than 80 percent of family planning services. Swedish midwives attend all normal births in public hospitals and Swedish women have fewer interventions in hospitals than American women. The Dutch infant mortality rate in 1992 was the tenth-lowest rate in the world, at 6.3 deaths per thousand births, while the United States ranked twenty-second. Midwives in the Netherlands and Sweden owe a great deal of their success to supportive government policies.
In the USA, 27 states license or regulate direct-entry midwives, or certified professional midwife (CPM). In the other 23 states there are no licensing laws and practicing midwives can be arrested for practicing medicine without a license. Some of these states are in process of legalization. It is legal in all 50 states to hire a certified nurse midwife, or CNM, who are trained nurses, though most CNMs work in hospitals. Please see the chart listed below for further information.