Fully investigate birthing options, training
This letter is in response to the front page article in the paper (Daily Bee, Nov. 25) titled “Midwives see growth of birthing options.” We need to expand on some statements, and correct some misconceptions.
The move from home births to a hospital based birth in the 1950s was specifically to improve infant and maternal mortality. While giving birth is a very natural process, it is also potentially lethal for either the mother or the baby. In 1950, 29 out of 1,000 infants died during or shortly after birth; in 2005, the infant mortality rate was 5.7 out of 1,000. In 1950, five out of 10,000 women died in childbirth, now that rate is less than one in 10,000. This improvement is directly related to better prenatal care for the mother, and better postnatal care for the infant.
The two northern counties of Idaho have many practicing lay midwives, and the state of Idaho has implemented a licensing program for these midwives. However, currently there are no practicing certified nurse midwives in these two counties. What is the difference? Huge! Certified nurse midwives attend nursing school and then midwifery school, and very much like any other medical professional they must pass examinations, they attend yearly continuing education, and they are held to strict professional guidelines and are certified to deliver their care. Lay midwives have no such standardized training or certification. Certified nurse midwives do deliveries in birthing centers or in hospitals, always with the back up of an obstetrician and the ability to save a mother’s or an infant’s life if something unexpected happens.
As pediatricians, we have attended thousands of births. Most women who give birth at Bonner General Hospital have an amazing experience, including being in control of the process, haying their wishes and expectations met, being in control of their pain, and having the outcome of a healthy infant. It is important to remember that there are two lives involved in a birth process-while it is important for a woman to have control over her environment, it is also imperative to do everything possible to have a healthy, viable baby. Even with the most perfect pregnancy, excellent prenatal care, and well organized labor, it is the 10 minutes before birth and the 10 minutes after birth that most affects the outcome of that infant. Unexpected emergencies happen in that time frame, and appropriate responses do affect the life and health of the baby.
Every couple expecting the birth of a child has the right to choose their birth process. But they should fully investigate their options, the training and expertise of their care providers, and think not only about what they want to have happen but also plan for the unexpected. Our philosophy is that most births occur without any problems, but in a setting such as Bonner General Hospital we are prepared to handle anything unexpected that might happen.
DR. JOYCE GILBERT, FAAP
Sandpoint
DR. GEORGE DeLAND, FAAP
Sandpoint