The Louisiana Midwives Association points of concern and contention are:

1)       The LMA would like the radius requirement of living within 25 miles to the nearest hospital eradicated.  We feel this inhibits women’s choices to give birth where and with whom they wish.  Most midwifery transports are for non-emergent care and are not life threatening.  Many areas in Louisiana are rural and do not have access to a hospital within “25 miles or 25 minutes” of a client’s home.  Do doctors insist their clients live within thee boundaries before being accepted into their care?  We feel this proposal would limit the ability of midwives to provide care and would be illegal under the rights of childbearing women.

2)      The required eight (8) prenatal visits by a midwife (two physician visits included) would dictate at what point the consumer could choose midwifery care.  Some consumers make the decisions late in pregnancy to seek midwifery care.  It should be left up to the midwife to decide if she is comfortable taking clients late in pregnancy because it is the midwife who bears the responsibility and liability of providing the care to the consumer.  Just as physician’s are not limited in accepting care at any point in the pregnancy, nor should midwives.  There are no prenatal visit limitations for CNM’s, so why should there be for Licensed Midwives?

3)      LSBME is also seeking to disallow midwives from attending vaginal births after caesareans.  The Louisiana Midwives Association feels this does not serve the women of our state.  Women who have had a previous c-section with a lower transverse uterine incision, with double suture layer closure, who are not induced with pitocin or who do not receive cytotec to induce labor have a 0.2% thru 0.7% risk of uterine rupture.  Women should have the ability to seek informed consent to choose the site and provider of their choice.  If the LSBME has allowed Licensed Midwives the ability to provide care in homes, hospitals, birth centers, and clinics, it would prevent clients from obtaining VBAC’s with midwives in any setting.  Such a precedence would again violate the rights of childbearing women and would force women to undergo caesarean surgeries if no physicians or midwives were willing or able to do so because of the proposed suggestions.  Women are being allowed to choose “C-Sections on demand” so why are they in turn being denied access to VBAC’s with the health care provider of their choice?  The American College of Nurse Midwives and the North American Registry of Midwives have both allowed CNM’s and CPM’s the ability to provide such care.  The C-Section rate in the U.S. has grown at an astounding rate of 40% in the last 10 years nationwide.  This further increases health care costs to YOU the consumer through increased insurance premiums!  If this trend is not reversed, we will continue to see rising premiums and limited providers and birthing options.