What's In a Name?

My midwife and her apprentice did a home visit today. Imagine the luxury of getting a prenatal on your own bed! All my kids huddled around to listen to heart tones and feel my belly (okay the teenagers didn't want to feel my belly.) Still it was very special. I only wished my husband had been home. I asked them both if they wanted to bail out if I was having the birth filmed. They asked if it would make us all famous- I answered it would probably make us all infamous. We talked some about Kansas midwifery law. While nurse-midwives are legal in all 50 states, midwives who are not certified nurse-midwives (CNMs) are illegal in Missouri (my home state just 10 minutes away), and allegal in Kansas (my current residential state). Since I live in a border town, I have to understand the laws of both. My midwife is a CNM, her apprentice is a CPM (certified professional midwife) which is recognized in some states, but not in others. Many legal battles have been waged in Kansas and Missouri to define what a midwife is, who can be called by that name, and what constitutes their practice. It is a long and tumultuous history. My book has chapters titled, "The Midwife Trials of Kansas" and "The V/BAC Wars: The Battle Over Elective Cesareans in Missouri." I want women to know about this courageous population of women and men who have fought long and hard to give them options in childbirth, that are safer, and more humane. But of course, midwifery continues to evolve. Sadly there are now midwives that I can no longer recommend as caregivers when that list used to be occupied solely by OBs. I won't recommend midwives whose practices mimic OBs when they are caring for low risk women. Unfortunately, the label "midwife" is no longer a guarantee of the midwifery model of care.