Midwifery’s Rebirth

A STUDY in the March American Journal of Public Health reported that certified nurse-midwives achieve excellent birth outcomes at a lower cost than physicians. The extensive media coverage received by the study portended a growing role for midwifery in today’s cost-conscious health-care environment. Yet just a few months before the study appeared, an experienced Syracuse midwife with a loyal clientele was sentenced for the crime of helping women give birth. Arrested in a sting operation, Roberta Devers-Scott was charged with a felony: practicing midwifery without a license. To avoid prison, she pleaded guilty in November to a misdemeanor, receiving a $1,000 fine and three years’ probation.

Unlike the birth attendants in the American Journal of Public Health study, Devers-Scott is an independent or “direct-entry” midwife. Like virtually all direct-entry midwives (but only 3 per cent of certified nurse-midwives) in this country, she attended births at home rather than in hospitals or birth centers. While CNMs are trained and regulated as part of the nursing profession, direct-entry midwives are trained at independent midwifery schools or through apprenticeship. Legal in some states, illegal in others, direct-entry midwives are the primary home-birth attendants in the United States.

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Archie Brodsky

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A STUDY in the March American Journal of Public Health reported that certified nurse-midwives achieve excellent birth outcomes at a lower cost than physicians. The extensive media coverage received by the study portended a growing role for midwifery in today’s cost-conscious health-care environment. Yet just a few months before the study appeared, an experienced Syracuse midwife with a loyal clientele was sentenced for the crime of helping women give birth. Arrested in a sting operation, Roberta Devers-Scott was charged with a felony: practicing midwifery without a license. To avoid prison, she pleaded guilty in November to a misdemeanor, receiving a $1,000 fine and three years’ probation.

Unlike the birth attendants in the American Journal of Public Health study, Devers-Scott is an independent or “direct-entry” midwife. Like virtually all direct-entry midwives (but only 3 per cent of certified nurse-midwives) in this country, she attended births at home rather than in hospitals or birth centers. While CNMs are trained and regulated as part of the nursing profession, direct-entry midwives are trained at independent midwifery schools or through apprenticeship. Legal in some states, illegal in others, direct-entry midwives are the primary home-birth attendants in the United States.