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New York City, A Haven for Nurse-Midwives - October 2013

The next destination after wonderful Minneapolis and the AABC Annual meeting was New York City. It is my first time in US and first time in New York. I am excited. I contacted about 12 midwives, which I found on the NYSALM web page and I managed to talk to 5 of them. I also attended one lecture about homebirth for midwifery students in Brooklyn. There were 5 New York homebirth midwives sharing their experience and their views, which was great.

After several interviews I had an idea that New York is almost a haven for CNM midwives. But it has a history, especially in the New York City. There was one hospital, St Vincent, which was very homebirth friendly, but it was closed in 2010 in very unclear circumstances. After that, homebirth midwives and most of the consumer’s groups struggled to change the law. It happened in several months and it had a very good outcome. The Midwifery Modernization Act provided midwives to practice independently from any form of collaborative agreement with a physician. This is one of the crucial things for midwifery itself, to be recognized as an independent profession. It is also crucial for midwives who are practicing out of hospital. The other really positive thing which is working in New York is law that insurance has to cover out of hospital midwifery services. These two things make the homebirth midwives in NY very happy. They appreciate it and they are aware that it is not so common in other states.

Almost all midwives agree that the movie “Business of Being Born” made such a difference; it educated people and spreads the message that midwives are a choice that can make difference. I met Cara, one of the NYC midwives who played a crucial role in this movie. In my opinion we should be thankful to her. We need such influential movies.

It was also interesting to discus the standardization of out of hospital midwifery care with them. They are aware that it is really politically the next step to have more accessible midwifery care, especially the out of hospital one. But they are also thinking about the power of the possibility of their own judgmental call. Martine, one of the NYC homebirth midwives put it into the words in such a nice way: “I have mixed feelings, because we are taking care of humans, we can’t be put in a box all the time. If it gets too regulated it might be my time to retire.”  I think that this is mirroring that homebirth midwifery care is mostly about individual care, one to one, and one of the beauties of it is that you as a birthing woman will still be human being, not a statistical number.

After I finished this series of interviews I felt really positive, not just about future of US midwifery, but also about the midwifery in general. I think in the case of New York it is really visible that if the system is working well, midwives are happy. When midwives are happy, mums are happy and babies are happy. This can continue into the whole society. I can really believe like with Kimm, another homebirth midwife, who said that: “Being a homebirth midwife gives me so much faith in humanity, even though it is so hard.” And I also agree with Barbara, who said simply: "We need more midwives.”

 

                                                                                                            Zora Javorská

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