Certified Professional Midwives Stand Ready for Out of Hospital Births During Pandemic
As the COVID-19 Pandemic reached the United States one thing became abundantly clear: while Georgia was prepared in some ways with ensuring the educational system would continue, its healthcare system has appeared to be underprepared. We have seen in other states and countries that maternity units were being used for additional quarantine areas. Pregnant families are wondering if the hospital is the best place to plan to birth their newborn and there appears to be no plan for some of Georgia’s most vulnerable- pregnant women and newborns.
Georgia’s Certified Professional Midwives train for this! We are prepared and ready to offer prenatal care in-home or in small office settings where only one patient is seen at a time. If you are pregnant and finding yourself uncomfortable with the idea of birthing in a hospital during a pandemic, there may be a midwife ready to help you! Have your entire prenatal record in hand, and begin to reach out.
We have sent the letter found below to the Governor, as well as to other maternity care professionals that may appreciate the help right now.
Members of the Task Force:
Our purpose is to bring to the full Georgia Coronavirus Task Force’s attention a healthcare resource that may be critically needed during this pandemic: Certified Professional Midwives (CPMs). CPMs are the only nationally credentialed midwives specializing in out-of-hospital birth.
It is important to note the following:
“During the SARS epidemic in Toronto in 2003, several hospitals closed their maternity wards to contain the infection (at least one hospital quarantined five newborns and their mothers for 10 days), and area midwives reported an uptick in interest in home birth among pregnant women as they came to appreciate the risks of giving birth in hospital settings...The SARS and H1N1 events remind us that hospitals ought properly to be the preserves of the sick and the individuals who care for them” (Armstrong EM. Home birth matters-for all women. J Perinat Educ. 2010;19(1):8–11. doi:10.1624/105812410X482329, emphasis added). As midwives, we are already seeing this “uptick in interest in home birth” through requests on social media as well as direct contact.
While health care facilities are currently capable of handling the influx of Coronavirus cases, that situation could quickly change. These skilled midwives would gladly assist low-risk women through their labors and births, managing these births at home, thereby freeing resources, providers, and space for those that need a heightened level of medical care. CPMs are trained to provide all typical components of prenatal, labor & delivery, and postpartum care, ensuring screening for maternity needs that would require escalation to CNM or OBGYN services.
However, it is currently illegal for Certified Professional Midwives (CPMs) to practice in the state of Georgia. While a few CPMs continue to practice because Georgia women still demand home birth options, the majority of CPMs have recently shuttered or are closing their practices, fearing legal jeopardy.
One of our Georgia CPMs, in her previous state of residence, was part of a CERT sub-district healthcare team that included a physician, cardiac and NICU nurses, a retired paramedic and EMTs. They were trained and tasked with storing the sub- district’s OTC medical supplies, knowing the location of additional supplies (which happened to be her own birth center) and acting as one of the first responders under the direction of the CERT leaders. As CPMs are trained to oversee and manage pregnancy, birth and postpartum in low-resource settings (mainly the home), we were viewed in that state as a vital partner in possible emergency situations where medical resources might be rationed or non-existent.
During this pandemic, if just 50 Certified Professional Midwives (CPMs) were legally practicing and delivering 6-10 low-risk patients a month (patients who choose to deliver at home), there could be 300 - 500 moms and babies safely remaining at home over the next month (with 900-1500 over the next three months.) These moms would avoid possible exposure and infection, and hospital resources and staff would be freed to serve in other areas.
Surely, there must be a legal solution for us to be able to provide care, if simply through an Executive Order removing legal jeopardy for the duration of the Coronavirus pandemic.
The following Evidence-Informed Practice resources for Certified Professional Midwives (CPMs) are available by request:
Practice Standards and Guidelines
Transfer Protocols and Guidelines
Informed Consent and Choice documents
Peer-Reviewed Studies suggesting appropriate scope of practice for community/out-of-hospital birth
We are available at your earliest convenience to answer any questions or assist as needed.
Sincerely,
B. Maria Cranford, CPM MSM
Education Advisor, NACPM - Georgia Chapter
Missi Burgess, CPM
President, NACPM - Georgia Chapter
Paige White, CPM
Vice President, NACPM - Georgia Chapter
Crystal Hanner, CPM
Secretary, NACPM - Georgia Chapter
Margaret Byrne, CPM
Treasurer, NACPM - Georgia Chapter
Tracy Cuneo, CPM BSM
Legislative Co-chair, NACPM - Georgia Chapter
