Alabama was recently found to be the worst state in which to give birth [link]. Our hospitals have some of the highest intervention rates in the nation and vital statistics data shows these interventions are not improving outcomes, there are only a handful of nurse midwives delivering babies, we have no freestanding birthing centers, and the state actively works to make home birth less safe by arresting midwives. Home birth is legal. You are free to give birth at home attended by anyone you wish. Your husband, your neighbor, or your garbage collector can deliver your baby in your Alabama home. Anyone, that is, but a Certified Professional Midwife. We need to change this insane law!

In 1976 the Alabama Legislature quietly changed the law regulating the practice of midwives. Their changes made nurse midwives the only legally recognized midwives in the state. By 1984 all existing midwives who had served families in their communities and homes were unable to renew their permits, forcibly retired by the state. Yet the Department of Public Health, the agency responsible for ending the practice of midwives, continued in some parts of the state referring mothers to local midwives, leaving families and midwives unaware of this change in the law. They continued to give birth at home or attend mamas in their homes. Until the state began arresting midwives.  

Today, mothers choosing to birth out-of-hospital must travel across state lines to birth legally with a midwife, find a midwife willing to risk prosecution by assisting them at home, or birth at home unassisted. The state claims the law protects mothers and babies. The Alabama Birth Coalition and the parents affected by this misguided law vehemently disagree. In coming weeks we will feature stories of how parents have been affected by Alabama's law regarding midwives. We must make this fact clear. Our campaign is not about home birth, it is about access to care in all settings. The fact that home birth midwives are illegal is just one symptom of a much bigger problem. Here are just some of the measures which make this true.

Our prevailing standard of maternity care has produced a cesarean rate of 36.1%, with rates ranging from 18.9-67.2%, depending on which hospital you give birth in. Cesarean section significantly increases risks to mothers--triple the risk of maternal death--as well as to babies and future pregnancies. The evidence supports a c-section rate of 15-20%. Our standard of care has caused an infant mortality rate of 9.2, higher than every state but Mississippi. Evidence indicates that 74% of women offered a vaginal birth after cesarean will succeed, yet Alabama’s standard of care has produced a VBAC rate of just 3.3%. Alabama’s standard of care offers parents no birth centers and just 20 nurse midwives licensed in the entire state, two options which substantially reduce the risk of cesarean and other unnecessary interventions. Only about half of those licensed are allowed to attend births. According to a Health and Human Services report, Alabama CNMs practice in the worst professional environment of all 50 states. In hospitals it is common for Alabama mothers with no medical indication to experience artificial induction or augmentation of labor, electronic fetal monitoring, restriction of food and drink during labor, or pushing in back-lying positions. None of these practices are supported by evidence. Our standard of care pits mothers who want to avoid routine but unnecessary procedures against doctors and nurses who think birth without medication and monitors and machines that go ping is reckless. The prevailing standard of maternity care in Alabama hospitals is failing Alabama mothers and babies. Is it any wonder, then, that a growing number of families are opting out of this standard of care, based on a strong body of evidence that Certified Professional Midwives provide a model of care which produces fewer interventions, greater maternal satisfaction, and no increased risk of mortality? 

Advocates have been working to change Alabama's midwifery law for 20+ years, and in the current political climate there is no end in sight. If you live in a state or country where midwives practice legally, please stand with us to make them legal in Alabama and to change the status quo for birth in all settings. All funds raised in this campaign will be used by the Alabama Birth Coalition to assist our efforts in the 2015 legislative session, where we will submit another licensure bill. Our top priority is to pay our midwife-turned-lobbyist, Jennifer Crook, to be available in the capitol throughout the session. 

We are grateful for your donation in any amount. Please note that the Alabama Birth Coalition is a 501c4, so donations are NOT tax-deductible.