Thursday, December 22, 2005

RICHMOND — Years stealthily slipping in and out of homes, dodging curious neighbors and looking out for police officers posing as parents-to-be all came to one fateful knock at midwife Martha Hughes’ door in 1993.

It was a county health department nurse — and she wasn’t expecting.

What followed was the sort of lengthy investigation considered an acceptable risk among “baby catchers” — women like Miss Hughes who spent years quietly, and illegally, tending mothers across Virginia.

State regulations being put in place this month will license certified professional midwives, letting dozens of homespun obstetricians come out of the closet.

Following years of lobbying in the General Assembly, Virginia advocates last session pushed through two bills giving legal footing to CPMs.

They differ from nurse midwives, who hold nursing degrees and practice under a doctor’s supervision.

Instead, CPMs are credentialed through the North American Registry of Midwives, a Georgia group whose certification doesn’t equal state recognition.

The legislation established an advisory board that will help form a licensing procedure standardizing everything from delivery practices to insurance requirements, explained Brynne Potter, legislative coordinator for the Commonwealth Midwives Alliance.

The regulations must be in place by Thursday.

About 20 states have similar laws.

It marks an entree into the mainstream for midwives, who largely shun Western medicine and birth as big business.

Viewing pregnancy as a journey, they emphasize close circles of women coaching each other through a rough but rewarding process, and scoff at the Caesarean sections and painkillers they say have taken the “labor” out of labor.

To them, midwifery is an almost mystical art. To the medical establishment, it’s a threat.

“Seeing 10 deliveries in no way prepares a person to do something that impacts two lives,” said Richmond-area obstetrician John Partridge, who opposed the licensing laws. “There will be people injured — mothers who will be injured and babies who will die.”

Sarah Kilpatrick, vice chairwoman of obstetric practice with the American College of Obstetricians and Gynecologists, fears the domino effect of licensing lay midwives.

“I would just be concerned that we are lowering our standard for women’s health care by licensing a group that doesn’t meet the same standards that the certified nurse midwifery group meets,” she said.

According to the Virginia Friends of Midwives, midwives operated freely until 1918, when the state adopted regulations matching reforms in American medicine.

In 1962, regulatory power passed to the Department of Health, and state officials would later limit the practice to those permitted before 1977.

It forced CPMs across the commonwealth to give up their practice or go underground, Miss Potter said. Many chose the latter.

They formed a network of cloak-and-dagger baby catchers, their names quietly passed between sisters and aunts, in prenatal yoga classes and breast-feeding circles.

“That invisibility was our ally,” Miss Hughes said. “As long as we didn’t get out there and aggressively advertise, nobody knew who we were, where we lived, what we did or how we did it.”

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