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THE HOMEBIRTH UNDERGROUND
If you want to have your baby at
home in Athens, you need to find a
renegade midwife. Local activist Susan
Hodges is trying to change all that.
by MELISSA IJNK
When Athens resident Susan Hodges was
pregnant with her first child more than 13
years ago. she decided that she wanted the
baby delivered by a midwife. It seemed only
logical that having a woman guide her
through the birth would be ideal
She began seeing a group of nurse mid
wives associated with a local doctor and was
planning on having her baby in the hospital.
Seven and a half months into her pregancy.
she changed her mind
She says the doctor put too much empha
sis on what could go wrong and not enough
on what could go right. She and her doctor
clashed over the necessity of fetal monitor
ing: the doctor insisted on it. while Hodges
says she'd read that it led to an increased
chance of an unnecessary Cesarean section
The last straw came during a tour of the hos
pital. when she asked if she’d be able to take
a shower. Her guide told her it wouldn’t be
possible — the shower. Hodges says, was
full of boxes. “I mean, it was a little detail."
Hodges recalls. “But there weren’t going to
he any boxes in my shower at home "
Hodges began considering having her
baby at home. When she brought it up to her
husband, a scientist who grew up in a med
ical family, he was suspicious. Nonetheless,
the couple did their homework, reading rele
vant literature and consulting with families
who had delivered healthy babies at home.
They found that homebirth is seen as an
ideal situation by groups like the World
Health Organization A 1986 study by WHO
found that “home is the most appropriate
birth setting for most childbearing women ’
In her quest for a midwife-attended birth
outside of a hospital. Hodges gradually
became aware of the obstacles that stand in
the way of a woman s options in childbirth
By law. a midwife
must have an agree
ment with a physi
cian to take over
should complica
tions arise. Hodges
was able to find a
local midwife who
was backed up by a
doctor from out of
town, but the educa
tion she underwent
in this search
prompted her to
found Citizens for
Midwifery, a national
non-profit organiza
tion based here in
Athens dedicated to
education, network
ing. and legislative
changes associated
with midwifery.
In order to prac
tice midwifery legal
ly in Georgia, one
must be a Certified Nurse Midwife (CNM) —
a Registered Nurse who goes Ihrogh a pro
gram accredited by the American College of
Nurs^ Midwives.
A jrerson without nurse training could in
past years be certified as a midwife through
the Georgia Human Resources Department,
but the state stopped issuing these certifi
cates in the 1960s Thus the only legal mid
wives in (ieorgia are nurses Hodges would
like to see this changed
She is also concerned that it’s almost
impossible to have a baby at home in
Athens Today in Athens, the only legal mid-
wives currently in practice are CNMs associ
ated with Athens Regional's Nurse Midwifery
Program, who deliv
er babies only in the
hospital’s birthing
center. Bettye Dann.
who works in Athens
Regional’s program,
cites what she says
are the advantages
of Certified Nurse
Midwives: “We are
trained to attend to
the overall health of
the patient, not just
her pregnancy."
However. Hodges
says, “nurse-mid
wifery has come up
through nursing
routes and nurses
have always been
subservient to doc
tors. It is doctors
who are deciding
where, when, and
how nurse-midwives
practice. Consumers
are out of the picture."
Hodges’ group advocates the adoption of
Certified Professional Midwife (CPM) stan
dards set by ttie North American Registry of
Midwives (NAHM) Such standards. Hodges
says, certify midwives based primarily on
what they know, not how they learned it. ele
vating experience over academics. Most
CPMs are educated through apprentice
ships: many undergo education through pri
vate midwifery training programs In order
to become a CPM, an applicant must pass
NARM's written exam. Applicants must have
CPR (cardiopulmonary resucitation) certifi
cation. submit letters of reference and pro
vide documentation of experience, knowl
edge. and skills
According to Hodges. 14 states regulate
non-nurse midwifery: 10 of those use the
NARM test as their licensing exam Another
20 states allow non-nurse midwifery Anyone
in Georgia can apply for CPM status Those
who gain it can frame the certificate, but it
won’t make their practice legal
ESTABLISHMENT PRESSURE
It was not always so difficult to arrange
for a homebirth in Athens. In the 1980s. a
group of nurse midwives set up an indepen
dent practice in town with the cooperation
of a local doctor and delivered many babies
in the mothers' own homes
One of the midwives. Deborah Sweeney,
also was a nursing instructor at the Medical
College of Georgia. Sweeney claimed Athens
Regional denied hospital training to her stu
dents. A lawsuit ensued in which Sweeney
accused doctors associated with Athens
Women’s Clinic of slander, “injury to profes
sional and personal reputation." and other
charges In the lawsuit. Sweeney accused the
doctors of tactics meant to pressure
Sweeney’s back-up obstetrician into termi
nating his relationship with Sweeney's com
pany Sweeney settled out of court on undis
closed terms and moved out of town.
According to Debbie Pulley, an Atlanta-
area non-nurse midwife with CPM status
Midwife Debbie Pulley checks out a newborn as the pioud
father looks on.
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