Vermont Gov. Peter Shumlin signed a bill last week to require health insurers to cover midwifery services and home births. Insurance companies such as Blue Cross Blue Shield will be required to cover prenatal care by midwives and home births in Vermont. Medicaid and the Vermont Health Access Plan already cover midwifery services and home births.
The Midwife Bill is intended to improve access to wide-ranging health services for women, reduce health care costs, and strengthen the quality of care that mothers receive during pregnancy and childbirth, according to a statement on the state website.
Vermont Public Interest Research Group, the largest nonprofit consumer and environmental advocacy organization in Vermont, reported that Shumlin signed into law the Midwife Bill surrounded by a happy group of mothers, children, and public health advocates.
“Access to midwifery care and home birth should not be limited only to those who can afford those services out of pocket,” Shumlin said at the event. “This law will ensure that all expectant mothers get the coverage and care they want and deserve.”
The bill came after Senate Health and Welfare passed a major health reform bill earlier this year to create “a universal and unified health system,” as stated in the Vermont H.202 Health Reform Bill.
The Big Push for Midwives is a group committed to building state-level advocacy campaigns toward licensing certified professional midwives (CPMs) across the nation.
Katherine Prown, campaign manager for The Big Push, said in a phone interview that there are improved outcomes with homebirths such as significantly reduced rates of low birth rate and preterm birth, caesarean sections, and also reduced costs. “There are many benefits associated with home birth,” Prown said. According to Prown, the problem is that to the medical lobby, CPMs and homebirths are obviously very small parts of the maternity care market.
Prown said childbirth outside of hospitals is becoming more popular. “Homebirth is only expected to grow, as births have been in and out of hospitals in general, but particularly in the year 2000 did homebirths begin to increase (in the United States).”
Critics of the bill include the Vermont Medical Society. Paul Harrington, Vermont Medical Society president said, as reported by the Vtdigger.org website, a nonprofit news organization: “We’re concerned it somehow creates the impression that homebirths are the safe alternative to hospital birth. It creates a false sense of security.” Harrington cited a report published in September 2010 by the American Journal of Obstetrics and Gynecology that found far more newborn babies died after home births than after hospital births. It said newborn mortality tripled in home births compared to hospital births. It also found that mothers giving birth at home had less risk of “lacerations, hemorrhage, and infections.”
Maine Medical Center researcher Dr. Joseph Wax led the study. According to its abstract, it was a systematic review of the medical literature for outcomes for mothers and children after home birth or hospital birth.
Prown said, “The medical lobby continues to have a monopoly over the maternity care in the United States and the Wax study is deeply flawed, as well very politically motivated to give mothers the idea that wanting a good birth experience is selfish and harmful to the baby, when it is actually the opposite.”
In only 27 states may CPMs legally deliver babies, and in 23 states it is illegal for a CPM to deliver babies. Only in New Mexico, New York, New Jersey, and now Vermont are home births covered by insurance.