The Battle of Midwifery

The Post-Dispatch ran a two-part article this this weekend (and this morning) on Missouri’s midwifery battle. The casual reader may find our preoccupation with this issue bizarre. But it’s not the midwife focus per se that we care about — it’s the Show-Me Institute’s staunch opposition to most occupational licensing regulations.

Advocates of midwife-assisted deliveries argue that the experience is more natural, offering new mothers the opportunity to experience the miracle of childbirth in a relaxed, conscious setting. Dr. Laurel Walter-Baumstark, a family physician on the board of the National Association of Birthing Centers, argues that "there is just no better model of preventive maternity care than the midwifery model."

But opponents counter that their opposition to legalized midwifery is focused on pre- and post-natal safety concerns, not money. For example, Dr. David Redfern, an obstetrician in Springfield, Mo., who testified against midwife legislation last year, argues, "[H]ow we [deliver babies] is very important, and we have to take patient safety into consideration."

But the doctor’s opposition misses the point. Eliminating occupational licensing requirements doesn’t mean an end to medical safety. The state is free to continue to sanction doctors (and other professionals) who properly meet their standards. What’s more, the state should set medical standards, as a way for consumers to ensure the quality of their medical practitioners. But it is not the state’s role to tell people how to live their lives. If a new mother wants to use a midwife to assist in childbirth, that’s her decision — a decision that no one is better-equipped to make than her.

And as the Post documents, doctor-assisted births aren’t necessarily qualitatively better than midwife deliveries (emphasis added):

“Medical interventions are on the rise. The rate of labor inductions in the U.S. has more than doubled since 1990 to 22 percent. The 2006 rate of births by C-section has reached 31 percent, the highest ever. But the Centers for Disease Control and Prevention says it can find no medical reason to justify the increases and says the interventions are not producing better maternal or infant health outcomes."

Before you dismiss this issue (or dismiss consideration of the role of occupational licensing in general), think of it this way: Are you really comfortable with surrendering your freedom to make your own decisions about your body? We shouldn’t be afraid of this type of choice; we should embrace it.