Home birth’s crazy-quilt legal status: Part 1

What a difference a few miles makes...

Okay, so I was a wee bit wrong about North Carolina. (Thanks to Russ Fawcett, Deb O’Connell, and Ida Darragh for their clarifying comments.)

Home birth is technically legal in the Tar Heel State. I say “technically,” because by state law the people who would be attending most of the home births in North Carolina—direct-entry midwives*—are legally barred from doing so. This sounds like a bit of a legal end-run, kind of like saying acupuncture is a legal activity… as long as nobody with needles is allowed in the room.

According to the Charlotte Observer report, home birth attendance in North Carolina is limited to registered nurses operating under the direct supervision of a physician. Due at least in part to that requirement for physician supervision, only about a half dozen of the 300 certified nurse midwives in North Carolina attend home births. So, yes, home births are legal, but if you’re looking for a qualified home birth midwife, in most of the state you’re on your own.

My legal fuzziness about the situation in North Carolina is understandable (at least to me). The laws governing home birth in the U.S. vary dramatically from state to state and are often quite byzantine.

Nowhere is this more obvious than in Charlotte. I’ve never been there, but from the look of things on the map, if you were to walk to the south side of town and take a long leap you’d land in South Carolina—where home births and the midwives who attend them are completely legal, and midwives are even paid by Medicaid for their services.

But just meander up and down the Atlantic coast a bit and things change, and change again. More on that in my next post.

* * * * *

* “A Direct-Entry Midwife is an independent practitioner educated in the discipline of midwifery through self-study, apprenticeship, a midwifery school, or a college- or university-based program distinct from the discipline of nursing. A direct-entry midwife is trained to provide the Midwives Model of Care to healthy women and newborns throughout the childbearing cycle primarily in out-of-hospital settings.” (Source: Midwives Alliance of North America.)

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Filed under Home birth, Politics

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