Why legislation matters
It is not for government officials to decide where and how a woman may choose to give birth. To remain silent in response to the cries of women and children is to be complicit in the actions (or often inaction) that are causing their distress.
As one woman described so well, "I'm not just protecting my rights as a mother... I'm protecting my daughter's rights."
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History of Midwifery in SC
Midwifery holds a long history of welcoming new lives into societies worldwide. Midwives are often honored as cornerstone community members. The word midwife means “with woman.”
In the 1930’s, South Carolina’s public health officials recognized the need for formal training of midwives and established programs. At that time, South Carolina had several thousand midwives who cared for families in their communities.
As the 20th Century progressed, pregnancy and birth became safer due to improved sanitation and hygiene, better nutrition, the invention of antibiotics and birth control. Our health care system became more organized, and the ability to address childbearing challenges improved.
By 1970, our health officials implemented an experimental plan to turn childbirth into a medical event for everyone. This plan was already in effect in the United States except in the South. The master plan eliminated independent midwives and established the mechanistic view of childbirth that prevails today.
Consequently, South Carolina midwives were informed their services were no longer needed. The change was a shock since some citizens still desired the personal care and conscientious service of midwives. Many appreciated the midwives’ reluctance to interfere unnecessarily in the birth process. Not all mothers wished to be institutionalized for birth, take drugs or be separated from their newborns. Nevertheless, the government supported such practices.
Midwifery in SC today
Having decommissioned the midwives of the previous era, the South Carolina Department of Health and Environmental Control (DHEC) moved in 1976 to retire the statute under which the program had operated. In public hearing of the matter, a new voice spoke to the place of midwives in maternity care. South Carolina became one of the first states to update the midwifery profession. Today’s licensing began in 1982.
DHEC oversees the routes of training, testing and regulation of South Carolina Licensed Midwives.
To effect healthy outcomes, midwives strive to care for the whole woman. Nutrition counseling, exercise guidelines, stress management, compassionate listening, health education, resource referral and preparation for birth typically complement the clinical assessments of each visit. Prenatal checkups are provided on a regular schedule. This approach yields low rates of premature delivery, high rates of successful breastfeeding, reduces the occurrence of low birth weight infants and supports the family unit.
Labor and delivery care is provided in the home or birth centers. Women are free of restrictions in labor and give birth as they choose. Newborns are welcomed gently and remain with their mothers. Licensed Midwives tend to mother and baby’s stabilization, monitoring and examination with special attention to parent/infant bonding.
Midwife care reclaims traditional ways of being “with woman,” in combination with the best of modern bio-technical theory and practice. It encompasses physical and emotional needs while fostering self-determination throughout the childbearing cycle. Utilizing the Midwives Model of Care, most women are able to have successful pregnancies resulting in normal childbirth, healthy babies and happy families.
Looking ahead
There is hope for the future of our country’s mothers and babies if a health policy implements the evidence-based changes we need. Forty years of research data demonstrates that practices consistent with the Midwives Model of Care achieve superior results in maternal and neonatal outcomes and decrease costs.
Yet, technology-focused care continues to rise in the U.S., increasing expenditure without producing better health, and costs for childbirth services have exploded. Cesarean section, with all of its attendant risks and costs, has become the most frequently performed surgery in the nation; premature deliveries are on the upswing; Neonatal Intensive Care Units are overflowing; and too few babies are successfully breastfed. Sadly, the U.S. is at the bottom of the world’s health care statistics heap except for one outstanding benchmark: we outspend every country in the world for pregnancy and birth.
Consumer demand for the Midwives Model of Care has grown nationally. Midwives are the specialists in care for low-risk pregnant women and their babies. Physicians are the specialists in care for pregnant women who are ill or experiencing complications. In the countries with lower costs and better results, midwives greatly outnumber obstetricians.
Birth is the place to begin building a positive future for South Carolina. Safe, effective and satisfying maternity care starts with evidence-based health policy. We are beginning that future now.