Call for Emergency CPM Licensure
Ohio Certified Professional Midwives Request Emergency Licensure due to COVID-19
Ohio Homebirth Midwives are seeing a spike in the request from healthy pregnant women to birth at home due to COVID-19.
Advocates for women’s and newborn health along with the National Association of Certified Professional Midwives asks the State of Ohio to immediately offer emergency state licenses to CPMs to allow these professionals to care for more pregnant people in the safety of their own homes.
Here’s how the licensure of CPMs benefits pregnant people in Ohio:
Licensing of CPMs at this time will allow CPMs in the state who haven't been comfortable practicing in an a-legal state to begin practicing keeping more low risk pregnant people out of the hospital.
Licensing gives the midwife the ability to continue doing visits for clients in their final weeks of pregnancy in the case of shelter in place.
It will allow midwives to accept insurance and Medicaid. 48% of births are paid for by Medicaid.
Midwives and out of hospital birth is a lower cost than hospital births. CPMs can fill a huge hole in the healthcare system if our healthcare providers become ill.
The rapid spread of COVID-19, as well as subsequent quarantine measures, may well lead to the unwillingness or inability of healthy pregnant people to give birth in hospitals.
Certified Professional Midwives (CPMs) are the only health care professionals trained specifically in the management of out-of-hospital patients for their certification.
The American College of Obstetricians and Gynecologists (ACOG) recommends pregnant people be considered an at-risk population for COVID-19.
The two following scenarios are likely to intersect:
1) Healthy pregnant individuals wish to avoid hospitals in order to minimize risk COVID-19 exposure to themselves and their newborns, and
2) Hospitals’ diminished capacity to care for labor and delivery patients in the face of vastly increased admissions due to COVID-19.
Policymakers must ask themselves which health care providers will assume care of these families in this scenario?
The 35 states that legally authorize CPM practice are better prepared for the imminent need to attend out-of-hospital mothers in their states. Indeed, the District of Columbia’s decision this past week to license CPMs may have been influenced by the threat of COVID-19.
Ohio does not currently grant licenses to CPMs.
This in spite of the fact that 35 other states legally authorize CPM practice. It is worth noting that the CPM exam is administered by the North American Registry of Midwives and is properly accredited and recently approved by US-MERA
(http://www.usmera.org/). US-MERA is an agreement on educational standards by the seven U.S. midwifery organizations, that is itself based on standards from the International Confederation of Midwives (https://www.internationalmidwives.org/).
Healthy pregnant people (in defined risk categories) are as safe, if not safer, giving birth at home compared to equivalent cohorts giving birth in hospitals (https://www.ncbi.nlm.nih.gov/pubmed/15961814).
The safety of out-of-hospital birth is increased by state regulation of CPMs and their integration with hospital-based providers.
Women’s health advocates are therefore calling for the issue of an IMMEDIATE EMERGENCY ORDER granting licensure to Certified Professional Midwives (CPMs) and any other necessary steps to bring their practice under the umbrella of state public health efforts to fight COVID-19.
written by April Kline with edits from myself and Aly Romot. Thanks for all your work on this!