There are several misconceptions which have surfaced during this discussion which we believe are misleading. First, we do not view the lay midwives as a threat to our practice or competition for our patients. Rather, we view the lay midwives as a threat to the safety of mothers and their unborn children. Another misconception which has been presented concerns the notion that lay midwives have better birthing outcomes than we as obstetricians and gynecologists do who deliver in the hospital. The patients they care for are generally healthy, low risk, non-substance abusers and mentally and physically fit.
Further comparison is very misleading.
Also the physician and the lay midwife end up responsible for perinatal mortality and morbidity that may be caused by a planned home delivery that occurs after transfer to the hospital. It is obvious, from following maternal and fetal rnorbidity and mortality rates, how far we have come in this century to improve the health and safety of mothers and their babies. There are sound medical reasons why untrained, unlicensed midwives should not be permitted to deliver, especially in the home. We also know that the same environment as in the home is available in most hospitals that perform obstetrics but with the personnel and equipment to take care of emergencies that can occur at any time. It is interesting that the alternative birth movement is a consumer reaction to paternalistic and mechanistic medical obstetrical practices which developed in this country early in the century.