Radical Doula

It’s nice to have some good news to share on Mother’s Day. I recently interviewed some advocate, midwives and doulas in Washington State about out-of-hospital birth options there. It’s good news and their model is really making headway for other states and access to midwifery. I elaborate on this in a new article over at Reproductive Health Reality Check, Barriers to Home Birth Fall in Washington State:

Nationally, only a small portion of women give birth outside of hospitals (around 1%) and very few of those women are low-income. In a recent piece for RH Reality Check, The Cost of Being Born at Home, I painted a grim picture of the options afforded to low-income women around the country who are considering out-of-hospital birth. Few out-of-hospital childbirth providers are registered with Medicaid. Cost and physical space available at women’s homes are also significant prohibiting factors. And lack of knowledge of the practice, as well as lack of targeting from media and advocacy promoting home birth (such as the pro-home birth film The Business of Being Born), impact low-income women’s decisions about where to birth.

But there’s at least one exception to this national trend, brought up by the advocates I interviewed and by commenters responding to my original piece-Washington State. In fact, thanks to a history of expansive access to midwifery care and a number of big legislative gains, low-income women in Washington State now have more birthing options than most women around the country.

According to Audrey Levine, President of the Midwives Association of Washington State (MAWS), 2.3% of births statewide in 2007 were performed out-of-hospital.  While still a low percentage, that’s more than twice the national average of 1%. What is even more impressive is the number of those births that are reimbursed by Medicaid.  According to Levine, around 45% of out-of-hospital births attended by midwives in the state are Medicaid births. That mirrors the percentage of births to women on Medicaid overall in the state-also around 46-47%. (Of the 26 states that license CPMs, only 9 allow CPMs to participate in Medicaid, so this percentage is a significant departure from the situation nationally.)

Read the rest here.

Also stay tuned for details about a home birth and low-income access live chat with me and a midwife at RHRC next week!