Earlier this year, I wrote a four part series about the risks to mothers and their newborns when rural hospitals stop delivering babies.
Throughout my reporting over the winter, the role of midwives, whether working in hospitals or delivering in homes, emerged as an important question to pursue. It wasn’t clear whether they could viably fill the gap as rural obstetrics units went dark.
My research revealed that the decline of rural OB units coincided with another trend. Out-of-hospital birth is becoming an increasingly popular choice for Minnesota mothers, though they remain a small sliver of all births happening here annually. In 2000, the state health department recorded two planned home births. In 2018 it recorded 721. Births in free-standing birth centers are also increasingly popular.
So this spring, I sent a query to several Facebook groups where families, midwives, doulas and other practitioners gather to discuss home birth. My questions were broad: Why did you choose home birth? What were you looking for in a midwife? What was your experience like?
Among the dozens of responses I received were several mothers who told me they chose an unlicensed midwife to deliver their baby. Margo Nelson, an unlicensed midwife, wrote as well, and I eventually interviewed her in Duluth.
As someone who covers health care frequently, who has several friends who chose home birth, and who has had three kids herself, I was surprised to learn that Minnesota is one of two states that doesn’t require midwives to be licensed. Utah is the other. Unlike most jobs that can affect health, including being a Certified Nurse Midwife, licensure is voluntary for midwives who deliver babies in a home.
I found this both remarkable and fascinating, and I was certain the MPR News audience would as well.
In reporting the story I learned that licensure is controversial, even among some midwives, and the reasons why some midwives choose not to be licensed are complex and often based on principle.
For me, coming to understand those reasons was among the most satisfying aspects of reporting these stories, and, I believe, the most important take-away. These stories are not just about home birth and midwifery. They’re about how we define personal freedom, how we understand risk and what it means to let a woman decide what’s best for her body.