Georgia Friends of Midwives

What is GFOM?

Georgia Friends of Midwives is a consumer group concerned with issues surrounding the problem of very limited birthing choices in our state.

GFOM was formed in 1990 in response to legal and political challenges to Georgia's midwifery community.  We advocate the preservation of safe, accessible and affordable childbirth alternatives as exemplified by the Midwives Model of Care™, including midwife-attended birth at home and in birth centers.

Our Mission

Our beliefs:

	Research shows conclusively that for most women a planned, midwife-attended birth at home or in a birth center is at least as safe as birth in a hospital.
	The Midwifery Model of Care results in excellent birth outcomes as well as deeply meaningful and satisfying family birth experiences.
	Fair regulation of direct-entry midwifery benefits both consumers and midwives.
	Certified Professional Midwives (CPMs), credentialed by the North American Registry of Midwives (NARM), should be able to legally practice in Georgia as they can in 33 other states.
	Midwife-attended home birth should be a real and accessible choice for Georgia families who, for any of a variety of reasons, prefer the home birth alternative.

Our purpose:

To promote awareness and public education regarding direct entry midwifery and the Certified Professional Midwife credential, and to ensure that the Midwifery Model of Care is available to all.

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General Information about Midwifery

Certified nurse-midwives (CNMs) are licensed health care practitioners educated in the two disciplines of nursing and midwifery. They provide primary health care to women of childbearing age including: prenatal care, labor and delivery care, care after birth, gynecological exams, newborn care, assistance with family planning decisions, preconception care, menopausal management and counseling in health maintenance and disease prevention. The CNM practices within a health care system that provides for consultation, collaborative management or referral as indicated by the health status of the client. This collegial relationship with physicians allows many hospital-based CNMs the ability to care for women with a wide variety of risk factors and obstetrical needs. While the majority of CNMs deliver in hospital settings, some CNMs also work with low-risk clients independently in birth center or homebirth practices. CNMs now deliver 9% of all babies born in the US

The majority of CNMs are educated in programs within institutions of higher education leading to a Masters Degree, and this has become the current standard of nurse-midwifery education. CNMs are certified through the American College of Midwives Certification Council (ACC) and practice legally in all states.

Direct-entry midwives (DEMs) practice legally in approximately 34 states, with licensure available in 20 states. Direct-entry midwives are independent practitioners educated in the discipline of midwifery through self-study, apprenticeship, formal midwifery school, or a college- or university-based program distinct from the discipline of nursing. A direct-entry midwife is trained to provide care to healthy women and newborns throughout the childbearing cycle primarily in out-of-hospital settings.

States that provide licensure for DEMs vary in their requirements. Most require the midwife be certified through The North American Registry of Midwives (NARM) as a Certified Professional Midwife (CPM), although some still have their own requirements in place. All states which credential (or license) DEMs, with the exception of New York, use the NARM Written Exam as their state licensing exam.

Efforts are underway in many states to make the CPM credential the basis of licensure, or a route to licensure for direct-entry midwives who practice predominantly in out-of-hospital settings. The CPM credential was created in 1994 by and for midwives. It recognizes a broad range of educational pathways, is competency based, and requires out-of-hospital birth experience. Practice is based on the Midwives Model of Care.   For more information about the CPM, go to the mission statement of the North American Registry of Midwives or contact them via email.

A good source of information is the Citizens for Midwifery. 

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Direct-Entry Midwifery in Georgia - A Brief History

From colonial days to the present, Georgia families have been served by community-based midwives delivering infants safely within the comfort and security of their own homes.   Mothers and babies have been cared for during pregnancy, birth and postpartum regardless of race, financial status, religion, or geographical location.  Home birth was particularly prevalent in the rural areas of Georgia where hospitals and physicians have always been and continue to be inaccessible to many families.  Today, the high cost of hospital-based physician care and the lack of health insurance for many working families lends new urgency to the midwife-attended home birth alternative in both urban and rural settings.  In Georgia, there are currently no licensed health care providers openly attending home births.

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Did You Know?

	The US ranks 25th internationally in infant mortality (National Center for Health Statistics, 1993)
	All the European countries with perinatal and infant mortality rates lower than that of the United States use midwives as the sole birth attendant for at least 70% of all births. (Suarez, S.H.; Midwifery is Not the Practice of Medicine, Yale Journal of Law and Feminism 5, 2 1993)
	From $13 billion to $20 billion a year could be saved in health care costs by developing midwifery care, demedicalizing childbirth, and encouraging breastfeeding. (Frank A. Oski MD, Professor and Director, Department of Pediatrics, John Hopkins University School of Medicine)
	The average cost of an uncomplicated physician-attended hospital birth in Georgia is more than $5,000, with a cesarean delivery costing $12,000 or more (for those without insurance).  The total cost of midwife-attended home birth is less than $2000, and the chance of a midwife's client needing a cesarean is less than 4 percent.
	Some insurance companies will cover midwife-attended home birth.
	Midwives are the most cost effective and appropriate primary care givers for all childbearing women in all instances and in all settings. (World Health Organization Report on Health Promotion and Birth, 1986).
	Today, only 6% of US births are attended by midwives. (National Center for Health Statistics, 1995).
	Midwives provide excellent personalized care, with each visit averaging 45-60 minutes and including nutritional counseling, in addition to the usual tests and analyses.   Midwives emphasize the responsibility of the mother to lead a healthy lifestyle, and continuously apply risk screening criteria to ensure that only those women determined to be low-risk proceed with plans for a midwife-attended home birth.
	Many Georgian families desire to have an unhampered, family-centered birth at home, whether for personal, religious, cultural, or economic reasons.   Georgia Friends of Midwives estimates that there are between 500 and 700 home births in Georgia each year.

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Midwives Model of Care™

The Midwives Model of Care is based on the fact that pregnancy and birth are normal life events.  The Midwives Model of Care includes:

	Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle;
	Providing individualized education, counseling and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
	Minimizing technological interventions; and
	Identifying and referring women who require obstetrical attention.

The application of this model has been proven to reduce the incidence of birth injury, trauma, and cesarean section.

Copyright © 1996-2001, Midwifery Task Force All Rights Reserved

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