Birth Options
Is home birth right for you?
- Home birth with a midwife is a safe and gentle option for healthy pregnant people with low-risk pregnancies.
- Home birth and birth center birth can be great options for healthy women planning a natural birth without pain medication.
- Midwives provide individualized and respectful prenatal, birth, and postpartum care for healthy mothers and infants planning a home birth.
- Midwifery care is grounded in the belief that pregnancy and childbirth are normal life processes.
- Midwives take the time to know their clients and provide personalized care that is responsive to the values and goals of each mother and family.
- In midwifery care, mothers, midwives, and families are partners in creating a healthy pregnancy, birth, and postpartum. Midwives provide excellent clinical care and education with a focus on informed choice, honoring the pregnant person and family as the center of the process.
- When a woman or baby need a higher level of care, midwives refer or transfer to other health care providers. Midwives have the skills, equipment, and medications to treat most childbirth emergencies. About 10-20% of midwifery clients planning a home birth or birth center birth end up transferring to the hospital for labor augmentation, pain relief, or when complications arise. Most transfers are not emergencies.
Safety
Oregon and national data show that community birth with midwives is safe for mothers and babies and is associated with low rates of intervention.
Oregon 2015-2017 term perinatal mortality rates from Oregon Vital Records:
- Planned community births with midwives: 0.72/1,000 (not including planned unassisted births)
- All births in Oregon: 1.48/1,000
2014 study of outcomes for 16,924 home births in the US:
- Cesarean section rate of 5.2% without harms to mother or baby.
- Great rates of breastfeeding, over 95% at 6 weeks.
- Lower rates of preterm birth and low-birth weight
Source: (Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009. Cheyney, M. Journal of Midwifery & Women’s Health, 2014; 59: 17–27)
When is home birth not a good option?
Some pregnancies and births are best cared for by hospital-based providers. Many preexisting medical conditions, such as diabetes, and diseases of pregnancy such as preeclampsia should be cared for in the hospital. You can read more about the evidence on home birth here.
There isn’t agreement about whether complex pregnancies (such as breeches, twins, and prior cesarean) that carry more risk are appropriate for home birth and we encourage you to do your own research to learn more about your birth options.
Types of Midwives
There are multiple types of midwives in Oregon:
Certified Professional Midwife (CPM)
The CPM is a competency-based credential that recognizes multiple routes of education. CPMs have met clinical requirements and passed skills evaluation and a written exam. CPMs provide prenatal, birth, postpartum, and well-woman care. Many states, including Oregon, include the CPM in their licensure requirements. Out-of-hospital birth experience is required for certification as a CPM.
More information on the CPM credential is available here.
Licensed Direct-Entry Midwife (LDM)
LDMs are licensed in the state of Oregon to provide prenatal, birth and postpartum care and they work in home and birth center settings. The CPM credential and additional clinical experience are part of the requirements for licensure as an LDM in Oregon.
Oregon LDMs carry oxygen, IV fluids, anti-hemorrhagic medications, local anesthetics for suturing, vitamin K and ophthalmic antibiotics for newborns. Oregon LDMs can order lab work, obstetric ultrasound and newborn metabolic screening.
Additional information about LDMs is available here.
Certified Nurse-Midwife (CNM)
Certified Nurse Midwives (CNMs) are trained in both nursing and midwifery, primarily in the hospital setting. CNMs are Advanced Practice Nurses and have a Master’s or Doctoral degree from a university-affiliated Nurse-Midwifery program accredited by the American College of Nurse-Midwives. They provide prenatal, birth, and postpartum care primarily in the hospital setting, though some CNMs practice in home or birth center settings as well. Outside of the childbearing year, CNMs also provide well-woman care throughout the life cycle.
Additional information about CNMs is available here.
Naturopathic Midwives
Naturopathic Physician Midwives receive a doctoral degree from a four- year accredited naturopathic medical school and complete clinical training in the treatment and management of pregnancy and natural childbirth under a licensed naturopathic midwife.
Additional information about Naturopathic Physician Midwives is available here.
Traditional Midwife
A small number of traditional midwives attend births in Oregon, often serving specific religious or cultural communities. While many traditional midwives have extensive training and experience there is no standardization of training and no regulation of practice. Traditional midwives do not use oxygen, IV fluids, or anti-hemorrhagic medications, and do not suture. Traditional midwives in Oregon must provide a disclosure to their clients and meet certain requirements, as detailed here.
Home Birth and Birth Center Birth
Home birth and birth center birth are both great options for pregnant people seeking a natural birth. The same types of midwives work in both settings and bring the same skills and equipment to births. Many Oregon birth centers provide home birth as well as birth center care.
Families may choose a birth center instead of home birth because of insurance coverage (some insurers will cover a birth center but not home birth), distance of their home from the hospital, preference for giving birth in a location that is not their home, or other reasons.
Find a Midwife
Most midwives and birth centers offer a free interview to answer your questions and give you time to see if they are a good fit for this intimate and relationship-based care. We encourage you to interview several practices to find the best match. Here are some questions you can ask:
You can find a directory of midwives from the state professional organization, Oregon Midwifery Council here
