Virginia Regulatory Town Hall
Department of Health Professions
Board of Medicine
Regulations Governing the Practice of Licensed Midwives [18 VAC 85 ‑ 130]
Action Disclosure requirements for high-risk pregnancies
Comment Period Ended on 11/25/2009
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11/25/09  10:51 am
Commenter: Beth Ashton

Informed consent--CPM's

I am a Virginia mother of three children, the third of whom was born at home under the care of a Certified Professional Midwife.  I opted for homebirth midwifery care with a CPM because I desired to give birth vaginally after a previous Cesarean section.  I carefully researched my birthing options, and I studied all of the current research available on VBAC, both in the hospital and at home.  I diligently interviewed several physicians and midwives, seeking out the best evidence-based care I could find.  In the end, my judgment led me to CPM care.  In working with my CPM, I was given ample opportunity to parse the research, and ask questions.  She was well versed in the evidence and my consent to her care was more fully informed than it would have been had I simply accepted the standard advice I received from the physicians' practices I interviewed.  I delivered a healthy baby safely and comfortably at home, and I hope to have the opportunity to do again, many times.  One wonderful thing about my homebirth VBAC is that my fertility is preserved in a way that another Cesarean section might have burdened.  I don't believe my physician disclosed evidence to me of the effect of repeat C-section on my future fertility, but that is an important value to me and my family.
Based on my experiences, I believe that CPMs already obtain more fully informed consent than physicians practicing obstetrics, and I personally believe that the regulation that has been passed here is redundant and is an improper government intrusion into the practice of midwifery and the right of families to determine the course of their own health care. 
Thank you.

CommentID: 10164