Home birth after c-section, legal issues

Many things like this are not per see illegal, but clear violations of terms on malpractice insurance. So the doctor will not recommend it because something is more likely to go wrong, and if it does, insurance will not cover it.

This is not correct. Tennessee is home to The Farm and Ina May Gaskin - the leader of the modern midwifery and home birth movement. They absolutely perform HBAC.

VBACS are legal in the US. However, IIRC midwives are not legally allowed to participate in them for at-home delivery in several states (around 20 IIRC). Free Handout: 3 Surprising Things ACOG Says About VBAC

Similar laws exists for midwife-assisted home births with twins.

It hasn’t been that long ago since VBACs were considered a violation of the standard of care for even a doctor in a hospital setting. But, I don’t recall it ever being illegal.

That’s a really useful site, thanks :slight_smile:

No law against it here in Victoria, Australia. A coroner recommended last week that “…the Health Minister consider regulating the practice of providing home birth services and develop a source of information to help prospective parents be fully informed of the issues associated with various birthing options.” during an inquest into the death of Joseph Thurgood-Gates, but no suggestion of introducing laws against the practice.

Hell, building a hundred foot tower on land you own out in the country and then trying to base jump from it while intoxicated probably isn’t illegal either, but why would you want to do it?

I can’t really speak to specific state laws, but in the US there is a common misunderstanding of what exactly is a "midwife’. There are three different types, a** CNM**: Certified Nurse Midwife (which requires an RN degree and then a Master level advanced practice RN; CM: Certified Midwife (also a graduate degree); CPM: Certified Professional Midwife (no degree required).

CNM’s and CM’s are certified by the American Midwifery Certification Board (AMCB) and are professionally associated with the American College of Nurse-Midwives (ACNM), CPM’s are certified by the North American Registry of Midwives (NARM) and professionally associated with the Midwives Alliance of North America (MANA) and National Association of Certified Professional Midwives (NACPM).

Why is this important? Because the professional associations and certifying organizations set education standards, ethical standards and general scope of practice, and these are what state regulatory boards use when overseeing or administering professional licensing. CNMs and CM’s must have a license to practice in all 50 states. Only 26 states require CPM’s to have a license.

So, I’m not sure if there is a specific law criminalizing VBAC homebirths. I don’t think a woman could be necessarily prosecuted for having one, but perhaps the state professional licensing board will discipline or revoke the license of the midwife who attended it. Again only 26 states require CPMs to have a license – which speaks to the controversy over CPMs and how some consider it negligent to allow them to work unregulated with little professional accountability. I think midwives in other countries are better integrated into their health care systems. Whereas, in the US CPMs can be totally at odds with the US healthcare system.

Or if all of that is clear as mud:
Comparison of Certified Nurse-Midwives, Certified Midwives, and Certified Professional Midwives

I would suggest looking to the states that regulate CPMs, since CPMs are primarily the midwives who attend homebirths, and what are the professional standards imposed by the state.

NARM might be a good place to start. OrMANA has nifty little chart that lists state laws and regulations concerning CPMs.

Here in Canada, my sister-in-law was given the option of regular birth for her second child by her doctor, after a C-section for the first one. It was 4 years later, so I assume that the extra time healing was a factor?

That was 13 years ago, there were no complications.

Basically, the doctor warned about the risks, the birth happened in a hospital where the chances of correcting problems was better… I understood this was slightly unusual but in light of the ongoing concern about unnecessary C-sections, there was an effort to reduce the number. Automatic repeat C-sections was one of the procedures under criticism as overcaution and overkill (so to speak).