Home births used to be popular in southern Indiana and in some corners of the county they still happen. With a significant Amish and Mennonite community, Daviess County officials say they still have about a dozen home births each year involving a midwife.
“We have two (midwives) in Daviess County that are licensed,” said Daviess County Public Health Nurse Kathy Sullender. “We rarely talk with them. They work with physicians but not from our area. They work through physicians from other parts of the state.”
There has also been a growth in the use midwives outside of the Amish community as officials say they have seen a trend for more “natural childbirths.”
“We see Amish, Mennonite. There are a few who are not Amish or Mennonite,” said Sullender. “A few years ago, it became trendy to have home births and water births and birthing centers.”
Home births are fine as long as everything goes smoothly but local officials say that when things go wrong, being at a hospital can be the difference between life and death.
“It is a risk when you deliver in the home. It is not only a risk for the baby but for the mom as well. If mom has a postpartum hemorrhage or something else that takes place, it is risky for everybody,” said Shawna O’Kelly Brinson OB director at Daviess Community Hospital. “It does concern me that midwives may not be carrying out standards of care that are safe. A lot of times when a baby’s heart rate goes down you may only have 10 minutes to get that baby delivered safely. Unfortunately, if you are not in a hospital setting with trained people and access to surgery, the outcomes are not that good.”
To try and still provide the natural birth setting that some mothers want and at the same time provide the backstop of more modern health care, DCH has made some adjustments for deliveries.
“We strive to help the moms out who want to deliver in a natural setting. If they want to come in here and do that we will try to do that as much as possible,” said O’Kelly Brinson. “By doing the delivery here we can keep it natural, but safe at the same time. I think that primarily the midwives are operating in the Amish community. A lot of the Amish in Daviess County do come to the hospital, but there are some that don’t. We have Amish from Orange County and from Illinois around Flat Rock because we do try to honor their wishes.”
Besides the Amish population, Daviess County has another group with most likely ties to home births and the used of midwives. The counties growing immigrant population though apparently does not rely on them.
“We are not seeing any indication of midwives in the immigrant community. I don’t think we have anyone in that group that is trained at all,” said O’Kelly Brinson. “We are seeing a lot of the Haitian population through our Healthy Start Initiative grant. Through that we get them involved in insurance and then follow them through their pregnancy and 18 months after the delivery of the baby.”
“I have not seen any indication of the use of midwives within the immigrant population,” said Sullender. “I have seen no paperwork on immigrant home births come through. All of the births in that group have either been at our hospital or at a hospital with a higher level of care.”
Daviess County has struggled with infant mortality over the last several years. Officials do not say home births and midwifes are to blame, but they are a contributing factor.
“A certified nurse-midwife in the proper setting is a great thing. The number of deliveries appears to be growing in the community,” said O’Kelly Brinson. “The concern is the health of the baby. At one time we were number one in the state of Indiana in infant mortality. We have done a lot of intervention to greatly reduce that. We are no longer number one in that and that is great news.”
“Infant mortality has a lot of layers to it, but midwives are one of those layers,” said Sullender.
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