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THERES NO PLACE
LIKE HOME:
LICENSING CERTIFIED PROFESSIONAL
MIDWIVES IN ILLINOIS
By: Kim Hu
HPA 432
Policy Action Plan

Theres no place like

home

What is a CPM?
A certified professional midwife (CPM)

has undergone certification through

the North American Registry of
Midwives. Programs are accredited by
the Midwifery Education and
Accreditation Council.

Background
The Status of Home births in the US
Out-of-hospital births have increased steadily in the past
decade.
Many reasons for choosing home birth
42.5% of home births were attended by CPMs
History of Midwifery
In 1915, 40% of all births were attended by midwives at
home.
Served impoverished rural/urban communities and
marginalized groups

Background
Home vs Hospital births as an economic issue
Maternal stays constituted 45.1% of hospitalizations
among adults aged 18-44
Medicaid funded 45% of births in the US in 2010
Delivering babies is expensive
Estimated cost of home birth is a
third of hospital costs for vaginal
birth

Landscape
An issue of health justice
Most home births attended by CPMs involve higher
educated, lower income, non-Hispanic white, married
women.
Poor birth outcomes are significantly higher for women of
color in the U.S., with black mothers being 4 times more
likely to die of pregnancy-related complications than their
white counterparts, and with babies being 2.5 times more
likely to die in their first year of life.

Landscape
Shortage of obstetricians in the coming years

According to ACOG 37% of currently

practicing OB/GYNs will reduce their work

hours, pursue non-clinical work, or retire
within the next 3 years, while the need for
OB/GYN services will increase 6%.

Landscape
The safety issues of home birth
Most studies show there is no significant

difference in health outcomes between care

delivered at home or in the hospital and care
delivered by CPMs and CNMs or physicians
among low risk pregnant women
However, very few RCTs have been conducted
Cochrane report cites this issue

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Governmental Stakeholders

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Non-Governmental Stakeholders
For

Against

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Neutral Non-Governmental Stakeholders

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Venue

State of Illinois
IL General Assembly

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Policy Vehicle
HB 4364 Home Birth Safety Act
Introduced 12/18/15 by Representative Gabel
Currently in the Health Care Licenses Committee (2/4/16)
16 Democratic and 3 Republican Sponsors
Proposal:
Amendment to 410 ILCS 535 Vital Records Act to include
collection of data
Data to be collected by IDPH through Birth Certificates
Can determine financial benefits or costs of program
Determine safety for women in Illinois
Possibly appease professional organizations

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Amendment
(410 ILCS 535/11) (from Ch. 111 1/2, par. 73-11) Sec. 11.

Information required on forms.

(a) The form of certificates, reports, and other returns required by this

Act or by regulations adopted under this Act shall include as a

minimum the items recommended by the federal agency responsible
for national vital statistics, subject to approval of and modification by
the Department. All forms shall be prescribed and furnished by the
State Registrar of Vital Records.

(f) Birth certificates shall include the title of the primary

individual delivering the child by providing spaces for the

designation of that individual as a Physician, Nurse,
Certified Nurse Midwife, Certified Professional Midwife,
or Other.

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Main Policy Champions

House of Representatives

Rep. Robyn Gabel (D)

18th District

Senate

Sen. Bill Haine (D)

56th District

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Secondary Policy Champions

House of Representatives
Barbara Flynn Currie (D)

Michael Tyron (R)

Mary E. Flowers (D)

Anna Moeller (D)

Senate
John Cullerton (D)

Pamela Althoff (R)

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