The Research Project, Week Fifteen, Call the Iowa Midwife

I searched all the universities of Iowa and could not find a single bit of research being done in Iowa that was worthy of this blog series. If you are from Minnesota you understand. Minnesotans are always making fun of Iowans and vise versa!

Continuing my focus on private universities this week I headed to Iowa’s most prestigious private university, Drake University in Des Moines. Renee Cramer, associate professor of law, politics, and society at Drake, has received a grant from the National Science Foundation to study the regulation, activism, and awareness of out-of-hospital midwifery care in the United States.

Currently there is a patchwork of state laws and regulations across the country when it comes to midwifery. Parents in Alaska who want to make use of a midwife for the birth of their child have access to state-licensed midwives for home delivery while in the state of South Dakota it is illegal for a midwife to practice out of hospital births. And in Iowa home midwife births are unregulated.

Professor Cramer plans to use her research to map all the diverse laws pertaining to midwifery. She and her research team will also study the impact of regulations on access to at-home midwifery, efforts to change the regulatory environment, and initiatives to promote and advocate for home birth.

According to a 2012 data brief from the Centers for Disease Control and Prevention:

  • After a decline from 1990 to 2004, the percentage of U.S. births that occurred at home increased by 29%, from 0.56% of births in 2004 to 0.72% in 2009.
  • For non-Hispanic white women, home births increased by 36%, from 0.80% in 2004 to 1.09% in 2009. About 1 in every 90 births for non-Hispanic white women is now a home birth. Home births are less common among women of other racial or ethnic groups.
  • Home births are more common among women aged 35 and over, and among women with several previous children.
  • Home births have a lower risk profile than hospital births, with fewer births to teenagers or unmarried women, and with fewer preterm, low birthweight, and multiple births.
  • The percentage of home births in 2009 varied from a low of 0.2% of births in Louisiana and the District of Columbia, to a high of 2.0% in Oregon and 2.6% in Montana.

Also according to the data brief, in 1900 almost all U.S. births occurred outside a hospital, the vast majority of which occurred at home. However, this proportion fell to 44% by 1940, and to 1% by 1969, where it remained through the 1980s. Home births are still rare in the United States, comprising less than 1% of births, however they have been increasing since 2004.

My sister, who is a nursing professor, has studied midwifery extensively. I am also a big fan of the popular Call the Midwife television show on PBS. This series is based on the best-selling memoirs of the late Jennifer Worth and tells colorful stories of midwifery and families in London’s East End during the 1950’s and 60’s. We not only see the midwives in action but also get to know them on a personal level and learn about the cultural changes taking place in that era.

Drake University was founded over 130 years ago to focus the traditional areas of theology and the Classics as well as the areas of science, law and other fields. The school was named after Francis Marion Drake, a Union general in the Civil War, a railroad magnate, and a governor of Iowa.

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