Hi Ellen. Until 2015, licensure for out-of-hospital midwives in Oregon was available, but not mandatory. This meant that it was not illegal to practice midwifery without a license in that state. So, the training requirements for those who chose not to pursue licensure were unregulated. Prior to 2015, in Oregon, a person could practice as a midwife without being licensed (i.e. Regulated). This meant that the consumer was responsible for all due diligence in deciphering whether or not an un licensed midwife was well-trained (or trained at all). Unfortunately, not all consumers do this. Also unfortunately, not all people who say they are midwives are well-trained as skilled birth attendants.
Therefore, the study you see is a great tool for investigating skilled vs. unskilled issues. But, it is not a good too for comparing neonatal death rates between out of hospital vs hospital (unless it took into account whether the care provider was skilled vs. unskilled).
I'm happy to discuss more as these issues are very interesting to me.
Carrie Blake, CPM, MPH
SIM Galmi Hospital
Massy, France
> On Jan 2, 2016, at 1:00 AM, MIDWIFERY-RESEARCH automatic digest system <[log in to unmask]> wrote:
>
> There is 1 message totaling 27 lines in this issue.
>
> Topics of the day:
>
> 1. Planned out-of-hospital births and birth outcomes
>
> ----------------------------------------------------------------------
>
> Date: Fri, 1 Jan 2016 17:29:23 +0000
> From: Ellen Blix <[log in to unmask]>
> Subject: Planned out-of-hospital births and birth outcomes
>
> I just read this article about outcomes after planned out-of-hospital births in Oregon, published yesterday in NEJM. The article reports higher rates of neonatal deaths after planned home/birth center births.
> http://www.nejm.org/doi/full/10.1056/NEJMsa1501738#t=abstract
>
> I was wondering about this: "Before licensure became mandatory in 2015, Oregon was one of two states in which licensure was not required for the practice of midwifery in out-of-hospital settings." (from the background section) What does it mean - that the midwife attending home birth not necessarily was licensed? Or not trained?
>
> Regards, Ellen
>
> Ellen Blix
> Professor, midwife
> Oslo and Akershus University College
> Norway
>
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> End of MIDWIFERY-RESEARCH Digest - 29 Dec 2015 to 1 Jan 2016 (#2016-1)
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