Denied: Oregon Raises Barriers To Home Birth For Low-Income Women

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Would-be home birth moms -- and the midwives who care for them -- say Oregon health officials are unfairly limiting birth options for many women who get their insurance coverage through the Oregon Health Plan.

JPR's Jennifer Margulis spoke with doctors, licensed midwives, mothers-to-be and others to get the story of a state agency that's making it harder for low-income women to give birth anywhere but a hospital.

Jennifer Margulis/JPR

Oregon has one of the highest rates of home birth in the United States. These births are usually attended by state-licensed midwives. But some pregnant women and the midwives who care for them say that a state agency is unfairly --and maybe illegally-- denying low-income women access to home birth. 

Jennifer Margulis/JPR

Oregon midwives are licensed to deliver babies at home or at independent birth centers. The Oregon Health Plan covers midwifery services, so that low-income women can also have choices in childbirth.

But midwives say state health insurance is unfairly denying low-income women access to home birth, leading some women to deliver their babies with no medical assistance.

Jennifer Margulis/JPR

Of the more than 45,000 babies born in Oregon each year, nearly a third are delivered by Cesarean section. Yet studies show that surgical birth is riskier for the mother, and not as healthy for the baby, as vaginal birth.

Women who give birth out of hospital are much less likely to have C-sections. But low-income Oregonians and the midwives who care for them say that a state agency is unfairly blocking women from even trying for a vaginal birth.