Being 35 & older does not mean high risk!
According the California Midwifery Law being 35 or older does not make a pregnant person high risk!
Being a certain age - whether 35 or 40 - DOES NOT mean you can’t have a homebirth or care with a licensed midwife. Many pregnant people 35 or 40 years or older can and do have healthy out-of-hospital births. Potential clients need to meet specific criteria - having a healthy pregnancy being the key factor! (I have copied and pasted those criteria for you).
I should preface this by saying I live in California and therefore sharing information based on the regulations for licensed midwifery care in California. Please consult your state midwifery laws if you are living elsewhere.
Actual reasons that California midwives consider a person “high risk” are clearly defined for California midwives. Usually pertaining to pre-existing health conditions that significantly affect pregnancy or birth.
“CRITERIA FOR CLIENT SELECTION
Criteria for initial selection of clients for community-based midwifery care assumes:
• Healthy mother without serious pre-existing medical or mental conditions
• History, physical assessment and laboratory results within limits commonly
accepted as normal and consistent with Business and Professions Code Section 2507(b)(1) with no clinically significant evidence of the following, including but not limited to:
a. cardiac disease
b. pulmonary disease
c. renal disease
d. hepatic disease
e. endocrine disease
f. neurological disease
g. malignant disease in an active phase
h. significant hematological disorders or coagulopathies
i. essential hypertension (blood pressure greater than 140/90 on two or more occasions, six hours apart)
j. insulin-dependent diabetes mellitus
k. serious congenital abnormalities affecting childbirth
l. family history of serious genetic disorders or hereditary diseases that may impact on the current pregnancy
m. adverse obstetrical history that may impact on the current pregnancy
n. significant pelvic or uterine abnormalities, including tumors, malformations, or invasive uterine surgery that may impact on the current pregnancy
o. isoimmunization
p. alcoholism or abuse
q. drug addiction or abuse
r. positive HIV status or AIDS
s. current serious psychiatric illness
t. social or familiar conditions unsatisfactory for domiciliary birth services
u. other significant physical abnormality, social or mental functioning that affects
pregnancy, parturition and/or the ability to safely care for a newborn
v. other as defined by the licensed midwife“
How we give birth and with whom matters!
I understand that some people out there do not want any regulations and think that even the above list should not apply. While I do agree that each individual and family should ultimately have the right to give birth in the location of their choice and with the provider of their choice, I also think there are real reasons that we should keep true high risk birth in the hospital with an obstetrician, the biggest reason being timely access to interventions for at risk pregnancies.
You might think giving birth in a hospital and, therefore, having easier access to those same interventions would actually be better for all pregnancies. That’s where you’d be wrong. I won’t get into all of those examples right now because that would require an entirely different article.
Instead, consider the countries that have such wonderful birth outcomes. We often refer to the fact that the US has the worst birth outcomes of any developed nation, not a title many of us want. We, also, note that in the countries such as Norway, Switzerland, Japan and the Netherlands, with great outcomes that midwifery care is the gold standard for normal pregnancies. We have seen over and over again that the countries we idealize for their great outcomes have one thing in common: Obstetric care is reserved for “high risk” pregnancy, birth and postpartum.
When we blur the lines by calling something like age “high risk” when it’s not, or when we push to have someone with true high risk factors such as uncontrolled seizures, a known clotting disorder or significant heart problems deliver at home we are hurting everyone. These approaches cause confusion among most non-birth folks. While also making homebirth less safe in some cases. I for one appreciate living in a state that has clearly defined actual risk factors. Which to be clear does not include age nor weight!