Certified Midwife Perspective: Birth Options & Prenatal Care in Illinois

Birthing a baby is one of the most powerful experiences in a person’s life, and finding the right prenatal care and birth setting is so important.

Unfortunately, ISAPN Board Member and certified midwife Debra Lowrance, CNM, WHNP, IBCLC, is concerned about limited OB and birth options in Illinois, especially in the south central and rural areas. With only a few hospitals south of route 70, OB services are already limited. Now, she sees hospitals closing in other parts of the state as well.

“In the state of Illinois, we’ve been seeing a decline in the number of hospitals that are offering OB services. Just recently, St. Mary’s in Decatur, Illinois, which had a very strong midwifery program, decided to close their doors.

“It’s sad because these are areas where midwives did have a strong presence, and they are closing the facilities. It’s just getting more and more concerning, I believe, in Illinois for care and for women and babies,” Lowrance says.   
  

Overview of Birth Options in Illinois

Thankfully, a hospital isn’t the only place to give birth. Expectant women have three options for birth and maternity care in Illinois:

• traditional hospital with an OBGYN or midwife
• birth center with a midwife
• home birth with a certified nurse midwife

There’s no wrong choice, and each setting has different benefits. However, for those with higher risk pregnancies (about 20%), a hospital setting with an OBGYN is the best provider.

“These are typically women who come into a pregnancy with an underlying condition or comorbidities. For those people, an OBGYN and hospital setting is probably the best place for them,” says Lowrance.

Another option is a birth center, though they have limited availability in Illinois.

“Unfortunately, in Illinois, we do not have a lot of birth centers available to us. Birth centers in other states or other regions are definitely more available than they are in Illinois. I believe we only have two, possibly three, in the state of Illinois, and only one of those is down state,” she says.

Finally, giving birth at home with a midwife is an option that she sees more and more people exploring.
  

Rising Demand for Midwives & Home Birth in Illinois

As a certified nurse midwife (CNM) and an advanced practice registered nurse with full practice authority, Lowrance sees firsthand the demand for home births. In 2018, she opened Labor of Love Midwifery and Women's Health in Robinson, Illinois. She and her team offer prenatal care, birth, and postpartum services and support in a home setting.

“You have a lot of women who are searching for other options, so they’re looking for home birth, and unfortunately, I am one of very few midwives in the state that actually does home birth. I think at the last count I had, we had maybe 25 midwives across the state that are doing home births. So the demand for my services is just skyrocketing.”

That’s even with some of the misconceptions around home births.

“A lot of people have been told for whatever reason that home births in Illinois are illegal. That’s not true,” she explains.

CNMs are licensed and highly trained for home births, and she’s hopeful more CNMs open their own home birth businesses in Illinois!
  

Advice for Pregnant Women in Illinois

Along with exploring birth options, Lowrance recommends working with a doula.

“If this is a first-time birth, I recommend getting doula care at minimum. A doula is a birth assistant. They’re kind of like an advocate for women in birth. They help women with positioning and birth choice and doing the things that really are going to facilitate this birth.”

She also recommends reading about birth.

“There are several research articles that people can get their hands on for more information about birth. I particularly liked the National Academy of Sciences’ look at birth settings across the United States and what their recommendations are. That came out in 2020.

“Evidence-Based Birth has some great research information. She takes all the information about every birth topic and reduces it down to readable bullet points for parents and for providers. If people have questions about birthing practices, those are well researched on Evidence-Based Birth sites.”   

And, finally, this reminder, especially for those pregnant and contemplating birth for the first time:

“Pregnancy is not a disease or illness. It’s a very natural occurrence in nature. We’ve done it for thousands of years, and we’ll do it for a thousand more. We have this ability innate in our body to do this.”