10/20/2024
Concerning HBAC in Arkansas---
Yes, you, a consumer, a person with a uterus, CAN legally have a VBAC in Arkansas. Anywhere you choose to birth a baby out of your va**na, you can do that legally, even if you have previously had a cesarean section.
What is legal and illegal in the state of Arkansas? Well, the law for licensing midwives in Arkansas defines a lay midwife as someone who performs for compensation those skills relevant to the management of women in the antepartum, intrapartum, and postpartum period of the maternity cycle. (section 2 of the LLM law). Then it goes on to state within the law (section 6 of the LLM law): This Act shall not prohibit the attendance at birth of the mother's choice of family, friends or other uncompensated labor support attendants.
Here is a link for the law for licensed midwives: https://www.arkleg.state.ar.us/Acts/FTPDocument?path=%2FACTS%2F1987%2FPublic%2F&file=481.pdf&ddBienniumSession=1987%2FR
It is illegal to be compensated for management of women in the antepartum, intrapartum, and postpartum period of the maternity cycle if NOT licensed as an LLM in Arkansas. SO, compensating an unlicensed midwife FOR management of women in the antepartum, intrapartum, and postpartum period of the maternity cycle IS illegal. (section 5 of the LLM law).
Here is that link again for the law for licensed midwives: https://www.arkleg.state.ar.us/Acts/FTPDocument?path=%2FACTS%2F1987%2FPublic%2F&file=481.pdf&ddBienniumSession=1987%2FR
If you speak with a lawyer, they might tell you that the law defines licensed midwifery in terms of payment and specifically allows for attendants who are unpaid. Your lawyer might also speak on the subject of the Arkansas rules for licensed midwives. How those rules state on pg. 36, list precluded conditions (303.01): The following conditions preclude midwifery care and the client must be transferred to a physician, CNM, or ADH clinician upon diagnosis. There may be additional high-risk conditions judged by either a physician, CNM, ADH clinician, or LLM that could also preclude midwifery care.
1. Previous cesarean delivery
2. Multiple gestation
3. Documented placenta previa in the third trimester
4. Insulin-dependent diabetes
5. Pregnancy that extends beyond 42 weeks 0/7 days gestational age unless there is a third risk assessment and a documented plan of care submitted to ADH. If the clinician advises against home delivery, the client must be transferred.
Here is a link to the LLM rules:https://healthy.arkansas.gov/wp-content/uploads/LLM_Rule.pdf
When you put all of that together, it means that if an AR licensed midwife were to take payment for management of women in the antepartum, intrapartum, and postpartum period of the maternity cycle from a client who has previously given birth by cesarean section, then that AR licensed midwife would be out of compliance with the rules governing the licensed midwifery profession in AR. And the Arkansas Department of Health could impose disciplinary action on that particular AR licensed midwife per AR LLM (203 and 204, pg 21/22/23). Is it ILLEGAL for the consumer or for the AR licensed midwife? The answer is emphatically NO, it is NOT illegal to either give birth by VBAC or to provide support or care to a potential VBAC client. It is however, a precluded condition in the AR LLM Rules, meaning a licensed midwives (non-CNM) who provides care while being compensated for such care will be out of compliance with one rule out of the entire set of professional rules.
Here is that link again for the LLM rules:https://healthy.arkansas.gov/wp-content/uploads/LLM_Rule.pdf
Biggest take away from this is that it is NOT unlawful/illegal to have an HVAC or attend a VBAC, it is out of compliance with one rule within entire set of the LLM rules for a licensed lay midwife in Arkansas to provide "skills relevant to the management of women in the antepartum, intrapartum, and postpartum period of the maternity cycle" for compensation to the person who has previously had a cesarean birth.
Here is that link again for the LLM rules:https://healthy.arkansas.gov/wp-content/uploads/LLM_Rule.pdf
Clear as mud? Meaning, find a midwife who will support you while being uncompensated, licensed or not. Then, because you value that midwife, find a way to support her for something other than "skills relevant to the management of women in the antepartum, intrapartum, and postpartum period of the maternity cycle". Can she offer a birth tub/liner? A birth kit? Childbirth classes? Babywearing classes? Nutritional instruction/education? Labs? Lactation services? Get creative. Our lawmakers certainly get creative when trying to skirt around laws. Let us also be creative and do what women will always do - support one another in pregnancy, birth, postpartum, and parenting years. May it be so!
Here is a link to the ADH page concerning all things for non-nurse licensed midwives:
https://healthy.arkansas.gov/programs-services/community-family-child-health/family-health/womens-health/licensed-lay-midwifery/
