It is not true that a diagnosis of CF puts you in a high-risk category. There are certain complications of CF which may and those must be considered carefully. Basically, the way you get what you want is to research everything anyone tells you about anything and shop around for what you want. It took me going to 3 different clinics (two in-hospital high-risk OB/GYN clinics) and talking to 5 different midwives (2 CNMs - nurse midwives, and 3 certified midwives). When I finally found a midwife who said she was willing to consider it, we sat down for three hours going over the legal stuff trying to find out if there was anything about my case of CF that would make it illegal for me to have a midwife attended homebirth. We never found anything. I ended up not being able to go with the midwife who helped me research the literature, but found another midwife who was happy to take me on. Together, from that point on, she and I researched anytime we came across an issue or something that one of us thought could become an issue.I tried to gain compromises with the OB/GYNs at the hospital but they wouldn't consider any. The unequivocal answer was "NO". I finally came to the realization that the healthiest thing I could do - barring complications - was to stay home. We did and it was fine. Because you have already had a safe, uncomplicated birth, more midwives might now consider you if you are again pregnant. If you have more specific questions please email me, I'm happy to answer what I can. All of this to say, certain conditions or situations are absolutely labelled high-risk by OB/GYNs. Some of them can be safely attended and cared for by a midwife. Others are beyond the scope of a midwife, but do well under the supervision of a nurse-midwife. Others still really need the care of a physician. Some physicians will and do attend home-births (as in the Chicago area). Some conditions and situations are mandated legally that they must be supervised by a specific kind of health-care provider during pregnancy and birth, others are not - it is left up to judgement and preference. Remember too, that even if you have been seeing a midwife and things are going well, if at any time a complication arises, there is the option of transfer to a physician and/or hospital. Even during the birth - even after the birth. Medical research has shown that if you live within 30 minutes of a hospital, birth at home is (when chosen wisely and cared for by a qualified attendant) just as safe as hospital birth - often more safe. Much of a midwive's training revolves around the observation, diagnosis and evaluation of complications. They are well-trained in how to handle the things they are capable of and are extremely aware of the things that are out of their ability and thus require transfer of care. When you look for a midwife, shop around and check EVERY reference. Ask specific questions so that you know you will be getting the best possible care. By the way, this should be done with ALL healthcare practitioners - not just midwives.
