Proponents of out-of-hospital childbirth have won Immigration approval to bring their own midwives to the Island.The Bermuda Integrated Health Cooperative received permission after the Bermuda Medical Council confirmed it didn’t need a full medical licence to do so.The victory follows eight years of struggle, said director Sophie Cannonier.“Midwives here in Bermuda function as obstetric nurses,” she said. “They are not available to the public for birthing outside the hospital. So when I started to investigate through Immigration how I could bring in midwives, that’s where the impasse came in. They said we were not able to do it. I was told we couldn’t bring people in because I wasn’t the holder of a medical licence. So we went back and forth trying to get the door open.”Residents now have access to Bermuda-registered US midwives Susan Cassel, Makeda Kamara and Lisa Dalporto.The trio will work under the auspices of the Health Cooperative, allowing residents to give birth “anywhere they want”.The move could prove a breakthrough in changing Bermuda’s medical culture, with costs far lower than typical hospital births, Ms Cannonier added.She said Ms Kamara spent the last week “trying to negotiate reasonable fees for insurance to cover our services”.The “medicalisation of birth” typically results in a considerably higher bill, the midwife said.“It’s the same problem we have in the US. If we’re spending all this money treating childbirth as a medical procedure, why do we not have better outcomes?”She added: “Once you intervene in a normal process, you are asking for trouble. All these things have additive costs.”Ms Cannonier said her eight-year-old son Ravi was the Island’s first “planned home birth” she was aware of in decades.She said she’s since had calls from overseas women who saw the Cooperative website and were interested in giving birth here.Said Ms Kamara: “We hope one day we’ll be able to have a free-standing birthing centre here in Bermuda. Why not? Women need to have a choice.”Gaining access to such choices will require residents to follow the hard-nosed example set by US consumers, she added.“When they pay a reasonable fee for their healthcare, people have to demand that insurance companies help them get the options they choose.”Either way, she said, “When you have a baby at home, you don’t pay for a facilities fee and all those other added costs.”Ms Cannonier serves as Cooperative director alongside her husband Michael Watson and Eugene Dean.For long-standing midwife Ms Kamara, a veteran of the feminist movement in the US, their fight is all too familiar.“Midwifery is the oldest profession that exists for women,” she said. “Most of the people in the world are born at home. It’s only in the Western world, where the move towards birthing in hospital took off in the 1950s, that we made this shift.”The Panama native recalled: “It wasn’t unusual, as I was sleeping in the night, to hear someone giving birth at home. To me, it was just something that happened. It wasn’t something anyone was afraid of. It was just something that people do.”Ms Cannonier, who was born in 1969 in her family’s Cedar Hill, Warwick home, said that seemed to coincide with the end of traditional midwifery in Bermuda.“When I decided to have a family I found out that the choice was no longer in existence here. But from the time I was little, my mother flooded me with her birth stories. She was very proud of it, and I wanted to have that. I didn’t want to go to the hospital for it.”Ravi’s birth in September 2004 was “an amazing, beautiful experience” that was not attended by any medical professional.“The obstetricians hadn’t seen a home birth. In fact, they tried to talk me out of it. They told me how unsafe it was,” she said.A return to traditional birthing in the 1960s and 1970s was followed by a return to the hospitals, Ms Kamara said.“We thought we had won the battle but during the 1980s and 1990s a countermovement began to take place. Hospitals began to teach their own childbirth education.”With out-of-hospital midwifing “disappearing” across the US its emergence in Bermuda is a special victory, she added.Based at Lotus on Victoria Street, Hamilton, the Bermuda Integrated Health Cooperative hopes to expand its services as more residents choose to explore their options.“Because of all this fear, we want to be very open with people and just let them know this exists as an option,” Ms Cannonier explained.“What’s important is that women have choices. If you’re going to tell me that birth is a normal process, then why try to control it?”Useful website: www.healthcoop.net.