Just to Clarify…

We here at 10centimeters aren’t against natural birth. Several of us have even had one. We’re not even against homebirth, given the right woman and the right midwife! We support women who choose to give birth without pain relief, women who choose c-sections, women who can’t have children, women who adopt children, and women who choose not to have children at all.  What we don’t support is the way the way the leaders of the natural birth movement try to shame women into having a very specific kind of birth using misinformation, half-truths, and occasionally outright lies. We also don’t support sanctimommies bashing women for their choices. We, however, DO NOT CARE how any individual chooses to give birth.

 

What are we for?

  • Better training and stricter clinical standards for homebirth midwives in the US
  • Mandatory malpractice insurance for all homebirth midwives
  • Mandatory reporting of outcomes and better recording (i.e., no planned homebirth transfers counted in hospital stats, no unintentional homebirths counted in planned homebirth stats)
  • Real evidence-based maternity care, with the understanding that science/medicine changes practices as the body of evidence changes
  • Open and honest discussion without stifling one viewpoint under the guise of not wanting to scare people or being “supportive”

67 thoughts on “Just to Clarify…

  1. I wanted to comment on your clarifications since some of them look like they are about as clear as mud.

    I completely agree with the first one. Education is of utmost importance in midwifery. The more we know, the better we can serve and support our community. I also think the NARM qualifications are laughably inappropriate for stamping new midwives as fit to practice alone.

    Your second stance on malpractice insurance leads me to believe you have never looked into this issue. It is a legal requirement in my state (CA) to carry malpractice insurance…yet no insurance company will give it to us. It is not possible. They feel the risks are too high and they simply will not cover us. The State of CA knows this so they have come up with a form that we have to have our families sign that states we do not carry malpractice insurance and this is considered informed consent and makes our practice legal; even without malpractice insurance. CA is not the only state with this issue either.

    As far as mandatory reporting…hospitals don’t even have mandatory reporting. They certainly have WAAAAAAY more adverse maternal and neonatal outcomes than home birth midwives; even after you take out of the high risk pregnancies and only compare apples to apples. Accountability would be awesome and eye opening but I bet you would be mortified at just how dangerous hospitals are when/if this happens vs. home birth. Also, I am not sure how an “unintentional home birth” would be classified as such or not qualify in one’s stats for a “planned home birth”. This doesn’t make any sense.

    Real evidence based maternity care is ever evolving AND subject to the knowledge and information one agrees with…right? Who/What is the overlying authority you agree with on these matters? ACOG? They don’t even follow their own guidelines. This is the inherent problem with evidence based maternity care. Who is giving the evidence? Who gets to say what the guidelines are? For example: inductions. When is a good time for an induction? How do you know? What does the evidence say? How often does this happen with adverse outcomes before the “evidence” changes? Sometimes common sense and treating people like individuals and not protocols is more important than what the “evidence” states. I am not discounting science at all. In fact, I read journal articles often and base a lot of my knowledge on them. However, not every body functions the same way and we need to account for that variable…being human. And this goes both ways, care providers make mistakes. Whether they are licensed or not, whether they are OB’s or Midwives or whatever. We are all human doing the best we can do for the betterment of all – most of us anyway!

    On your last point, I could not agree more. Except from reading your recent entries, it seems you are using misguided and/or incorrect information to base your opinions and then judging people for their actions or their choices without ever having gone to the original source for their input – this is called gossip. I realize you are using their own words from posts they have made but again, without ever having gone to the person who wrote them for “clarification” you might be misunderstanding the scenario. I believe this is a violation of your attempt to promote understanding here.

    • Hospitals may have more adverse outcomes, but that’s only because 99% of births in this country happen there. As a percentage, homebirth is much higher. Just look at the stats from the CDC.

    • “However, not every body functions the same way and we need to account for that variable…being human.”

      I am really glad to hear a midwife say this, because it seems like very few homebirth midwives believe this. I read lots of “trust birth” and “your body was made to do this.” Well, your body was also made to have a heart and lungs that functions properly, and yet we all know that sometimes, hearts and lungs don’t function correctly. No one tells you “trust circulation” or “trust respiration” if you have a heart defect or asthma. So why is it so hard for many natural childbirth advocates to accept that bodies ARE different, and some bodies might not be able to birth properly and safely if left on their own?

      • Can I just say that I consider myself a natural childbirth advocate, but don’t like the way I am clumped with all the other natural childbirth advocates in many of these statements. Though, I know it is a natural thing to do(I do it to, but I really try not to). I don’t try and brainwash people, I don’t really like the whole concept of trusting birth for above mentioned reasons. I try real hard to use research in all that I do. Just because I think that natural childbirth should be supported, doesn’t put me in the category that you seem to put me in. Thanks. Rachel

        • Rachael, I’ll admit that we often say Natural Childbirth Advocates as if they’re one big blob. I know that not all Natural Childbirth Advocates believe exactly the same thing, and that there are many thoughtful and well-meaning people who consider themselves part of that group. What we really mean is the leaders of the Natural Childbirth Movement, and to some extent, many of their followers, who are often just parroting what the leaders say. We’ll try to make the difference more clear in the future, though I can’t speak for the commentors on the blog. Thanks for your comment.

        • Hi Rachel,

          I’m glad that you rely on research rather than trusting birth. I am not sure what you are objecting to in my statement, though. Here is what I said:
          “So why is it so hard for many natural childbirth advocates to accept that bodies ARE different”
          Note that I said MANY natural childbirth advocates. I didn’t say all. I didn’t even say most. I said many. You are not one of the many. I am glad for that and wish there were more out there who felt as you do. 🙂

  2. First I need to point out some issues. If you are working in Cali, and you can’t get insurance it must mean you are a CPM. CPMs are ILLEGAL in Cali so you are a criminal.

    Second, there are several places willing to insure CPMs and One of our members has a list. If you can’t afford to pay for it , you should not be working.

    AS for manditory reoprting and hospitals–wrong. All that info in many states is reported as an attachment to the birth cert.

    You can yell all you want to about us using incorrect info but you have provoded nothing to back your statement so it’s useless.

    Science is evolving and we do actually have people who set current standards.Places like the AMA and WHO. You clearly have no idea how things like that work.

    • I think that CPMs are legal in CA *if* they are licensed. Licensing in CA requires more than NARM requires for the CPM though. The recent case there was someone practicing before she was licensed.

    • Mama Tao…I am sorry for any injustice that you may have been served and I apologize if I am unnerving you in some way with my point of view. However, directing your anger out at me won’t help you sleep at night. Your judgments about me are incorrect and instead of asking questions you went right to assumptions.

      I am a student midwife in a meac program apprenticing with two experienced (10+ years of attending home births each) LM’s (one of them is also a CPM). LM’s can not get malpractice insurance in CA (at least all of the reputable LM’s I know don’t have it and this is what they tell me) BUT it is legal to practice as long as we are giving informed consent that we do not carry it. Our families know this BEFORE they enter care. Nothing I am doing right now is illegal and I most certainly am not a criminal.

      I also was not yelling…still am not yelling. This is text on a screen…emotions can only be attached by the reader.

      Further, I am aware of the AMA and the WHO and other such organizations. I was just stating an example with ACOG. The medical profession is NOT omnipotent. They do not have all the answers. None of us do. I feel that women will get better quality of care when we really listen to them and the medical way of doing that is by applying protocols to everyone…this is not good quality care and many, many women are leaving hospitals to birth at home; which can be done safely under the right conditions. Sure some midwives get themselves into trouble by taking on more than they can handle. I would say the same with OB’s and hospitals. Babies and Mothers die at hospitals too…at an alarming rate using their evidenced based care and protocols.

      Truth is…at the end of the day…I see that we are all trying to do the best we can to make a difference for families. This kind of mean spirited slander and gossip is not helping anyone.

    • Wow Mama Tao take a chill pill before you bust a vain. Your like a Nazi or somthing. I bet you potty train your kids a gun point….. RELAX WOMAN!

  3. yes- it is hard to get an insurance company to cover you when you are illegally practicing…. CNM’s can get insurance just fine–maybe because they are legal and far better trained? if i was an insurance company i wouldn’t cover a CPM either- they kill too many babies.

    • This is an unfortunate point of view and what the media would like you to believe Liz. Stories where hospitals and staff kill mothers and babies rarely hit the media. As a doula, I have been personally exposed to my fair share of travesties that occur within the “safety” of hospital walls; including unnecessary deaths. We all do our best to provide good quality care. To some degree, there are well-trained, educated, experienced OB’s & CNM’s that are known as “butchers” in my community. I am all for education…but how one practices is personal and far too many women are getting lost in a system that sees them only as liabilities and not people. This is why many families choose home birth. They want to be respected, heard, cared for…and a good midwife will risk out families that should not have a home birth for their safety. Even so, things happen – no matter how educated we are and where we are. We can not control outcomes in process as natural and unpredictable as birth.

      Are their crazies out there?! Yup…on both sides. I agree with you there. But please do not lump me or my reputable midwife friends in that group.

      • Why don’t you do yourself a favor and learn a bit more about Liz before you try to tell her what the system is telling her to believe. I think you might fins she’s no sheeple.

      • Aspiring Midwife-
        You are saying that you personally witnessed death of either a mother or baby in a hospital setting? What kind of death was it that you were personally exposed to in a hospital?

      • Yeah… click on Liz’s name and it’s a link to her blog and her homebirth story. Sadly, Liz knows plenty about just how dangerous poorly trained midwives can be.

      • It’s not the good midwives we want gone, it’s the uneducated hacks. Like it or not OBs can’t take an online course and witness 20-50 births. They actually have to do the time, CNM’s too. It’s the ones who are too selfish to get a proper education, who think that childbirth is all about their “calling” They are the ones who need to go.

        • Tara the problem here is all CPM’s are treated the same way here, there is no belief that any of them are educated, just that they are ALL hacks. You are correct that OB’s do not take online courses and only witness 20-50 births. That is why they are remarkable to have when needed.
          You are incorrect though about CNM’s. They can attend an online schools (Frontier being one of them) and according to the American Midwifery Certification Board which administers the CNM boards they do not have a requisite number of births, or clinical hours they must pass. That requirement is set by each individual school for CNM’s so some may get a lot others maybe none.
          CPM’s all have the same standard of 43 births 20 that you assist with and 23 that must be primary care (meaning you are in the role of the midwife but with supervision for all you care) Do I think this is enough? No I would like to see this number increased I had over 80 births (most of them Primary birth) under my belt when I tested.

          A CNM’s education takes as long as a CPM’s 4years, same time and believe me many, many hours. Graduates with CPM’s from MEAC accredited school receive Bachelors in Midwifery. http://www.meacschools.org/ When did 4 years of education centered on Midwifery studies and a Bachelors degree equate to not being a proper education?

          Ladies do your homework before spouting out misnomers that are passed around the anti CPM crowd…it makes you no better than the NCB people passing around half-truths that you so readily slam.

          • Bliss –

            Can you help me understand the need for MEAC when ACME already has midwife certification covered?

          • Stephanie,
            MEAC predates ACME in conception and government approval for accreditation. Why would they just through away MEAC just because another governing body decided to create another accreditation?

            The Midwifery Education Accreditation Council (MEAC) was established as a non profit corporation in 1991 by the National Coalition of Midwifery Educators. The US Department of Education originally approved MEAC in 2001 as a federally recognized accrediting agency.

            1994, ACME approved criteria to accredit direct-entry midwifery education programs; the first program was preaccredited in April 1996. In 2006 ACME was recognized as an institutional accreditor.

          • Bliss –

            That is true for direct-entry midwifery. Not for nurse midwifery. Then the ACNM accreditation precedes MEAC by roughly 11 years (1982).

            Can you explain to me why we need two models of midwifery in the United States? Because really, that is the purpose of the two accrediting bodies, is it not? To validate two very different types of programs.

  4. “Your second stance on malpractice insurance leads me to believe you have never looked into this issue. It is a legal requirement in my state (CA) to carry malpractice insurance…yet no insurance company will give it to us. It is not possible. They feel the risks are too high and they simply will not cover us. The State of CA knows this so they have come up with a form that we have to have our families sign that states we do not carry malpractice insurance and this is considered informed consent and makes our practice legal; even without malpractice insurance. CA is not the only state with this issue either.”

    Wow. Women are supposed to trust a provider that has been deemed so unsafe that even an insurance company won’t provied them with liability insurance? That *is* scary. Insurance companies base their premiums on what os called an “experience rating” for a particular industry first, and then add or subtract based upon the safety record and record of any claims filed against an individual or business who holds the insurance. You can rest assured knowing the insurance industry takes this incredibly seriously, and are not just refusing to cover CPMs because they want to irritate you. It is, by definition, because the insurance company will not make money off of an industry with excessive claims and risky practices. Bottom line. They are not interested in birth, birth experiences, etc. They are concerned with safety – not because they’re altruistic (necessarily or primarily), but because what is safest will cost them less, plain and simple. Women are told outright that no insurance will cover their birth attendant because s/he engages in practices too risky to cover and then they STILL CHOOSE that provider? I find that quite interesting.
    I do think home birth has it’s place in a way…but there should be standards and guidelines, if not for the mother at least for the baby. One thing that bothers me about it is lack of professional care for the baby. I realized in a lot of the sad stories, the problem occurred because the midwife failed to notice anything wrong with , or they didn’t have the experience to detect subtle signs of serious trouble. It isn’t always to do with inadequacy of care of the mother.

  5. I think the author of this post was trying to be diplomatic in saying that all “homebirth midwives” should have higher standards and carry malpractice insurance. I don’t have to be diplomatic– I’ll straight up tell you what this means. The CPM “credential” (it is not a degree– it’s not conferred by any accredited university or college) and all other lay midwifery designations are not worth the paper they’re printed on. The ONLY midwives in the U.S. who deserve to be called a midwife and take on the blessed and life-and-death responsibility of attending mothers during birth are Certified Nurse Midwives. There are reasons that CPMs are either uninsurable or flat-out illegal– the lack of education and standards makes you DANGEROUS. Sorry to be a buzzkill, but that is the truth. If you care about being the BEST you can be for mamas and babies (who are really the most important people here) you should get the BEST education you possibly can and earn a respectable degree and title which lets you work at home or in the hospital, anywhere in the world, and which qualifies you to carry malpractice insurance to protect the families you serve. The arrogance of the CPMs, other lay midwives, and their supporters is mind-boggling. Why, when there is a perfectly legitimate way to become a midwife, would you settle for less? Why are you selling families short? Why are you promoting something which is sub-standard everywhere in the world? Why do you insist on continuing to pursue what is considered–for good reason– CRIMINAL in a number of states, and murky and alegal at best in others? Why continue to dupe unsuspecting women into thinking that all midwives are created equal, and that the lay midwifery “alternative” education is sufficient? You are lying to yourselves, and most importantly, you are lying to mothers and families by misrepresenting yourselves as qualified, educated, safe practitioners. Shame on you and ALL lay midwives who do not see that their selfishness and unwillingness to reach for the very highest standards endangers families. There is no excuse. NONE. Not when there are avenues to become a Certified Nurse Midwife.

    • CNM’s are not taught how to attend a home birth though. They are only taught how to practice within a hospital setting. There are skills that LM’s know how to do that CNM’s never learn; and likewise in the reverse because LM’s will never practice in the hospital setting. This is why LM’s are sometimes preferred by families for home birth over CNM’s.

      If I had the money and personal free time I would want to go to a CNM program in addition to my meac school but this will have to wait until my kids are older (some born at home and some at the hospital).

      • Nobody needs to “know how to attend homebirth”. Birth is birth is birth no matter where it occurs. You don’t need any special skills to be a homebirth midwife. You aren’t anything special or that smart or anything. What is it you think you know more about that a CNM (who has REAL medical training)?

        I love how you admit you don’t have the time or money to get a real degree, so you’ll just get this piece of paper! What passion!

        • You’re just being silly now. The only difference between a home and a hospital in how you deliver a baby is that if something goes wrong you have NOTHING to work with. CNMs are better trained becasue they are medically trained adn don’t jsut trust birth. TEHy can tell when something is wrong hopefully before it happens…long before it happens, becasue if they can’t everyone is screwed.

        • Sorry Bambi but your statements are false, there are many skills that are needed to be a good homebirth midwife and as Aspiring just stated CNM’s do not learn those skills. I wonder what makes you an expert in saying that “Birth is Birth no matter where it occurs” because if I thought this way you are right I would find myself in trouble fast.

          CNM’s are not taught how to do even adequate let alone skilled fetal heart Tones with a Doppler let alone a fetoscope. CPM’s are… CPM’s also need to be aware when a very min ute changes are occuring that may signal a problem in the near future. We train this way so we can transport our families before the problem because serious. CNM’s don’t train with this fine of a sense of problems. And actually when a problem occurs they call in the OB’s so truly they don’t deal with the issues they just pass them on.

          I know you have had a bad experience yourself, and truly nothing I or Aspiring or any other supporter of CPM’s are going to say a word you agree with. I am sorry for your loss it is terrible, but don’t punish hundreds of woman who do want CPM care because it is not right for you.

          • Bliss, you said, “CNM’s are not taught how to do even adequate let alone skilled fetal heart Tones with a Doppler let alone a fetoscope. CPM’s are… CPM’s also need to be aware when a very min ute changes are occuring that may signal a problem in the near future. We train this way so we can transport our families before the problem because serious. CNM’s don’t train with this fine of a sense of problems. And actually when a problem occurs they call in the OB’s so truly they don’t deal with the issues they just pass them on”

            Well, hospital-based CNMs are going to rely primarily on EFM, so no, they probably don’t rely on doppler nearly as much, but CNMs who deliver at home do use them. And when a CNM does see a problem, of course she refers to or consults with an OB. But isn’t this what CPMs should be doing too? If they are really committed to taking good care of their patients, they should be transferring to a hospital for backup OB care at the first sign of the problem. They shouldn’t be waiting until it’s become a full-blown emergency. Your argument that CPMs are better trained than CNMs doesn’t hold water.

            You also must be aware of the fact that a perfectly normal birth can go south very quickly. I had a “textbook” natural childbirth with a terrific CNM. Immediately after delivering the placenta, I started to bleed out. I had a fairly rare complication, a cervical laceration. My midwife was able to rule out retained placenta and extracted several large clots manually. While she was doing this, she gave orders for an I.V. to be run, and had the nurse give me a shot of pitocin. Once she knew that my cervix needed to be stitched, she got me into the operating room within minutes. I’m beyond grateful that she knew exactly what to do to determine the source of the problem, and that she was able to get backup when the problem was beyond her skill set. This is how the midwifery model of care is supposed to work.

      • I’m sure homebirth midwives do have more experience with emergencies than do hospital caregivers.
        Since preventing dangerous situations interfere’s with the birth experience. I imagine they might have more experience flailing about, trying to limit liability while saving the baby and mom.

        I burn my cakes all the time. I’m really good at scraping off the burnt part and covering it with icing. I wouldn’t say that makes me a good baker, but I get the job done.

    • Marlo, thank you for your very educated reply. The question of malpractice insurance is very salient. If home birthing was comparably safe to hospital birthing, then those who function as CPMs would be able to obtain malpractice insurance just as OBs and CNMs are able to. It is also important for the public to realize the educational difference between a lay midwife and a Certified Registered Nurse Midwife. The CNM has a Bachelors degree and a Masters Degree in Nursing with a specialization in midwifery. The CNM is licensed and regulated by all the state boards of nursing. If the CNM endangers a patient by not seeking the appropriate level of care for the patient, ie, transfer and timely surgical intervention, the CNM will be held responsible for malpractice and sanctioned by the state board of nursing. It is also interesting to note that the RN who wishes to become a midwife does not have the option of becoming a CPM without surrendering her RN license. The only option available to the RN is the CNM certification along with the Masters Degree.

      The CPM is very different entity from the CNM who follows the educational rules, obtains the requisite degrees from NLN accredited programs, and adheres to national standards and state licensure. One might question the motivation of those who seek a shortcut.

      I am a Certified Registered Nurse Anesthetist who has specialized in OB anesthesia for the past 18 years. In my hospital practice, we deliver roughly 160 babies per month. I have only a safety agenda. We support mothers who wish to deliver with as little medical intervention as is reasonable to those who elect to have a C/S without even so much as a trial of labor. I live in a large city in the southwest. We do not have CNMs in our hospital but there are several at the county hospital who do an excellent job and are well respected members of the hospital staff.

      I have seen so many unforeseen situations arise in labor that I have come to regard laboring mothers as ticking time bombs. There are so many unknowns that can be hinted at with continuous monitoring. Even the lowest risk patients can have a skinny cord with no Wharton’s jelly, cord around the neck, body, and or limbs, occult infection, marginal abruption of the placenta, full abruption, velamentous insertion of the cord, vasa previa, placenta accreta, malpresentation, 9 lb baby trying to come through a 7lb pelvis, prolapsed cord, GBS infection of the baby, chorioamnitis, pre eclampsia, eclampsia, PIH, HELLP syndrome, etc. Anyone who thinks that these complications can be easily diagnosed prior to labor is sadly mistaken.

      In our hospital, which is pretty typical of large city hospitals, we can have a baby in distress out in about 5 to 7 minutes. We intervene before the baby is severely compromised unless the mother refuses which is incredibly rare. I have only ever seen stillborns which were already dead upon admission to the hospital. I have never seen a baby die during labor, not once. We have never had a maternal death in the past 18 years and I knock on wood as I write this. Perinatal mortality is very low in the US because there is so much we can do.

      Home birth makes about as much sense as home heart attack treatment, home stroke treatment, home cancer care, home surgery, etc. Don’t young mothers still want the best and safest for their babies? I know I did. I carried those 2 babies for 9 months safely and I wanted to make sure they were subject to as little risk as possible during the most dangerous time in their little lives, birth. I wanted to be surrounded by the smartest, most educated, most ethical, licensed, insured, and credentialed people available. I wanted every monitor there was and I wanted the babies out at the first sign of trouble at any cost to me.

      I apologize for any health care provider who has seemed brusque, hurried, unconcerned, whatever. I can absolutely assure you we want you to walk out of the hospital with a perfectly healthy baby with no hypoxic sequelae. We have a safety agenda. That is our bottom line. We accept personal financial responsibility for your outcomes unlike the uninsured CPM.

  6. I don’t understand how this post isn’t crystal clear, and easy to understand. I also don’t see how any of this is objectionable.

    *Licensure and insurance mandates aren’t meant to make life easy for the MW, or the business. it’s a cost of doing business that is meant to protect the customer!*

    Figure it out, or do things differently, as other businesses don’t get to say “no one wants to insure me, so Im not gonna get insure and practice anyway”. If you are an electrician, you don’t get to work without insurance. period. And if you do, you are very harshly penalized. If someone dies because of your uninsured work, you can be bankrupted, even jailed. This insurance rule IS very hard on small companies, and does force people out of business- but we dont allow them to work without it just because its expensive or not available (companies wont insure everyone. If you have lots of accidents, hire convicts, etc, forget it). The industry adjusts, businesses adkpjust, the consumers don’t adjust.

    Instead of whining that no one will cover CPMs, maybe you should find out why is is, and do something about it (hello, Florida!) OBs get insurance, as do CNMs, why are CPMs different? Could it be because CPMs are not very safe, and are not provably competent? Insurance companies don’t say no because they conspire against HB, they say no because the risk is too high.

    Families deserve to be protected from MWs as much as they do from negligent and unethical contractors or dangerous doctors. If CPMs claim to serve women, why are they against this protection for them?

    • *Licensure and insurance mandates aren’t meant to make life easy for the MW, or the business. it’s a cost of doing business that is meant to protect the customer!*

      YES! THIS! I get so tired of hearing midwives complain about insurance. It is there to protect the patient more than the midwife, and they need to understand that. Malpractice suits are the best way to get care for a child who is disabled due to an incompetent birth attendant and will need lifelong assistance – that assistance is a fortune and most parents can’t afford it without the malpractice insurance payout.

      • Which is why people that work in hospitals should have it. Home birth midwives are supposed to risk out high risk women from care.

        It is political. This is why we can’t get it. Pure and simple.

        • “Home birth midwives are supposed to risk out high risk women from care. ”

          First off, they don’t. Many, many CPMs will take on breech or twins or VBAC – all of which have a high enough risk of going pear shaped that they ought to be done in a hospital.

          Second of all, sometimes women are low risk until something goes terribly wrong during labor. A midwife can be diligent about only taking on low risk women, but that doesn’t tell you whether she will do the right thing when the sh*t hits the fan.

    • Every state is under different laws and regulations. I think that is great for your CPM in Washington. Here in CA…we are licensed by the Medical Board and they control a lot of what happens in this state including what insurance can or can not cover. The attempt to license midwives but also make it so that they can not get insurance, even though that is the law for LM’s to carry it, was an attempt to make home birth illegal here in a sneaky way. It didn’t work and the informed consent clause protects us from being illegal as long as we inform our families of what is what.

        • Thank you Mama Tao. This is new to me as a student since all of my preceptors and our community midwives do not carry malpractice insurance. There must be a logical reason for this since there appears to be an option available here. I sent them a request for a quote.

          I am not a bad person. Just learning and growing here trying to support women in their birth choices in the best way I can.

      • Aspiring Midwife, let’s be clear, no one was trying to make homebirth illegal. It isn’t illegal for some one to have their baby at home. They were trying to make it illegal for a group of people who have a low certification standard and a high rate of poor outcomes to get paid to attend a birth at home. Also, it sounds like you have had a lot of education and apprenticeship. Please note that this is not the case for many CPMs. Certification can easily be completed in a year. Also getting an online Masters Degree is usually quite different than a correspondence course.

        Also while I will say there are few little tricks that can be picked up by attending homebirths (shower curtains make great mattress covers) you have not made a compelling argument for why CNM training does not adequately prepare one for homebirth practice. CNM’s do know how to use a doppler, many CNM’s and RN’s know how to use a fetoscope (although it is a bit of a dying art). It is far easier to come from a place of a comprehensive holistic (and by holistic I mean deep understanding of human physiology) masters level midwifery practice and pick up a few tricks, than it is to be able to use a fetoscope but lack the judgement, understanding of physiology, assessment skills, and experience necessary to safely assist the childbearing family.

        I don’t think anyone here is being completely anti-homebirth. I am agreeing that ‎”A society that places a low value on its mothers and the process of birth will suffer an array of negative repercussions for doing so.” – Ina May Gaskin. I think it places a low value on mothers to let people with inadequate training, no oversight, and no transparency, get paid good money often out of pocket to attend childbearing families. And those negative repercussions are the high rates of neonatal death.

  7. Aspiring-I’m so sorry I wasn’t trying to come off rude at all-please forgive me! I know laws in different states are as such and quite agree with you and I dont think you are illegal or uneducated by any means<3 meant to post more nut I have two lively toddlers! Thank you for what you do!!!

    • Oh no I didn’t think you were being rude at all. I am genuinely happy for your CPM 🙂 I wish it was easier here to practice but clearly it is getting harder and harder. The medical community wants us out of their pockets. It is really political.

      • You mean they don’t actually care about the dead babies that result from bad midwives?? It’s only “political” because you can’t admit that it’s because you are a threat to public health.

        • Wow Bambi. You are hostile. If a midwife offended you along your path in life, I am sorry. I am not that person.

          • No, your just someone as ignorant in training. You are going to be getting the same half assed education as her midwife. So good luck with that. Her midwife didn’t know what to do so why should you?

          • I am really very sorry. I can see there is nothing I can say. You all hate what I represent. I truly am sorry. No one should have to lose their babies no matter what.

  8. I am so amazed at the amount of hatred in this board. I am not some died in the wool “trust birth only”, fanatic natural birth Midwife. I respect birth and I respect people ability to make choices about there lives.

    No one on here can say that all CPM’s are uneducated and dangerous. That is such a hateful generalization. I could make many such generalizations about the type of people you might all be, but what would that solve…

    Wow people, there will never be a solution that is seeded from so such hatred.

    Sorry Heather but I thought you truly had an idea of a place where people could really brainstorm about solutions and not be stuck in rhetoric. All I am seeing is a bashing place, a place to make those who have been wounded and lost a baby feel vindicated in their anger. May you all find some peace…

    • “No one on here can say that all CPM’s are uneducated and dangerous.”
      And very few of the people here think that. Personally, I do think most CPMs need more education, but I don’t think they’re horrible people. I think many of them just plain don’t realize how much more there is to learn, but they mean well. It’s hardly “bashing” to say that standards should be set as high as possible for babies’ safety. I think CPMs are capable of learning more than they do – “bashing” would be if I said they were too stupid to learn more.

      • Quark you are right that there are some on here not all about bashing and I am very sorry for that generalization. You in many postings have made very valid points and I believe Heather comes truly from a place of wanting to create change. I know there are some on here like this. But there are also others, very vocal ones, who just seem to want to be as mean and angry as they can be. I understand that this is coming from a vulnerable place in them, but they are lumping all CPM’s together, and are passing around serious falsehoods as well, the same thing they accuse the CPM’s of doing.

        You and I agree that the educational standards could and should be increased. And believe me there are many CPM’s who believe this and are working towards it. Not all Midwives are scurrying to remain substandard and cover our butts. They do not have “Habits” that lining their pockets will support, cuz believe me none of us CPM’s are getting rich.

        • Thank you for seeing that. I wish for transparency, accountability, collaboration, and acknowledgement that there is much more to learn. I absolutely don’t hate CPMs. I will however call out leaders of organizations or “movements” that try to tell people that garlic will prevent GBS or that getting an epidural makes them a bad mother. What I do ‘hate’ is that we all started out trying to make the healthcare system more compassionate, evidence based, and individualized and some very outspoken wrong people decided to make it ‘us or them’ where all OBs are evil and bad CPMs are oppressed like witches in Salem.

          I really do hope to find more and more places (like this one is trying to be) where we can say for a minute “stop the madness” and find a way forward before birth culture gets anymore divisive, because that doesn’t serve childbearing families one bit.

    • Actually, Bliss, just about every other first world country does say that CPMs are uneducated and dangerous. Even in countries with midwifery-led models of maternity care a CPM (or ‘lay midwife’) is usually considered illegal.

      I live in one of those countries and I don’t hate midwives at all. All my children have been delivered by midwives. My friends have planned homebirths with independent (but university trained) midwives.

      I am not angry at all, I am simply amazed and confused by why anyone thinks the CPM credential is acceptable in the US when it isn’t acceptable anywhere else.

      Please also, note, that the women on this board who have lost children ARE vindicated in their anger. I tell you, if that happened to me I would be filled with righteous wrath and I would be directing in exactly the same place they are. What do you think you would do?

  9. Bliss-I agree<3 sorry if I was sounding argumentative or rude in any way-it is a sad place to be here<3 just wanted to support Aspiring and to encourage all of you to speak with compassion and peace<3

    • Thank you Kileah & Bliss. I am done here. I feel really sorry for the adverse outcomes these women have experienced but hatred for CPM’s and LM’s is not the answer. More education is and I think this for CNM’s and OB’s as well. Adverse outcomes can happen in any location with any care provider. As a doula, I have seen very, very sad things occur in hospitals. I support everyone’s choice to birth in the way they feel is safest for them. Whether that is a planned cesarean birth or a home birth or anything in between. If that makes me a criminal; lock me up.

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