Darby and Laura Speak Up

And now for something completely… related to yesterday’s post about blaming mothers for homebirth loss!

Shortly after they attended, as “midwives,” the recent tragedy in Eugene, Darby Partner and Laura Tanner were back on Facebook (though not on their business pages…those got deleted) telling us all how our birth is our responsibility, and if something terrible happens…well, it’s not the midwives fault!

In early August, Darby came popping onto the Made to Birth facebook page to tell those posters who are concerned with the lack of education offered in most CPM/DEM correspondence courses to avoid hiring midwives with that education. The post has since been deleted, probably because some of the other commentors were making too much sense.

 

Interestingly enough, Darby doesn’t even have THOSE qualifications; in this email sent in June to the MANA Students and NewMidwives yahoo group, she explains that she is self-taught:

 

Wow, apparently taking any sort of organized course-work before the NARM exam to become a CPM is OPTIONAL. But I digress.

Even more telling is Laura Tanner’s comment on Birth Without Fear, when asked what should be done with negligent midwives. Just two days after she attended Margarita Sheikh’s labor and the death of her beautiful son Shahzad, she wrote this on a post in the facebook community Birth Without Fear asking the question, “What can/should mamas do when their care providers act negligently?”

So let me get this straight. Some actions may be criminal, but not really. Parents need to “own their birth experience” (whatever the hell that means). Must mean nothing should be done to negligent midwives, because it’s the parent’s fault for hiring them. Am I right?? This is utterly brilliant. I can just advertise myself and accept money for midwifery services, and then when I screw up, I can just blame it on the people who hired me for picking such an idiot!

What do you think? What should be done about negligent midwives? How can we prevent them from practicing in the first place?

 

76 thoughts on “Darby and Laura Speak Up

  1. Margarita TRIED to own her own birth – when she asked REPEATEDLY to go to the hospital! That poor woman.

    I also find the comment from Tanner regarding midwifery going to hell in a handbasket because there are more and more requirements to be a midwife. Really? Insurance is evil? Education is evil? Knowing what the hell you’re doing is EVIL? Knowing infant CPR IS EVIL??????

    Okay, now that my blood pressure is sky high and I feel like I’m going to have a stroke, I’m going to get back to work.

  2. Also, wasn’t Darby Partner and Laura Tanner that kicked the friends out amd took Margarita’s cell phone? This making Margarita voiceless during the birth of her child. So, who was really in the driver’s seat?

    Also, every profession is built on education. Why should MW be any different.

  3. Simple. A few prosecuting attorneys with the stones to bring a case against a couple of them should do it, especially if they have any decent PR skills to present their case in the press.

    Right now, they can play at being professionals without having any negative consequences when they hurt or kill someone. Seeing some of their “sisters” do the perp walk won’t change the hardcore homebirth freaks, but it will change the great majority of people who haven’t taken leave of their senses to truly consider the possible consequences what Dr Ricki Lake recommends.

  4. “How can we prevent them from practicing in the first place?”

    What I’d like to see, personally:
    -CPM credential eliminated, and OBs and CNMs as the only legal healthcare providers for births, whether in the hospital, a birth center, or at home
    -Standards that doctors and midwives must adhere to that would prohibit them from taking on high risk homebirths (pre or post term, pre-e, vbac, breech, etc)
    -Serious criminal penalties for anyone practicing as a midwife without a CNM and lost licenses for CNMs who disregard safety standards for homebirths
    -Malpractice insurance required of homebirth CNMs, no exceptions.

    I think putting all that into place would vastly improve homebirth safety; women could confidently hire a CNM for a homebirth knowing that she was expertly trained and would transfer to a hospital if the medical circumstances warranted it. I personally would still never choose a homebirth even with those regulations, but I’d feel it was a safe choice for others.

    • It’s a good thing that “what you’d like to see” is just in your head. Have you had a homebirth? Do you understand that birth is a natural physiological event? Do you realize that ALL doctors and nurses training the birth field NEVER see a NORMAL, unmedicated birth in their training?

      Just a few thoughts.

      • Never see a normal umedicated birth in their training? I had a student nurse at my second birth – she saw a completely normal, unmedicated birth IN A HOSPITAL. And I am certainly not the only one that has done such there, as many of my friends have, too. That’s a crazy statement. I think you’ve been hanging around NCB boards too much and have the clouded impression that everyone that works inside hospital walls is an evil person out to “get” you with whatever medication they think would make them the most money.

      • Summer,

        “Do you realize that ALL doctors and nurses training the birth field NEVER see a NORMAL, unmedicated birth in their training?”

        Hardly. In nursing school alone I saw two during my L&D rotation; I cannot even remember the number I’ve seen since I’ve begun working. Your statement is blatantly untrue and epitomizes what the uneducated (read: CPM/DEMs) struggle to spread – misinformation, half-truths, and outright lies.

        You’ve “learned” well.

        • “Do you realize that ALL doctors and nurses training the birth field NEVER see a NORMAL, unmedicated birth in their training?”

          This statement is false, because for one thing we can never say “ALL” and “NEVER” I hate that people would say such a statement. I can say however that many Dr.s do not see uncomplicated, unmedicated births while in training. One reason, 1) the hospitals they do rounds in usually take the more complicated births. 2) The training Docs also group into the riskier, complicated births to gain the experience, and lastly 3) because many hospitals have a 90-95% epidural rate it is more uncommon to see an unmedicated birth, (and I take this rate straight from the mouth of OB’s in my area. Cuz you see even though I am one of those dreaded CPM’s i actually have good relationships with several OB’s and a few CNM’s in my area….Actually we all respect each other for the parts we play in our clients lives. I benefit from their expertise and they support the care I give to my clients, knowing that I will send my clients to them or transfer into the hospital if needed…

          MNMommyJosie while I do not think “everyone that works inside hospital walls is an evil person out to “get” you with whatever medication they think would make them the most money.”
          I do believe that many choices in the hospital are made with their bottom line and not with the clients interest. Cytotec for example is truly used not because it is the better medication for the job it does but because it is more cost effective for the hospital and more convenient. The problem being it is more dangerous to the mother and baby. Cervadil which is made for cervical ripening, unlike Cytotec which is an ulcer medication is more expensive and must be kept stable in a refrigerated environment. Yet Cervadil has a much lower rate of side effects and can be removed if these become evident until cytotec which once in is there and cannot be removed. So in this case, yes the Hospital is not serving the best interest of the mother. Another aspect of care that is negligent is inductions before 39-40 weeks without medical reason, These inductions have been proven to have a higher risk for mom and baby and lead to a higher rate of c-section births. They put babies at risk because we have seen a great increase in these babies being born to soon, with a whole cascade of issues….Why are many of these inductions occurring, because Dr.s don’t want to get called in at any hour and interrupt their days, they like schedules. because after a woman has bonded with a doctor then is told they will be out of town around their due date the mother chooses to induce to be with the caregiver they know, perhaps the mother should have been made aware that this Dr was not going to be in town at her due date and could have found another to connect with. Another reason is for those mom’s who are just tired of being pregnant, and just need the support that they are doing great and the honest evaluation that their baby needs the extra weeks

          I am lucky to live in a town that has passed an agreement with all hospitals to not induce before 39 weeks unless for medical necessity. But most communities are not so lucky….When hospitals have 42%-64% c-section rates there is a big problem in the system

        • What is with this misconception that people working in a hospital have “never seen a normal birth”? What is your definition of normal? There are lots of women who come into hospital whose labors are so quick and normal that you couldn’t intervene even if you WANTED to! Some women really want an epidural and the hospital staff try to accomodate them, but they don’t get the chance because the labor progresses too quickly to do that.Unless you think that all hospital births by definition are “abnormal”, I can tell you that they happen several times a day, every day. My first day in OB as a medical student I saw about 5 completely normal, intervention-free deliveries, and that means no IV, no analgesia, woman in any position she wanted, etc. All of your arguments are discredited when you keep coming up with ridiculous statements like this.

      • Nope, never had a homebirth, and I have no desire to. But I have friends who have had homebirths or are planning to, and it scares the heck out of me that they may be getting a poorly trained care provider. One friend is planning a homebirth with a CPM this fall in a state that does license CPMs. There are some CPMs who are knowledgeable and sensible, but there are some who are loons that continue to “trust birth” while the mother clearly needs to transfer – and the scary thing is that with a CPM, there’s very little oversight or way to get rid of those bad eggs. If someone truly wants a natural, intervention-free birth, why not seek out that birth in the safest way possible: with a CNM, after being evaluated for any risks that could make the birth dangerous for mom or baby.

        Also, “natural physiological event” does not equal safe. Nature doesn’t particularly care if some moms and babies die, as long as the majority live to continue the species. Personally, I don’t find “the majority of moms and babies live” to be reassuring enough; I’d rather go with “we will do everything that science enables us to do to keep you and your baby safe.”

        • So if you acknowledge that some CPM’s are knowledgable and sensible then shouldn’t you respect that your friends are smart enough people to interview and find these knowledgable and sensible CPM’s…

          I agree there are some loon’s out there, but I have seen CPM’s that are loon’s, OB’s that are loon’s and CNM’s that are loon’s …. hell I have worked in the hospital in enough areas to see loon’s all over the place. But there are also highly qualified people as well….

          What I try to “trust” about birth or I should say human nature is the innate instinct to protect. Especially to protect our offspring. So I suppose I always hope and assume that parents are actively thinking about who they are hiring for the care of their pregnancy and birth, regardless if it is in the hospital or home. That they are seeking out those with knowledge and that make them feel well cared for. This of course will be very different for everyone. Now don’t go ranting at me that I am blaming parents for a caregivers incompetence. An incompetent caregiver is just that, but many mothers also state they just didn’t feel right about their caregiver then stay in their care…. Well what do they expect when the outcome is not to their liking. This happens with Dr’s all the time. Woman have traumatic hospital births and blame the Dr. but truly don’t they need to take a little responsibility for not listening to their instincts…. Some woman in turn will have loved that very same Dr. One size does not fit all.

          Some woman truly want a hands off birth and in no way will go to a Dr. or CNM for that manner… others want every intervention known to man, I know some woman who schedule their epidural to happen before one contaction is felt….Many people fall in between this. There are competent and knowledgable CPM”S, Dr’s and CNM’s to care for these many diverse women…

          • Yes, I trust my friends to interview the CPMs. I do not, however, trust the CPMs to be honest about their past transfers and whether they’ve handled any births negligently. Some of the commenters here have experience with CPMs lying about their transfers and bad outcomes. There is not enough oversight to weed out those lying CPMs. With a doctor, they will lose their license if they are negligent or guilty of malpractice. CPMs can just lie about it and if they are a good enough liar to convince a mom in the interview, then no one will intervene to protect the mom.

          • Quark “With a doctor, they will lose their license if they are negligent or guilty of malpractice. CPMs can just lie about it and if they are a good enough liar to convince a mom in the interview, then no one will intervene to protect the mom.”

            Sorry but this is a fallacy, Dr’s do not always loose their license for negligent behavior or being guilty of malpractice. Many times the Doctor gets a fine, a reprimand, or a suspension. Then go back to practicing as though nothing happened. Kind of what like Attitude Devant has complained about Oregon Midwives.. Sometimes nothing even happes other than a peer review, if a lawsuit is not enacted the hospital has no real issue to deal with and it is considered a teaching opportunity and dealt with by peer review. Do not delude yourself that Doctors are loosing their licenses if the act negligently.

            It is very sad that a CPM would lie about there transport rate…. This would be another reason to support the standardization of CPM’s throughout the nation thus allowing a registry that can have accountability that parents could check… Listen out of hospital midwives have been around before there were hospitals people went to…Eradication of this manner of birth is not going to happen. Why not focus energy on making it safer. As people have asked here what I am doing in that vein….what are any of you doing. Sitting at home all angry saying CPM’s should be illegalized isn’t really very helpful in finding a working solution….

          • I don’t think anyone here wants to eradicate homebirth. I sure don’t. I DO, however, (like you, apparently) want it to be made safer, and I think that starts with the education and training that goes into making a homebirth midwife. I also think it should be restricted to truly low risk mothers (i.e., no breech and HBAMC) and that malpractice insurance should be required. I do actually like your idea of an independent board, provided it was made up of midwives with the appropriate training.

  5. First- non CNM/CM MWs should be banned.
    Second- prosecute the ones who practice, vigorously.

    It’s really pretty simple. Why should American women be harmed by MWs that wouldn’t be allowed to practice anywhere else? Don’t we deserve better?

    I also have a solution for those that say “but I want a lay MW” or “its my right” or “its my religion”. We cannot ban the mom from choosing whomever she wants to attend her birth. BUT, We CAN regulate the term MW, and also anyone that chooses to take money for attending a birth. Anyone attending a birth calling herself a MW or taking money for providing birth services must be a CNM/CM, or go to jail for practicing MWery without a license, plus any penalties for negligence.

    You could still hire various non MW support people, like a lay attendant, or its religious equivalent, but those people would be required to provide the mom with info informing them that they are not qualified to provide any more than labor support, etc. Anyone attending non family, or more than 3, births in a non medical/MW role would still need to be registered. They would be required to keep records of this consent, or face fines. Any death not inevitable (congenital defects, etc) would need to be reported in an easily searchable database.

    So long as they don’t call themselves MWs, or represent themselves as LnD experts, etc, they would be allowed to support moms. Ironically, this is exactly what Carla Hartley would want, less the title of MW. It would allow moms freedom, but protect them from untrained MWs.

    Ideas?

    • I agree Stacey. I think one of the biggest problems is allowing untrained, underqualified people to call themselves midwives. It confuses people who have no idea that there are different kinds with vastly different qualifications. Another huge problem is the fact that no one reliable is tracking homebirth outcomes.

    • Did you know that prior to sitting for the North American Registry of Midwives exam, (NARM) which must be passed prior to applying for Oregon midwifery licensure, a minimum of 40 births, 135 outpatient visits, and 1350 clinical hours must be documented. That does not include the additional 25 births (10 being continuity of care births) 20 more newborn exams, 20 more prenatals and 20 more postpartum visit. that are required for above the CPM requirements for Oregon Licensure.

      To sit for the equivalent nurse midwife American Midwifery Certification Board no minimal number of births, outpatient visits, or clinical hours must be documented. Rather, nurse midwife students must complete an accredited nurse midwife training program. In 2010, Oregon Health & Science University required nurse midwife students to complete 30-50 births, 150 outpatient visits, and 760 clinical hours. Their didactic education directly related to birthing does not exceed the education hours either. The major difference is that these students attend the mandatory classwork of English, Math and electives that give them the credit hours to earn a bachelors. Which can also be done in several MEAC accredited CPM programs thus earning a Bachelors in Midwifery…

      • Please. These are laughable requirements. 40 births? I know the licensing statutes well. You gloss over the fact that only twenty of those are as the primary midwife. So you doula for 20 more and WHEEE! You IS a licensed midwife. Licensing in Oregon is a JOKE.

        • True 20 births are as a Primary, the other 20 are not Doula births as you must be doing way more than a Doula does for those 20. Those 40 are not enough to get your licensed in Oregon though as I stated you must have additional primary and continuity births. If you laugh at these numbers for CPM’s then you must also need to laugh at the CNM’s number requirements as well since technically they do not need to have any documented births. I like at least that OHSU midwifery school requires 30-50 (not really different from the CPM requirements) They also do not qualify those as being primary births… so they to could be “doulas” as you would like to call them…

          Personally I would like to see the CPM become even more rigorous in their qualifications, and the NARM board given governing power over the practicing CPM’s nationally. I believe this would be the best for the birthing community at large. you ladies want a place to see what midwife has issues like you can for a doc, well then support this option. Because the option of totally getting rid of CPM’s, probably isn’t going to happen…

          • I job dream on midwife.org – and I never see a hospital looking for a midwife with less than a Master’s. So I’m thinking the program you’re referencing is worthless anyway.

          • “Personally I would like to see the CPM become…more rigorous….”

            Well, hell yes! A LOT more rigorous! And what are you doing to make that happen? Trolling around here? You should be AGREEING with Heather instead of bragging about this credential that needs to become more rigorous.

        • In order to practice maternity care safely, you absolutely just need to have seen and participated in a lot of births. It’s all about volume. No wonder new CPM’s think bad things are incredibly unusual. If you’ve only been to 40 births, chances are you’ll get lucky. Especially if say more than half of them were 2nd or subsequent babies. It’s just not enough experience. I had done 50 before I even started my residency. The more you see the more you are likely to run into various complications, and more than once, so that you “respect” birth (not “fear”, but “respect”). It is a normal life event but it is a hazardous thing, accept that already.

          • And I should point out that I did not feel qualified to practice independently after those 50 births. Nor would the “medical establishment” accept such a small amount of experience. If you have no “fear” of the birth process, it’s very simple: it’s because you just haven’t seen enough.

  6. I wasn’t clear- couldn’t see to edit.
    It should say “prosecute those non CNM/CM MWs that still practice”
    and “birth services” means a MWery or medical role.

  7. Sadly it is not just CPM’s who think that all births can be handled at home. Birth Sense who is a CNM in a response when I questioned her about breech NOT being a variation of normal stated that women who have GD, mild hypertension, meconium in the fluid and advanced maternal age can all still safely give birth at home. The woo is permeating even those who are educated!

  8. I agree, make it illegal, fine them, and prosecute the crap out of them. Make it legal for CNM’s to do homebirths(in whichever states it is currently illegal) and outlaw anything less. What should happen to all the competent CPM’s though?

    • You can create a direct entry qualification that meets minimum standards set by a nursing/midwifery board. A four year tertiary course (like a Bachelor’s) that is sufficiently rigorous to qualify a midwife to practise both in a hospital and at home.

      I think, basically, there should be no one calling themselves a midwife and delivering babies at home that would not be qualified to do the same in a hospital.

      • See my above comment concerning the education comparison of CPM’s and CNM’s. CPM’s have the same if not more didactic and clinical experience if they have been educated to the North American Registry of Midwives (NARM) I don’t think the answer is dissolving the credentials of CPM’s but instead make it a nationally recognized norm in all states as CNM’s are. Let the NARM become their governing body just as CNM’s have their national governing body and Ob’s have ACOG to govern them. Many , many homebirths happen without any problems. Just as there are deaths in hospitals under OB and CNM care that should not mean we not have any OB’s or CNM’s, a death at a homebirth should not signal the dissolution of CPM’s.

        Sadly this birth was not attended by midwives who had proven their knowledge by the rigorous conditions set up by NARM. I would entreat any mothers reading this to not choose a midwife licensed or unlicensed that has not passed her CPM exam. To even sit for your exam you must show exhaustive documentation of your experience that is all witnessed/signed/notarized and then question for full validity by a team at NARM.

        • Bliss, you know as well as I do that most CPMs got the credential via the portfolio evaluation process and had little to no didactic training whatsoever.

          • I would contend that most who do the PEP process do have didactic training. It may not be equivalent to sitting in a classroom with a set amount of classroom hours but is still relevant as didactic training. it is true that many programs are online or distanced based, just as there are several CNM programs that are also online and distanced based.

            PEP process midwives still have to write up their own Practice Guidelines and Informed consents. Another difference with CNM’s who do not write their own as they are not usually developing their own practice but joining one.

            As a Nurse who chose the CPM route I am always intrigued at how a CNM with less clinical experience is supposedly more experienced. I dealt with the same issue as an RN…Associate nurses versus Bachelor nurses. Associate nurses have more clinical hours and more didactic hours than Bachelor nurses, yet Bachelor nurses are considered better….Better for management but not patient care.

  9. This is extremely inappropriate. Reposting from a private group is both unethical and illegal. Remove this post immediately and any others that repost private emails. I will pursue this until it is taken care of. Remove yourself from the MANA Students and New Midwives Group as no one is welcome who does not respect the privacy of the group.
    Janelle
    MANA Students and New Midwives
    Group Owner
    Moderator

    • The FB groups are not private, so as far as I can see there is nothing wrong with reposting the exact comments made on a public forum!

      • She is talking about a private Yahoo group “MANAstudentsandnewmidwives” It is a private group and all who join it are informed they are not to share information written there.

        And not that this applies here but FB groups can be made private and may have the same requirements of members to not share what is written

        • You know, the biggest problem lay midwifery has is this insistence on secrecy. One would think you ladies had something to hide!

          • Do you mean like Doctor’s and hospitals? Have you ever tried to get real numbers regarding the amount of Cesareans they do, Epidurals, Episiotomy’s…. I have watched Doctors and Anesthesiologists lie or withhold information to mothers to gain their cooperation. Not really true informed consent, are they trying to hide something?

            You don’t think other professions have their private groups that it is not OK to share information divulged there. Many doc’s discussed cases via message boards that are private for a reason. There is no difference with this Yahoo group. It is made private for a reason, sadly some people do not have a problem sharing information….what would you think if the shared info regarded a client case? Don’t run off about HIPPA violation either because care providers are allowed to discuss clients cases with other providers in a private manner for care….

          • Lay midwives and CPMs do have something to hide and it’s their incompetence! Breech home births where the baby suffocated, denying mom transfer to a hospital with competent care, failure to recognize serious womb infections, telling clients to stick garlic cloves (is it roasted or tossed in olive garlic I must ask) up their yoni’s to “cure” GBS, only to watch newborns succumb to systemic GBS hours later…Yes I think that they have a heck of a lot to hide.

            Too bad they’re being exposed – causing quite the brewhaha it seems.

          • Oh jeez, Bliss! There are numbers available on MDs everywhere. Ever heard of the National Practitioner Databank? MDs have it, CPMs don’t. And while I’m at it, what’s up with the no malpractice insurance. There are loads of people who’d love to sue the hell out of the CPMs who killed their babies, but y’all got no inshaunce! Because OH! the Oregon legislature specifically exempted y’all from it. Must be nice to practice any old way you want and no one can touch you….

    • First of all, I am not in the email group, as I have no interest in being a CPM. I do, however, have concerned friends in the group.

      As to the legality and ethics of posting this here…

      There is no expectation of privacy if you send an email to a group with hundreds of members. In addition, posting a screencap for “purposes such as criticism, comment, news reporting, teaching, scholarship or research is not copyright infringement.” (http://lifehacker.com/193343/ask-the-law-geek–is-publishing-screenshots-fair-use.)

      I do thank you for reporting me to my server for hate speech, though. As you can see, the site is still here.

      • Fantastic attempt. However what you are looking at is a preceftly legal screen cap. It is an original picture owned by the person who took it. Considering Microsoft recently lost their case in trying to prevent people from capturing their software with screen caps, I seriously doubt any judge will see fit to rule differently.

  10. Hello there. As an apprentice midwife studying to be a CPM, allow me to say that the terrible tragedy that happened SHOULD NEVER have happened. CPM’s have to have course work, a very long involved skills test, 50 births with a highly qualified midwife, and the exam. I am studying with an amazing CPM who has practiced safe homebirths for over 30 years and 1400 babies. A CPM can be qualified, professional and safe… or they can be reckless, unsafe and selfish. You need to look at your options and decide what is best for you. in our area, CNMs can’t practice outside of the hospital which has a 46% C-section rate.

    • That’s the problem Jeri. A CPM can be qualified and competent, but there’s nothing about the certification that ensures they will be. It’s a made-up degree, created solely to allow insurance billing, and the quality of the women holding the credential ranges from a few super-awesome midwives to the vast undertrained middle, to downright scary ideologues.

  11. Jeri Clark – you think a CPM who has presided over 50 births is qualified to be a solo practitioner?

    I am curious – why don’t you complete the CNM pathway instead? it seems like you are not too far down the CPM path just yet.

    • As I stated above are CNM’s then not qualified? Their numbers are no better, nationally they are actually worse as there is no consistency on clinical hours and birth as set by the American Midwifery Certification board before sitting for their exam.

      I am an experienced RN with experience in L&D so I am even more close to gaining my CNM and have no desire to. I appreciate the quality and quantity of education I received. I completed 80 births in my education before sitting for my exams. I would have felt sadly negligent to my clients to have only attended 30-50 in hospital births as a CNM, where I even able to get that many (I am going by the OHSU model here)

      • You also need to remember that many CPM’s weren’t nurses when they started their midwifery programs. I don’t know about your educational history, but I’m studying to become a BSN then CNM, and I can honestly say that I’m terrified of what I see in my classes alongside of me as being the future of the profession – and these are the educated ones! If it’s scary in a college with crazy strict regulations to get into the nursing program itself, how scary is it in a program with little previous requirements?

        • Oh I remember in nursing school being terrified that some of my classmates where going to be taking care of patients, and some of them where the highest scorers in testing. Didactic excellence does not sometime equate to common sense and being a good care provider.

          So much of what we learned as nurses in nursing school was how to pass our nursing exams, this was even stated by our instructors…. When did we really learn how to be nurses,? When we went to work as ones…. And many of the ones I was worried about… they ended up in management and research. 🙂

          You are correct that many CPM’s were not nurses first, and there are many people I see around me that scare me, but there are others who regardless of not being nurses are excellent midwives. Would I like to see these Midwives made illegal? No they are a benefit to families… Would I like to see the scary ones be weeded out, yes…

  12. Wow, talking about 50 or 80 births like it’s some huge all-encompassing body of work is pretty pathetic. From what you’re all saying, you seem to think that this is enough to make someone an expert in birth. Bliss, why would you NOT do a CNM– especially since you already claim to be an RN– so that at least you have a legitimate degree and even more L&D clinical experience? The pro-midwife arguments here are so weak that I wonder if *any* midwifery education program is really sufficient. A doctor who specializes in obstetrics sees MANY HUNDREDS of births before going into practice on her/his own. These are not all “high risk” or “full intervention” births, either. Most of them are totally normal, a large number of the normal ones are unmedicated, and of course they also see every type of complication that can arise. If a CPM can’t say the same, then she’s got no business taking the lives of mothers and babies into her hands. And don’t you dare say “good midwives are hands-off,” because that is the WORST cop-out of them all. A well-educated, competent, responsible care provider absolutely accepts that she has an active role in the birth, and understands that responsibility. There is none of this “own your birth” (i.e. “if it goes wrong it’s all mom’s fault”) crap. Professionals with real education don’t need to make excuses, don’t need to lay blame, and don’t need mantras like “trust birth.” Real educated professionals know very well the good, bad, and the ugly– and exactly how to deal with all of it. You can’t get there from a correspondence course, or a handful of hours of “didactic training,” or a few dozen births during an apprenticeship with another lay midwife whose educational background is also completely substandard.

    • marlo ^^^^^ yes that! all of the above. these are HUMAN BIRTHS people–little babies lives we are talking about—- who in their right mind would not want to be properly trained before having such a heavy weight on their shoulders–the matter of life and death???

  13. attitude devant
    August 22, 2011 | 7:59 pm

    “Personally I would like to see the CPM become…more rigorous….”

    Well, hell yes! A LOT more rigorous! And what are you doing to make that happen? Trolling around here? You should be AGREEING with Heather instead of bragging about this credential that needs to become more rigorous.

    So if I don’t agree 100% with Heather I am trolling around here? I did not think I was bragging but giving out information. I guess I don’t see things as absolutely Black and White. I do see the need for reform and change, I am not of the belief like many that CPM’s just need to be banned that is very true I think there is a middle ground.

    What am I doing I am actively communicating with both the national body and my local level to raise the bar on CPM education. I am supporting the causes that will make CPM’s become a national accepted norm thus giving a level of credibility that should be worked to attain as opposed to under ground midwifery that cannot be monitored in any way. I am working with local healthcare providers (Doctors, CNM’s, Lactation specialists, Chiropractors, to name a few) to bring the best care to clients and meet their needs…. Sorry I had a half day of working and was caught up in the discussion on this board through out the day…. What’s your explanation? But of course you cannot be a troll cuz you agree with the author 100% Funny how that goes…..

  14. Heather
    August 22, 2011 | 6:16 pm

    “Lay midwives and CPMs do have something to hide and it’s their incompetence! Breech home births where the baby suffocated, denying mom transfer to a hospital with competent care, failure to recognize serious womb infections, telling clients to stick garlic cloves (is it roasted or tossed in olive garlic I must ask) up their yoni’s to “cure” GBS, only to watch newborns succumb to systemic GBS hours later…Yes I think that they have a heck of a lot to hide.

    Too bad they’re being exposed – causing quite the brewhaha it seems.”

    You are correct in much of this, The above stated crap is horrible and should not be hidden….I still do not see the relevance of taking down an entire profession due to some midwives incompetence. Why like me do you not call for more rigorous training and monitoring? Do you not also get incensed when a woman has vaginal exams in a hospital every hour by several different people, after her membranes are ruptured and then cause a uterine infection that must be treated with antibiotics. Thus subjecting mom and baby to this….This is horrible in my eyes. Why does it happen? Because for one reason the students need to learn somehow, and yes I have seen it happen Many times while working in L&D… How about the woman who are never counseled by their Medical provider on their diet and end up pre-eclamptic, oligiohyramnios, or with an IUGR baby because they were not counseled to eat 80 grams of protein a day, cut down on sugars in their diet and drink half their body weight in fluid oz in water…. To me this is negligent care to not help teach your clients optimal nutrition in pregnancy. but what can you do in a 15 minute appointment…. I could go on and on…. both sides have caregivers that are not serving their clients in the best possible way, but just like I do not lump all dr’s in the same pile….Don’t lump all CPM’s

    • But again, it would be good if CPM’s had mandatory nutrition class requirements.

      It’s also like Dr. Amy has said – requiring licensure does not make providers competent. Some people test well, as you mentioned before – that doesn’t mean they are good nurses/MD’s/Midwives or any other profession out there. I work in a regulated, licensed industry and am regularly terrified at what I see going on with some licensed professionals. There’s no fix all, and that is absolutely true.

      I just had to comment because you mentioned nutrition and pre-e. I had a friend of mine who insisted on driving to her hometown hospital (2.5) miles away for care because they gave their patients a free car seat with a birth, rather than seeing a midwife like I did semi-locally, because the car seat was the priority – her words. She ended up with pre-e and was admitted for a week into the hospital. She had her husband bring her a bunch of egg rolls and cream cheese wontons in the hospital one night because she was craving it, and I wanted to bash my head against the wall because I couldn’t figure out why no one had talked to her about what she should and shouldn’t eat. Sure enough her BP went through the roof the next day, and they induced her at 35+6.

      All the while I was thinking of another dear friend of mine who saw the same CNM as I did, was coached on nutrition, had pre-e twice, but still went 36 weeks and 38 weeks before she went into labor NATURALLY and did everything naturally without the fear and issues that my other friend had experienced.

      Which brings me to another rant. While OB’s are criticized for being too negative in labor, I think family practitioners need to be taken out of the equation. Our local hospital has only FP’s, and their c-section rate is embarassing, their methods are crazy. The horror stories I’ve heard – especially when pregnant – have made me want to sew myself up and run far, far away.

      Rant over. 🙂

  15. Oh no, Bliss! I’m a total baby-and-woman-loving troll. And the last thing this state needs is more whack jobs practicing without any real limits. Have you ever filed a complaint with the OHLA? Because I have. And let me tell you, they couldn’t give two figs about dead babies. They just care about letting their precious midwives practice unhindered. Do you know that 30 per cent of licensed Oregon midwives have had complaints filed against them? Pretty amazing, huh? And what are the midwives doing to police themselves? Pretty much nothing. In fact, nothing.

    So if you’re such a collaborator, then why don’t you write a guest post for Heather on how midwifery in Oregon could clean up its own act? I would just love to hear what you suggest.

    • No I have not needed to file a complaint with OHLA, but I am very aware of the high number of complaints, I know of several of the cases actually and while some have foundation that should be addressed, a good 50% or more of them have no basis. Many of them also do not come from the families at all and the families are helping the midwife fight them.

      What I would suggest is just exactly what I am suggesting and that is the Midwives of Oregon need their own independent Board just as the Nurses of Oregon and Dr’s have their own board. It would also allow for fully protected peer review like the Doctors in the hospital have. Of course I am sure most here will disagree whole heartedly with me on this

      I have a question for you have you ever filed a complaint against a Dr in a hospital for negligent and dangerous care? I have and found that the Docs only looked out for their own…The complaint became a joke and the doc got a slap on the wrist and that was all…i also saw this happen way to many times while working in the hospital.

      Someone said why don’t I become CNM and work in the hospital…. because I saw way to many terrible things happen in the hospital to wan to be a part of that …. I watched the insurance system deny people care that they needed, I watched clients be abused, I watched babies suffer and be born way to early for the convenience of professionals… No thank you, that system has way to much change needed for even me…

      • Bliss, you are not paying attention. Midwives have their own Board, and it is a freaking disaster. Read Heather’s post on “The Sorry State..” and weep. There are no legal limits on midwife practice, the Board does not discipline midwives for egregious misbehavior, and any ideas that Oregon midwives would restrict OOH birth to low-risk patients have been proven to be foolish hope. Go and read Oregonmidwifereviews.blogspot.com and see what your colleagues are up to. Educate yourself. Right now you’re living in clouds of hopes and dreams while babies are dying all around you.

        • No you are not paying attention the OHLA board is not the equivalent of having your own governing board. The State board of Nursing and the Oregon Medical Association are independent boards not under OHLA. When I speak of a midwifery board I am speaking of an independent board.

          There are also many restrictions for licensed midwives to keep births to lower risk parents. You are probably speaking of Breech and VBAC clients which many professionals feel are low risk in the context of our midwifery rules here in Oregon… The recent rule change changed many practices in this state to support only low risk clients. Many mothers have since the beginning of the year been risked out of licensed midwifery care, what do some of these mothers do….Have unassisted births or find an unlicensed midwife… You cannot forse some people it would seem to bandon the birth they plan on having.

          I have been to that blog and feel very sorry for that embittered mother. She clearly felt ill treated by a certain midwife. She even states how much she liked “L” and returned to receive care from here when she felt the facility was run by a bad midwife… Not a wise decision I would say, but her decision non the less. Personally I would not birth with the person she has a complaint about either, but many love her…to each their own.

          Believe me I am very educated on this and have attended many meetings throughout the state in regards to this topic, on both sides of the fence. No clouds of Hopes and Dreams here… I respect birth and all the dynamics encompassed within it. babies do die, that is true, some have died in the hospital, some have died at home. Some have died in-utero. Is there always someone to blame? No not always, sometimes babies die. Are there incompetent caregivers that contribute to the death or disabling of babies and mothers, yes, sadly there are in both hospitals and homes there are…..No clouds and dreams sadly.

          • “….she clearly felt ill-treated” by Laura Erickson. Hellooooooo!!!! Wake up girl! You think that stuff is made up? You think Laura didn’t pull that crap? You won’t criticize Laura because YOU are afraid of her! Is that any way to live…or to practice? The stuff she describes (and it’s not just Laura, and it’s not just her own experience) is shocking. And you call her “embittered?” And you blame HER? What about her MIDWIFE??

            When I talk about midwifery malpractice, you always wanna talk about OBs. Well if I have a bad outcome with an OB, I can sue his butt and get compensation. With midwives, I am shit out of luck. Does it not bother you that people have NO recourse against midwives who hurt them and their families?

          • Attitude Devant “….she clearly felt ill-treated” by Laura Erickson. Hellooooooo!!!! Wake up girl! You think that stuff is made up? You think Laura didn’t pull that crap? You won’t criticize Laura because YOU are afraid of her! Is that any way to live…or to practice? The stuff she describes (and it’s not just Laura, and it’s not just her own experience) is shocking. And you call her “embittered?” And you blame HER? What about her MIDWIFE??”

            First off I choose not to state the midwifes name, since the client has decided to remain anonymous I am not personally going to pull any names into this. Secondly you obviously did not read my whole paragraph when I said I would not birth with that midwife, I do not doubt much of what she complained about, I am in awe she even returned to their care for a second pregnancy. I could not say any amount of love for my primary apprentice who was now a midwife there would pull me back to that situation. Oh and I am in no way afraid of said midwife, you assume an awful lot I see….

            I haven’t even discussed Midwifery Malpractice insurance with you but I personally think all malpractice insurance is crap. I think it is what makes good Dr’s make bad decisions, what ties the hands of hospitals from giving individualized care. It is always a constant battle. I would love to see our medical system not be crippled with lawsuits. You want to sue a midwife…you can, just because she does not have medical malpractice insurance does not mean you cannot sue her. Other parents have done it, of course your right if your looking for big bucks you won’t get them…most midwives are poor, but you can still get what they got and probably put them out of business…

            I find it sad that you could find compensation for a life with money, but that does seem to be the way of people….very sad…

          • Not compensation for a life, Bliss. Help with the medical bills from a disabled child. Putting a bad practitioner out of business because she’s had so many suits she’s uninsurable. Help with funeral bills or hospital bills from the hemorrhage or infection that she failed to diagnose or prevent.

            Something, ANYTHING, to put the brakes on bad caregivers. And Hey! I posted Laura Erickson’s whole name because she came on THIS VERY BLOG using her own name and tried to coerce a former patient by shaming her. So, if she uses her name here, I use her name here too.

          • Sure, you can sue a negligent midwife if you have money left over after paying for your infant’s funeral and counseling for your other children, or after you finish paying for the care of your profoundly disabled child. Because if you don’t have that money, you’re not suing-no attorney will take your case! I don’t know if you’ve read Liz Paparella’s story (her blog is linked in the sidebar), but her midwife was found guilty of negligence in the death of her daughter and was given an insulting fine and a slap-on-the-wrist suspension (she still got to practice while suspended??) by her friends on the Texas Midwifery Board. Several of us contacted literally every attorney in the state of Texas (thousands of them) and not a one was willing to take the case because the midwife had no malpractice insurance.

          • Oh, yeah. Good old Faith Beltz who couldn’t figure out that horribly painful contractions and profuse bleeding was an abruption. Yeah, Faith is such a great midwife she was even training other great midwives. What a demonstration of the power of the CPM credential.

            Seriously Bliss, why would freeing the Midwifery Board from OHLA make it all better? I’m curious as to your reasoning. Surely the OHLA does nothing to hinder Melissa Cheyney at present. Why would an “independent” board be better?

  16. That we even have more than one “class” of midwife in this country is ludicrous. To have people attending births with the title of “midwife,” accepting payment (including in some cases health insurance), and taking people’s lives in their hands without having the highest possible level of training is just plain wrong. Why is this allowed to stand? Why are you supporting this? We love midwives. REAL midwives. Who are these “responsible” CPMs? I’ll tell you who they are: they are the ones who see the light and go to NURSING SCHOOL to become CNMs so that they can be safe, licensed, and insured practitioners who can see their patients through their pregnancy and births no matter what issues may arise. They can be with their patients at home OR in the hospital, because their medical knowledge and expertise qualifies them to work in a high-tech environment as well as a low-tech one. No CPM can say that. Not one. To show any support whatsoever for the CPM “credential” is to admit complete contempt for education and total disrespect for patients and *real* medical professionals. Settling for the “lesser” qualification of CPM for yourself is cheating the most important people of all– the babies. You owe it to the babies to be the BEST. Not the crunchiest, not the hippest, not the cuddliest, not the fuzziest, not the most “trusting,” not the most “faithful,” not the most “hands-off,”– just THE BEST you possibly can. You CAN NOT be the best educated, the best qualified, and the safest care provider if all you aspire to is the CPM or less. It’s just indefensible. It’s time that all midwives have the same educational standards, all the same clinical training, and all the experience that is required of CNMs in the US and Licensed or Registered Midwives in other developed countries. No more stratification among “types” of midwives. Babies deserve better.

    • Are you familiar with the requirements to be a Registered Midwife in Canada? Though it does vary according to province, they are NOT required to be CNMs. They do not have to go through nursing schools. In fact, many Canadian midwifery students come to direct entry midwifery programs in the US for their training.

      • There is one direct entry school in the us approved to train students to be a Canadian RM, and that is Bastyr University. They actually get a bachelors or masters degree in midwifery. The vast majority of DEMs in the US do not get a university degree. If they get a CPM, they go the PEP route which doesn’t even require a high school diploma.

  17. P.S. How can you make the hospitals a better place if you don’t go and try? Do you think you and other “sensible” CPMs or CPMs-to-be could become CNMs and then try and make the environment for your hospital mamas feel more like what you envision? Not a lot you can do about insurance. And if you’re going to charge mamas $4000 give-or-take out of pocket for your “home services,” then it’s not like you’re really saving them any money anyway. So why not go and “be the change you wish to see” in the hospital, and get better-trained and better-educated while you’re at it?

  18. Everyone here who thinks Oregon CPMs are so awesome ought to head over to Oregonmidwifereviews.blogspot.com and read what Astraea has to say. I guarantee you will be shocked.

  19. First- non CNM/CM MWs should be banned.
    Second- prosecute the ones who practice, vigorously.

    It’s really pretty simple. Why should American women be harmed by MWs that wouldn’t be allowed to practice anywhere else? Don’t we deserve better?

    This is untrue, the CPM credential is accepted more then the CM, for example with the international aide org. MSF. Rather then shut them/me out of health care, support a National standard. I am a CPM in school for CNM, why? pure economics, will it make me a better HB midwife , I doubt it, will it make me eligible to manage high risk pregnancy in hospital for an OB, no doubt it will, as that is the intention of CNM training. As CPM’s our goal is only to care for low risk woman at home.

  20. @Marlo, in my experience working along side CPM’s and CNM’s at hundreds of births. I think CNM training leaves the practitioner least prepared to practice with the skills that are valued for homebirth. That is why CNM grads SEEK out CPM’s to learn how to function as ‘real’ midwives in a homebirth practice. It is not about the wall paper in a birthing ‘suite’.

  21. My heart and all the compassion that lives within me goes out to this woman who lost her child… I can’t even imagine the sorrow they must be feeling. I can’t believe there is so much hate and fighting surronding this womans loss you who have participated should b ashamed. She asked to go to the hospital!! She was in labor for 8 days!! I had a long difficult labor at home (3 days) with an amazing midwife who had delivered over 400 babies. Heart beat was strong I was exhusted, I was stuck for 8hrs @ 7 or 8 cm… at one piont my lay midwife came to me and said that we need to progress or go to hospital its just been to long… the point is to birth that baby not hav a great birth experience, u hope for great experience but!!! If going to the hospital needs to happen get in the car and go!!! And who leaves a. Laboring woman in transition? At that piont u just don’t leave, my midwife slept on my couch while I was stuck just because I was so far apart, a lot can happen in an instant heartbeat drops blood sugar drops… Iam so sad for this woman and her family. It was no way her fault. I am so sorry for your loss. There is nothing that compares… heartbroken

  22. This is just crazy. I just heard about all of this since I’m visiting Eugene. I had hired Darby as my birth doula (she collected half the money) and she COMPLETELY FLAKED on me when I was in labor. I called her at 2am or so late January, 2010 when I was in labor and she told me I was not in labor and to go back to sleep. I had my son the following morning with my WONDERFUL back-up doula Olive who drove all the way down from Portland. Darby was always late for our scheduled appointments (one time by 2 hours) and yet was disgruntled when I was late 15 minutes once after having called. Anyhow, when she found out I had my baby, she blamed the entire situation on me! Also, the friday prior to my birth I thought I was definately in labor and so called, and she was at the Wow Hall drinking and sounded very intoxicated. She also asked me a few times if I wanted to give birth to my son at home as she was qualified. I understood she was studying to be a mid-wife. I had absolutely no desire to give birth to my son in the tiny apartment. Thank God for how the situation turned out – a wonderful birth, natural, and with trustworthy women and a wonderful, beautiful healthy son.

    • Just curious? Was this before or after this tragedy on july 24th? I just want to know if Darby continues to think she can deliver babies after what she did to this woman.

  23. WHAT THE HELL? and…..OMG now I’m pissed, who the hell does she think she is, they took a life and are casual about it and on top of that want money..and wait has the never to call the Maternity system evil…women every day take the wheel when they are pregnat, there is no such thing as a normal birth but when you have two people who were intrusted with your life and the life of your unborn child and then have the nerve ignore and prevent the pleas for help thats just plain murder no matter how you see it. this is all upseting some thing needs to be done with people like this. dont loose focus….a life was taken away un-needlessly

  24. Anyone in their right mind and with common sense would know to suction an infant when he/she is born!!!You don’t rush to do CPR if the baby is not breathing!! Performing CPR before suctioning is literally drowning the poor baby in its own fluids! GOD gave us brains for a good reason not to go out and kill innocent babies!! Especially Lil Shazad he WAS my grandson!!

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