Why is it so easy to believe that there are OB's out there who practice unethically and/or convince women of unnecessary interventions and cesarean sections but it is so hard to believe that there are home birth midwives out there who practice unethically and/or are under-trained?
Why does it mean that if one accepts that our home birth midwifery system is flawed here in the US it means that person is anti-home birth and anti-women's right to choose?
Why can't it mean that someone who is advocating for SAFER out-of-hospital standards mean that they care (maybe, even more) about women and protecting a woman's right to choose?
Why must home birth midwifery be protected so much that the preventable losses at home births are hidden and/or ignored by the home birth community?
Why does it mean that if we accept that birth may not always be normal, even for a woman who is low risk, it means we are living in fear?
Your post today reminded me of a post on Safer Midwifery for Michigan from last year:
ReplyDeletehttp://safermidwiferyformichigan.blogspot.com/2012/07/where-is-my-midwife.html
I don't know the answers to your questions. But recognized your questions as ones I've often asked myself.
Honestly, I do not understand why the NCB community has made, and continues to make these choices around incompetent midwives and dangerous beliefs around birth. On one hand, there seems to be this kind of old crone wisdom fatalism, where they say things like "some babies just aren't meant to live" and "birth and death are on a continuum" and minimize the deaths/morbidity. Although, they are quick to trumpet hospital death rates. The things that these celebrated birth people get away with - Gloria LeMay, Lisa Barrett, Janet Fraser, Cara Mulhallan and all the midwives on Hurt by Homebirth and the ones you listed in your post - these women all have so many supporters, are highly respected, and have blood on their hands. If OBs had their results, the NCB community would be calling for their heads. But what do I see in my FB feed today from a CNM and a doula? A graph that supposedly shows how dangerous hospital birth is for women and babies, and how homebirth is so much safer and so on. I don't get it. I just don't get it. The only explanation that rings true for me lately is that it is a cult. One, big, dangerous cult.
ReplyDeleteDoula Dani,
ReplyDeleteYou ask important questions, and demonstrate a great deal of insight. Thank you.
Ok, if homebirth is not going away (like assault rifles and marijuana, haha), then lets regulate it like OB/GYNs are regulated. They need proper education, training, and an adequate number of years and deliveries before private practice. They need licensing in whatever states they practice. They need malpractice insurance to protect their clients. They need credentialling and recredentiling in CPR, NRP, obstetrical hemorrhage, and fetal HR interpretation like OB/GYNs do. They need annual recredentialling with their oversight organization of 150 hours/3 years CME. They need accountibility and reprimand with root cause analysis for sentinal events. They need a collaborative agreement with an OB and a hospital. This would weed out the birth junkies and hobbyist and poor practitioners.
ReplyDeleteI agree completely. I really do like the idea of the US become more like Europe, with homebirths the norm for healthy women, but we can't have that while our midwives are not up to par with their European equivalents. Honestly, if we put have the energy into it that we put into complaining how our health insurance stacks up to European models...
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