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What Do I Know, Anyway?

The education of LMs and CPMs is often called into question. So, what do we know about pregnancy, birth and postpartum?

Certified Professional Midwives have a fairly rigorous educational process that can be read here. Not all states use the CPM test to certify midwives, but many do, even as they have additional strictures required. California is one of those states. While it does use the NARM exam (North American Registry of Midwives), they also require their own standards above and beyond what NARM requires to sit for the CPM exam.

A note of importance: In California, midwives are licensed by the Medical Board of California - the very same board that licenses physicians. Despite all the rantings and ramblings of others about the professionalism or knowledge LMs and CPMs hold, I can hardly imagine the MBC continuing to license incompetent and unsafe women. I'm sure it can happen, just the same as unsafe doctors have licenses, but the great majority are competent and skilled.

Schooling is rigorous - two examples of curricula can be seen here and here. On top of this, we also precept with a mentor midwife for at least a couple of years. Most of us have doula experience under our belts as well, so have seen more than just lovely homebirths.

Before I became a midwife I'd seen a maternal death by amniotic embolism, babies die from congenital issues, shoulder dystocias, cesareans, and more - all in the hospital. I'd worked for 10 years in hospitals before working towards a midwifery degree. I bounced back and forth between being ready for a midwifery practice and being too scared to take that much responsibility in my hands.

I kept attending hospital and birth center births, taking more and more responsibility as I was able to and entrusted with. Wonderful doctors, nurses and Certified Nurse-Midwives taught me volumes about normal and abnormal birth. I am ever grateful for those that took me under their wings. (Two of my favorite, an OB and a CNM, read my blog, as a matter of fact, and would be amused to hear how ignorant I am considering the level of knowledge I've accumulated in their stead.)

Moving into the birth center setting, I worked with those undernourished migrant women that blinder-wearing doctor believes I have never seen. I've easily attended over 450 births of said migrants and assisted at an amazing array of complications and poverty-driven problems or concerns.

It took a great deal of emotional and spiritual maturity before I could plow forth and finish getting my licenses and practice independently. I'm glad I waited. I've now been working in the birth realm for over 23 years.

Sure, not everyone has as much background as I was privileged to experience. But there are minimum standards for the states that have legalized midwifery. We aren't barefoot illiterate women with dirt under our fingernails carrying black bags with sage and dead chickens inside - oh, and knives to put under the beds to cut the pain. We are educated, mature, skilled and responsible women who cherish our roles and love our clients, their babies and their families more than words can say.

We are not selfishly keeping women from an epidural or having a hospital birth. We are providing an option - a LEGAL option - to women who are disgusted with a system that views birth as a series of medical crisises that must be controlled at every turn.

If we were so dangerous and homebirth was so incredibly dangerous to babies, why would midwifery still be accepted and "allowed" to continue legally?

Some people's view of who we are and what we have accomplished to get where we are is darkened by prejudice and ignorance of their own kind. Where is the open mind? Where is the ability to see something different than what they learned? I could never speak about medical care providers as a group in the derisive tones midwives are often spoken about.

We are individuals - and so should be seen as such.

Reader Comments (4)

all but 2 states that license midwives ( New York and Rhode Island) use the NARM exam which is the written part of the CPM .

July 5, 2006 | Unregistered CommenterAnonymous

otnhtHow perfectly stated. Said doctor should take a long hard look at her own experiences and education. Perhaps she could learn a few things. Oh, wait, she already knows it all, doesn't she.

July 5, 2006 | Unregistered CommenterAnonymous

Anon: Thanks for that! Very helpful. (Could have checked as I wrote this, couldn't I have?)

Hannah: how nice I was mentioned on that other blog! I'll have to send her a thankee. :)

July 6, 2006 | Unregistered CommenterNavelgazing Midwife

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