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Monday
Aug012011

Why I Left Homebirth Midwifery

I received a comment the other day to my “This is ‘Dr. Wonderful’?” post, one that deserves a place as a post itself. Here, written by a local midwife here in San Diego, is the comment. I respond below, taking each sentence at a time. 

“Barbara,

Why after well over a year, on the week his mother has passed away, would you attack him in this way? We’ve all known about these gyno lawsuits, that have gone nowhere all this time. Could it be because you are no longer in his favor? I would suggest before attacking Dr. Biter in this fashion, you should check yourself at the door. I would be interested for you to share with your loyal followers your own reputation in the San Diego birth community. Many of us know how many times you have been called out for inappropriate actions during births. We find it no coincidence that homebirth midwives in San Diego are very busy and yet you had to close your business down. The people that read your blog only know one side of you and the rest of us know where you really stand amongst your peers. So before you go throwing stones...... 

Dr. Biter is a people pleaser to a fault, no doubt about that and when he fails to please everyone, he doesn't do a very good job of swallowing his pride but he never comes from a place of malice with his clients. He is not perfect but to call his character into question on this sort of forum is just purely unprofessional. The people in our birth community here have too much class to call you out on a blog, but enough is enough. You have your own reputation to be concerned about.  

I am intentionally signing this anonymously because I will not expose myself and my family to your vindictive nature, which many of us have witnessed firsthand and is clearly displayed here in your blog.” 

Dear “Anonymous” midwife at IP Address 70.181.185.xxx in Encinitas, CA… (ain’t technology wonderful?) I can see your house from here. 

“Why after well over a year” 

I posted a brand new item in the Dr. Biter saga. 

“on the week his mother has passed away” 

I did not know that Dr. Biter’s mother had died; apparently I was on the DO NOT CALL list. 

And not that I’d purposefully be cruel, but no one asked about the Medical Board and their lousy timing. Or what about the women and the lousy timing their botched surgeries or their neglectful care caused to their families? What about the really profane amount of pain those women were in for months and years? Or the insane amount of money they’ve spent to fix what went wrong? Who’s thinking about them? 

Me. 

“would you attack him in this way?” 

No attack. Sharing information. Correcting a mistake I made. 

It was crucial for me to speak out because I spoke out so loudly for him before. It is crucial that women know there is more to the story than I initially reported. As disturbing as this might be to you and your peers, women read what I write and take that as a letter of reference. It is extremely important to me that women have the updated version of the reference. Women went to him because of what I wrote; now, in the name of Informed Consent, women can choose to go to him still. 

“We’ve all known about these gyno lawsuits, that have gone nowhere all this time.” 

Lawsuits are one thing. Being brought up on charges by the Medical Board is another thing altogether. And, as Licensed Midwives, licensed by the same Medical Board, I would have thought you would know the difference. And the lawsuits are not “going nowhere.” Lawsuits take many years to wind their way through the court system. Just because we can see the dates the lawsuits were filed does not mean we have access to the entire court process or knowing where in the process the lawsuits are. Often, when settlements are made, they are made with gag orders, so we really don’t know how many are (or were) out there, do we? 

“Could it be because you are no longer in his favor?” 

He fell out of my favor long before our (his and mine) last contact. This has absolutely nothing to do with being liked; it’s about women’s health and safety. How High School can you be? 

“I would suggest before attacking Dr. Biter in this fashion, you should check yourself at the door.” 

What are you wanting me to check? The lawsuits against me? There are none. The charges from the Medical Board? There are none. 

“I would be interested for you to share with your loyal followers your own reputation in the San Diego birth community.” 

Ah, my reputation in the San Diego Birth Community. Yes. I am a pariah here, that is quite true. Is it because I use my voice and “pen” to speak out about injustices in the Natural Birth Community? Is it because I refuse to compromise in the safety of women and babies? Is it because I know too much and you all want to silence me? Sadly… and I do mean very sadly, it is all of the above. I will not shut up, no matter how hard you and your peers try to freeze me out, how hard you and your peers try to make me squirm or how many lies you and your peers tell about me, trying to convince others that I am wrong or bad. 

“Many of us know how many times you have been called out for inappropriate actions during births.”  

Name ONE. 

And if there were any times…  ANY (and there are none), you would have only heard about them in Peer Review and everything said in Peer Review is confidential. Remember? I could have you censured for even saying that one sentence. I have proof of who you are and that you said this. Hiding behind an anonymous comment does not absolve you of breach of confidentiality. I am considering taking that sentence to NARM and filing a complaint against you and your peers. I know better than to go to your Peer Review since the self-policing is non-existent. In fact, this is one aspect of non-nurse midwifery that seriously needs some help. Who oversees midwives? Each other. There are no independent panels anywhere that can impartially judge another non-nurse midwife’s actions; sadly, including you and your peers as well. 

I pity your clients and those of your peers that you would be so reckless as to breach another woman’s confidentiality on the Internet. Wow. And I’ve been told that, because of my blog, there was the “potential” for breach of confidentiality of Peer Review cases… of which NONE ever happened… and here you are, talking out of school yourself. How unprofessional and untrustworthy can you and your peers get? 

But, even if there was no confidentiality agreement, you could not point to ONE case where I was “called out for inappropriate actions during births.” I should sue you for that statement. 

“We find it no coincidence that homebirth midwives in San Diego are very busy and yet you had to close your business down.” 

“We” -Are you speaking for all the midwives in San Diego? You were elected spokesperson? 

I closed my practice for a number of reasons and yes, a part of that was the ostracization from the other midwives because it was clear I could not trust them to back me up. Women who did  come interview with me told me the comments that came from you and your peers, the threats of “you’ll end up on her blog” or “she transfers too much.” I know all about what slanderous lies were said to purposefully destroy my practice in an attempt to make me stop writing about how LMs/CPMs need more education, skills training… and even a more professional Peer Review. 

But, I took the shit that was dished out to me by my “sister-midwives” (snortylaugh) and created something even better. Something you and your peers can never take from me.

“The people that read your blog only know one side of you and the rest of us know where you really stand amongst your peers. So before you go throwing stones......” 

What “peers?” You weren’t in my “Peer Review” (and I am using that term loosely). It does seem as if you’ve been talking about me with the “Peer Review” group I was in and wow, isn’t that a breach of confidentiality, too? Over and over, examples of being unable to trust the midwives in this county… quite disturbing, actually. 

What stone am I throwing? It seems like you’re in the rock pile, sister, not me. I am demonstrating proof, not hearsay, not my opinion, but giving proof… my first-hand knowledge as well as what is public information from the Medical Board. 

“Dr. Biter is a people pleaser to a fault, no doubt about that and when he fails to please everyone, he doesn't do a very good job of swallowing his pride but he never comes from a place of malice with his clients.” 

I’m sitting stunned at this comment. So, when he tried to please women by giving them a birth that wasn’t safe, just because he doesn’t come from a place of malice he should be forgiven? His damage overlooked? I cannot believe you #1 believe that shit #2 think that is a valid excuse for trying to keep me quiet! I’m going to leave that statement to hang out there by itself… a noose, just for you and your peers. 

“He is not perfect but to call his character into question on this sort of forum is just purely unprofessional.”  

Are you kidding? Do you even know what professionalism is? Half a handful of midwives in this community understand professionalism and you and your peers, most assuredly, are not one of them. The coffee-klatch Peer Reviews, the back-biting, the sloppy practices, the incestuous “training,”… try and talk to me about professionalism; I could just start with midwives taking their children to prenatals and births and move on from there. 

“The people in our birth community here have too much class to call you out on a blog, but enough is enough.”  

Is that a threat? “Enough is enough”? 

Ah, yes. Class. That’s what the midwives demonstrated when I was unceremoniously kicked out of Peer Review late last year. When I was told to move because the community didn’t want me here anymore. Classy as hell when I was told that I hadn’t done one thing wrong, that, in fact, I was a great midwife, but that my blog demonstrated the “potential” for breaches of confidentiality. And classier still when I was told I was suspect because Dr. Amy had said good things about me. Or when I was told I wasn’t welcome at community events because women were worried they would end up in my blog. (Who perpetuated that myth?!) But, classiest of all when I was told a post I wrote about CPMs needing more education set me apart from the rest of the midwives, that I had, for all intents and purposes, become a traitor to the CPMs… and all that from a post I wrote THREE YEARS AGO! I can only imagine how delighted you midwives are now that I have taken to really speaking out that non-nurse midwives are, for the most part, quite lacking in education and skills training and should have much more of both before becoming CPMs. And yes, myself included. 

See, the thing is, even CPMs interviewed by NARM think CPMs need more education and skills training, so it isn’t like I’m saying anything bizarre or crazy. 

What I find interesting is you and your peers expend so much energy on me and what I say (holding meetings, passing emails, etc.), yet if you spent half as much time on more education or training, there wouldn’t be anything for me to write about! 

(repeating)“… too much class to call you out on a blog….” 

But with an enormous lack of courage to approach me in any civilized, professional and proactive way. This says so very much about non-nurse midwifery and the cliquish and coffee klatch-ish unprofessionalism I do not miss one tiny bit. 

“You have your own reputation to be concerned about.” 

You are right there. I have my own reputation to be concerned about. And I hold my head high with my reputation. I am proud of who I am as a midwife, monitrice and doula. I am proud of who I am as a woman, a writer and a truth-teller. 

You and your peers can try to knock me down, try to kick me, try really, really hard to make me shut up, but I am not going to. This is not a popularity contest. You and your peers think that just because I’m not in your community anymore, I won’t have anything to write about? Oh, how wrong you are. Women still speak to me, tell me their stories that they want told, but are too scared to tell themselves. I hear all about so many of you midwives; your clients still talk to me. 

I will keep talking about midwifery, about education for non-nurse midwives, about the lack of skills training for far too many non-nurse midwifery students and I will keep speaking out for mothers and babies. NO ONE will make me shut up about their lives. 

“I am intentionally signing this anonymously because I will not expose myself and my family to your vindictive nature, which many of us have witnessed firsthand and is clearly displayed here in your blog.” 

Your “anonymous” isn’t so anonymous in this day and age of anyone can find anyone with a few clicks of the keyboard. 

If you really knew what you had to say was the truth, to not be violating confidentiality, to truly be backed up by your peers… to have any validity at all, you would, as I do, stand proud and use your name. 

I find it interesting and pretty darn amusing that sharing facts and telling the truth is seen as vindictive in your mind. Speaks about your nature, now doesn’t it. 

I have not attacked you, your family or your peers. On the other hand, you and your peers have slandered, lied and purposefully attempted to destroy my business, my living, how I pay my bills and care for my family… all the while hiding “anonymously” and quite unprofessionally. 

And if my blog is so distressing to you and your peers, so concerning, why are you and your peers here reading? If I am so atrocious, why are you and your peers validating what I say by just being here? 

Oh, that’s right. Because I have valid and true things to say. Because what I say hits too close to home for your (and the others who would silence me’s) comfort. 

If you and your peers don’t like what I have to say, get lost! 

If, however, you and your peers are interested in the health and well-being of mothers and babies and desire to better non-nurse midwifery and the safety of homebirth, then keep reading because that is exactly what I will continue to write about.

References (6)

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    You actually make it seem so easy with your presentation but I find this topic to be actually something that I think I would never understand. It seems too complicated and very broad for me. I'm looking forward for your next post, I will try to get the hang of it! ...
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Reader Comments (28)

That message screams "You are doing something I don't like and are hitting too close to home, shut up now". It's the typical rhetoric and I am sorry you are the subject of it. Many of us have dealt with that vindictiveness and it really sucks. If you behave how they want you to, you are welcome in their fold. The moment you question or speak out, oh you are in so much trouble. Gotta love the cult-ish aspect of that community!

August 1, 2011 | Unregistered CommenterBambi C

Barb, I find that people are most vicious with those who threaten them most with the truth.

Keep speaking the truth, and we will keep listening.

As a future non-nurse midwife (CM), the issue of training and skills IS important, albeit painful at times. If non-nurse midwives are ever to be seen as on-par with CNMs, we need to continue these discussions, and keep moving toward better qualifications.

Keep up the good work! ((((HUGS)))))

August 1, 2011 | Unregistered CommenterJen B

Wow Barbara. I wish I had something intelligent to say, but I think you said it all. You continue to support me in this distant way in my becoming a nurse midwife. Thank you for that. If what you stand to accomplish is to make a difference, then you can see it accomplished, because you have made a difference to me.

August 1, 2011 | Unregistered CommenterAubrey

Barb, you are truly phenomenal. Thank you for being such an inspiration.

August 1, 2011 | Unregistered CommenterAnonymous

Um. Does this scream 'Trust Birth' and its founder to anyone else but me? *paranoia*

August 1, 2011 | Unregistered CommenterMe

I really appreciate that you've taken the time here to address privacy concerns in the homebirth midwife community. I've seen patient information online more than a few times, and as someone who could be fired (and rightly so) for that behavior, it always makes me wonder where on earth the professionalism is. Shouldn't other midwives make a huge stink if they see Midwife X tweeting about how her current client's labor is progressing? Or if they see a Facebook entry with details about a client's birth?

Part of being a professional is policing your own community; it's in everyone's best interest to do so. I'm really perplexed as to why this aspect has been so lacking in so many midwife communities.

August 1, 2011 | Unregistered Commenterla piranha

Excellent post, wonderful thoughts. Keep up the amazing work Barb.

August 1, 2011 | Unregistered CommenterMidwife{ology}

Barb, as a client, I am so grateful to have you in my life. When I've heard other midwives in the community slander your name, I knew you were the right midwife for me. Why? Never once have I heard you speak negatively about another person in the birthing community. When I brought up things that were said about you, I saw you embrace the words that could have so easily torn you apart. That is professionalism if you ask me. When it comes to clients ending up on your blog, I remember you asking if you could post about me & my issues. Not once did you ever post anything about me that I never consented to.

Keep speaking out and speaking truth Barb. I am proud to call you my midwife.

August 1, 2011 | Unregistered CommenterFelicia

RE: ME

Please explain. I personally see nothing about that comment that relates to the Trust Birth initiative.

August 1, 2011 | Unregistered CommenterKaty

It is terrible when a community is so incestuous and co-dependant that it can’t police itself. If someone can be removed for questioning the group then no one else in the group can question without the real fear of being kicked out nor can the group grow in a positive direction. In business it is more important to be respected than to be in someone’s “favor”. In business it is more important to be professional than to be someone’s friend. In the medical profession it is more important to take care of the patient’s health and safety than patient’s good feelings or the practitioner’s statistics. Business is business and until midwifery is run as such it will always be on the brink of self destruction.

Oh Barb. To be sent such an 'anon' email... she could at least have signed it. & this peer review thing? It sounds like BS to be. Here in the UK we have the Royal College of Midwives who oversee us... & boy do they oversee us!

August 2, 2011 | Unregistered CommenterLiz

Why do I find you so refreshing? Because you do tell the truth about midwifery and birth. Because I do not feel guilty for going to a hospital to have a baby since you encouraged me that I can make my informed choices. It's not like rebelling and civil disobedience when your actions put your life and your baby's life at risk. Standing up for homebirth is great, but standing up for safer birth for women in all places is better. Trying to root out the safest birth in any situation by looking at whatever evidence you can find helps women. I love what you have posted that is good about Dr. Biter, and am sad he was not the Dr. Wonderful he appears to be. Maybe that kind of perfect isn't possible, don't know. But I do know that as a mother who has given birth, I want to make an informed choice. If I trust a birth provider/medical person, then I trust them wholeheartedly. I would want to know their practices with my bladder in surgery just as much as their practices in birth. Thank you for sharing openly.


I am different than you in many ways Barb, and you know what I mean...but I would not be afraid to have you attend my birth from what I have seen. You are open, you are raw about your own skills. And I would rather have someone with me who really is going to give it to me straight when I am in labor and transfer me than have someone put me at risk and stay home longer just to wait it out. You see, depression after birth that is provider caused comes from broken trust. If I have a bad birth experience, but a provider that tried everything for me and advocated for the safest birth (physically, mentally, emotionally), then I would have only reactions to the negative in lack of control of the event, but not in my provider's actions against me. If the worst happens, even with some provider error (because no one is perfect), things can be dealt with if the provider is honest, open, and is truly trying for the best for the client/patient/etc. It's about knowing the mom, knowing birth processes, and knowing the limitations.

Thank you for trying to share a balanced picture of birth. In the future, you may find you've changed your mind about even more. That is not bad, that is education.

August 2, 2011 | Unregistered CommenterDawn

Barb, I just wanted to thank you for your commitment to truth and integrity. As someone who has lost a child to an inexperienced staff member putting ideology over good medicine (within a natural childbirth focused hospital-based team), I have seen the backlash when one speaks up.

However I have also seen the professional mechanisms within the hospital address the issue and professional consequences be dealt out. There will always be medical error, issues around training and continuing education, and judgment calls to be made. And I have gone on to have two children elsewhere where the team was amazing (and respectful).

The difference between a healthy birth team and an unhealthy birth team is how these realities are managed and mitigated. When people spend their energy attacking those who question and who advocate for good OUTCOMES, not only experiences, that is where I know it is not a healthy team.

Best to you.

August 2, 2011 | Unregistered CommenterJennG

Hi Barb,
I'm a new reader in the last few months, and although I've never commented before, I love your blog! I'm a doula and much of what you say resonates with me. I am so sorry you are dealing with this in your community, and appreciate your willingness to keep blogging about these vital issues despite these naysayers. And to be honest, I have so little respect for anonymous commenters... if you are putting your whole self out there, it is only fair that they do so as well!
Rachel Strietzel
Chicago, IL

August 2, 2011 | Unregistered CommenterRachel

Love you, Barb.

August 2, 2011 | Unregistered CommenterLili

Interestingly, until this post, I had no idea that the midwife community in San Diego treats you as a pariah. I'm guessing this is because you are ACTUALLY professional and when you talk about what needs to change, you talk about the midwifery community at large rather than specific individuals. I could not name a single other midwife in the San Diego area, which should say something more about your professionalism, because your blog is the only contact I have with the community in San Diego.

I really respect your words and thoughts on the (lack of) education among the HB midwife community (and on other aspects of midwifery/birth/women's rights). I am sorry that this pack of back-biters and coffee-klatchers had so much to do with you leaving the homebirth midwifery community, but I expect you are going to have a fabulous practice as a monitrice and doula, because your integrity, education, and true care for the safety and comfort for women and babies during birth shine through in your words. If I lived in San Diego, I would absolutely choose you as my birth attendant when I have children.

Keep up the great work here and elsewhere, Barb!

August 2, 2011 | Unregistered CommenterCorey

Barb,
I wanted to leave a response here to let you know how much I appreciate you and your writing and your ability to share your truths with us all so that we may learn with you. Being a client of yours I can say that you are an amazing midwife. Your blog is one of the reasons I chose you as a midwife also. I read everything you had posted. If we cannot share information and take an honest truthful look at what we are facing when it comes to giving birth in this day and age then how ever do we grow. The thing about life is, that life is always changing. You learn from your life experiences and you learn from others life experiences. This dialogue and introspection enables us to improve on whats good and let go of what is not so good. You continue to hold your head up high and speak your truth. We will continue to read what you have to say as your words and thoughts are a beautiful gift. Thank you for choosing to share them!

August 2, 2011 | Unregistered CommenterElizabeth Stevens

I'm respondeing only because it seems you think you have a clear idea of who sent the orginal email. I want to be clear that first, I don't live in Encinitas, although I was there the other day. Second, I am not a midwife and have never attended this "peer review" you are refering to. The information I am refering to has come directly from the mouths of some of your former clients who have gone on to use others for their next births and shared thier stories.

You are right, its all a conspiracy.

August 2, 2011 | Unregistered Commenter"anonymous"

"anonymous": Yes, clients have gone on to other midwives. I'm sure they *do* have their reasons, but I'll be damned if any of them have talked to me about it.

I *highly* doubt you're the same person. You don't write the same, your spelling sucks and the lilt is different.

But, go ahead and pose... doesn't bug me at all. And still, STILL hiding behind "anonymous." Sheesh.

August 2, 2011 | Registered CommenterNavelgazing Midwife

You tell 'em, sista! Unfortunately, to tell the truth is to step on toes.

August 2, 2011 | Unregistered CommenterSamantha

I read your blog from afar. Wasn't aware of all the tension in the midwifery community where you live. (Am not very familiar with the American model of midwifery.) Just wanted to tell you that the notion of a monitrice-doula, with midwifery skills but connected to the hospital and willing to work with OBs, is brilliant. This is exactly what I would have needed when I was pregnant (midwifes are regulated where I live and I was considered too high risk for them to accept me, and besides, I did need medical help, if not medical bullying), and couldn't find. I'm sure I'm not the only one to feel that way. The gap you are filling is huge and your insight is admirable. You're giving me hope.

Oh my! it hurts me to see this going on between "sister" midwives....so sad this is happening when what we all should be able to do is support each other. Barbara i follow your blog, i read every time i can i am licensed here in miami florida and i DO feel CPM's including myself need more learning /practice...more information...i agree with you... u need to keep speaking for US who follow you plz do not stop. much luv

August 3, 2011 | Unregistered Commentereunice

It must feel like you're boxing at shadows trying to argue against innuendo and snide remarks. That's crazy!! If someone has something to say with regards to care and professionalism just spit it out and address it and everyone can move on. This type of shady accusation is pointless and undermining. And unprofessional and so very very high school. It's bullying and shame on any trained and professional midwife that stoops to this level.

August 4, 2011 | Unregistered CommenterKaren

way to go Barb. Love your blog and FB site!!
Deb O'Connell CNM, CPM, MS

August 4, 2011 | Unregistered CommenterDeb O'Connell

I've thought about that word "Conspiracy" a lot, "anonymous," over the last couple of days.

Definition: "A secret plan to do something unlawful or harmful."

It's not a conspiracy if I know about it... been TOLD about it... been asked to be a PART of the plan.

So no. Not a conspiracy at all. A strategy, yes. Conspiracy? Not at all.

August 4, 2011 | Registered CommenterNavelgazing Midwife

Barb, I love your blog, and have been a reader ever since I googled "birth plan" and was brought to your PERFECT birth plan for modern hospitals, which helped me push the issue with my husband about having our 3rd baby at home, and subsequently helped me write my own birth plan for that same baby when at 42 weeks I was risked out of a homebirth and needed a good birth plan for my induction. I remember thinking that you transitioning to a mortice/doula was such an honorable thing because there are so many of us who can't (for many many reasons) give birth at home and NEED someone with the training, expertise, knowledge and compassion that I see dripping from every blog post.

I find it very very VERY sad however, that this decision was made because a midwife trying to provide quality care for her clients was shunned in her own community and therefore unable to provide that care (without a backup, you cannot provide the same quality care you can with one) and yet you are still working towards bettering the midwifery care in the US. bravo, Barb, Bravo! You are an inspiration and I am eternally grateful for your blog and for you! I am myself an aspiring midwife, but until I can have access to the training I need (I live in a town with ZERO midwifes, not even CNMs, and with 3 small children would need to go the self study/apprentice route and with ZERO midwifes that becomes difficult to actually acquire the training I need), I will be training to become a doula so that I can at least help the women giving birth in the hospitals have the knowledge, information and support they need to have a beautiful birth experience. Again thank you for all you do, and SCREW YOU San Diego midwives for being catty and unprofessional!

August 11, 2011 | Unregistered CommenterBrittney

I don't agree with all of your view points, but I just wanted to applaud you for standing up for higher standards and more education for non-CNMs. For a group of people (CPMs) that supposedly have the interests of the women they take care of at the forefront, being so accepting of a lack of knowledge and accountability among their peers is frightening. Keep up the good work and thanks for fighting for mothers, babies, and families.

August 24, 2011 | Unregistered CommenterStephanie

Good for you, Barb!

xo

September 17, 2011 | Unregistered CommenterJen C.

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