CPMs, Don't Read This!
Sunday, July 22, 2012 at 06:39AM You don’t have to read this because you’re not going to respond anyway, right? You’re not going to give me the time of day, not going to acknowledge that you even read my blog anymore, right? Well, now that I have your attention.
Your silent treatment tactics are not going to work. I will not be quiet about what I know about our “profession.” I will keep enlightening people as to the inner goings on and the mindset of the majority of CPMs/DEMs. And your thinking you can freeze me out with dis-information is incorrect; there are puhLENTY of apprentices and a few CPMs who quietly validate and verify where you’re coming from and going to. I speak the truth and that scares the shit out of you.
So, you can stay silent, but I will not. I have begun a letter-writing campaign to the legislators who have signed on to support the bills that would legalize CPMs in each of the states. I am letting them know there is another side to the story they’re being sold. I am not alone in my campaign.
Until you are able to have a healthy discourse about your behaviors and beliefs, the profession of CPMs will stay stuck in this un-professional, coffee-klatch, secret society style of presenting itself. Buck up and take some responsibility for your beliefs and actions. Only then will we really them be professional.
Navelgazing Midwife
It's a few days later and I realize I wrote this rather snarkily and the message might have gotten lost in that attitude.
I really want there to be dialogue, not silence, between those that believe CPMs need more rigidity and those that do not. That is the take away message.
Sorry if I wrote out of my frustration instead of my logical, more professional brain. I apologize.
Reader Comments (17)
The silence may be reckoning, Barb.
How many hours or days or years of silence and introspection did it take for you to come around?
We can hope that this is what it is. Reckoning.
Maybe this dialog has been written off as hateful internet blather - but I don't think so. And these issues will keep resurfacing as long as midwives refuse to come to their own reckoning about the current state of "professional" OOH midwifery.
Maybe I'm naively optimistic - but I'm choosing to see the silence as reckoning. The time has come.
Oooo, I hope so!
I've been looking for YEARS for a midwife that feels the same as I do about the politics of CPMs. I catch babies for families that cannot afford their outrageous fees and when they ask why mine are reasonable and real I explain that I am not running a yellow page ad and not am I driving a NEW Lexus or Prius.
If you stand up to them--they will slam down your practice with gossip and lies. So, be very careful if you need to make an income.
I left homebirth midwifery about 2 years ago.
http://navelgazingmidwife.squarespace.com/navelgazing-midwife-blog/2011/8/1/why-i-left-homebirth-midwifery.html
They can't do anything to my business. It's the ONLY way I can speak out.
What states are you writing to? I'm not in the medical field but would write as a citizen if South Carolina is one of them.
The states that have legislation pending.
I doubt there are many legislators in any state who have an informed and intelligent idea of what midwifery really is all about. And, unfortunately, since most are men, I doubt that many really care. It is very sad, really.
I read a post on a popular natural parenting website yesterday, it was a woman identifying as a CPM, practising in my area, who was looking for a birth assistant. Her post said, "I cannot sign off on hours because I haven't gotten my 50 births yet." My blood ran absolutely cold...I thought to myself, "Really? Can you run a "midwifery" practice without having been to 50 births? Is this really happening in our world? How can that be good for women?
Can the non-listening CPMs who won't speak to Barb (ha) tell me what the hell that is all about?
@Corita, in Florida, a CPM/DEM can only be a preceptor once they have been to a certain amount of births AFTER being licensed, which would be "signing off", but they are required to do more births than that to get the license in the first place.
I do hope Maryland is on your list. The CPM bill didn't make it far last session, but they are preparing now to re-introduce.
Lisa: Get me the contact information and exactly what the Bill is going to be asking for and I'll consider whether it is something I can support or not. Thanks for bringing it to my attention.
Barb, I guess this is a good time to say thank you for telling your truth for so many reasons...as a person, as a professional and as a member of a community of parents having babies. As someone who has experienced first-hand how cruel nature can be and how much a part of nature death is, I am particularly drawn to your writing about risk-taking and lack of professional care.
But even if that were not the case I recognize that you are willing to share your actual struggles in public even when it risks your livelihood and when it separates you from what was your community of peers. There is no real way to thank someone for that, and in my experience the impulse comes from a place that isn't about thanks and praise anyway. But I definitely am one of your internet witnesses.
I am deeply saddened if the NBC indeed is engaging in any kind of boycott. People who have been internal to our communities and then engage critically can be the most important heralds of whether philosophy and inquiry is turning into dogma and disdain.
I was writing elsewhere about a birth-related topic today and it occurred to me that one of the stories midwives like to relate is the one around Semmelweis and doctors not washing their hands, going from cadaver to labouring woman. I'm not sure I agree with the 'pop culture' version of this story, which I first read in a feminist text a long time ago, but if we take it as a cautionary tale in not listening to the outsider physician questioning current practices...I think CPMs have some thinking to do.
It seems to me that they may be the modern equivalent of those doctors, maintaining that the status quo in the current educational requirements and the culture of uncritical support of all midwives, even those who practice out of scope, in the name of midwifery is unrelated to what in some areas, like Colorado, appear to be rising rates of perinatal loss.
Why (or) are you opposed to all the legislation? Isn't certification and requiring midwives to be registered a step in the right direction? Is it a blanket opposition or are you looking at the states, state by state? I'm only familiar with the states around me, to be honest.
I know there are other issues, but there are midwives against regulation that want to practice w/o certification, and there are midwives who would rather not need certification legislation but recognize that certification and regulation are a step they should take for their clients sake. And there are others (maybe I'm lucky to know this type) that are working with consumers to get legislation that will legitimize midwifery and hold midwives accountable, and allow consumers to have a 'standard' of care and professional requirements that they should know and expect. I see that as a win-win and in our state and know the midwives have had to concede to a lot of stuff they probably didn't really want to have.
I agree with you, I DON'T understand the midwives fighting against efforts to legitimize midwifery because it will 'limit them'. I do think that homebirth midwives need to have a certain standard of experience etc.. I'm talking about states where midwifery is legal, but CPM's and DEM's exist-- and consumers often think all midwives are the same. The legislation will prevent anyone from calling themselves a midwife. There will be oversight, certification and standards.
I could also see that you may be against all legislation because you want the standards to be much higher- more like a certified nurse midwife? I guess I can see that too, but in the state where home birth midwifery is legal, what I see you are suggesting is that what you want would possibly make homebirth illegal instead of having legislation? To me that seems like the worst option of all.
Are there any efforts out there by the CPM's that you support, are they all so similar that you disagree with all of them? I'm curious, I thought some of the efforts pushing for legislature were doing a decent job of doing the right thing, putting safety measures in place (safety for consumers), review boards, consumer protection etc.. And would lead to good things... possible insurance reimbursement, better collaboration with drs/hospitals, and more transparency for consumers.
In any case, I'd almost rather not name names because I'd really like to see this legislation passed. I know there are a few midwifes that are silently hoping it is not passed again- because things will be easier for them and they won't be regulated at all- but I see regulation as a protection for consumers. (I hate the term consumer, client--- the mothers, children, families)
Just trying to get a handle on the strongly worded post...
Jess
You are a very brave, honorable person.
Jessica, you bring up great points. The legislators I initially wrote to were with regards to HR 1054, Access to Certified Professional Midwives Act of 2011, a piece of legislation that asks that Medicaid be required to pay all CPMs around the country. I have big issues with that because 1) Many/Most CPMs have no malpractice insurance 2) Many/Most CPMs have no OB supervision or collaboration 3) Many/Most CPMs have serious issues with hospital transfers around the country and that needs to be addressed before insurance reimbursement 4) Many Medicaid clients are higher risk and until CPMs clarify and stick to the definition of low-risk, I am unsure about the trust level that they will a) risk out higher-risk women b) be able to recognize problems/situations that require risking out to an OB.
I do not have an issue with legislation, per se... for goodness sake, I'm legal because of legislation in my state! (CA) Therefore, as women around the country are asking me to write to legislators about the various bills, I'm reading about them and making a case-by-case basis as to whether I back it or not.
What one challenge is is that it seems the legislators don't do a lot of discussing outside their Districts, so I'm sending letters. Not sure if that's going to make a blip of a difference, but at least I will have said something instead of nothing.
Thanks for asking me to clarify. It was important to.
I am curious as to what your side of the CPM story is. Are you going to share the letter you are writing?
guest: Not sure what you mean about my side of the CPM story. I've written extensively why I've left homebirth midwifery (the title of the post, as a matter of fact) and what issues I have with the CPM credential.
I'm glad to share the letter I wrote:
Dear <Congressperson>,
I see that you recently added your name to the H.R. 1054, the Access to Certified Professional Midwives Act of 2011. I am a Certified Professional and Licensed Midwife in California, a state where non-nurse midwifery is legal and I want to speak to you as a member of my profession.
I recently left home birth midwifery after realizing just how un-professional CPMs/LMs are when it comes to healthcare. While there are a few who hold the standards required to keep women and babies safe, sadly, I feel the majority do not. Many CPMs/LMs do not adhere to the requirements of home birth midwives to keep their clients in the low-risk status, instead accepting and continuing care with high-risk women, including those pregnant with breeches and twins. If one were to believe the research, it specifically states that women be low-risk in order to have a safe birth.
Here in California, our law requires us to have obstetric supervision, yet no doctor in the state will put their name behind a CPM/LM because of the lack of education and skills training non-nurse midwives have. CPMs’ methods of learning have been called into question across the United States since there is little standardization and even less oversight for the midwives. Also, very few CPMs/LMs carry malpractice insurance, something that should be a requirement.
I encourage you, <Congressperson>, to reconsider adding your name to the H.R. 1054 because there are too many holes in the professionalism of CPMs, it being quite unfair to ask that the people pay for Medicaid to pay CPMs when they do not even have malpractice insurance or physician supervision/collaboration.
If you have further questions, do not hesitate to contact me.
Barbara E. Herrera
San Diego, CA