CPMs, Don't Read This!

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.

Update on Monday, July 23, 2012 at 10:34AM by 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.

Succinct Reasons CPMs/DEMs Need to Get Their Act Together

Before I begin, I feel it's really important to say I am not anti-midwife, not even anti-CPM. I am against the way things are at the moment and am for increasing the standards for all CPMs/DEMs and believe it will only help home birth in the United States. I felt I needed to clarify before you started this post.

Sara Larane Savel, answering a thread about Michigan’s introduction of Senate Bill 1208 which would, among other things,  limit midwives to those that are Registered Nurses first, not permit breech births or other complicated cases out of hospital and require them to carry malpractice insurance, created this piece she calls “Midwives: Bringing it On Themselves.” I rarely quote entire posts, but this was so spot on, I can’t help but write it all out for you here. I’m going to interject between her points. She says:

“As a Michigan tax payer, I support strict regulation of homebirth midwives if they are to receive Medicaid reimbursement and be covered by insurance. The truth of the matter is that the midwifery movement has brought this situation on themselves.

Sara was once an avid home birth advocate, in her words, “Before I got pregnant and had a baby, I was convinced that I was going to have an all natural midwife assisted birth. I knew lots of women who successfully homebirthed with lay midwives, and was close to a retired DEM. I knew all the catchphrases about birth being a normal event, about doctors being cut happy, and rambled on about the Dutch ad nauseum.” Like me, she became disillusioned by the Natural Birth Community (NBC) and has chosen to speak out about her discoveries. Her list of reasons CPMs/DEMs are in such negative light right now includes:

1. Not transferring high risk clients to obstetrical care.

This happens all the time and is something I’ve done (not done) myself. I attended a twin home birth and the births of women with very large babies. It took a really out-of-range woman to get herself risked out. I’ve watched as midwives have taken and kept high risk women over and over again.

     2.   Describing many high risk conditions as "variations of normal" in order to promote an agenda that all birth is "as safe as life gets" regardless of the medical needs of individual mothers and babies.

Exactly. Saying that breeches and twins are “variations of normal” is absurd. Breeches and twins come with unique sets of complications that are anything but “normal.”

    3.   Refusing to set concrete and consistent educational standards for classroom and clinical training.

This has to be one of the most confounding parts of CPMs… why they can’t come up with standardized education requirements is baffling.

     4.   Refusing to require hands on clinical training in emergency births.

While there is some hands-on training, there isn’t nearly enough. I believe there should be some rehearsing at each monthly Peer Review or more frequently if your Peer Reviews are further apart. I believe different groups of midwives and students should work with each other in these scenarios so each woman gets an idea of how the other person works during an emergency because we never know who we might end up with at a birth. However, the midwives/apprentices that work together the most should practice so much each knows the others’ body memories and actions without thinking. I believe these scenarios should include shoulder dystocias, surprise breeches and twins (including calling 911!), postpartum hemorrhage, neonatal resuscitation, the umbilical cord falling off, a partial release of the placenta, placental fragments still inside the mom, mom freaking out, TTN, fetal distress, hypoglycemia in the newborn, calling EMS and role playing that scenario as well as giving report to EMS and RNs and OBs at the hospital. (I’m sure there are more I’m missing. But the Big Three [PPH, NR and shoulder dystocia] are often the only ones addressed. That has to end.) I believe the more experienced midwives should lead the charge to educate the less-experienced women and insist on these scenarios any time midwives, apprentices and students are in a group together, even if it is a social setting. Spend 20-30 minutes before or after a gathering to practice some scenario. In my experience and in talking to midwives, students and apprentices around the country, this aspect of midwifery care is sorely lacking.

     5.   Fighting every attempt to hold midwives accountable.

This is confounding! When a midwife does something wrong, for goodness sake, instead of holding a rally for her, hold her accountable via Peer Review and legally if necessary. What is with supporting all midwives merely because “there but for the grace of god go I”? It’s ridiculous and extremely unfair to the women who lose their babies or have their child damaged by an inept midwife… even if it was an accident. Sure, accidents happen, but we hold OBs accountable for accidents. Why aren’t we doing the same for midwives?

     6.   Fighting every attempt to regulate midwives.

Another confounding aspect of CPMs, insisting that all midwives receive the same education and skills training via the same mechanisms. It does suck there aren’t schools around the US for women to attend in person, but at least the ones that are out there could be similar in their classes and information imparted. That CPMs are permitted to take classes via mail from a variety of schools is just weird. At the least, they could all be MEAC-accredited schools, even though MEAC isn’t the be all and end all for the education of midwives in America.

     7.   Unconditional support for midwives under investigation or on trial when a baby dies. Creating a culture of animosity against mothers who speak out against dangerous midwives.

Mentioned above. And it is just awful mothers who’ve lost babies in home births are made to feel like crap for speaking out. We expect and encourage women to speak out about their hospital births… usually in the negative to validate the home birth culture… but any time a mom speaks negatively about home births, she is suspect and considered a troll or one of Dr. Amy’s minions. That has got to stop! Women who’ve suffered through their home birth experiences have every right to speak up just like women who’ve suffered hospital birth experiences. We would never consider silencing a woman telling her hospital trauma story. Why do we do that with our troubled/pained home birth mamas? It’s simply not fair.

     8.   Not speaking out against dangerous midwives. There is an intrinsic code of silence in the midwifery community. Even when they think a midwife is at fault, they will stand in solidarity with her because they mistakenly believe that prosecuting dangerous killer midwives in some kind of medieval persecution. The concept of midwifery is more important than ethics, safety, integrity, or human beings.

Again, mentioned above and agree 100%. I do think a large part is the “there but for the grace of god go I” mentality, but midwifery is still seen as a calling and with that brings an entire (often unspoken) spiritual aspect to the profession and it seems like heresy to speak out against the women who are a part of the group. It is disgusting to me how dangerous midwives are spoken about in behind closed doors yet are allowed to continue their path of destruction with women and babies. What about the protection of our clients? Don’t they deserve to know who is and isn’t operating within the standards of care and who flagrantly flaunts the boundaries of safety? Isn’t there a space between lying and slander? I believe there has to be.

     9.   Double standards:

These are brilliant.

-         Saying that birth is as safe as life gets, and then switching to the statement that birth is inherently risky when something goes wrong.

-         Blaming mothers for not doing "research" or "trusting birth" when a midwife fails to do her job.

-         Using scare tactics to keep women from going to the hospital or seeking obstetrical care, then blaming the mother for not transferring when something goes wrong.

-         Telling women that "babies die in hospitals too" when it is actually a midwife error that caused a homebirth loss, and had the mother been in the hospital the death would likely have been prevented because of the availability of technology.

-         Wanting to be considered "professional" birth attendants, yet refusing to hold to consistent standards of education, scope of practice, oversight, regulation, and ethics.

-         Wanting to receive Medicaid and insurance reimbursements but refusing to hold liability insurance.

-         Saying they are not health care providers and do not practice medicine, yet want Medicaid reimbursement.

-         Claiming to support women yet abandoning them if they speak out against dangerous midwives.”

I couldn’t have said this better myself.

Sometimes things we write take on a life of their own. Sara told me she scribbled these words down in a 15 minute break while her three-year old was watching Bob the Builder. Inspired, Sara… absolutely inspired. I wish I’d have said these words myself. Thank you for allowing me to share them here.

Reigning in the Renegades

This is a comment in the “Guest Post: From an Ex-(CPM)Apprentice” post but it needed to have its own light. This is the third such comment about risk in home birth. She writes:

“’From another ex-apprentice: “I too quit because of that question just WHEN does someone get risked out?”’"

 "’If not for HIPAA, I would list the scenarios I witnessed ...’"

“I had to read these words a couple of times to assure myself that they were not mine. I have felt/thought these exact same things. And yes, the lack of risking out criteria is the reason I left my apprenticeship. The home birth community is small, and describing some of the high-risk cases that I've witnessed handled at home would reveal too much - and perhaps the identity of the client(s).

“Student CPM for Safety in Birth:

“The experience you are describing is what I had hoped for when I started on my path to become a CPM. I was also enrolled in a MEAC accredited program. Unfortunately I cannot give MEAC accredited education a resounding commendation, nor can I give one for the apprenticeship model.

“I learned wonderful, incredible things in my apprenticeship. I witnessed low-risk, attentive, appropriately managed home births. I learned some facets of midwifery care that I do not believe I would have learned in another setting with a different type of provider. BUT - there were some GLARING black holes: in risk management, in skills, in theory, in practice - that I could not ignore anymore - and I could not fill these black holes on my own. I also felt that parents and babies and families were being put at risk - and I didn't want to participate in that charade any longer.

“I know there are midwives practicing with appropriate protocols and standards, who have been trained in evidence-based practice - it's just that the CPM credential does not guarantee that. (This took me a long time to learn and accept - as I was pursuing this credential). And I haven't seen even an INKLING that NARM or NACPM or MANA or MEAC whoever is working on this.

“I would like to see the vision of Student CPM for Safety in Birth to come true. I would. CPMs - organizationally - need to take a good, hard, look at their practices and standards. But unfortunately, I don't see that happening.

“I'm glad that the public - and home birth parents - are coming forward. I'm glad this discussion is happening. It should have been happening years ago.

“Thank you NGM for providing this forum.”

Just before this comment came through, I got an email from a frustrated CPM who had some thoughts I’d also like to share. It seems she’s darn tootin’ tired of being lumped in with all CPMs, especially the ones that don’t adhere to accepting (and keeping) only low-risk women. She’s seen as a “medwife” whose standards are too stringent, yet all she’s really doing is operating within the boundaries of the laws in her state.

What is so wrong with having parameters? It’s what keeps women and babies safe. They weren’t created to annoy midwives or clients, but to make sure the woman and baby make it through birth safe and alive. Her (and my) wish is that these out-of-bounds, renegade midwives would get with the program and stay within the standards of care of low-risk clients. Mothers and babies would be safer and midwives would not be so reviled if they obeyed the rules.

Midwives are known for operating on the periphery of society, it’s a part of the natural birth culture. But, it’s time to strengthen the rules and (in my opinion) force midwives, through peer pressure that starts from the moment the student decides to be a midwife, to follow the rules.

It isn’t a bad thing to follow protocols! Our job is to help women and babies have great, safe, births, even if they have to happen in the hospital. We have got to stop apologizing for transferring and transporting women. It is a normal part of the possibility in a homebirth.

As always, the clients’ desires come into this discussion.

“But, what if the woman wants to have her twins/breech/VBAmC/etc. baby at home? Don’t I have a responsibility to serve her?”

The answer is no. If the woman is low-risk, perhaps yes. If she is high-risk, no. You have a responsibility to serve her correctly, within the normal and safe boundaries of birth. The line must be drawn somewhere and it must be drawn further back than it is at this point. Midwives all have boundaries they won’t cross, whether it’s a preeclamptic woman or a woman with triplets, there are lines they won’t cross. (Except for a couple of high profile midwives around the world.) Bringing the limitations inward can do nothing but keep women and babies safer as well as (not that this is the most important aspect, but it’s important nevertheless) helping our publicity problems. If a homebirth midwife was seen as careful and adherent to the low-risk status of women… what the studies watch for when they report on such things… then we can begin to save not only lives, but our own faces.

I think this new way of thinking would be hardest on the older (not age) midwives who’ve, through time and experience, had an edge over the newer women, both with skills and arrogance. They’ve never seen anything tragic happen, so nothing they’re doing could be wrong. When, in reality, it’s probably only a matter of time before something does… if they stay on the same track they’ve been on. And because it’s the older midwives who are the mentors, they’re teaching the younger, less seasoned women, things the newer midwives simply don’t have the skills or experience to understand yet. So much of home birth midwifery takes time to learn.

So what of the women who would be left out of home birth care if midwives tightened the parameters? I believe there would be a period of adjustment, a rash of women threatening to UC and women trying to strong-arm midwives into attending them. But, I think after the women in our country saw we were serious, they would deal with it, hire the midwife as a monitrice (who also stuck to her guns about no “surprise” home deliveries) or doula and had as decent a hospital birth as possible. I can see clearly the emotional blackmail that would ensue and it would be crucial for midwives to withstand the coercion.

Of course, in my perfect world I would also make hospitals welcoming, respectful, open to vaginal births after cesareans, vaginal twins and breeches when safe enough and having immediately lower cesarean rates so women wouldn’t be terrified to go into the hospital. I also think that many women are unnecessarily scared by hospital deliveries and midwives can have a hand in un-brainwashing that belief, too. Of course, they have to believe it first and that might be the biggest challenge of all.

Lastly, I want to see midwives who adhere to standards rewarded, not vilified. It shouldn’t be this way, but they are the brave ones in the bunch, the “renegades” of those that refuse to conform. Just because the majority are out-of-bounds doesn’t make them right. (And, in my experience, it is the majority that do not adhere to the strict low-risk standards.)

I was one of those midwives who took almost any client that asked and it’s a miracle a couple of those mothers or babies aren’t dead. I’ve witnessed midwives taking high-risk clients and again, it’s a miracle those women and babies are still here. I’m tired of seeing my “sisters” flaunt the low-risk standards we all know are the right things to do. For crying in a bucket, let’s do them.

Guest Post: Licensing Midwives

My dear friend Colleen Scarlett, LM, CPM in Miami, FL wrote a comment to my "Dandy Commentary Continued" post, but it's so fantastic, I needed to make it a blog post itself. Here, she says exactly what I wish I could say. Whatever she says below, hear me saying, "Me, too!"... because I am.

"I'm trying to understand the logic behind not licensing midwives. What I hear, when you get past the rhetoric, doesn't make sense to me.

When I hear "Licensing limits who we can take care of!" I hear, "I want to be able to take on high-risk cases!" Because, having a license has allowed me to take care of any woman who CAN be expected to safely birth at home, including women on Medicaid and with insurance. While yes, women expecting twins, breeches, and who have hypertension or diabetes cannot be taken care of at home, SHOULD we actually be doing that? And, aren't low income women especially deserving of midwifery care? Do they KNOW what low income women go through seeking out a provider? Or how they're treated like cattle once in the obstetric system? Or does freedom of choice only apply to the middle- and up class? There's a reason why the vast majority of women having home births are white, middle class, and college educated.

When I hear, "Licensing midwives doesn't honor the traditional paths into midwifery!" I hear, "I can't be bothered with devoting time, money and effort into midwifery school,.....I want to start as soon and as cheaply as possible!" The fact that someone can "self-study", catch a few babies, sit a ridiculously easy exam, and call herself a midwife makes me cringe. The fact that a midwife can start practicing and not know how to start an IV or suture makes me want to scream.

When I hear "It's the woman's responsibilty to make the right choices for herself and family!' I want to scratch my eyes out. Yes, she IS responsible, but SO. ARE. WE. We are ultimately responsible, for her health and safety, and for her baby's. We need to be able to provide her with good, safe care. We need to be able to work with the system, not against it. We can kick and scream about how horrible the obstetric system is til we're blue in the face, but it sure is nice to know they're a few miles down the road when the shit hits the fan.

I LIKE being licensed. I LIKE being able to have take Medicaid and insurance, because more women can choose a home birth without denying herself and her family, or stressing about paying their bills AND me.

I like being able to have a lab account, and a nifty lockbox on my office door, and I like being able to run labs and cultures in my office or at a clients home, and not having to send her to a clinic or doctor.

I like being able to call a back up OB and know a prescription is being faxed over to the client's pharmacy of choice.

I like being able to order, and adminster, IV antibiotics for GBS+ women, and not having to pretend GBS is no big deal because I don't know how to give an IV or because it's illegal for me to have them.

I love the fact that I can carry pitocin, and methergine, and O2, and sutures and Xylocaine. I love that I don't have to pretend herbs are just as effective in stopping a hemmorhage, or that seaweed is an acceptable alternative to suturing.

I like being able to walk into a hospital with a client in labour, with her chart in my hand, and I like being able to give report without fear of prosecution. I like the fact that in the rare instances of emergency transport, I don't have to make up a story for the EMTs, or clean up the evidence before hiding in a closet before they arrive. I like being able to ride in the ambulance with her, and monitor heart tones. And honestly, the EMT's would rather have some one that knows how to take care of a labouring woman, because Lord knows, they don't know jack about catching babies, and would seriously rather not have to contemplate that during a transport.

I like not having to wait, agonizingly, until she's a train wreck before I make the decision to transport.

Maybe those who try to convince everyone to "trust birth" are trying to deflect the attention away from what DEM's are lacking.......education, skills, legality, access to medications.......perhaps those who try to convince others that midwifery without collaboration with the obstetric system is more "authentic" or "traditional", to make up for the fact that they have no access to it? Some sort of delusion that all you need for a safe birth is enough trust, and if something goes wrong, it's actually the WOMAN'S fault, for not trusting, for having fear, for not speaking up, for not listening to her instincts.

I know when I first started my midwifery education, I was enamored with the concept of the "Traditional Midwife", the Mountain Granny with her herb garden, teas, tinctures amd poultices, her gnarled hands with years of oral tradition and apprenticeship under her ample apron, her basket of knitting by her rocking chair while she patiently waited for the baby to come. But then I grew up.

Our amazing tradition of midwives, our Martha Ballards, our Anne Hutchinsons, Miss Mary Coleys and our Gladys Miltons, our Ina May Gaskins, have given us centuries of knowledge and skills, our philosophy that birth is natural, woman and family centered, and that skilled hands can save lives. But none of these great women EVER balked at the idea that more education, training, and skills were a good thing. And the beauty of learning from our past is that we can intergrate, learn, and apply our knowledge. That we can continue to learn, and grow, and provide increasingly better care to our women and babies.

I can't imagine that traditional midwives, all over the world, would NOT want to have access to hospitals, doctors, medicines, clean instruments, IVs, and the support of their governments health care system.......we have become so distant from the reality of childbirth, how many of us actually KNOW (not know OF, actually KNOW) a woman or baby who died, from a preventable cause, during or right after birth? How many of us go into our pregnancies filled with dread that we may not make it? We take it for granted that we, and our babies, are going to be just fine BECAUSE we have, maybe too much, access to modern medicine.

In the blog post ("Why state licensure is not the answer for midwifery"), an article ("Her Home-Birth Battle") is linked about a Massachussetts baby who died from GBS sepsis. I can't help but wonder, if the midwife was licensed and regulated, would she have screened the mother for GBS according to Mass. Department of Health and ACOG guidelines? Would she have had a back up OB, because the mother was a VBAC? Would she have sent her in for biophysical profiles and non-stress tests every 2-3 days when the pregnancy went post-dates? Would she have administered prophylactic antibiotics when the mothers membranes ruptured 3 days before labour started? Would she have been required by her laws and rules to transfer this mothers care to her back up OB when she began to show signs of infection? If she had, most likely this woman's baby would have been born alive.

I keep hearing, "Licensing does not make better midwives!" and it's true. I know some LMs who lack skills and judgement. And while I don't think licensing per se is going to make a better midwife, I think across the board, standardized education that meets, not just the minimum, but NECESSARY skills. Unfortunately, for the less than motivated, that means going to 20 births and reading some books is not going to cut it.

I love the profession of midwifery, I love our tradition, our philosophy, our dedication....I would really like to see us around for a long, long time."

Goddess, I love you, Colleen. Thank you for speaking my mind. You're the best!

Dandy Commentary Continued

Continuing with what Birth a Miracle Services said in the post “Why state licensure is not the answer for midwifery,” the owners, Naomi Kilbreth and Haley Grant say: 

“A key componant (sic) of home birth is the mother taking responsibility for her birth. That means going to the hospital if she feels something is wrong, maintaining a healthy lifestyle, and being careful about which midwife she hires (ie. one that is well trained and experienced).” 

It is the woman’s responsibility to take care of herself and to hire the appropriate care provider, that’s certainly true. But once the provider is hired, the woman is depending on the provider, in this case, a midwife, to be her advisor, not her friend. 

Midwives do tend to be friendlier than many other providers. I stand first in line, guilty of this provider-as-friend attitude, both being one and applauding them. As time has passed, though, and through my own and others’ experiences, I see that a friendly provider isn’t nearly as important as a skilled one. I’m even guilty of encouraging women to choose a provider based on personality. 

“Most of us have very similar training, so I encourage you to picture yourself in a small room with the midwife –for 20 hours. If a quirk bugs you in the interview, it’s going to be greatly exaggerated when you’re in labor.” 

How’s that for advice on how to choose a midwife? groan of embarrassment 

While we had somewhat similar training, our levels of experience were vastly different. How is a newly pregnant woman supposed to gauge which experiences are great and which are useless in homebirth? While the birth junkie might learn about things like shoulder dystocia and hemorrhage and what a midwife should know when dealing with them, birth junkies are almost always born after their own babies’ births. It’s hard enough trying to teach women they have choices in childbirth; imagine the greater challenge of teaching them to be their own midwives! And that is exactly what BaMS is suggesting. 

“That means going to the hospital if she feels something is wrong….” 

Pardon?!? 

Do you women (BaMS) honestly believe women who hire midwives are supposed to “feel if something is wrong?” I know that most women hire midwives to let them know if something is wrong. Believing that women can “feel” a baby in trouble is cruel to the women whose babies died without their feeling one blip of concern. And it’s flat out wrong. Ask any midwife who’s overseeing a woman in labor, everything fine and then, during the next 15-minute fetal heart tone check, she finds the heart tones down in the 80’s. How long were they there? Sure, there are things to do to try and resolve the low heart tones, but seriously, shit happens in birth. And shit can happen fast. Having a midwife who knows what to do is crucial; her friendliness irrelevant. 

And it’s baffling to me how you think a woman in the middle of labor is supposed to take her contracting butt to the hospital. Drive? Call an ambulance? You make birth sound like a giant UC (unassisted childbirth). And terribly, terribly unappealing. 

(The great majority of) Women aren’t looking for a midwife to make every decision for her. They are not abdicating responsibility to a midwife who uses them like a marionette. Women look to midwives as counselors, as the experts in an area they don’t know much about. 

When hiring a plumber… or a car mechanic… most of us couldn’t care less how the job gets done, just that it gets done right. There are others who think the process is fascinating and learn, perhaps, to do it themselves. They might need help when learning… books, the Net or even talking to the technician. They might even go on to become the expert, inspiring other would-be plumbers as they snake the random toilet. 

Birth, in its crudest form, is like this. And a midwife knows more than the client. She is being hired to know more than the client! That isn’t the remotest commentary on her intelligence or the knowledge she does possess, but who wants to learn to be an expert in every trade or profession we utilize in our lives? I sure don’t! 

It’s great that women learn about the interventions and technology that might be (will be) used in their births. They can always learn more information… if that’s what they want to do. Homebirth women tend towards the information-heavy, that’s true. But should homebirth women have to learn everything in order to protect themselves from the midwife? Or shouldn’t there be a minimum standard they can count on so they’re able to relax during the pregnancy, labor, birth and postpartum period, trusting that the midwife really is looking out for her best interest (and that of her baby)? 

As many others have said, we go to all sorts of people assuming they have a certain level of competence… dentists, accountants, lawyers… even nurses, repair people and barbers… all carry with them the burden (if you will) of a minimum level of professionalism and knowledge. It should be the same for homebirth non-nurse midwives. 

I want women to trust midwives to act and react in their best interests… and the interests of their babies. I hate that I’m writing a “How to Interview a Homebirth Non-Nurse Midwife” piece. I shouldn’t have to!

Yet, with beliefs such as the one quoted at the top of the page, it’s more and more clear how critical that hand-out will be.

Amber Plyler Changes Her Mind

I got the most delicious email the other day. Sharing, with permission.

“Yep, it's me!  The dreaded GBS doula....  So much has changed since our last encounter on your blog, and I just wanted to share! 

I had completed 9 months of training to become a CPM when we had our 'encounter' on your blog about my GBS post.  I have since researched, read, observed, studied, prayed, and soul searched and have done a complete transformation of my path.  I quit the CPM program and am now pursing midwifery as a CNM instead.  I'm in nursing school and will be finishing up my nursing degree and then on to my masters in nursing with a midwifery specialty. 

There were so many things that caused me to stop and think and change my mind - calling people out is tough.  For the one being called out and made a public spectacle, it feels horrible!  All eyes are on you as you are criticized, belittled, and attacked.  Many said I handled it with grace, but I almost cracked!!  That being said, it's those call outs that cause you to stop, think, and re-evaluate and maybe - just maybe - realize what you are saying and the direction you are going is dead wrong.  So thank you.  Thank you for being one of the one's to call me out, make me stop, think, and re-evaluate where I was headed. 

I'm blogging my journey and thought if you were interested in the mindset of a student midwife turned nurse midwifery student, I've poured my heart out in these posts..... 

Be the Change You Want to See in the World 

and 

Lack of Standards”

The “encounter” Amber speaks about was my “This is Informed Consent?” piece that comments on a post (since revised) she wrote about using Hibiclens in labor for GBS positive women. Amber, a doula and student midwife, was giving a lot of medical advice and very little fact to back things up with. Granted, I learned a couple of things in the same thread, namely that the Hibiclens “wash” is really a “douche,” which makes me like it even less. But, as I detailed my pretty pointed (even harsh) comment, I was read the flippin’ riot act about naming Amber, her business and her website in the first place. 

“I think it's a little harsh to call the writer out by name. In all honesty, it feels a bit dirty to me. Was it not enough to simply communicate directly with her? I don't quite grasp what there is to gain here.” 

“… just wanted to address the fact that I'm sorry that this discussion has been directed at a specific person posting...and by name. I believe it could have been done with more integrity had it been addressed off-line and Amber had remained nameless.” 

“To provide information is one thing. A post sharing these same thoughts could quite easily have been made and names omitted. To contact a person you do not agree with and share information is one thing. To publicly use their name and then post your opinion is another….” 

You get the gist.

I, of course, defended my calling her out and, happy to say, Amber was a part of the discussion throughout the comments… and she went and revised her post and I wrote about that, too; Babies in Bloom GBS Redux. Amber’s “Blossoming Babies” blog has since been taken down… replaced with Midwife{ology}. 

So, Amber, as I said on your blog, I am so proud of you I could burst! Thank you so, so much for sharing your path with all of us. I, sometimes more than others, totally understand what it’s like to just put yourself out there. You are a remarkable woman; never forget that. 

Sometimes being addressed by name isn’t the end of the world, but the beginning of a whole ‘nother one.

When Gossip Becomes Slander/Libel

Gossip: a person who habitually reveals personal or sensational facts about others

Legal Definition of Slander: A type of defamation. Slander is an untruthful oral (spoken) statement about a person that harms the person's reputation or standing in the community. Because slander is a tort (a civil wrong), the injured person can bring a lawsuit against the person who made the false statement. If the statement is made via broadcast media -- for example, over the radio or on TV -- it is considered libel, rather than slander, because the statement has the potential to reach a very wide audience.

Definition of Libel: An untruthful statement about a person, published in writing or through broadcast media, that injures the person's reputation or standing in the community. Because libel is a tort (a civil wrong), the injured person can bring a lawsuit against the person who made the false statement. Libel is a form of defamation, as is slander (an untruthful statement that is spoken, but not published in writing or broadcast through the media).

It seems I have become a topic of conversation at the local California Association of Midwives’ meetings.

Two months in a row, a piece I wrote – and pulled – has been discussed. (Although now I am really tempted to put it back up!) The latest meeting’s public minutes had this statement. I didn’t edit it; this is how it was written.

Barbara’s blog….neg piece about LM’s …a physician is now using her statements in their state to ban LM’s in his state..navelgazingmidwife..

Now, the blog piece I wrote was seen as negative by some, but not by all Licensed Midwives. Sure, plenty commented their anger or frustration that I wrote that I felt LMs needed more education, but for goodness’ sake, it is my OPINION. And I am allowed my opinion.

One person who commented to the PULLED piece said a legislator had mentioned my blog during discussions of something or other, but, first of all, there is NO proof of that at all and second of all, my words did not help to “ban LM’s in his state” (whoever "he" is).

I am LIVID that a group of LMs, CPMs, students and supporters have gathered together TWICE discussing my piece (once again, a PULLED and then revised piece) and are putting out, in email and words, the implication that I am single-handedly destroying licensed midwifery.

Have they ever invited me to come speak about what I wrote? No.

And people wonder why I have issues with professionalism in Licensed and Certified Professional Midwifery; see Example A above.

Because it is apparent that my local community is reading my blog, I hereby demand that the California Association of Midwives and the local licensed midwives that have begun and perpetuated this libel cease and desist or I will bring charges against the lot of you.

And I have PROOF of who started this slander in a vile (and amusing) email by a local Licensed Midwife. She even said she was going to spread the word about my "true self."

Any emails or comments will be used in court. Keep your thoughts to yourselves, oh, local women who are yacking about me.