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Entries in CPMs (2)


I Believe...

I've been asked a few times why I left homebirth midwifery for monitrice-doula service and I thought I'd clarify for those that think I left because I no longer support out-of-hospital birth. Nothing could be further from the truth. And while "truth" is typically black or white, for me, life includes grey, which often comes across as contradictions. "I know; life's complicated," as Annette Bening's character in The Women says. I concur.

And, as is a woman's prerogative, I reserve the right to change my mind at any time, without notice.

Therefore, TODAY:

- I believe in out-of-hospital birth.

- I believe in homebirth.

- I (grudgingly) believe in a woman's right to birth where and how she chooses, whether that is an Unassisted Birth or a scheduled woman-requested primary (or otherwise) cesarean. 

- I believe certified nurse midwives have a great education and skills foundation by the time they call themselves CNMs and are practicing independently. I believe CNMs are blessed/lucky to have a collaborative relationship with OBs and are able to write prescriptions. That doesn't mean I don't acknowledge the limitations of CNMs, especially with regards to supervisory relationships with OBs. And having to pay malpractice insurance. And having a harder time doing homebirths if that is their desire.

- I believe there are some really great non-nurse midwives, but believe those women have learned through extraordinary means, the least of which is school and the standard one or two year apprenticeship. Experience cannot be underestimated when choosing a midwife. Choosing the least expensive midwife might not be the best way to choose the person you're hiring to keep you and your baby safe and, quite possibly, alive. And yes, there are always exceptions.

- I believe non-nurse midwives could use some increased education and skills requirements before they go out on their own.

- I believe pre-admission education for Certified Professional Midwives needs to be added.

- I believe there are a handful of MEAC-accredited schools that adequately educate student midwives... going above and beyond the basic NARM requirements :Nizhoni (points off for mis-formatted website), Florida School of Traditional Midwifery, Birthingway College of Midwifery and Bastyr University... schools that cost $20,000 or more and require more than the standard three-year committment. 

- I believe the "minimum standards" either need to be higher or eliminated altogether, leaving the expectation of a fully-trained midwife who, once she has a license in her hands, is not a danger to others. (I am not alone in this as the latest information from NARM demonstrates.)

- I believe women wanting to be a midwife should not choose a program because of it's low cost and speed of graduation, but should have a goal of more school and more experience in order to serve their clients better and more safely.

- I believe Continuing Education requirements should be more stringent, the cost be damned; the added education should be invaluable and worth every cent.

If I've forgotten anything, I'm sure you'll let me know.

So, there you have it. What I believe today... did yesterday... and probably will tomorrow. We'll have to wait and see about the day after that.


Google Alerts - What's in the News?

If you don't have Google Alerts, why not?

I love the alerts. I get a smattering of obstetric news this way. It's one of the coolest functions of the Net; consider trying it!

I have alerts on these words:

- "Navelgazing Midwife" (and I love seeing who's yacking about me in their blogs or articles!)
- homebirth
- "home birth" (you need to put the quotes around phrases or else you get a million irrelevant notices)
- waterbirth
- "water birth"
- "natural birth"
- midwifery
- midwife
- "San Diego midwife"
- "Licensed Midwives"
- "Licensed Midwife"
- "Vaginal Birth After Cesarean"

and then some that relate to my office. I used to have "Kauai" and "Hawaii" but got way too many to be able to read and since we're not heading to Kaua'i this year, I removed them.

A few interesting headlines that have come through recently:

Choosy Mothers Choose Cesareans - This atrocious Time Magazine article highlights a child psychiatrist (!!!!) that chose to have a cesarean long before she ever even got pregnant... and once she was, she did, indeed, have a cesarean-by-choice.

"In an increasingly technological and medicalized society, maybe even childbirth is losing some of its magic and becoming less about the miracle of life and more about simply getting a baby out safely and without incident. 'We put a lot of emotional, psychological and spiritual value around birthing,' says Dr. William Callaghan, an obstetrician at the Centers for Disease Control and Prevention. 'But perhaps we are coming up with different cultural norms.'"

Sad. Very sad.

Who Can Help Women Give birth? Pa. Court Will Decide -

Diane Goslin, a 50-year old midwife who's helped more than 5000 babies be born in Pennsylvania, many of them for Amish families, is waiting to practice again - but only will be able to if the state recognizes Certified Professional Midwives. Goslin has been a CPM for 12 years and lost an Amish baby in 2005. The coroner's report says Goslin was not responsible for the death.

The court counters that there are (Certified Nurse) Licensed Midwives for a reason. Goslin says, "There is no amount of nursing school that could prepare me any better," she said.
"I hope the court sees it that way."

Malpractice Insurance: killing issue for midwife bill? -

It looks like the lack of insurance for homebirth midwives might destroy any attempt at getting CPMs legalized in Missouri.

Jamie Lynn Spears Terrified of Giving Birth -

Oh, for goodness sake.

Apparently, mom showed Jamie Lynn a "natural birth" video and it freaked Jamie Lynn out, causing her to barf. What the hell did she show her? So, now, Jamie Lynn is so afraid to birth vaginally, she wants a cesarean... so she "doesn't have to face the pain."

Someone better call that girl up and tell her what great videos to watch and that having a cesarean is FAR from avoiding the pain of birth.

Negligence Kills 130,000 Mothers a Year in India -

"In developed countries, the maternal mortality ratio is 27 per 1,00,000 live births. In India, it is 540. In developed countries a woman’s lifetime risk of dying from pregnancy related complication is one in 1800. In India, the ratio is one in 48."

"In India, nearly seven million abortions, in legal or illegal method, take place annually. For every legal abortion, 10 are induced illegal abortions. Other major factors that cause to mothers’ deaths are hemorrhage, eclampsia, obstructed labor, sepsis and pre-existing conditions such as anemia and malaria. The studies show that 60 per cent of all maternal deaths occur after delivery. Yet, less than 17 per cent of women in India receive any postpartum care. Health facilities are available to only 34 per cent ladies and in rural areas three out of every four babies are born at home under unskilled personnel."

"Nations are uprising. Globalisation has opened the door for fresh developments – both in thoughts and practice. Unfortunately, the world remains careless to the third world, as it has been always, particularly to the mothers, the most vital source of power of human civilisation. International conferences are held. Agendas are taken. NGOs are involved. But we forget as usual that maternal mortality is not just a health issue, it is an issue of human rights."

A top obstetrician on why men should NEVER be at the birth of their child -

This article is written by Michel Odent, MD... the wonderful natural birth-oriented obstetrician that first became famous for his birth center in Pithiviers, France in the 1960’s and 1970’s. He now works in London (but as an OB? From what I understand, he is now only a researcher, author and lecturer).

Michel Odent says in part:

"That there is little good to come for either sex from having a man at the birth of a child."

"For her, his presence is a hindrance, and a significant factor in why labours are longer, more painful and more likely to result in intervention than ever."

"As for the effect on a man - well, was I surprised to hear a friend of mine state that watching his wife giving birth had started a chain of events that led to the couple's divorce?"

"Or another lady describing how the day after her husband had watched her deliver their child, he had fled to his hometown of Rome, and never returned again?"

"For many men, the emotional fallout of watching their partner have their baby can never be overcome."

This is a pretty significant piece! I wonder if, in 20 years, we will look back in horror that men were ever at births. I wonder if his article will have any impact on birthing today.

I know that some men have a really hard time watching the birth. Some cultures, as we know, don't even permit husbands from viewing the labor or birth. Do they have something? What of the UC movement? Should they reconsider their husband-as-midwife after all? Perhaps the norm is to have a woman assist, not the partner be the primary care-taker. I know many partners who struggle with "what to do" in labor. Is witnessing the birth too much to ask?

Interesting questions.

Well, that's a little wrap-up of recent news in birth. I love when people send me tidbits; Google doesn't catch them all!

Now go! Get yourself Google-Alerted!