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….”
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.