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Tuesday
May102011

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.