"Where is my midwife?"

Dear Kirsti Kreutzer, Sylvia Santaballa, Maria Radonicich, and Anna Van Wagoner,

I recently learned about your "Where's my midwife?" campaign.  I'd like to know where my educated, licensed, insured, ethical, transparent, accountable midwife might be? You know, the one who practices within a defined scope of practice, who risks out carefully according to clearly defined protocols…that one who works collaboratively with the hospital and doctors and appreciates that sometimes women and babies need help.  Where is my midwife who is insured?  Where is my midwife who reports her outcomes and makes them known publicly?  Where is my midwife who appreciates the value in balanced information and real informed consent over warped ideology?    

And furthermore, where is my midwife who will get me to the nearest hospital should I need help instead of driving me nearly an hour to a hospital in another state so she won't get in trouble?  Where is my midwife who recognizes breech babies are high risk and is humble enough to admit she doesn't have the skills necessary to attend such a birth?  Where is my midwife who won't use prescription drugs illegally, or techniques she's not trained in using, but will get me to the people who can safely do so should I need it?  Where is my midwife who understands scientific evidence enough to use antibiotics instead of garlic to treat Group B Strep?   

Where is my midwife who is accountable to women and babies first and foremost?  Where is my midwife who can see the errors and mistakes in her own practice, and that of her greater "profession", acknowledge them, and work to change them?  Where is my midwife who acknowledges the dead babies that didn't have to die and doesn't pretend they didn't exist?  Where is my midwife that knows many of these deaths were preventable and were the result of negligent care?  Where is my midwife who sees the alarming discrepancies within the practice of midwifery and shares my concern?  

You see ladies, it isn't about increasing the number of midwives out there, it's about improving the quality of care, educational training, standards, ethical practices, and outcomes within midwifery first.  Supporting all midwives as one lump group is completely disregarding the enormity of the issues they face within their own practice, many of which are extremely dangerous and rather unaccountable.  You're asking for a double standard here.  I wish that Natural Childbirth Advocates would realize that if they can't first fix what's at "home", you can't very easily point a finger elsewhere, nor can you spread their mission safely.  When I read your call to action statement, I read it differently perhaps that you intended:  (note italics are where I substituted the words "home birth" for hospital") 

"Are you tired of witnessing women being violated during birth and feeling  to stop the train wreck happening before your eyes? Do you wonder how there can possibly be such a giant gap between what medical research recommends and the standard procedures in home birth? ... Are you ready to stop being a bystander and work for change?

Let’s stop talking about how bad things are and do something. Let’s come together, gather our allies, learn from the people who have improved maternity care in their communities and lay the groundwork for a full-scale birth revolution! Join the national grassroots movement to change maternity care.

"Where’s My Midwife?" invites you to spend a weekend at the Farm in Tennessee, plotting and scheming, coming up with activities that can be carried out in any community at any time for little to no money. These activities will raise public awareness about our broken midwifery model of care, and draw attention to the methods that are producing better results for mothers and babies. We need to put public pressure on the people, organizations and businesses in positions of power and hold them accountable for improving outcomes."

Hosting retreats on "The Farm" and sending women out there to promote midwifery without addressing the issues within the profession itself is grossly irresponsible.  If you want to promote midwifery, it ought to be a sound, consistently reliable, transparent, professional service you're promoting, not something dysfunctional that means a million different things.  

When will this be about honest self-reflection and improving maternity care on all fronts, finally moving past blind ideology, and acknowledging that many midwives are part of the problem in this "train wreck" called maternity care?  Enough finger pointing and diverting blame elsewhere.  Time to clean up your own house before criticizing hospitals.    

I do support collaborative care, including excellent midwives, and I want to know where is my midwife who practices ethically, has sound educational training behind her, is licensed, insured, and accountable?  This is certainly not just any midwife in America, and most often not home birth midwives.  In fact she's rather elusive and I'm not entirely sure she exists.  I hope for the sake of improving all maternity care that she does, that I just haven't met her yet.

Sincerely,

Safer Midwifery for Michigan