Tuesday, October 30, 2012

Coming Soon!

Dear Readers,
We haven't forgotten about you, or the need to blog regularly.  We're working to create some documents that will be useful to you, and to mothers who are considering midwifery as an option.  As you can imagine, this process takes time.  We want it to be well done, and to fully consult with MI midwives so that the information we present is accurate, credible, and useful.  We have a few meaty posts coming up, but would like to include the completed documents before we share them with you.  

Some of the topics we'll be addressing include:
  • Choose A Midwife Safely 
  • Midwives: Credentials, Educational Training, & Scope of Practice
  • Routine Assessments During Pregnancy:  What's Necessary & Why
  • Examining Current MI Midwifery Laws & How They Impact Care
** We are open to other ideas or suggestions from midwives or families about information you think women need to have, that would better help them make more informed decisions.  Our primary focus is developing tools that support safe options.  Women need to know who they are hiring, what their strengths & limitations are as professionals, what to expect during sound prenatal care, and how the laws impact their care with a midwife so that they can make a genuinely informed decision. Feel free to suggest your ideas in the comments below.  

** If you are a midwife in MI (or elsewhere) who would like to help develop this kind of content, we'd love to hear from you!   Please contact us.
We're also working heavily on a surprise project that will be announced in the next couple of weeks.  Thank you for your patience and stay tuned!  Big things coming soon.


The Safer Midwifery for MI Team

Tuesday, October 23, 2012

Checks and Balances

I originally sought the care of midwives because I wanted more personal care.  I didn't like the fact that our OB's office had 10 doctors, each of whom we would meet during the course of our prenatal care, but none of which I felt really knew us.  We had no idea who would show up at the birth, and I was worried about how they would care for us if they didn't know us.  Our first baby was born naturally, vaginally, and without issue in the hospital, with a doctor we didn't know too well.  He treated us with kindness and respect, and ultimately did many things to keep me, and my baby safe. 

Converesly, our three midwives spent an hour with us at every prenatal appointment.  We knew them intimately, considered them friends.  Hell, we even enjoyed tea and family play with a train table my son still talks about.  The resulting care?  Our baby died because of preventable injuries sustained at birth. 

Are doctors perfect and midwives evil?  Absolutely not.  Could this story easily have been the reverse experience?  Sure.  What then was the difference in care?

I've come to understand that while relationships matter, safety and the checks and balances of a licensend, ethical profession matter more.  While I once complained about long waits, short doctor visits, and too many care givers in a practice, I now see the need for a collaborative approach.  All good care givers need appropriate checks and balances, even midwives.  They need to hear differing viewpoints, to bounce ideas off of one another, and to be held accountable when mistakes are made, in order to funtion in a healthy, balanced way.  I now see the value in the kind of care I once resented...just too little too late. 

Appreciating and assessing risk factors in a client seeking an out of hospital birth is critically important to protecting the safety of that mother and baby.  Midwives often say that birth is normal, safe for low risk women without signs of complication.  The problem lies in the efficiency of how assessents are performed, and even more importantly how they are valued.  Disregarding the importance of assessments, avoiding them altogether, or even failing to risk out appropriately based on the results of such assessments is putting mothers and babies in great danger.  Risks are being taken then, that do not need to be taken.  How is this possible?  There are no checks and balances, no guidelines, no scope of practice for midwives practicing out of hospital birth in MI.  They can take any risks they want, avoid any assessments they choose, and call anything a "variation of normal".  No questions asked. 

If a midwife presents biased information about gestational diabetes testing to a mother, then tells her how great her nutrition habits are, and further expresses a belief that many times the test shows a false positive, why on earth would the client then value that test?  Has she been adequately informed, in a way she can truly make an educated choice for herself and her baby?  Does she know the risks of not doing the test?  Again, there is no standard for what "informed consent" actually means in midwifery. 

Why is this so vitally important for out of hospital birth?  In the event of an emergency due to any complication, a mother or baby in the out of hospital birth environment are at detrimental disadvantages to get the care they need immediately.  Precious minutes cost lives.  If midwives were truly attending only low risk women, results would no doubt improve.  Unfortunately, that's not what's happening.  Instead we have midwives who don't inform clients, who don't value assessments, who don't risk out.  We have midwives who are boasting online about delivering three breech babies in a year, delivering twins, and this is not to mention all of the severe near misses...those situations midwives knowingly take on to "honor a mother's right to out of hospital birth" instead of telling her the safest place in a high risk situation is at the hospital. 

Are midwives capable of implementing appropriate checks and balances?  Sure.  Are they capable of defining appropriate assessments, and adhering to low risk birth in the name of safety?  Sure.  Are midwives able to practice conservatively and collaboratively?  Yes.  The problem is that it isn't happening consistently.  Women and babies deserve a consistent standard of care, and midwives who function within a defined scope of practice.  Families want midiwifery they can rely on and trust.  At present, hiring a midwife in MI is (as I've said many times before) like Russian Roulette. 

This is precisely why we NEED Safer Midwifery in MI!! 

(In Development:  A document is currently being developed in conjunction with exemplary midwives, that lists the appropriate assessments that every midwife should seriously consider with her patient's clinical history.  We'll highlight it here on the blog as soon as it is finished, so women know what to look for in prenatal care.)

Wednesday, October 17, 2012

Introducing "Death Midwives"

What is a "death midwife"? 

     "Just as a birth midwife provides care at the beginning of life, a death midwife
     provides care during the final stages of life. Professional death midwives can offer
     the dying and their family spiritual and emotional comfort, advocate for their
     rights, guide them through paperwork, plan special burial rituals, and act as a
     liaison with funeral homes. Although certification processes are still relatively
     new and not yet standardized, there are a number of options for people interested
     in training and certifying to be a death midwife or, as it sometimes called, death doula."

     "Family-Directed Choice means you have the right to care for your loved one through  
     death at home; and to make educated, informed decisions about the death and dying

After Death Home Care ~ Ann Arbor, MI
     "In 25 years of professional life I have been helping people make empowering choices
     concerning their health care, specifically in women’s health and childbirth. My work
     as a home birth midwife for many years gave me the privilege of working very
     personally with families during a major life transition."
     "Preparing the body for a home funeral: This document is intended for the primary
      person takingthe lead in preparing the body for a wake and his or her helpers."

     "Death is as certain and sacred as birth."

This post feels like a collection of links, and it is.  There isn't much conversation written between the lines, mostly because I'm speechless. 

I see many parallels in language, words like "empowerment, choice, and educated/informed decisions" to that of home birth midwives.  The other glaring parallel is that "certification" is earned in a weekend workshop, but a self-appointed person or group.  18 hours of online learning is also considered sufficient. 

I find it interesting that these folks are even referring to themselves as "death midwives or doulas", and many of them are home birth midwives or doulas in practice.    I suppose at least in this line of work, the clients and families they are serving are knowingly coming to end of life.  It's the irony that gets me.  Thoughts? 

Monday, October 15, 2012

The Greenhouse Birth Center Gets A New Name

Not even two days after closing of the Greenhouse Birth Center, LLC to avoid any consequences in civil court, the same midwives have forged their own new business. Never mind that two of them have filed for bankruptcy to dismiss accountability for wrongful death(s), and they pulled the same move with the business itself. 

Check out Harmonious World Midwifery  (AKA Sage Midwifery)
(Formerly known as the Greenhouse Birth Center in Okemos, MI)

The "Harmonious World" midwives are charging $3,000.00 per birth, but surely can not afford malpractice insurance to protect the families they serve.  Not only have their staff and practices gone without change, their language too remains the same:

      "The midwife is trained to work with normal, healthy pregnancies, thus she is aware       of identifying deviations from normal, healthy pregnancies, and will refer the mother
      to obstetrical care should complications arise."  

The least they could do is tell people the truth!  How about telling women they trust birth...at all costs.  If pregnancy becomes "high risk", they'll just tell you it's a variation of normal anyway.  There are assessments that can be done to evaluate risk, but these midwives will tell you instead how unnecessary those assessments are...leading to severly lacking risking out protocols.  If your baby dies because they didn't inform you of the risks, and they didn't do their jobs...well then the baby just wasn't meant to live.  If they could be honest with women, and if women still chose their care, knowing the truth, at least they are choosing something that they want and believe in. 

Instead, these midwives continue to pretend to be something they are not.  They are feeding women the same false idea that they know what to look for and will get them help if they need it.  Every single infant death and injury over the past two years, is proof that this is nothing more than a false ideal, something to lull mothers into feeling safe when they are not.  It's either a crafty marketing tool to broaden their client base, or denial in recognizing the gap between what they tell people and how they actually practice.   
Indoctrination continues: 

      "Pregnancy and birth can be a normal and empowering process in a family's life." 

...unless you are taken advantage of to advance an agenda, and/or your baby dies because of severe negligence.  How is that empowering?  

      "Thus, I have great faith in the notion that families are to be primary in the role of       
      decision-making for their care." 

This basically means that families are birthing unassisted, and should anything go wrong, the midwife has absolved herself of any, and all responsibility.  It should clearly be understood to mean that you're not paying $3,000.00 for the care of a professional that takes responsibility for your safety.  There is nothing about this relationship that will be fiduciary.  A more accurate description would be: a mother, fed a bunch of lies about how her body can do this, trained to think she will be empowered by her experience, and then left in the dark when it ends in disaster.  Midwives work very hard to craft "informed consent" to alleviate themselves of liability should things go wrong.  They hold workshops on this very topic, as evidenced in recent posts. 

Hey Audra Post, CPM, founder of "Harmonious World".  How many of the 300 babies you had the privilege of delivering died?  How many were injured?  How is it that you are under such financial and legal stress that you have to file for Chapter 7 bankruptcy to avoid a wrongful death lawsuit, but can somehow manage to open a new "business"?  My pregnancy and birth were far from "normal", and you either didn't bother to tell me, or didn't recognize that there was an enormous problem.  The same is true for your CNM "Birth Assistants", Clarice Winkler and Shelie Ross.   

Don't think for one second that the women of this community won't see through this charade ladies.  Families deserve to know the truth about who you are. Your websites, old and new, are full of misleading information.  

Your despicable actions speak for themselves.  You are not destitute.  You are not mourning. You clearly do not have one bit of remorse for the harm you have caused to many families, or you wouldn't still be practicing.  I can say you are strategic, sneaky, and relentless.  I can also say you have cost too many lives.  The kind of people you are continues to be revealed in your own actions.  

Unfortunately the pattern will continue, and it will only be a short matter of time before tragedy strikes again.  When nothing about improving practices takes place, when nothing is learned in retrospect, then the dabalacle continues.  It's like the dog that chases it's tail endlessly, pretending he doesn't hear his owner's call.  He continues in this manner until he (or in this case someone else's baby) falls over dead. 

Nothing, I repeat nothing, is "harmonious" about the way you operate, and nothing about the care women are receiving from your group is "empowering," no matter what you call your "business". 

Wednesday, October 10, 2012

Breech Birth at Home

With many of Michigan's CPMs slated to attend the Breech Birth Coalition's annual conference in Washington D.C. this November, it's time to start talking about breech birth at home.  Women in MI, and elsewhere must be more informed than we were.  When a woman is faced with a breech positioned baby at the end of pregnancy, it's very difficult to really "research" effectively.  It's easy to listen to what a trusted care provider is telling you, and see only through a lens that supports those notions.  Before you consider a vaginal breech delivery outside the hospital, please check out these resources and clarifications. 

We have talked a great deal on this blog about the concerning, variable training for becoming a CPM.  The fact that a midwife, of any credential (CPM/CNM or otherwise), would even consider a delivery as high risk as a breech delivery at home should be an enormous red flag.  No midwife, without an immediate medical facility, and physician presence, is prepared to properly attend a breech birth.  In fact, in other countries like Europe and Canada where midwifery is an integral part of their medical system, there are explicit guidelines for risking out mothers with breech presenting babies from home birth.  It's a very high risk delivery that sometimes needs immediate emergency care and extremely close monitoring.  These countries have determined that screening women to determine who is low risk/high risk, is the most appropriate way to a) keep babies and mothers safe, and b) prevent tragic outcomes.  Research was done directly because of the fact that women in Canada were choosing home birth for breech birth because they didn't feel they had options.  Canada's response can be found here.

     "Women in Canada and abroad are requesting the option of breech vaginal delivery.    
      Will it be obstetricians and gynecologists offering this, or, since many hospitals are not
      offering breech vaginal delivery, will women rely on midwives to do so? Some women    
      with a breech presentation elect to deliver at home because they believe they will be    
      refused a breech vaginal delivery at the hospital. It is urgent that we take on this 
      responsibility and that every hospital in Canada offer safe breech vaginal delivery. We 
      need to meet with our colleagues in midwifery to support their request for breech
      vaginal delivery in hospital and access to consultation with their obstetrician
      colleagues. We cannot condone home breech vaginal delivery; thus, we 
      must offer breech vaginal delivery as a safe alternative in our maternity 

I want to be clear that having a breech presenting baby doesn't mean that mothers in the US, cannot aim for a vaginal delivery in the hospital.  Doctors in the US willing, and with enough experience to attempt a breech trial of labor, are harder to find, but they do exist across the country.  In Canada, they explicitly state that women need to be informed of all risks, and not abandoned should they make a choice that differs from a physician's recommendation.

A "Trial of Labor" for a vaginal breech delivery is very different from automatically scheduling a cesarean.  It's is also very different from a midwife stating, "recent research supports vaginal breech delivery, I could delivery your baby at home...or at our freestanding birth center."  The research she's likely referring to is a 2009 study by the Society of Obstetrics and Gynecology.  If you read this Clinical Practice Guideline, you will quickly learn that this research was explicitly written to take place in a hospital, with an obstetrician, and an operating room present.  

What exactly is a "Trial of Labor" then?  A trial of labor refers to an attempted vaginal breech delivery given very specific safety guidelines.  Those guidelines begin with proper evaluation of candidacy before labor even begins.  An ultrasound is necessary to determine important factors such as baby's estimated weight (no less than 5.5 lbs and no more than 8.8 lbs are considered qualifying), fetal head attitude, cord position, type of breech position, etc before determining if a woman and her baby meet the criteria for a trail of labor.  There are other factors in determining candidacy outlined in the SOGC's research.  If mom and baby meet these criteria, then fully informed consent about the risks of both a cesarean and a vaginal breech delivery must be addressed, and documents that show record of such informed consent are signed.  

The SOGC research further specifies guidelines for managing labor and delivery with a thoroughly experienced physician on hand.  Some of the highlights include immediate pelvic exam upon waters breaking, active pushing in labor should not exceed 60 minutes, and continuous fetal heart monitoring, among others.   Another critical note named in this guideline is for a health care provider current in neonatal resuscitation to be present. 

For more information about the SOGC's recommendations, visit this link to their brochure on the topic for public education.  

If a woman, and her physician, have closely evaluated her candidacy for a vaginal breech trial of labor, then I see no reason not to support that effort inside hospital walls, where emergency care is immediately available.  The notion of CPMs, or anyone else for that matter, attempting this kind of delivery in the home setting is disturbing.  The fact is that area CPMs are attending a conference held by an organization who, as they put it, "...are not medical professionals," but are instead, "well read mothers and families." Their aim is to learn more about delivering breech babies in the home setting, as if there were no other options.    This speaks volumes about their intentions, their misunderstanding of what the medical world can offer, and their lack of appreciation for the risks involved in this kind of delivery.  

I sincerely hope that women can sift through the muck, the misinformation, the misguided relationships, and the agendas to see that if a vaginal breech delivery is what you seek, there are safe ways to go about it.  (And that is not outside a hospital)  If you're in the hands of a responsible midwife, who appreciates safety, she'll help you find a physician that will work with you on determining whether a trail of labor in a hospital is a safe option for you.  (If your midwife tells you breech presentation is just a "variation of normal" and she can handle it, find yourself an OB immediately.)  There has been good research on this topic as noted here.  I hope we can learn from Canada to first see that home birth is not a safe way to delivery a breech baby, and second that our hospitals, midwives, and doctors will continue to work together to best serve the women that need them. 

Monday, October 8, 2012

What do MI Midwives Make of Public Outcry for Safer Practices?

What do MI midwives make of public outcry for safer practices?   

Well, they think they are the victims. 

Instead of working to examine and improve practices, the leaders of midwifery in MI are hosting workshops to teach fellow midwives how to protect themselves.

Instead of acknowledging the very real problems that permeate midwifery, and out of hospital birth, they are convening to talk about how to protect themselves by revisiting "informed consent". 

Instead of finding ways to bargain for malpractice insurance that would protect families, they are discussing how to protect their assets.  

     "I just attended an informative workshop at MANA on protecting your assets. 
     We will be sharing information." 
     ~ Patrice Bobier, MI CPM, and MI Midwives Association board member

Instead of hearing the voices of concerned families, doulas, and other midwives, they are choosing to pamper themselves with massages, pedicures, and a good dose of denial.  

Shouldn't the focus be on how to make out-of-hospital birth as safe as it can possibly be?  Shouldn't the conversations be about why and how babies are dying preventable deaths?

 Not according the the Michigan Midwives Association...

The only true statement in this entire advertisement is, "Midwifery in Michigan has seen many crises this past year."  Our definition of "crises" differs greatly.  The real crisis is the number of babies that died or were injured, and the families (not the midwives) mourning the loss of their children under preventable circumstances.   This crisis is further complicated by the dysfunctional and dangerous practices that every midwife attending out-of-hospital birth has seen, but won't admit.  Ignoring these instances, these families, these babies is the crisis.  Pretending there aren't problems, and refusing to address them adequately will lead further down the same self-destructive path.  

If midwives are mourning, it's because the truth is spreading across MI, and women demand safer, more reliable options for out-of-hospital birth.  I'd like to see a workshop that addresses issues of screening for risk, reporting outcomes, educational standards, defining scope of practice, and how to bargain for competitively priced insurance.  The profession of midwifery, as it pertains to out-of-hospital birth, would move forward much more effectively if the leadership could address the issues that are causing the problems, instead of wallowing in self-pity for tragedies that are created by negligent midwives themselves...and then further going to great lengths to deny any responsibility whatsoever.  

Instead, the Michigan Midwives Association continues to support not only negligent midwives, but criminal midwives too.

     "Support midwives who are facing prosecution for doing the everyday work that we 
     do: Ireena Keeslar lives in Indiana, but practices also in Michigan, attending 
     homebirths and births at her freestanding birth center. She was charged with 
     practicing nurse-midwifery without a license and is in the pre-trial stage at this 
     point, with her next court day pending. Her legal expenses are likely to be 
     considerable. You can donate to her cause by sending her paypal at   
     warriormidwife@gmail.com or by writing her a letter of encouragement at 
     7570 E 750 N, Howe, IN, 46746."

It would appear that "warrior" midwives, are even above the law.  Even though the state of Indiana requires a state issued license to deliver babies as a midwife, you can just let it lapse, and your supporters will be asked to support your irresponsible actions by funding your court battles.  Better yet, just come on across the border and set up a birth center in Sturgis, MI because we have no regulations here.  

Where are the midwives that are asking people to contribute money to the families who have to battle in court to hold negligent midwives accountable...midwives who file for bankruptcy multiple times over  wrongful death lawsuits?  Where are the midwives funding medical care and treatment to injured babies across the state, whose injuries are the result of pure negligence?  Why do these families turn to the court system?  Well, because no one else will hold midwives practicing this way accountable, least of all their own professional organizations.  Nope, the mentality is: must protect the sisterhood, must protect the "harassed, sued, interrogated, targeted" midwives because so obviously when a baby dies, it's the midwives who are mourning.  

The focus must shift to protecting families.  

This not a "witch hunt" ladies, it's a call to action.  We want you to step up to the plate, to offer us something better that we can depend on.  We want you to be educated, responsible, professionals who work hard to keep us as safe as you can.  If you are unable to redefine yourselves, to raise your expectations, to better admit your faults along with your successes, to practice ethically & safely, then our state has an obligation to set it's own guidelines to keep people safe.  We want better for Michigan families.

Wednesday, October 3, 2012

Dear MANA Sisters: A Letter from a Midwife


Today's post comes from a midwife, who cares deeply about advancing the profession and improving safety.  Her identity is confidential.  We want to offer a safe space for midwives who are interested in talking about their concerns, and advocating for improved practices, to freely speak.  Here are her insightful thoughts: 


Dear MANA sisters,

I received my MANA Newsletter today and read it cover to cover, as I do, and have done, since becoming member of MANA nearly a decade ago.

I want to start off by saying I am one of you. “I am a midwife!” I go to trainings with you. I attend conferences all over the country. I stand in circles where we hold hands and sing and cry. I march public rallies in support of midwifery and home birth.

You, sisters, trust me. You call me at all hours of the day or night in confidence to review a difficult birth, to lament about a trying apprentice, or to decompress after a demeaning experience during a hospital transport.

When you look around a room full of midwives, my face is one of those among yours. I am not an anti-midwife, or an anti-homebirth crusader. Quite the opposite: I am a staunch supporter of midwives and home birth.

I have been humbled by the knowledge and compassion I’ve experienced among midwives and I am proud that I have been trained by so many wise and wonderful women. The sisterhood of midwifery has fundamentally influenced who I am - and for this I am grateful. But I did not enter midwifery to experience sisterhood. I entered midwifery to serve women, their babies and their families.

What I find so concerning lately from the midwifery community is a lack of acknowledgement that certain conditions exist which create higher risks for mothers and babies in home birth. And when a family suffers a loss, there appears to be a dismissive attitude toward that loss. Somewhere along the line home birth midwifery has been deemed “as safe, if not safer, than hospital birth,” and nothing will change that. Close the book. End of story.

This attitude causes suffering. And the statement in the MANA News about a piece of legislation introduced in Michigan being merely “knee-jerk” and the result of (euphemistically) an “unfortunate birth outcome” makes me wonder:

What the position of MANA is in the case of “unfortunate birth outcomes?”

What I know about the Michigan bill is that it was drafted quite thoughtfully by former midwifery clients and members of the public who want increased safety standards, public reporting of home birth outcomes, and more rigorous educational requirements than another licensing bill that was proposed.

Is it the position of MANA that asking for increased safety, more transparency and accountability, and higher level of education in licensing midwives is frivolous or undesirable?

What part of the Michigan bill, specifically, is “terrible?” Has anyone from MANA spoken with the state Senator or the advocacy organization who introduced the bill and tried to understand the rationale for the provisions in the bill?

Is it the position of MANA that “unfortunate birth outcomes” should play no part in drafting legislation to license midwives?

How many “unfortunate birth outcomes” are acceptable to MANA? At what point are these outcomes not aberrations or statistical outliers, but indications of the quality of care provided by midwives?

What is MANA’s position statement regarding families who have lost a baby with a midwife? Does the client’s perspective count in this circumstance? Or does MANA only care about clients whose babies lived? Are the voices and opinions of home birth loss mothers important to MANA? Or is it the position of MANA to minimize the death of their child (“unfortunate outcome”) and to ignore their perspectives?

As a midwife - as a woman called to serve women and babies - these voices are vitally important to me. I believe women. I believe these women when they tell me they were deceived into trusting a situation was safe that actually had increased risk. I believe women when they tell me they were deceived into believing the credentials bestowed on midwives conferred accountability and professionalism. I believe women when they say they were reassured that their home birth - in a risky circumstance - was safe.

What is the recourse when home birth proves to be unsafe? What is the response of the professional organization that purports the safety of home birth? Do you care about these mothers? Do you care about these babies? Does MANA admit there are circumstances when birth at home increases the risk to the baby and mother? Does MANA support, promote, encourage home birth with a midwife in ALL circumstances? Does MANA believe home birth deaths should be investigated? Does MANA believe that any death that occurs under the care of a home birth midwife was of no fault of the midwife? Does MANA believe that midwives are infallible?

How is MANA assuring that home birth midwifery is as safe as it says it is?

I want to belong to a professional organization that is mature enough to address these concerns and has enough integrity to address the weaknesses of midwifery as well as its strengths. If we want our profession to thrive, safety needs to be part of the discussion now, and it needs to be a part of the discussion always.

Turning a blind eye means these “unfortunate birth outcomes” will continue to happen. And some may truly be “unfortunate birth outcomes” but others may be due to negligence, carelessness and malpractice. In order for me to stand proudly in a sisterhood of midwives, I need this profession to be making diligent efforts to discern the difference. 

Monday, October 1, 2012

MANA Brushes Baby Deaths Aside

The Midwives Alliance of North America (MANA) has issued their September 2012 newsletter.  The representative from the Midwest, and MANA's Press Officer, Jana Studelska, has made MI midwives out to be the victims, insulted efforts to improve safety, and brushed aside baby deaths all in one foul swoop.  Instead of accurately reporting on the public outcry for safer practices, she chose to refer to legislative discussion as, "a knee-jerk reaction to an unfortunate birth outcome."  ("an" meaning Magnus, and implying that he was the only "unfortunate outcome")

Let me just point out first, that we cannot know how many "unfortunate birth outcomes" there have been this year, or any in recent past, because midwives in MI do not report data on their outcomes to any reliable source.  We do know that if we look at the Greenhouse birth center alone in the past year and a half, there have been at least two deaths, and one serious injury.  That's not accounting for the families that have contacted Safer Midwifery with extremely concerning accounts of negligent care they received from other home birth midwives, or those who haven't yet reached out.  

I'll give Jana the benefit of the doubt...perhaps she just doesn't know about the magnitude of the problems families are facing here.  That's right Jana, families, not poor, persecuted midwives who are not practicing safely!  Well founded concerns based on awareness raised by strong groups of parents, doulas, and former CPM apprentices who want safer midwifery options, is the root of a call to action.  Citizens want safer options.  This is why legislators are concerned.  This is why numerous bills are being written, and this is why we must find a safer way to practice midwifery in the state of Michigan.  Nothing "knee-jerk" about that.  Calling the hard work of concerned citizens, and our legislators, a "knee-jerk reaction" is completely degrading, and appears to be another attempt to downplay the severity of the issues.  On second thought, maybe Jana does know the magnitude of the issues here, and just chooses to ignore them to further MANA's agenda. 

I'd also like to point out that MANA's Executive Director, is Geardine Simkins, CNM, MSN, and Michigan midwife.  I don't know much about Ms. Simkins, other than the fact that she has been very supportive of the Greenhouse midwives, even backing them up at times when they overbooked.  I also know she supports licensing for CPMs, and actively serves as an executive for the organization that issued this newsletter.  I have to say, I'm enormously disappointed with MANA, NARM, and any affiliate who would let tremendous concerns for safety in our state go without adequate response, and course of action to improve.  If this newsletter represents the position of MANA as a whole, then I am gravely concerned about the leadership running this organization. 

And, speaking of leadership, it should be dually noted that none other than Clarice Winkler, CNM from Greenhouse Birth Center is named as the Program Chair for MANA.  Never mind criminal investigation, state investigation, multiple deaths, previous sanctions, and multiple bankruptcies...why not give her a position of leadership at MANA?  

I think this speaks volumes about the group behind the "Big Push for Midwives", the group fighting so hard for licensing for CPMs so they can be reimbursed by insurance companies.   This is the group defending the Indiana midwives on trial, who have opened up shop in Michigan.  This is the group educating and "certifying" CPMs, and further setting the imaginary bar for their practice. 

I'm so disgusted that MANA would downplay any baby's death to be an "unfortunate birth outcome".  How about severely negligent care, followed by no accountability whatsoever on the part of NARM or MANA, their parent organization, and no work whatsoever toward improving safety?  In fact, it's been quite the opposite...downplay, ignore, spin, push forward.  No one from MANA has talked to my family about what happened, attempted to understand what happened, or questions what took place.  Yet, our son's death is brushed aside as an "unfortunate outcome."

What about all the other babies who have died or were injured?  How about investigating for yourself MANA, every single baby death or injury that occurs with a care provider that YOU "certified"?  And that doesn't mean biased peer review.   How about acknowledging the problem, and getting to work at improving practices?  How about holding our midwives to the same standards as midwives internationally?

Looks like the spin and twisted perceptions start at the top for this pseudo-professional organization.  Readers, I hope you'll let them know how you feel.  And more importantly, I hope you'll call your Senator and State Representative today and tell them that we must do better than MANA and CPMs for Michigan's families.  
Find your legislator here.

Bothered by this?  Visit this webpage for contact information for Geradine and Jana, and let them know how grossly they are misrepresenting the concerning state of midwifery in Michigan. (If you click on this link, you need to select their name on the page to access their email.)