Now that the holidays have settled into a nice new year, we're back on track for talking about the serious issues families are facing with the current state of midwifery in MI. We'll start the year with a series of posts related to assessments, testing, and their relationship to safety. We hope you find them thoughtful, and useful.
What do you get when a group of professionals have no practice standards?
A crap-shoot as to what kind of care a client gets.
A group of us were discussing creating a list of routine prenatal assessments and cares that should be offered by all maternity care providers - specifically CPMs and OOH midwives. There is such a variation of practice, training and skill among these "professional" midwives that it is difficult for a client to know if she is getting appropriate care or not during her the course of her care. Former apprentices have voiced concerns numerous times about the lack of safe care they'd witnessed -and the complicated nature of the problem. A point we keep coming back to is that CPMs have no professional guidelines. There is no document or position statement by an OOH midwifery organization that lays out appropriate care (routine tests, follow up, labor assessments, timing of FHTs in labor, etc). There just are no standards. And that is the root of the problem.
But it sure seems like midwives should be breaking down the issues surrounding what constitutes appropriate care and assessment during pregnancy and birth. You know, like writing actual professional practice guidelines. Midwives are the ones who keep asserting that they are "professionals." THEY should be sitting down together
and writing these standards and disseminating this information
to each and every CPM out there saying: "These are our professional
standards." "This assures safe and competent care." But instead they
know that CPMs do whatever the Hell they want [homeopathic
streptococcus, anyone?] and they don't do anything about it except cower behind the tenet of "informed consent."