Where is the Leadership: Part I

Part I:  This post will be the first in a two part series.

What does ...

Having your CPM credential revoked by NARM + Multiple dead babies + Larceny & Misrepresentation = for a MI midwife??  

It equals...still practicing without real consequences.  Yep, you read that right, still delivering babies for MI families.  How can this happen?  

The bottom line is that MI has no laws or regulations in place to stop the reckless midwives like this from practicing.  NARM can hold their peer review sessions, make polite suggestions for change, and midwives can stop referring clients to someone they know to be dangerous, but nothing is in place to prevent that person from continuing to practice. Heck, these midwives can even move to another state, and still practice, if the laws in that state don't prevent them from doing so.  (i.e. Michigan = hotbed for midwives who don't like to play by the rules.) 

Case in Point:
Bridgett Ciupka's (former CPM) NARM credential was revoked in 2004.  Yet, four years later, she was the midwife for Ms. Mushin and her baby, Alia Mushin, who died in-utero, while still under Ms. Ciupka's care, after her mother was 4 weeks post-dates. Further concerning events were charges of Larceny and Misrepresentation in 2009, for which she is still on probation, according to current court records According to Metro Midwives and Birth Partners, Bridgett is still practicing in MI.

The scary truth is that this is just one example.  In MI, we currently have OOH midwives who have served probation for wrongful death, who are in the midst of a criminal trial in other states, who have filed bankruptcy repeatedly to avoid civil accountability, and who have numerous deaths and injuries on their invisible records.  We have midwives who have faced criminal charges for the death of mothers and babies, and those who have dodged charges that should have been pressed.  Ironically, these are precisely the midwives leading Michigan's professional organizations for midwives, and the drive for legislation.

What could these particular midwives have to say about all of this?  Well, they say home birth is still safer than hospital birth, that babies die in hospitals too...in fact some babies just aren't meant to live. They say that peer review through NARM is working, despite the fact that it does nothing to prevent dangerous midwives from continuing to practice.   They continue to offer home birth to women who have had three prior cesareans, and brag about their success on FB, despite having lost a mom and baby after a HBAC2 (Home birth after 2 cesareans).  They continue to offer home birth for breech babies and twins, insisting that it's "just a variation of normal".  They tell mothers who have pre-eclamspsia that it is safe to have a home birth, but when she strokes as a result, it's all about the choices she (the mother) made, and nothing about the professional responsibility of the midwife.  

These midwives tell women to trust birth and their bodies, but don't tell them that sometimes women really do need medical help, or when to get it.  They pretend the system is working like a well oiled machine, when in fact they are covering up the truth about what is really happening out there so they can continue selling an ideal that doesn't exist.  It's an ideal that can't exist while the dangerous midwives continue to represent the leadership.  

Don't just take my word for it.  Here are the thoughts from an anonymous midwife who shares the same concerns: 
 
      "My greatest frustration in all of this is that so many of the midwives have become 
      defensive in this state when it comes to discussing regulations and clinical 
      judgement.  When a well-liked midwife acts erroneously, in terms of poor clinical 
      judgement, the first concern seems to be about her as a midwife." 

     "I know midwives who gave up midwifery because of frustration with MMA not 
     wanting to admit that another midwife was incompetent or negligent, because that 
     midwife was also internationally known and well liked.  The view is that if we as 
     midwives censure one bad midwife, we are failing to stick together and will 
     provide fuel for the OBs and others who would like to see midwives disappear. 
     Our censure is seen as a crack in the armor of our united front to promote 
     midwifery as a profession. It is also seen as being disloyal to the sisterhood. I 
     suppose the general feeling is that any of us could make a mistake, and no one 
     wants to be criticized for the care that they provide. Feels to me like insecurity 
     about the perception we would like families and other professionals to have of us." 

So where is the leadership?  The midwives we are talking about here, are not representative of every midwife out there.   Clearly there are midwives who are concerned about what they see in the OOH birth community.  The dangerous midwives are blending in with the rest to unsuspecting mothers, protected by professional midwife organizations who would rather defend people like this to protect their cause, than confront reckless practices to ensure safety.  The voices of mothers sharing their stories of negligent loss, the voices of concerned doulas, apprentices, and fellow midwives, all fall on deaf ears.  It is easier to ignore the problems than to acknowledge and address them.  It would make midwifery look bad to admit there are problems.  

My question is, when will the leadership shift?  When will the ethical midwives who are practicing safely, those that care about this profession and the mothers and babies they serve more than themselves, rise up and change the culture of OOH midwifery today?  It is concerning that the current leadership doesn't see, nor do they have any interest in, addressing these matters.  Furthermore, they are corrupting an entirely new generation of aspiring midwives, instead of doing what is right, and pushing for legislation that would serve to protect them further.  When will our legislators do what is right on this issue?  When will women in this great state demand better, more consistently reliable care? 

This blog is not about smearing midwives.  It is a call to action for the good to rise up and make OOH midwifery what it has the potential to be.  Unethical tactics, dangerous practices, cover ups, and denial won't get any of us anywhere.  How can we effectively improve what is broken if the leadership of OOH midwifery pretends that problems simply don't exist, all for the sake of protecting a "sisterhood."  Who is protecting the mothers and babies? We want leadership that is honest, ethical, and can lead OOH midwifery toward safer practices for MI families. 

**OOH means Out of Hospital Birth, referring to home birth and/or freestanding birth centers