Tuesday, April 24, 2012

Funding Renegade Midwives

1. a rebellious individual who rejects conventions or laws of a group  
2. an individual who rejects lawful or conventional behavior

I have met in recent years, several midwives who work hard to serve their clients with a great deal of ethical responsibility.  They are educated, licensed, insured, transparent, cautious, and appreciate that sometime birth falls outside their scope of practice.  They know when and how to seek transfer of care and appreciate that at any moment "normal" birth can deviate.   These midwives build healthy relationships with and within hospitals and work to hold safety of mom and baby in the highest regard. 

Let's consider the question, What is a "renegade midwife"?  A renegade midwife is someone who prides herself on making a statement through her work, one who "trusts birth" at all costs and believes that when things go wrong it's just the way it's meant to be.  Renegade midwives are those to often put their clients in danger by taking on known high risk situations to better advance their own movement or to prove a point.  A renegade midwife will tell you that any risk factor is, "just a variation of normal", that moms know how to give birth and babies know how to be born, and fill their clients with fear about the hospital instead of building a healthy relationship with them (and yes, that effort goes both ways).  A renegade midwife doesn't report her outcomes, nor is she accountable to anyone.  She is uninsured, unlicensed, and unafraid to practice even when it's against the law.  These midwives "fly under the radar" and pretend their work is serving women, empowering them.  These are the midwives that put philosophy above safety and pose great danger to any mother seeking their care. 

With families speaking out more and more about their less than perfect experiences in the hands of renegade midwives during home birth and at freestanding birth centers, the question of support comes into play.  The trend appears to be that the Natural Childbirth advocates instantaneously jump on the bandwagon of support to protect their “choice”, their pleasant outcomes, their “movement”, and ultimately themselves without any real analysis of what may have gone wrong and why.  What ever happened to the responsibility to review adverse outcomes and improve practice?  Why are these “communities” so quick to dismiss the experiences of families who do find the strength to come forward and talk about what happened to them? Perhaps the very "advisory boards" that support them should offer advice that includes careful analysis of adverse events aimed at improving practice instead of asking for donations to support legal fees. 

For those who criticize the action of a lawsuit I ask them this…What other choice do these families have but to turn to lawsuits when there are no regulations or laws by which to hold midwives accountable?  Would they suggest discussing it over dinner and cookies and accepting that, “some babies just aren’t meant to live?”  When we experience something we knows to be reckless, unethical, and dangerous, is it socially responsible to say and do nothing? Is it acceptable for those people responsible to walk away without so much as a reprimand? Certainly not.

Even further, many of these “supporters” are throwing their money behind renegade midwives to support them financially due to the burden of legal fees, never mind the fact that if they had been responsible in having liability insurance in the first place, the “burdens” wouldn’t hit their pocketbooks so hard.  

A friend of mine brilliantly drew this analogy:

“Imagine you are sitting on an airplane, about to take off, when the flight attendant comes on the speaker and says this: "Hello ladies and gentlemen, before we take off we will be passing a collection plate around the cabin. You see, your captain and co-captain had a crash last year and a few people died. The settlements to the survivors and families are really steep and so they are hoping that you will consider making a donation to help them out. They love flying and can't wait to get you up in the air today! Thank you!

Seriously . . . would anyone on the flight put money in the plate? I doubt it. Moreover, would anyone stay on the airplane? I for one would grab my stuff and get the hell off. “

I’m growing weary of the folks that can’t see outside their own good outcome and recognize that something is very wrong for many of us - and it’s no coincidence.  How can people blindly support individual midwives knowing that their actions are at the very least questionable, to the point of costing babies and mothers their lives?  How about working toward improving out-of-hospital birth instead of ignoring and vilifying the outcries of families across the country while the midwives act like martyrs?  Recognizing the problem is the first step. The next is doing the hard work necessary to improve outcomes for all of us. 

For the moment, I hope that families in the Natural Childbirth community will choose to spend their money wisely and, in the meantime, have the sense to get off any plane that is piloted by irresponsible captains.


  1. " How about working toward improving out-of-hospital birth instead of ignoring and vilifying the outcries of families across the country while the midwives act like martyrs? "

    YES! YES! YES!

  2. Yes!! The community needs to listen and do something. Stories like ours shouldn't be occurring like they are.

  3. That was a great post. Failing to analyze the events that lead to an adverse outcome is incompatible with any sort of caring position towards moms and babies.

  4. Yes! Thank you for putting it into words for many to read.