Thursday, July 12, 2012

So Many Questions

I'd like someone to explain to me why midwives are seemingly infallible?  Why are they not capable of making mistakes, of acting negligently, of doing harm?  Are they not human?  Are they somehow immortal?  No matter how much you love your midwife as a friend or "sister", no matter how "empowering" your home birth might have been, is it too much to consider that midwives are human and make mistakes?  Is it too much to understand that in the nature of their job those mistakes can be so great that they cost lives and permanent damage?  And further, if those mistakes are repeated, does a community not deserve to know there is a problem?  

Why are midwives not capable of malpractice? (Meaning they deviate from a standard of care that otherwise prudent people of the same profession adhere, putting women and babies at risk of death or injury.)  The inherent problem here is that too often there is no consistently defined, standard of care I suppose.  

Why is it that when a family suggests mistakes were made and actions are taken to hold midwives accountable, that that family is made out to be the enemy?  Why is accountability not expected of the "profession" of midwives?  Why is every death or injury not worthy of at least an investigation?  Why is every death and injury not reported to anyone?  Why are these situations ignored, dismissed as irrational, or worse imagined never to have happened?  Why are these situations not acknowledged, addressed, and carefully analyzed to improve practice?  

How is it that Michigan has no regulations for midwives to date?  How is it that there is no defined scope of practice or mandated reporting of outcomes?  Why can anyone call herself a midwife regardless of educational training?  Why do midwives not have to be certified in neonatal resuscitation?  Why can midwives traffic prescription drugs illegally and that's somehow okay?  Please tell me how midwives who are arrested repeatedly or out on bail on one state can come to MI and set up a birth center, no questions asked?  

Why do midwives not have to bother with carrying insurance?  Are they infallible, on par with God himself who can make no mistake? Why don't we expect more of our midwives? Why are midwives exempt from any and all accountability?  

I don't presume to have the answers to these questions because many of them are puzzling to me.  I will say this...that midwives and the women who value their care need to think deeply about these questions.  If midwifery is to be a responsible, professional, sustainable option for women, midwives must hold themselves to a higher standard. Having "choices" in the birth of our babies does NOT mean subjecting ourselves to unaccountable, randomly educated, and apparently criminal midwives.  

Why can't we expect midwives to be educated, licensed, insured, ethical, and held accountable when they have made mistakes?  What's wrong with higher standards?  Why is it rendered "anti-midwife" sentiment to expect professional standards and conduct?  Can't I have my midwife, my choice, and some standards too?

Establishing standards does not equal elimination of choice, it simply asks that those choices be as safe as they possibly can be.  


  1. >I'd like someone to explain to me why midwives are seemingly infallible?

    Because midwives are told that they provide care "as safe as hospital births"

    And that

    "Nations with the lowest infant mortality employ midwives as the primary maternity care providers for the majority of women"

    And that midwives are "skilled" and "experts" in providing care in an out-of-hospital setting.

    And that there is essentially no difference in types of maternity care providers:

    "Medscape Today in their article "Science and Sensibility: Choice of Birth Place in the United States: Qualified Home-Birth Providers" states "Fortunately for the American public, evaluations that compare professional competencies and practices among maternity provider groups have found more similarities than differences in the basic skills and components of care that are offered to healthy women across birth settings.[37,38]"

    Over and over midwifery organizations assert parity of skill and competence with medical and obstetrical professionals - and midwives believe this. They believe they are providing the best care - or care that is equivalent to that in another (hospital) setting. Because they are told this. Over and over and over.

    Attend a midwifery conference - there will be endless sessions about how great midwives are. Carte Blanche.

    They are displaying the hubris for which they have so much disdain in the medical community.

    Midwives have been told that they are SAFE, GOOD, COMPETENT, and EXCELLENT so many times that they are blind to any other reality.

    A true profession should be able to address where common practices (written standards or not)are causing harm and make recommendations to remedy these harms.

  2. Bravo. Saying it doesn't make it so. And hubris kills moms and babies. How about some humility. Some apologies. And some grace.

  3. Faith Beltz, the CPM that killed Aquila Papparella, opened a birth center in the same city not even one year from the death
    WITH a complaint pending in the same state!!!

    Until they are prosecuted for practicing medicine w/o a license, and jailed, they will keep on killing. The worst come to Oregon, where no regulation exists.

  4. Faith Beltz the CPM that KILLED Aquila Papparella opened up a birth center in the same city, not even a year after the death, while a complaint was pending there!

    They have NO SHAME. They need to be prosecution for practicing medicine without a licence, as that is what most of them are doing. Then, they need to be jailed- they kill more people than pot dealers do, right? I have no idea why they are so protected.

  5. Midwifery conferences are big conglomerations of people who revere midwives or who already are midwives and there is a lot of effort and organization put into patting those midwives (themselves) on the back. No mention is made of fetal loss, maternal loss or injury... it's lots of hubris, lots of demands for equal treatment, recognition, licensing (to make their illegal activites legal, like prescription drugs they carry and administer without scripts or adequate knowledge on proper use or potential problems). There are still the "old school" midwives who use slogans such as "keep your license off my vagina" and other murky statements meant to say, "We can call ourselves midwives without your state licence or oversight or regulation"... and then there are the "newer school" midwives who demand licensing, want the same respect and recognition as CNM's although the levels of training are vastly different. It needs to STOP.