tag:blogger.com,1999:blog-346749784229772317.post7932816410376964160..comments2022-03-09T03:58:19.101-05:00Comments on Safer Midwifery for Michigan: What We're Seeking: Defined Scope of PracticeMWShttp://www.blogger.com/profile/04125751490256911705noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-346749784229772317.post-7674346623443823832013-10-06T15:23:28.636-04:002013-10-06T15:23:28.636-04:00Out of hospital or "homebirth" deaths ef...Out of hospital or "homebirth" deaths effect change and despair upon women as mothers much deeper than a hospital death with or without negligent caregivers. There may be no transport(s), no ambulance, no sirens, and no need to search for support from counselors, social workers, or other helping professions. The hospital provides all of these. :) Even dialing 911 is part of the cascade of getting help while at home. First responders, EMTs, and paramedics all have varying degrees of experience. Depending on their experiences and location they may get called out once a week or once an hour on other types of calls...but for a homebirth emergency? Mothers and community members and volunteers all need more training in at home emergencies and certainly help in how to hire a caregiver for their birth, their child, and their unborn baby. I think we could begin making birth safer from the bottom up rather than from the top down. How about beginning with Community Midwives who do not offer birthing services yet are willing to come alongside their communities and families and offer consumer education or counseling and referral services? A government, a system, and education for women as mothers BY women as mothers...that would make midwifery safer in my opinion. Mature professionals: (1) can clearly define their role and have a defined scope of practice, (2) offer unique services, (3) have special knowledge, skills, and are specifically trained for a particular profession, (4) have an explicit code of ethics or moral code, (5) have the legal right to offer services, (6) have the ability to monitor the practice of their profession or are able to 'police' themselves, and (7) are able to put the needs of clients of ahead of their own and put the needs of their students or interns in perspective in order to replicate themselves as professionals (Nugent, 1981). S.E. Blau https://www.blogger.com/profile/02747099618058122476noreply@blogger.comtag:blogger.com,1999:blog-346749784229772317.post-80647740203777625042013-01-04T11:46:20.134-05:002013-01-04T11:46:20.134-05:00Hello Undercover Midwife. Thank you for contributi...Hello Undercover Midwife. Thank you for contributing to the discussion on this blog. I want to say that I understand where you are coming from in your criticism of hospital OB practices. Hospitals are not perfect. Physicians are not perfect. And there are some backwater corners in rural areas that are still doing appalling things to women in labor. <br /><br />But I'm going to echo "Safer Midwifery" here and say this blog is not about hospital-based practices. It is about improving midwifery. I try to refrain from criticizing what I know to be true about hospital practices when engaging in this discussion about midwifery. It's not that it's not a factor - it just diverts the topic of discussion. <br /><br />In regards to midwifery - I don't know a single midwife who isn't acutely aware of the variation of practice among midwives. It's usually in private that one will say to me "Holy Crap, Midwife X did XYZ." Or they lament the lack of use of anti-hemorrhagic meds, or oxygen, or qualified assistants at births. Or the lack of skills a new CPM has to care for clients. They all talk about this - it would be nice if this discussion was happening on a professional level - to improve the safety of midwifery care - instead of in hushed conversations. The lack of practice standards for midwives is one of the main reasons I'm no longer working on becoming a CPM. This group of professionals was not acting professionally. <br /><br />Safe midwifery care is important. This is why I participate in these discussions. Is there anything that can make midwifery safer in your opinion? I'm interested in your perspective and experience regarding midwifery. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-346749784229772317.post-88563897824213941722012-12-17T13:37:32.346-05:002012-12-17T13:37:32.346-05:00They are not under my scrutiny because my baby did...They are not under my scrutiny because my baby didn't die in the hands of an LPN nurse. This blog is not about nursing. It's not even about maternity care. It's about midwifery in our state, and the problems that are taking innocent lives. There are so many issues to address with midwifery alone, we chose to focus on that area of improving maternity care. If you, or someone else would like to start a blog about hospital based maternity care and the issues you'd like to see change, I'm sure many would benefit. It's simply not the focus here. I agree, there is a shortage of caregivers. That doesn't mean offering substandard care is an appropriate solution. Why wouldn't midwives strive to be the gold standard, strive to be as safe and educated as they could be? It's simply not the case. Instead they are taking unnecessary risks in the name of choice, and telling women to trust birth, to trust themselves. Well, that's all terrific until trusting your body fails. There is no risking out, there are no standards, and there is no accountability. If midwifery and out of hospital birth are to be a reliable option, the practices and profession must improve. I'm sure there are many issues and inconsistencies in a hospital, but those aren't the issues our advocacy group is addressing. Safer Midwifery MIhttps://www.blogger.com/profile/04587761670182623797noreply@blogger.comtag:blogger.com,1999:blog-346749784229772317.post-8714524299441443272012-12-17T13:22:34.975-05:002012-12-17T13:22:34.975-05:00Dear Undercover Midwife,
You can visit our blog ...Dear Undercover Midwife,<br /> You can visit our blog as often as you like and complain about the medical field, hospitals, or even episiotomies if you like. While you may not agree with the standards for education, or the practices you speak of, the fact remains that none of your complaints make midwifery or home birth one bit safer. This blog is not about preaching that hospitals are perfect, wonderful, or without room for improvement. This blog is about midwifery, the lack of standards, the false notions that women are being sold, and how to improve it. Why do I not write about hospitals and Obstetricians? That's not what this blog is about. My baby did not die from an episiotomy. He didn't die with a resident without experience. He died with negligent midwives, as did many, many others in recent years. Disproving of hospital care does not mean women should be running home to birth their babies, it means our culture should be fighting to improve the system. The worst hospital in MI doesn't make home birth safer, or midwives more professional. It's a mute point. You're not comparing apples to apples. Safer Midwifery MIhttps://www.blogger.com/profile/04587761670182623797noreply@blogger.comtag:blogger.com,1999:blog-346749784229772317.post-30420489917406628432012-12-16T12:47:30.637-05:002012-12-16T12:47:30.637-05:00Hospital guidelines in Michigan effect women far m...Hospital guidelines in Michigan effect women far more often than homebirth and midwives. RNs and LPNs with 1,2,3, or maybe 4 year certificates or degrees now work 24/7/365 in OB depts. No offense to anyone but putting a student in the OB dept in a teaching hospital needs to be addressed by practice standards as well as the concerns you folks have voiced. State laws and hospital rules allow students who have never seen a birth to attend birthing mothers. These students rely on other more experienced nurses and other staff in the hospital setting as well as experienced mothers giving birth for subsequent births of their children. How many of these students are trained to ignore the requests of birthing mothers due to protocol of hospital, doctor, or routines? For 30 years I have heard women complain about OBGYNs who argue for episiotomies right in the delivery room. Later these docs make comments about stitching moms up better or tighter than before. This is outdated, not based on research, and in fact is based upon practices dating to doctors who kept slaves for experimental procedures. Women need their health care to be based on facts rather than the inexperience of students and their ignorant OBGYN docs. I am sure that this shows up in other areas besides slashing episiotomies on 60-90% of women in the USA and Michigan too.S.E. Blau https://www.blogger.com/profile/02747099618058122476noreply@blogger.comtag:blogger.com,1999:blog-346749784229772317.post-14087481595986953682012-12-16T12:36:38.717-05:002012-12-16T12:36:38.717-05:00The shortage of caregivers contributes to this pro...The shortage of caregivers contributes to this problem. Also, Michigan is a long state geographically. Why should women need to travel over an hour to get to a Level 3 hospital for births? Why aren't you educating women about the various levels of hospitals as well as the various levels of midwives who practice in Michigan? RNs and LPNs who have 1, 2, 3, or maybe 4 year degrees are the attendants for women in hospitals 24/7/365. Why aren't these professionals under your scrutiny? A student can work in OB dept via a teaching hospital after how many months of college instruction? S.E. Blau https://www.blogger.com/profile/02747099618058122476noreply@blogger.comtag:blogger.com,1999:blog-346749784229772317.post-76272486534311520412012-07-27T22:09:49.186-04:002012-07-27T22:09:49.186-04:00To be fair, most of these practice standards shoul...To be fair, most of these practice standards should be part of professional practice guidelines - not encoded into state law. Especially those that would change over time when practices are re-evaluated for safety and efficacy (*ahem* breech at home & garlic in hoo-haas *cough cough*).<br /><br />But CPMs have done this to themselves by not creating their own professional evidence-based practice guidelines specific to OOH practice - so it becomes up to the state to babysit these people. Not ideal.Anonymousnoreply@blogger.com