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Tuesday, May 24, 2011

Submission For Midwifery Online UK (I am submitting, If they don't take it I'll still have posted it here)


                                 The Truth about the American Midwifery System
                                                         By Jade Jymson
It should be stated before reading this that I love Midwives. Both of my children were placed, squalling and pink onto my belly by an American Nurse Midwife. I went into labor early with my first child and my midwife, who was out of town at the time, drove eight hours to get back to me so that she could deliver my son. This was all during what was being called the worst snow storm of the year to hit the east coast.
Had I gone to an Obstetrician I’d imagine I would have been handed off to the next in command under my doctor and perhaps have been aided in delivery by a person I had never before met. This kind and determined woman who plowed down the interstate through two feet of snow, is the very reason that I went with a midwife to start with. I enjoyed our appointments and we soon became close friends. Six years later when I became pregnant with my daughter, I returned to her for care and we became even closer.
Recently in my State a midwife was brought up on charges of practicing without a license. I rallied behind Amy Medwin as did many others in my state. Having seen “The Business of Being Born” I had been led to believe that all American Midwives were as knowledgeable and professional as my own Nurse Midwife had been.
Considering I write this for a British audience I have to point out a few facts. The British Midwifery system is not the same as the American one. Your midwives are much like our Nurse Midwives. They are required to have a college education and spend many years studying and watching babies being born, making sure that they are trained to handle the emergencies that can arise in a normal low risk birth. They are made to follow rules and protocol—women are risked out left and right for not being good candidates for midwifery services. You do this not to be cruel and not because you do not trust birth, but because you understand that even a normal birth can go south in a matter of seconds. If the US followed the British example, I would have nothing to write about today.
The issues in the US start with the shoddy system in place to regulate Non-Nurse Midwives. We have several names for them, Certified Practicing Midwife (CPM), Direct Entry Midwife (DEM) and Lay Midwife (LM).
There are differences in the methods of training between these practitioners, but for the purpose of this essay, I will lump them all together—because in the end, they are all the same.
In the US, Non-Nurse Midwives are not required to carry any type of malpractice insurance. If they should made a mistake that leaves you or your child permanently damaged then you are left with no action to take against her. Lawyers here are not even interested in taking the case of such a practitioner because there is simply no money to be had. You and your child can be left alone to deal with what could be lifelong damage requiring millions of dollars in medical bills and possibly lifelong nursing.
This might be a small risk to take in Brittan where the midwives come so highly trained and such problems are unlikely. In the US it is sadly all too common. Here, to become the highest trained of the non-Nurse Midwives (CPMs), one must merely complete a GED certificate ( High School Equivalency and can be earned as young as 16). For her formal midwifery training, she takes a minimum of several freshman level anatomy class and must watch no more than 40 births. If all of these births are C-sections then they are still counted towards her requirements.
There may be many women who are Non-Nurse Midwives who do have higher qualifications. They could have Ph.Ds.’, but in America there is no way to find out. Because there are no databases showing a midwife’s credentials it is impossible to look into their background. An American woman cannot tell if a Non-Nurse Midwife has a Doctorate and transfers at the first sign of trouble, or if she has a string of dead babies in her wake. Women entering into the pool of Midwifery in the US have no way of knowing anything about their midwife in advance.
As if this is not bad enough, many of the so-called midwives practice in States where they are not legally allowed to work-- Laws seem to have no meaning to them and the freedom of birth choice seems to override the safety of their clients. They take on risky deliveries such as first time mothers with breech babies, older mothers, twins and women with high blood pressure and Gestational Diabetes.
These women make a mockery of everything it means to be called Midwife. They seem to care more about the location and emotions that occur during birth than the outcome of a healthy mother and child. To them birth seems to be more about dodging the system than it does truly being “With Woman”.
To those of you who have earned your very respectable title of Midwife, I applauded you. You have taken the vow to help women get the best outcomes of labor, while keeping the women in your care in a friendly and safe environment. Please do not let these American Faux Midwives place themselves in the same category as yourselves. They have not earned that title and they make you all look bad.
Believe it or not it is possible to support the fine art of Midwifery and still be an activist against dangerous practices. I urge you to tell any of your clients who are planning on giving birth in the US that the only midwives here who have comparable training to the British Midwives are Certified Nurse Midwives. They are insured, they are listed with the State Boards of Health and they have many, many years of training with all types of births. They are held accountable for their actions and are backed by OBs.  Knowing that the US midwifery system is not as cut and dry as it is in other countries, I hope this can be a warning to anyone planning a midwife assisted birth in the US.

1 comment:

  1. I don't believe that a longer amount of medical training necessarily makes someone a better birth assistant. The medical model encourages patients to hand over their decisions to someone who is better educated, and that makes me inherently uncomfortable with it. I trust the advice of a wise, older midwife who has delivered hundreds of babies over the judgment of a young doctor who has read hundreds of textbooks on the subject. That's my personal preference, and you can disagree with me. But I appreciate having the ability to choose choose a CPM rather than a CNM, which is legal in my state, rather than having to submit to a legislature that decided without my consent that CPMs are somehow inherently dangerous.