by Erin Odom and Courtney Price
Stephanie Keach’s baby died during an attempted home birth 15 years ago.
After the stillbirth, a local certified nurse-midwife called for the attending midwife to be charged with manslaughter, Keach said.
Keach’s midwife was a certified professional midwife, known as CPMs, a certification not recognized in North Carolina.
Keach, who lives in Asheville, doesn’t blame her midwife for her child’s death. An autopsy revealed the baby had a heart condition, and it was unclear whether doctors could have saved the baby’s life, anyway.
“Sure, I could have ultra-sounded, found the defect, C-sectioned and (had an) open-heart-surgery for my child …but that is not my way,” Keach said. “I believe in God and trust in the natural order of things. It doesn’t mean it wasn’t and still isn’t a painful ache in my heart.”
It’s becoming more common for parents to seek out direct-entry midwives – who practice illegally in the state – to deliver their children in the privacy of their own homes, rather than a hospital. To legally give birth under midwife care, parents must find certified nurse-midwives, who are licensed to practice in North Carolina.
The growing trend has opened up a debate among parents and medical professionals, as some believe direct-entry midwives should be allowed to practice.
Popular local midwife arrested
Medwin
The discussion swelled last month when Charlotte-Mecklenburg Police arrested Emily “Amy” Medwin, a popular direct-entry midwife in the greater-Charlotte area, after a baby died during a home birth in Rowan County.
Medwin was charged with practicing midwifery without a license and resisting arrest, both misdemeanors. She has since been released from jail on a $100 secured bond and is scheduled to appear in court in Rowan County on Wednesday, March 23.
WBTV, the Herald Weekly’s news partner, reported the Mecklenburg County Sheriff’s Office recently issued an additional warrant for Medwin’s arrest for illegally practicing midwifery.
Court records say Medwin was at an east Charlotte home on Allister Drive last month when a baby was born. He had to be rushed to the hospital with serious injuries, WBTV reported.
Dr. Susan Roque and CNM Marcia Ensminger, from All About Women in Mooresville, support local direct-entry midwives and have served as back-ups to deliver home-birth mothers’ babies at Lake Norman Regional Medical Center in the event that something did go wrong. They are both disappointed in Medwin’s arrest.
“It’s a shame,” Roque said. “Amy Medwin is absolutely one of the best lay midwives that are out there.”
Tanya Bailey, president of North Carolina’s chapter of the American College of Nurse-Midwives, said the issue isn’t Medwin’s skill level.
“Licensure essentially ensures public safety,” she said. “If you need a license to practice, you need a license, and she knowingly practices without a license.”
Direct-entry vs. nurse midwives
North Carolina law doesn’t outright prohibit direct-entry midwives; instead their training does not meet the requirements set by the state’s nursing board to obtain a license.
In 1983 the state General Assembly passed the Nurse-Midwife Law, which placed the administration of midwifery under the Board of Nursing. In the same legislation, those who practice without a license are guilty of a misdemeanor.
Midwives in North Carolina – CNMs – must first be trained as a nurse. Nurse-midwives then achieve a master’s degree in science with a specialization in nursing or midwifery.
For those states that do recognize the direct-entry midwife licensure, midwives must have an apprenticeship with a reputable midwife or complete a program that is accredited. Direct-entry midwives, which are sometimes referred to as CPMs or lay midwives, are nationally regulated and can legally deliver babies in 26 states, including Virginia, South Carolina and Tennessee, according to the Midwives Alliance of North America. The certification doesn’t require college-level education.
“There’s been a rush to judge the entire direct-entry midwife profession as uneducated and unsafe,” said Manisha Cavendish, a Huntersville resident who is a clinical psychologist. “Trained and experienced (direct-entry midwives) … fill a need no other provider does at this time in the Charlotte community.” Cavendish planned a home birth with midwives for her second child, but delivered the baby before help arrived.
Home versus hospital
Both programs require midwives-in-training to actively participate in births under the supervision of a licensed obstetrician or midwife. However, the nurse-midwife certification does not require training in birthing at home.
In fact, most who practice in North Carolina – midwives and doctors alike – are hesitant to offer at-home birthing services.
Within the medical profession there is some disagreement on which is safer.
Roque, the Mooresville obstetrician, supports home births.
“Across the world home births are being carried out,” she said. “A lot less happens at home than at a hospital. It’s a safe environment, and we should be pursuing more home births within the states.”
Ehab Sharawy, a doctor at Huntersville OB/GYN, said, “The most important driver this subject has is patient safety. It’s a fine line between the autonomy of the patient and the concept of ‘Do no harm.’”
CNM Beverly Holmes, of Lake Norman OB/GYN, believes women should have the choice but feels most comfortable attending natural births in a hospital setting.
“Most of the time birth goes well regardless of the setting,” she said. “I like going all natural as the day is long. But if mama or baby needs anything, it’s good to know safety measures are behind the curtain.”
Nurse-midwives must have a back-up physician for home births, partly for cases where emergency surgery might be necessary. Midwives are not trained or licensed to perform surgery.
Mooresville resident Christine Lampel believes her nurse-midwife saved her life after she delivered at Lake Norman Regional three years ago.
“I hemorrhaged immediately after the birth,” she said. “The bleeding was profuse, and the pain was unbearable. If I had chosen a home birth in this situation, I would have died.”
A home birth with a qualified professional is safe for low-risk women, said Ensminger, of All About Women.
But, Lampel said, “In a home setting, you can’t always predict these types of situations or be prepared.”
Still, Ensminger, who delivered Lampel’s baby, believes it could be safer for a low-risk patient to deliver at home. “Labor and birthing are normal physiological processes. Hospitals make it a medical process,” she said. “Fetal monitoring doesn’t increase mortality, but it increases the C-section rate.”
“Right now you’re not comparing apples to apples,” Sharawy said.
Generally, patients identified as high risk would choose to deliver in a hospital. The state has mandated steps to reduce the rate of cesarean births, which hovers around 30 percent in North Carolina.
In 2008 the American Medical Association submitted a letter to the Missouri Supreme Court opposing the state’s lack of midwifery regulation. According to that letter one study “showed that the incidence of neonatal death was twice as high (3.5/1,000) for planned home births as for hospital births (1.7/1,000).”
But a 2000 British Medical Journal study of North American home births showed that women who planned to deliver at home experienced lower rates of medical interventions.The study also showed home birth to be as safe as hospital birth for low-risk women.
Keach, the Asheville mom who lost a child, went on to birth three healthy children in a home setting. “Birth is, has been and will continue to be a time of magic, mystery and forces beyond our control,” she said.
March 17, 2011 at 8:33 pm
A big thank you to Erin Odom, Courtney Price and the Huntersville Herald! How refreshing and encouraging to see such a fair and balanced article on such an extremely important issue! Keep up the great work!
March 17, 2011 at 8:55 pm
Thank you Huntersville Herald, for a fair and balanced article. Many thanks too, to those professionals who are willing to support the integrity of informed choice and consent for all clients.
I’m not sure I understand
‘Ehab Sharawy, a doctor at Huntersville OB/GYN, said, “The most important driver this subject has is patient safety. It’s a fine line between the autonomy of the patient and the concept of ‘Do no harm.’”’
The patient always has the inalienable right to self – determination, even if they choose to go against medical advice! This is the basis of informed choice – all information must be made available – not just the information and options that are acceptable to the medical professional.
It should also be noted that CPM’s are trained and able to administer medications to control post partum hemorrhage – licensure would ensure timely and appropriate transfer of care when and if it becomes necessary.
Currently the US falls well below most other first world nations (and several developing nations) in maternal and infant morbidity and mortality – the system is failing to protect and preserve the life and health of women and their babies.
Under the current obstetrical, system the financial cost of significant morbidity associated with hospital aquired infection, post-surgical complications, lack of post-partum care and availability of breastfeeding support cannot even be estimated. The emotional, spiritual and social cost is endless…
I look forward to the day when every woman can choose where, who with, and how to have her baby; when CPM’s are legal, licensed and acknowledged as co- members of the maternity care continuum.
Thanks again for an informative article
March 17, 2011 at 9:32 pm
Thank you for this article. I do want to point out one thing. The woman who said she hemmoraged after birth said she would have died if she had been having a homebirth with a CPM and that happened. This is simply NOT correct. CPMs are equipped for such an emergency. They carry pitocin with them to stop hemorraging, should it happen.
March 18, 2011 at 9:51 am
If Medwin is one of ‘the best’, I would really hate to meet the worst.
March 18, 2011 at 10:34 am
Safety is a red herring. When will people understand, that all this talk about the baby is taking attention away from the main point, which is the experience of giving birth. You just can’t have a good birth experience when you are being birth raped in hospital !!!! sure some extra babies may be saved or avoid injury in hospital, but destiny did not intend those babies to be. Which is why the mother can’t bond and likes them less than her other children (see babble – http://blogs.babble.com/being-pregnant/2011/03/15/mom-confession-i-think-i-love-my-son-a-little-bit-more/ )
Mama Tao http://themamatao.blogspot.com/
March 18, 2011 at 12:07 pm
Really Jade Jymson?
Before I say anything else, let me say that I am 100% behind midwifery and home births for low-risk mothers.
But Jade, you point out all the wrong reasons for home births!
>>”all this talk about the baby is taking attention away from the main
>>point”
So the baby is not the main point???
You do realize that–after the your wonderful experience of giving birth–you have 18+ more years to go right?
And that the experience of giving birth will only be one of many many memories your child gives you.
>>”birth raped in a hospital”??
As a mother and an ob/gyn I find that extremely offensive.
My primary goal as a physician is the safety of my patients.
In a birthing situation, that means the mother and the child.
I’ve been in births that have gone extremely well and the parents are in tears of joy and cannot thank me enough.
I’ve been in births that haven’t gone as well too.
And in those cases, I try to do my best to ensure the well being of the mother and child.
Sometimes that means doing things that are unpleasant to the mother/child…but it is not “rape” and never have I been accused of such a thing.
>>”extra babies….destiny did not intend those babies to be”
Really??? You speak about children as if they are chickens on a chicken farm.
>>mother can’t bond and likes them less than her other children
So are you basing that comment soley on a blog post or is there a scientific study somewhere that backs that statement?
What does that say about mothers that adopt? Or mothers that have natural children and still adopt afterwards?
Are you going to tell those adopted children that their mothers don’t really love them?
March 18, 2011 at 1:48 pm
Bungle Bum–As a OB I think you should really READ my blog–I think you might find that it give you all KINDS of info you never knew about! ;)
themamatao.blogspot.com
March 18, 2011 at 2:21 pm
quite frankly Jade, you do not create a good advertisement for your blog – in fact your comments really are offensive and the message that I hope you intended gets totally lost. Lets work together to create positivity, instead of dragging each other down – it isn’t helpful, kind or true and doesn’t do a thing to change the in hospital birth experience. BTW I’m a midwife and homebirth mama, and ‘natural’ til it hurts – but we have to improve birth for EVERYONE if we are going to create a better world for our babies to inherit!
March 18, 2011 at 5:06 pm
“and ‘natural’ til it hurts”
There’s really no need to be redundant.
March 18, 2011 at 5:46 pm
‘natural’ needn’t hurt – don’t be rude
March 18, 2011 at 5:58 pm
lol
March 18, 2011 at 2:02 pm
bunglebum
there are ALWAYS going to be strange folks out there who are determined to be as provocative as possible – as a midwife, I wouldn’t accept Jade Jymson as a homebirth client either!!!
Many OB’ s work extremely hard ensuring the best outcome for mothers and babies – my point is that midwives and physician/surgeons have entirely different skill sets, philosophies and practices; our training is in different but related fields. That doesn’t mean there isn’t some overlap – I’ve known midwives who are more medically minded than many doctors and conversely, OB’s who are Midwives in Disguise. Different but Equal. We have to move beyond beating each other up and focus on those who need the care we can provide – midwives for all mothers, with OB collaberation for those mothers who need them; fetal medicine specialists for those fetuses who need them; neonatologists for those newborns who need them. In any other field the most appropriate professional is the one who does the job – it simply is not cost-effective in ANY sense to ask an electrical engineer to come change a light-bulb!
The discussion is interesting, and I think if the medical society etc would step down off the pedestal that they think is their rightful place, they’d realise that there is room for all kinds – the evidence clearly demonstrates the safety and efficacy of midwifery care, in EVERY setting – we need OB’s to do what they do best – surgery.
I wont even dignify callingyouout with a response!
March 18, 2011 at 2:36 pm
Oh my–how UNNATURAL are you guys! Mama Tao goes UC all the way baby! Midwives are as UNNATURAL as OBs…But really, read my blog!
March 18, 2011 at 5:08 pm
As is your right, Jade. Please, dont chastise others for choosing a different path. Midwives are a profession and, as with all professions, some are ‘better’ than others – same could be said of bloggers! From the way you have presented yourself on here, I think I’ll take a pass on your blog – I generally try to focus on positive, life-affirming and community building ideas; but thanks anyway
March 18, 2011 at 5:37 pm
Why don’t you jsut come out and say it! You are nothing more than a medwife! You make jsut as much money off a totally natural event as an OB. Next your kind will be standing out under a cloud saying you made it rain! Piff! I bet you don’t even believe in the windsheild whiper method of divination or Dolphin Assisted Birth! Greedy Midwives like you are what gives homebith a bad name!
March 18, 2011 at 5:45 pm
I’ve never heard of either of those things that you mention – I do, however know how to spell! You have NO idea who I am, or what I do – but frankly, thanks for the giggles – you’d make a great ‘angry comedian’!
March 18, 2011 at 5:56 pm
WEll that is the point I have been trying to get you to understand teh entire time…I feel like I’m being squished into a box here!
March 18, 2011 at 5:09 pm
the evidence clearly demonstrates the safety and efficacy of midwifery care, in EVERY setting – we need OB’s to do what they do best – surgery.
That’s ridiculous. You don’t even differentiate between types of midwife.
March 18, 2011 at 5:42 pm
that’s because, in every way that matters, there is NO DIFFERENCE. Midwives are midwives – they are experts in normal pregnancy, childbirth and post-partum care.
OB’s are experts in obstetric surgery, complicated pregnancy and the management of high-risk conditions such as eclampsia, obstetric cholestasis, DIC etc.
March 18, 2011 at 5:51 pm
Huh, bachelor’s and master’s degrees vs. post high school “certification.” Why go to a psychiatrist when I can just get therapy from my neighbor who watches Dr. Phil?
March 18, 2011 at 6:02 pm
really? check out just how many ways there are to become a midwife – you just might be surprised. BTW dont just parrot something you read or were told – really explore how much work goes into becoming a midwife. Truly, if you’re not interested in having a homebirth or midwife care for you, why would it matter to you? No one is going to force you to have your babies at home with someone you don’t want to be there – please, dont force me to give birth somewhere I dont want to be with someone I dont want practicing on me! Simple really, isn’t it?
March 18, 2011 at 6:14 pm
That’s right! If you want to make sure your car is fixed ccorrectly you need to learn all the parts of the car so you knwo if your Mechanic is doing it right! I don’t know why you keep getting mad at me safe mama! We agree on so much!
March 18, 2011 at 5:04 pm
@j4birth, how do CPMs obtain the pitocin they carry around with them, exactly, as it is a controlled substance and they do not even have any licensure in NC? If they do, they obtain and administer it illegally. What if the pitocin doesn’t work because there is retained placenta in the uterus, or because there is a cervical laceration? Do you trust an unlicensed person who may have just a high school diploma to attempt to manually remove pieces of placenta from the uterus, perform a home d&c, or stitch up your bleeding insides with no anesthesia, no antibiotics, no sterile supplies, and no skills or experience?
There are lots of places in the world where women are literally dying for lack of access to modern obstetric care. It’s ironic that American women want to be attended to by hobbyists and witch doctors in the name of “personal choice”.
If a baby dies at a homebirth attended by an illegal lay midwife, it sure sounds like murder to me. What would you call it if an amateur brain surgeon killed a patient by drilling holes in their skull? Where is the accountability here? If I slip on a wet floor in Walmart and break a leg, you can bet that someone will be held accountable. Why should someone be able to kill a baby and get away with it? Unbelievable.
March 18, 2011 at 5:38 pm
Oh dear, I hardly know where to begin… I think you should check out the international maternal mortality figures ; right NOW women are literally dying HERE precisely because of ‘modern obstetric care’. There are lots of places in the world where midwives and homebirth are the norm – and they have FAR BETTER OUTCOMES, across the board, for mothers and babies.
You are precisely the kind of person who would never be a good homebirther – if YOU slip on a wet floor and break YOUR leg, why is that Walmarts fault? You slip – your fault!!! This is why we have defensive medicine and the rush to overtreat and overmedicate and a 33% C-section rate!!! This is not the way homebirth/midwifery clients generally live their lives.
Homebirth families are educated, conscientious, and recognise that LIFE has risks – and that includes risks that are only present in hospitals. Personally, I wouldn’t let you out of the house on your own, in case you slipped!
March 18, 2011 at 5:50 pm
That’s right! Lots of places, no need to name them! And no need to mention that Midwives in other countries have to have a college education while CPMs here only have to have a high school education!
What is a college education but something that makes you a little sheeple for THE MAN! Colleges are out to end the freedom of home birht which is why we here in the US know a woman should not have to go to college to be a midwife!!
March 18, 2011 at 6:03 pm
spell check please, its very distracting
March 18, 2011 at 6:08 pm
I am sorry; I was raised in a public school because my parents didn’t love me enough to unschool me. Sentences start with capital letters BTW ;)
March 18, 2011 at 6:16 pm
What? No come back? Eh? Nothing?
March 18, 2011 at 6:28 pm
I’d really enjoy meeting you – perhaps we could do coffee?
March 18, 2011 at 6:36 pm
Coffee is unnatural, but we can get an organic water sometime :D
March 18, 2011 at 6:38 pm
I too, am the product of my parents (whom I adore) and of the public school system. I too, make mistakes – I’m only human…born at home no less (with a midwife and a student midwife) – perhaps thats why I forget capital letters:)
March 18, 2011 at 7:01 pm
Now you’ve made me feel very sorry for you! At least you were born at home!
March 18, 2011 at 5:54 pm
That’s an awesome analogy. The midwife tells you sticking garlic up your cooch will fix GBS, but that’s YOUR fault.
March 18, 2011 at 6:04 pm
sorry, anatomy and physiology for midwives doesn’t have ‘cooch’ in the index. Did you mean ‘vagina’? Its alright to say it!!!
March 18, 2011 at 6:12 pm
CPMs take Anatomy and Physiology?
March 18, 2011 at 6:15 pm
Midwives take A&P, yes.
March 18, 2011 at 6:18 pm
Where?
March 18, 2011 at 6:13 pm
Oh, please. Vagina vagina vagina. I like to mix it up.
March 18, 2011 at 6:14 pm
Oh, and way to stick to the substance!
March 18, 2011 at 10:39 pm
I definitely don’t aspire to be a “good homebirther”, but if homebirth were something I was interested in, I would choose a qualified attendant with an adequate education, and that would rule out any direct entry midwives. The statistics that you mention don’t exist, by the way, that’s a myth. The places where midwives are the norm do not use the equivalent of American direct entry midwives either. Don’t you understand this? You can’t just read some books about birthing babies written by laypeople, for laypeople, and some stuff on the Internet, and go to a handful of home births where by sheer luck nothing really bad happens, and then decide that you’re an expert. This education you speak of, that homebirthers and their midwives have obtained, is not recognized by any accredited university or licensing board, here or elsewhere. The claims you make are not validated by any peer reviewed scientific research.
I’m not sure about these risks that are only present in hospitals, other than the risk that you’ll have access to really good pain relief, but certainly there is risk in everything. When you choose homebirth, you choose an increased risk of neonatal death compared to hospital birth. If whatever is appealing about homebirth is worth the added risk, then by all means, take the risk. And if you are representing yourself as a qualified primary care provider when in fact you are a hobbyist who thinks birth is neat, and a baby dies as a result, be accountable for the risk you took. Real professionals are accountable for their actions. Lay midwives aren’t. They kill babies, and their “professional” organizations do nothing. They don’t carry malpractice insurance, so there are no damages to sue for. They rarely face criminal charges, and when they do it’s a wrist slap. And the worst part of all is that the homebirth community covers up their crimes and pretends that nothing bad can happen. It disgusts me.
March 19, 2011 at 7:27 pm
which statistic is that then? the C-section rate in NC is about 32% and in the US as a whole about 33%. Check out The Big Push!! I’m also absolutely positive that the same agency that accredits the CNM educational pathway, has approved the CPM pathway. Until and unless you have some credible evidence to back up your statement that home birth carries an increased risk of neonatal death, be very careful what you say as you just make yourself look incredibly ignorant of matters that obviously aren’t an issue for you as a non-homebirth family. I absolutely support and defend you right to choose whatever pain relief you want – I’m only interested in whether you are sufficiently educated about the risks of epidural and narcotics, or non-pharmacological methods – risks for both you and your baby. Whatever you want is fine with me! Leave me and other homebirth families alone and quit trying to impose your values on US!
March 19, 2011 at 9:53 pm
Which statistics do you want? Anyone can access the CDC linked birth/infant death database (http://wonder.cdc.gov/lbd-current.html) and see for themselves that DEM attended births outside of the hospital have 3x the number of neonatal deaths as CNMs in hospital, 2x the number as MDs in hospital. Let’s not even talk about the studies, because it appears that there are methodological flaws in every study that exists. Please provide your evidence that there are “places in the world” where midwives equivalent to american DEMs are “the norm” and what are these better outcomes?
I think you should research the difference between MANA and ACNM, and then notice that the ACNM does not approve of any direct entry midwifery education programs (with the exception of the CM program at SUNY Brooklyn, which is different from a CNM as well and prepares graduates for licensure only within NY state).
The increased risk of death at homebirth does anger me, and it is an issue for me, because I work in the eeeeevil hospital, where homebirth train wrecks come in. I have truly seen healthy, term babies die of what should only be third-world complications in the hands of DEMs. I have seen a lot of babies die, but nothing haunts me like those do. They wouldn’t have happened in the hospital.
It is true that a great number of c-sections are done which are unnecessary in retrospect, but that’s the thing, you can’t know until it’s over. Likewise, when your baby dies a preventable death at home, you probably couldn’t have known except in retrospect. I’d rather have the unnecessary c-section than the dead baby any day.
March 20, 2011 at 4:32 pm
thank you for a reasoned response. you might be surprised at how much of what you say I happen to agree with. However, at its a biggie – it is NOT your right to make anyone do anything that is deeply offensive or contrary to their personal beliefs. I have seen healthy term babies die without warning too – and the best evidence suggests that it is prenatal care that makes a difference in the IUFD rate. I wont dispute your experiences – I would urge you to remember that for each ‘train wreck’ you have seen, there are hundreds of perfectly healthy babies, born at home, that you will never see. I think you should access the BJM published study of out of hospital birth attended by CPM’s in the US – you might be surprised!
March 18, 2011 at 6:12 pm
You make a lot of assumptions. There are many ways to become a midwife and I think that’s part of the problem. I have witnessed homebirths and hospital births. I know a lot of babies born both places. I think you are being dishonest. It’s a conclusion I came to entirely on my own. You assert that OBs and defensive medicine are the cause of our poor maternal mortality rates. Amnesty International doesn’t agree. “”Mothers die not because the United States can’t provide good care, but because it lacks the political will to make sure good care is available to all women,” said Larry Cox. And by good care, I’m going to guess they don’t mean undereducated women coming to your house.
March 18, 2011 at 6:27 pm
So what, precisely, is good care in your definition? Does it include the World Health Organisations ‘definition of a midwife’? I will absolutely assert that a ‘healthcare’ (thats irony BTW) system, in which there is a LOT of money to be made, and paid out, by a few individuals and corporations, is not the way to create equal access to good providers. Political will in America is financed through donations, made by powerful lobbies, of which ACOG is only one. Defensive medicine absolutely contributes to increasing C-section rates with the associated co-morbidity. Defensive medicine is the reason hospitals use continuous fetal monitoring, despite the best evidence being that it should only be used where there is access to fetal blood sampling, in order to determine which babies really need to be delivered quickly (Cochrane database). Unless you have evidence to back up your claim that midwives are under-educated, be careful. A degree doesn’t make an expert – otherwise doctors would never make mistakes!
March 18, 2011 at 6:38 pm
Doctors are accountable for their mistakes. I consider good care to be care from a competent care giver who is legally accountable for their actions. There is no reliable way to assess the competency of a CPM.
March 18, 2011 at 6:46 pm
really? have you checked out the core competencies and the skills exam and the written exam? I suppose letters of concern for performing a 24hour induction of labor and a C-section on a woman who wasn’t even pregnant constitute ‘accountability’ in the medical field(happened in Fayetteville)? Or maybe forcibly confining a woman to bed-rest when she suffered a threatened miscarriage (despite no evidence to support this as appropriate treatment) and she still lost her pregnancy, constitutes ‘accountability’?Florida)
The above examples both involved legally accountable doctors (a pair in Fayetteville) – not experts in normality. yet again, people who live in glass houses shouldn’t throw stones!
March 18, 2011 at 7:02 pm
I’m not going to argue about specific instances I know nothing about. I’m sure there are no shortage of attorneys willing to take on a legitimate case of malpractice.
March 18, 2011 at 9:03 pm
undoubtedly, and theres probably plenty who’d take on Walmart for you when you fall over, but that wont make it anyone else fault that you fell over because you chose to shop at Walmart!! i assure you – the evidence for the cases I gave is available – check out the NC medical Society pages for some REAL horror stories – puts it into perspective I think.
March 18, 2011 at 10:55 pm
So if I fall in Walmart, and say I fall because there is a leak coming from a freezer case which causes a puddle on the floor, this is my fault? Suppose everyone at Walmart knows the leak is there, but no one does anything about it? And suppose that I’m not even the first person to fall because of it. The leak has caused small puddle that’s very hard to see and I slip and am injured, you say that’s my fault, too bad so sad. So Walmart has no obligation, legally or morally, to address known public safety hazards?
March 18, 2011 at 6:27 pm
They have this game called “Operation”. They sell it at Wal-Mart.
March 18, 2011 at 7:40 pm
I like you! operation is how my midwife learned to deliver!
March 18, 2011 at 8:04 pm
exactly!
March 18, 2011 at 6:52 pm
coffee is not unnatural – it comes from beans which are a vegetable and constitutes one of my major food groups:D
March 18, 2011 at 7:04 pm
Processing is unnatural– ;) Everything is unnatural and I can prove it! And I don’t mean to misspell, I’m lysdexic
March 18, 2011 at 7:00 pm
emom appears to be suffering from a complete loss of reality, sense of humor failure and general constipation of dis-satisfaction with life. Move on…its really not healthy to get this irate if something really doesn’t affect you – if it does, well be more honest and tell us what your problem REALLY is (BTW, I watch Dr Phil so I can diagnose the above conditions:))
March 18, 2011 at 7:11 pm
emom is suffering alright! I think she has too many toxins and could go for a nice pennyroyal colonic! Being that unnatural has been proven to cause cancer and heart attacks in small unporfessional studies that I can’t refer you to. I’d bet she was spine raped by an epidural and that is why she can’t even say the word vagina. One day she might just erupt into a pot of toxic unnatural jelly!
March 18, 2011 at 7:18 pm
don’t joke about my spine rape
March 18, 2011 at 7:24 pm
Oh! Hit a nerve! Boom Tish!
March 18, 2011 at 10:51 pm
Please check the facts. CPMs study A&P, plus… http://www.narm.org
I practice with CPMs in a State that licenses direct-entry midwives. We carry anti-hemorrhagic drugs and are skilled in stopping a life threatening hemorrhage. The same as in the hospital. Yes, I have seen a life-threatening hemorrhage handled with skill in the home setting by a CPM in the same way I have seen it handled in the hospital. What was great about the midwife being licensed was that she could call 911 for backup without the threat of arrest. That is SAFETY. Pushing our midwives underground is ridiculous. Don’t have a homebirth if it does not feel right to you. Allow those who trust in homebirth to receive equal rights given to those in the States that allow licensing of CPMs.
BTW…Check the Oregon licensing board. Since statistics on LMs (licensed midwives) have been being kept (1980s), no woman has died from a postpartum hemorrhage at home. Yes, there have been hospital transfers for hemorrhage. Collaboration is necessary.
Personally, I am tired of hearing stories that go something like…”I would have died if I wasn’t at the hospital”. Sometimes that can be true, but most of the time it isn’t. It is used as a fear tactic and birth in our culture is too full of it.
March 19, 2011 at 6:04 am
“CPMs study A&P”
EACTLY !!! also my younger girls study A&P in homeschool.
If it is called the same thing that means it is not different from what docots and nerses study in collage.
Actually the course i designed and teach my girls is BETTER, they are far more prepared to birth babies, becuase I also include the chakkras and energy lines in our A&P lessons.
I also gave them a certificate with a gold star on it so now they are just as qualified as any up himself doctor with his fancey degree
the public should WISH their doctor knew as much about the human boyd as my five year old !!!11
Like to see him sort out a shoulder dyistoria in a non interventionsit manner by waving his hands over mama’s maridian lines and chanting !
March 19, 2011 at 5:11 pm
Jade – this is safemama… please!!! dont make me have to come over there….:) Actually, reading it again, I’m more convinced than ever that you’re doing it deliberately – no one can consistantly get that many words mis-spelled without real effort!!! I bet you’re a PhD, aren’t you?
March 19, 2011 at 12:51 pm
No, Walmart doesn’t because YOU really should have researched your Walmart better.
March 19, 2011 at 5:07 pm
I was going to suggest it would be your own fault for shopping at Walmart instead of supporting local retailers, but no doubt, you’d jump on me for that. I’m sorry if you have a problem but refusing to discuss ‘specific cases of which you know nothing’ and then accusing midwives of killing babies is a fine example of double standards. You obviously are incapable of reading current research, are relying on poorly conducted meta-analysis which has been completely discredited by INDEPENDANT researchers and have a major axe to grind here. You are not adding anything to the discussion that will improve anyones experience. Risks inherent in hospital admission include, infection, allergic reaction, major surgery, forceps or vacuum extraction, disruption of bonding and breastfeeding and seperation of parents and infant, You do appear to have some understanding of some of the care provided by midwives – I wonder what your experience is?
Your way is NOT the only way…since you aren’t an aspiring homebirther, I’d like to suggest that getting this angry and irate about an issue that needn’t concern you is NOT healthy – your blood pressure will rise and you’ll stroke out getting this upset!! Go read and comment on something that affects you – leave homebirthers alone – you haven’t convinced a single person who wants to birth out-of-hospital that they shouldn’t!
March 19, 2011 at 5:16 pm
oops, my mistake, this should have been my response to Organic orgasmic mama – but emom and oom are both SO out to lunch with their comments I can’t keep up with the nonsense!
Anyway, the above response applies equally to both of you – you dont have to give birth at home with a midwife – dont try to make me give birth in a hospital with a doctor!!!Simple, really
March 19, 2011 at 7:48 pm
I’ve never shopped at Walmart in my life, nor am I angry, and I already explained to you that I have been present at both types of birth. I have even witnessed a home birth in my own house. And if you could be so kind, I’d love to see where I said “Midwives kill babies and Doctors never do!” I merely asserted that you were being dishonest by not differentiating between the types of midwife, to which you said, “There is no difference.” Which brings us back to you being entirely full of shit. Woops! Is it poop in your anatomy book or feces? I’ll try to remain technical.
March 19, 2011 at 8:17 pm
I certainly never accused you of saying “Midwives kill babies and Doctors never do!” YOUR WORDS, not mine.
I again assert that you are very angry, evidenced by your childish use of profanity.
I dont need you to be technical, polite would be sufficient.
March 19, 2011 at 8:38 pm
Uh, yeah you did. The fact that it took me this long to employ the most innocuous curse word in the English language in response to you is actually pretty solid proof that I am not angry. Vagina.
March 19, 2011 at 10:18 pm
quote my words that said
“Midwives kill babies and Doctors never do!” I’ll say it again – YOUR WORDS, NOT MINE
March 20, 2011 at 12:30 pm
I’m sorry if you have a problem but refusing to discuss ‘specific cases of which you know nothing’ and then accusing midwives of killing babies is a fine example of double standards.
I was summarizing.
March 19, 2011 at 10:06 pm
You would suggest I shop locally instead-hilarious. Because those locally owned businesses are all good guys, right? They’d never do anything negligent that might lead to someone being injured.
Maybe I’m guilty of painting all DEMs with the same brush, just because I’ve seen some babies get killed. Maybe there are some who really mean well, who believe in what they’re doing, who strive to provide safe, respectful care so women can be autonomous birthing goddesses who bond instantly and live happily ever after. They still are dangerous, because they do not have enough education. They do not know what they don’t know, and therein lies the problem.
Thanks for your concern about my health, my BP is okay though. Maybe you could recommend a good homeopathic remedy for my anxiety level though?
March 19, 2011 at 10:57 pm
Safemama, present some evidence, I’ll read it.
I cant make much of a difference in the hospital when the women are coming in from home with their babies already dead, now can I? But believe it or not, we save babies who otherwise would die every single day. I love what I do, I witness miracles regularly.
It’s not just your body when someone else inhabits it, and what about the baby’s choice? Isn’t that a pro-abortion slogan? So you support women’s rights to kill their own babies?
March 19, 2011 at 8:15 pm
I see what you are doing here emom, and I don’t like it one bit. You have no right to tell safemama that her A&P class does not count just because it is a 100 level course and does not compair to the ones taken by those in the Masters and MD programs! So what if they left some stuff out? The point is that lay midwives have taken *an* A&P course, which you siad never happened! This is simply not true!
March 19, 2011 at 8:49 pm
In fifth grade, I dissected a cow’s eye. Can i preform your grandma’s cataract surgery?
March 19, 2011 at 8:26 pm
quite honestly, Jade, emom and oom, much as I’ve enjoyed our little chats, I really do have other things to do…
not interested in changing your minds, not trying to ‘bring you to the (homebirth) dark side, dont care what you do with your lives; just want the same respect from you guys – leave us alone if it doesn’t affect you! none of you have explained how this does affect you so I just cannot be bothered with this – one day, we’ll go for that cup of water (cheap date Jade!!:)
March 19, 2011 at 8:45 pm
Why do you think you know how affected we are by this? Do you have an opinion on circumcision? Do you have a penis? I agree that I have better things to do. Arguing with someone who makes up a version of who I am to argue with instead of responding with salient points or evidence really is a waste of time. Ciao, have fun on your same sex water date!
March 20, 2011 at 5:04 pm
why do you need to be nasty? I believe your hate speech indicates a significant level of anger, and fear, which is the root cause of so many destructive emotions. I think my comments explained that none of you had explained how homebirth affects you until fairly recently – now we get to hear what your issues are and a discussion can result. I respect the work of nurses and doctors, CNM’s and CPM’s, pharmacists and chiropracters, etc. However, I do not respect anyone who uses their position of trust to bully mothers into accepting less than evidence based care, informed choice and consent – which includes the right to refuse medical advise and/or treatment. Thanks, but please try to be civil – we can agree to disagree – I wish you peace
March 19, 2011 at 10:17 pm
Safe mama, it affects me when I have to care for a woman who comes into the hospital after she births a dead baby at home in the care of someone too inept to repair the lacerations she sustained in the process. It is not right that all she gets out the months of anticipation and preparation for the child she already loves is a little tiny coffin and a hundred sutures. I don’t want that to happen to any more families. Homebirth is about ideology, not evidence, and it kills babies. I can’t respect that.
March 19, 2011 at 10:23 pm
read the EVIDENCE – I have cared for women and babies who have be brutalised in hospitals. Since you work in a hospital – start making a difference there and quit beating other people up! My body, my baby, my choice!!!!
March 20, 2011 at 6:39 pm
When I worked in a hospital, it affected me when I had to care for women who were permanently disabled after ‘accepting’ the care of people too arrogant to believe there could be another way. I cared for women who had their bowels sliced open during C-section. Women whose wounds failed to heal. Women who were traumatised by repeated vaginal examinations, women whose ‘failure to progress’ (according to some arbitrary standard that is not physiologically sound,) led to drug therapy, pit to distress, and the surgical removal of her subsequently compromised infant. I care for babies born with conditions incompatible with life – and I did it with compassion and respect and gentleness. I cared for babies who were born to drug addicted mothers and babies who were born to mothers who were given narcotic pain relief in labor (not a lot of difference in their adaptation to extra-uterine life). I cared for mothers who developed life – threatening conditions of pregnancy. I cared for a woman whose healthy, term baby died – (no cause was found on autopsy) she was induced, labored with an epidural and sustained a 4th degree tear.
‘ It is not right that all she gets out the months of anticipation and preparation for the child she already loves is a little tiny coffin and a hundred sutures.’ I dont want that to happen to any more families’
I couldn’t agree more. None of those events are fair. Homebirth is not an ideology – here’s just one piece of evidence http://www.bmj.com/content/330/7505/1416.full?ehom
Homebirth is the way the human species survived over millenia. It is a family’s right to choose how there children are born and who attends them. This is NOT about you and how this makes you feel – people have different understandings and deeply help convictions about birth, death and what happens in-between. If I say I feel circumcision is mutilation of a normal healthy organ, thats my right to feel that way – it is not my right to stop other parents from choosing to circumcise their child. I can respect everyones right to parent in the way that fits their values – and that includes the parental decision regarding place of birth. Thank you
March 20, 2011 at 4:45 pm
http://www.bmj.com/content/330/7505/1416.full?ehom
there’s the evidence – I’m glad you love what you do – but dont fall into the trap of thinking that everyone should feel as you do – for some of us, its very much a case of ‘just because we can, doesn’t mean we should’ . Thank you for the good work you do – but just because its not ‘right’ for me to jump out of an airplane for fun, doesn’t mean others shouldn’t be allowed to do so!
March 20, 2011 at 7:57 pm
Thank you for such a fantastic article. It was great to hear opinions about homebirth from our local care practitioners and to hear different sides of the argument from both CNMs and OBs. Thank you for writing such an informed and well-balanced article.
My only quibble is with a quote from a CNM who said that CPMs are not licensed. A CPM is licensed but her licensure is not recognized by NC. There is such a thing as a non-CPM lay midwife who is not licensed.
As a homebirther, I would not want to birth with a lay midwife who was not a CPM. CPMs receive oversight, peer review, and continuing education.
Thanks for the great article, it’s the best one I’ve read yet!