Who said this?
… [T]he [CPM] credential has a huge hand in creating some of the “bad apples” as you call midwives who damage and ruin lives. CNMs and MDs see a zillion more variations of the norm AND abnormal before they ever start practicing on their own. A CPM has seen a *few* typical variations, but if they haven’t ever seen the nuances that can lead to tragedy, how are they supposed to recognize it? …
No, it wasn’t me, although I agree with it wholeheartedly. It was actually a midwife, a CPM, in fact. It was Barbara Herrera, also known as Navelgazing Midwife.
Herrera is part of a tiny but growing trend of homebirth advocates willingly to seriously address the deadly shortcomings of the CPM credential. She was writing in response to a post by Imogen-Alternative Mama entitled Home Birth: A Different View.
Imogen emphasizes that she is a passionate supporter of homebirth, but:
… I hate to admit it but I can’t help but worry when I read stories of women giving birth to breech twins at home with a CPM – to me, that is way too risky. That’s not to say that there isn’t a whole load of wonderful CPM’s out there – there are. But there are also plenty who are underqualified, underexperienced and take too many risks.
I cringe when I read stories of CPM’s advising mothers to refuse GBS testing, lest it come back positive and end their chance of a home birth. Why do we think that midwives are somehow immune to greed? We’re all very happy to assume that doctors only care about lining their pockets, but when a midwife advises against testing that could save a baby’s life, coincidentally preventing the mother from having a homebirth and paying the midwife for it, nobody bats an eyelid.
And Imogen is suspicious of the refusal of the Midwives Alliance of North America (MANA) to release the death rates at homebirth:
Ignoring the fact that sometimes things go wrong at birth, even totally natural home births, is irresponsible and ignorant. Furthermore, I am very concerned about the fact that MANA (Midwives Alliance of North America) are hiding their data on homebirth death rates. Surely if the statistics showed that home birth in the US is as safe or safer than hospital birth, they would be shouting it from the rooftops? Instead, they are withholding the data and only allowing access to those who can prove they will use it for “the advancement of midwifery”.
Herrera responds enthusiastically:
Bravo!!! *standing ovation*
Your observations are 100% accurate… right on… exactly what I’ve been saying for a long time and am only just now getting much louder about it.
There are absolutely CPMs that are undereducated and underskilled. If we had a standardized system as you do in GB and in Canada, it’d be a whole lot different around here. But it isn’t. We’ve got a mish-mash of education routes and an endless supply of incestuous apprenticeships that perpetuate (what I call) black holes of knowlege that are only discovered when something goes awry.
I also believe homebirth can be a safe and wondrous option for women and babies. I *do* believe there are limitations to that safety and women need to suck it up that they can’t always have The Experience they want.
When another commenter insists that it isn’t the CPM credential itself, but rather the “bad apples,” Herrera disagrees as I quoted at the top, and continues:
It’s far, far easier to learn to sit on your hands than it is to recognize and manage the slew of silent-to-deafening complications that can -and do- arise in even the most normal of births. Not often… maybe even not rarely… but they can happen.
Preparation is never a bad thing. Neither is more education and experience.
I have heard privately from a number of CPMs expressing similar sentiments. Most fear going public with their concerns because they believe (probably correctly) that they will be ostracized by their colleagues. It is therefore refreshing to see a midwife who isn’t afraid to counsel CPMs to reform themselves as if babies lives depend on it … because they do.
