Thursday, September 8, 2011

midwifery and the great divide....

As many of you know I have been volunteering for Friends of Michigan Midwives for a few months now.  Yesterday I turned in my resignation for my position.  When I started working with them, I was under the assumption that this included ALL midwives.  And that our goal was openly supported by ALL midwives.  Afterall...we were their friends.  Friends help each other out.  After my last conference call with several other volunteers, I was left was a sour taste in my mouth.  Something was stated (that I have now been told I must have misunderstood) that just didn't sit well with me, so I started digging.

Upon my research, this is NOT a group that includes all midwives.  This is a group whose sole purpose is to push/back/support a bill, that on the surface (imo) seems great.  Making Midwifery legal in the state of Michigan.  Upon digging, and asking questions...not so great.

There are a TON of midwives that do not want State Licensure.  Midwifery in the state of MI is not legal.  NOR is it illegal.  It is one of those gray areas.  The bill would cover CPMs (certified professional midwives), and all other midwives who are not CPMs now must become CPMs (there is claim that midwives would be grandmothered in for 3-4 years).  The claim is so there is a standard of care.  But I have seen OB's...they are suppose to have a standard of care, right?  And they are elminating vbacs, pushing epis, pushin inductions, pushing time-frames on moms/births... So for me, standard of care doesn't really mean much.  What I want is midwives that trust birth.  As a parent who spent a lot of time researching homebirths, and researching midwives I feel that moms, and dads are 100% capable of finding a midwife with a GOOD record, a midwife they can trust.  A midwife with experience, and education (which doesn't always mean "book taught").  The more I think about state licensure for midwives, the more I realize the power that is being taken away from parents.  I have heard that Licensure will require neonatal resuscitation...isn't that just smart practice?  As a mom...that would be one of the FIRST questions I'd ask interviewing a midwife.  What happens IF something goes wrong...what training/education do you have?  Licensure is not needed for that.  Another is that there would be 3rd party reimbursment from medicaid to cover homebirths.   I have even been quoted talking about this recently in an online publication.  BUT here is the thing...for me, someone who is planning to become a midwife...I am so passionate about homebirths that should I ever have a client who cant afford me...I will find a way to make it work.  Barter some or even ALL of my services.  There are midwives already that DO this.  So 3rd party reimbursment just makes it about money (again, imo).

The State of MI is not even ASKING that midwives become licensed.  They want them to be registered with NARM (North American Registry of Midwives.  So fine, lets just ask that Midwives all take the NARM exam.  And leave State licensure out of it.  I get very concerned when people start involving the government...who has proven time after time they just care about money and will screw anyone over, no matter promises have been made along the way.  This bill MAY be great.  It MAY be the best bill outta all the others in the states.  But once it's introduced...midwives WILL lose power eventually.

In other states, breech births and multiples births have been used a a bargaining chip to pass the bill.  I have heard that this wont happen here.  I have also heard (although now being told I misunderstood) this MAY happen here.  They are not putting any definition of birth in the bill.  They are leaving it in the hands of the midwives to decide what births they want to attend.  Okay, again, that seems great.  BUT...look at what has just happened with the Medical Marijuana Dispensaries.  The Medical Marijuna law is vague.  Now the State is staying that dispensaries are illegal.  And dispite the revenue these business were bringing to the state (at least the ones that were actually doing the business legit) these businesses are being raided and forced to close.  Who is to say that this same thing WILL NOT happen with midwifery?  What happens if a Licensed midwife attend a birth, something goes wrong.  Someone sues (b/c we live in a sue happy country), the state says, "well, the law doesn't cover breech births", even tho the midwife is licensed...she goes to jail.  MAYBE I am stretching it, maybe I am not.

ANOTHER concern, if a midwife chooses not to get her license, the claim is that her status would stay just as it is now.  That just can't be.  B/c right now we are riding the gray area.  Remember, not legal, not illegal.  Licensure would make the other midwives ILLEGAL.  And then the witch hunt begins...turning in the midwives who are now marked with the scarlet A...better yet, scarlet UM (unlicensed midwife).   It divides what once was a beautiful into two groups...the legal midwives vs. the illegal midwives.  Right now, even though there may be a great divide in opinions/views...all midwives are in the same boat...floating in the gray area together.

I know that in posting this, I am stepping across the line and joining what others are calling the naysayers.  But it is what it is.  I have found my voice.  And I will use it.  This affects my future as a midwife someday.  And I refuse to sit silent in fear of offending anyone.  I truly hope that my friends on "the other side" of this divide understand that I have to make my own choices, and that they still love me for me.  But I must cross over to the other side now.  And I hold my head up high doing so.

I have recently come across someone who has a very LOUD voice against state licensure...Carla Hartley.  In fact, I have an appointment to speak with her over the phone tomorrow (and I am rather excited about it!).  Here is what she writes about this....and I agree, 100%.


Etymology: L, licere, to be allowed
the granting of permission by a competent authority (usually a government agency) to an organization or individual to engage in a practice or activity that would otherwise be illegal. Kinds of licensure include the issuing of licenses for general hospitals or nursing homes, for health professionals such as physicians, and for the production or distribution of biologic products. Licensure is usually granted on the basis of education and examination rather than performance. It is usually permanent, but a periodic fee, demonstration of competence, or continuing education may be required. Licensure may be revoked by the granting agency for incompetence, criminal acts, or other reasons stipulated in the rules governing the specific area of licensure

Ask yourself:
• Has history proven that licensure of midwives is a good thing for birthing women or for midwifery?
• Does licensing restrict or expand "with woman" midwifery service?
• Does a licensed midwife have the freedom to serve the birthing women who hire her or does she really work for the license grantor?
• Does the added expense of licensing help hold midwifery service down to something the average family can afford?
• If birth is a normal function and midwifery is not medicine why would we need MALPRACTICE insurance or licensing or other medical related red tape and approval?
• Is licensure based on a false premise that birth is a MEDICAL event?
• Do birthing women need to be protected from midwives?
• Does licensing increase the competition and contention among midwives?
• Can you agree to acting as an agent of the state, promising to report other non-licensed midwives as part of your license agreement?
• Does a license mean a midwife is a BETTER midwife than one who is not licensed or just the perception of "official" therefore better?
• What will the trade-offs be once you are licensed?
• Does a license protect the midwife from persecution or prosecution?
• Will papering up make you a better "with woman" midwife?

Remember...those who grant the license may alter its conditions and take it away at any time. A license is not FREEDOM TO PRACTICE--it is REGULATION OF PRACTICE.
 (by carla hartley)

No comments:

Post a Comment