"do you have any evidence for your dramatic assertions" -- Just giving my thoughts, didn't know I needed to cite references! LOL! However, anyone can go to the ACOG and AMA websites and read their view of homebirth. I don't think it's far-fetched to say that ACOG would prefer all births to take place in hospitals with a physician attending.
Excerpts from a conversation are like statistics, they can be made to sound like pretty much whatever you want.
"from my 30 years of experience in the birth field" -- I have great respect for your many years in the birth field. Your experience nearly triples my 11 years!
"even the most knowledgeable, responsible midwives have poor outcomes sometimes and are vulnerable to receiving bad publicity." -- No argument there. However, doesn't it seem reasonable that IF some midwives began practicing irresponsibly, poor outcomes would begin to rise. Not in huge numbers, I agree, because birth is a normal process and the vast majority of the time works beautifully all by itself. But given the same rare difficult situation - one where the decisions of the midwife DO make a difference - the odds of a good outcome are better with a responsible midwife than with one who acts irresponsibly. I should also point out that acting responsibly isn't limited to intervening or transporting when you should, but it also applies to leaving labor and birth alone when it doesn't require anything more than a calm, supportive presence.
"bad publicity blows over and is not the end of the world" -- I agree, but it can cause damage.
"the public is seeking out alternatives to medicalized birth, not because midwives are so wonderful but because hospitals are so dangerous." -- It's been my experience that the reasons for seeking midwifery care vary. For some, it is because they feel hospitals are dangerous. Others don't feel the hospital is so dangerous, but choose out-of-hospital birth because they feel more comfortable at home. Some have heard wonderful midwifery birth stories or been present at a midwife-attended birth and choose OOH birth because they do feel midwives are "so wonderful". The reasons for choosing midwifery and/or OOH birth are, in my opinion, as varied as the women themselves. It is also my opinion (and I realize you may disagree) that in some rare instances a hospital can be a wonderful place for a birth and an irresponsible midwife could be dangerous. Note that I said *rare*
"it's easy to judge other practitioners and do armchair quarterbacking on what they should have/could have done when things go wrong." -- I don't believe I am "armchair quarterbacking". This all began with someone mentioning that they know of midwifery students who used births where they caught the baby with a more experienced midwife literally holding their hands and they were counting this as a "Primary" birth experience. I just clarified that that situation, while a valuable learning experience, is not a "Primary" birth experience. The idea behind a "Primary" birth is for the student midwife to be making the midwifery-related decisions, with a senior midwife in attendance to supervise. It makes for a nice trasition from student midwife to midwife. I then went on to express that I hope new midwives who feel they need more experience continue to practice with a senior midwife. This just makes sense to me.
"the consumer is a pretty savvy judge of who is ready to be a practising midwife." -- I agree and I would add that midwives are pretty good judges as to whether they are ready to be practising solo or not. I never suggested there are ill-qualified midwives running rampant. I just hope as midwifery continues to grow that we maintain the high quality care that midwives have been providing for ages.
I certainly hope I've managed to clear up any misunderstandings. I came to the MT forums for a pleasant diversion from my many hours homeschooling and studying. I honestly don't have the time or energy for long posts.
To all the student midwives out there - good luck in your studies! I know you will realize your dream and be an excellent midwife!
To Gloria - thank you for all you've done for midwifery and for the lively discussion. I wish for you continued success in all you do!
Signing off to get some work done,
Sherry S. Rumsey
Student Midwife, MCU