Midwifery Today Community

 Well said Sherry!

 <<Probably the worst thing that could happen for midwifery is if we started having more and more bad outcomes hitting the media. ACOG would have a field day with that!  Probably the worst thing that could happen for midwifery is if we started having more and more bad outcomes hitting the media. ACOG would have a field day with that!>>

No, the worst thing that could happen is that more women would have their bellies sliced open unnecessarily.  Even if you had the WORST midwives in the world, they wouldn't have a 35% primary c section rate or a 50% induction rate.  ACOG can have all the field day they want with midwives, but their stats are so bad, I can't imagine how they hold their heads up.  When it comes right down to it, even chimpanzees could do better than the ACOG performance. 

We have to remember that women are having their babies at home unassisted all over N. America and the stats on that are very good.  I find it very interesting that, the more education a student midwife gets, the less likely she will allow anyone to "manage" her own birth.  I know doulas and student midwives right across Canada (where I live) who are assisting home birth families because there are no midwives to be found where they are located.  I offer to do telephone coaching for them in complete confidence.  I find they are very responsible about phoning if they have a question and knowing when to seek help.  Often, a midwife can help those coming up in the midwifery profession by just doing telephone consults as needed.  Each woman will find her own comfort level but remember the two most important things a midwife can do:

Show up and don't drop the baby. 

Gloria

 Hi Gloria! So nice to see you here! My post was not that it would be the worst thing that could happen, but "probably the worst thing that could happen for midwifery". My meaning was that midwifery is really coming into a lot of attention and that has ACOG and hospital-supporters already chomping at the bit to squash us. What a blow it would be to midwifery and birthing women's options if midwives began having bad outcomes due to new midwives not practicing responsibly. Even if it were only a few bad outcomes (or probably even 1), it would be splattered all over the media and blown way out of proportion to the detriment of all midwives. Much progress would be lost. ACOG would latch on to it and scare expecting couples to death. Of course, we all know the horrible things that go on in hospitals *every* day and we all wish everyone could see the reality of hospital vs. home birth, but sadly, that isn't the way it is. We're working on that, trying to get the word out that home birth is safe, that midwives *are* knowledgeable and responsible. It would just be really bad if some midwives weren't, because it would reflect on all of us - fair or not.

hmmmmm. . . .Sherry, do you have any evidence for your dramatic assertions?  It's easy when you're entering a small, marginalized profession to perceive that there are conspiracies and dangers around every corner but, really, "chomping at the bit to squash us", "what a blow", "splattered all over", "scare expecting couples to death"---these expressions are not useful in strategizing for power.  

from my 30 years of experience in the birth field, what I have seen is:

1. even the most knowledgeable, responsible midwives have poor outcomes sometimes and are vulnerable to receiving bad publicity.  

2. bad publicity blows over and is not the end of the world

3. the public is seeking out alternatives to medicalized birth, not because midwives are so wonderful but because hospitals are so dangerous.

4. it's easy to judge other practitioners and do armchair quarterbacking on what they should have/could have done when things go wrong.

5. the consumer is a pretty savvy judge of who is ready to be a practising midwife.

Gloria

Hi, yarra! You're so sweet! Thanks for offering, but I'll probably be visiting them myself at some point.

GloriaLemay:

 

We have to remember that women are having their babies at home unassisted all over N. America and the stats on that are very good. 

 

 Are they? I didn't know we had stats on unassisted birth. Where can I find them?

 "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

I was saying that all roads require some type of clincal experience, or an apprenticeship. But picking a midwife to work under while also doing formal schooling will result in more hands on experience, and perhaps a finer midwife in the end (than doing your clinicals in short order to meet a school's requirements).

I liked the interchange between Sherry and Gloria. There are so many different perspectives out there. In the end, I pick Sherry's approach, personally. I had a very difficult and complicated pregnancy w/#1, and a perfectly straightforward #2. I'm thankful for my midwife's expertise and knowledge, leading to a planned unscheduled c/s with the 1st, and homebirth with the 2nd.

 Hi guys!

This is Amy, and I am also an AAMI student. I really like how flexible it is and it is definitely very family friendly. I am also attending a four year, so having a flexible schedule is something very important to me. AAMI is a very close knit school and feel like it is really preparing me for my career in assisting women!! So excited to meet everyone! Anyone who has questions about AAMI can also contact me as well!

Hi Ladies,

It has been a really tough decision for me between MCU and National College of Midwifery... It makes it even harder because Im in the land of Seattle Midwifery so everyone thinks Im insane for picking an alternate route.

For me, I feel like going a MEAC approved route is the best way of making sure that I dont find myself a few years down the road and spinning my wheels or find myself back at the beginning staring down educational requirements.  AAMI seems like a great program, but when you live in the land of MEAC and SMS, it just isnt practical.

My desire has always been to be an apprentice trained midwife, I dont feel like books alone are even marginally going to be able to stand in for experience, so what I love about NCM is that it is based on the apprentice model.  In that framework, it gives you alot of room to learn information in the way that makes sense for you.  I know from doing online courses previously that really structured timeframes and information without application doesnt work for me.  I might complete a course in 3 weeks.. or it might take me 3 years to really get through the information and finding a way to apply it so that it resonates with me and stays in my memory vault instead of just being something I regurgitate for a test.

The negative of NCM is that the program is so open.  It requires review, planning and involvement from your preceptor.  That can be really hard for a busy midwife to take on a student and have to be involved in more then just the clinical areas of their education.

I feel really lucky to have found a midwife willing to take that on with me and what Ive seen of NCM's program makes it feel like they make those responsibilities as easy as they possibly can with example sylibi, no course time limits and flexible learning paths.

I've gotten some pretty good feedback from some folks via MDC on the program, but nothing on these forums yet, so Im curious to see if anyone has anything more to add that has actually been through the program.

I agree with you, Hypnomama. If I'm not mistaken, there are some states that require graduation from a MEAC-accredited program for licensure.

The schools I'm looking at (Birthingway College of Midwifery, Florida School of Traditional Midwifery) offer didactics (via on-campus classes, timeframes, etc.) and incorporate the apprenticeship model by having students find preceptors for their clinical training.

Gloria, what are your feelings on MANA, NARM, MEAC, the CPM credential, and licensure?

Hi, Rebekah! Nice to "meet" you!

Yes, there are definitely people in B'more who are interested in midwifery. There are several CNM practices, including two birth centers (in the Annapolis area) and one that does homebirth. There are also a couple of DEMs and quite a few doulas and childbirth educators.

The Baltimore City Paper recently did an article on homebirth and unassisted birth. Here's a link. It's long but very good.

http://www.citypaper.com/news/story.asp?id=15918

Are you, by any chance, the same Rebekah who has posted to the Navelgazing Midwife blog?

 [From Brlnbabies, Moderator:  I'm going to move the posts from this same discussion under Midwife Chat over to here since it's confusing to have the same discussion under two separate places.  This is Gloria's response below.]

I think that Midwifery Today sells a little handbook for student midwives with all the info in one place.

I have heard such good things about Ancient Arts Midwifery (AAMI).  Carla Hartley, the director, is a real midwife's midwife and has put together a very comprehensive distance program.  Also, you could check out the courses offered by ConsciousWoman.org---they are approved for DONA, MEAC, IBCLC continuing education units and are very reasonably priced.  www.consciouswoman.org 

I think that internet classrooms are the wave of the future and that more and more midwifery education will be done this way in the next 5 years.

[... and this is JoyfulMother's response]

Gloria-

I've been looking at Ancient Art Midwifery for quite some time now.  My only concern is a lack of access to preceptorships; I'm in New Brunswick, Canada.  In your opinion, what are some of the better options for places to go to get the hands-on work?  I know I will have to travel to do so.

I am also not concerned about being able to be licensed when NB does legislate midwifery, as I am not interested in working within the system (have seen what has happened elsewhere and was part of the early planning to push for legislation in NB, withdrew myself due to concerns with the direction it was taking).  I am looking to provide the best, most empowering midwifery care available.

Cheers,

Amy

[And Jenni's response to above!  Whew!]

Midwifery Today sells a book called Paths to Becoming a Midwife: Getting an Education. I have it and I recommend it.

My only problem with AAMI is that it's not MEAC-accredited. If I'm not mistaken, some states require potential licensees to have graduated from a MEAC-accredited program. I want to be eligible for licensure in as many states as possible. Also, I once contacted Carla Hartley, and her response to my e-mail was a bit off-putting. She said she was very radical and I might not want to be associated with her. Radicals don't scare me; it just seemed like she was suggesting I look elsewhere. 

 Hi Alex and others,

Just wanted to say that I love MCU. I consider myself apprentice-trained (or in training and school trained. I work closely with my preceptor - getting hands-on experience, bouncing ideas, clarifying items that come up - whatever! My school work and "clinical" work mesh together nicely to make a well-rounded education, IMO.

I say this because I get the impression that some think it's "apprenticing" or "school". I don't think it has to be an either/or situation. Of course, I do understand that it's difficult in some areas to find a preceptor to work closely with. But if you can find a midwife to "apprentice" with, then she can be your preceptor if you choose to go to a MEAC school (well, I guess there is that stickler of  practicing legally - maybe that's what the issue is). For me, going to MCU has lead to what I consider an "apprentice plus" education.

 Sherry,

It's so great that we have options so we can all find the programs that speak to us.  I drool over some of the MCU course descriptions and love that they have herbal and homeopathic courses.. not just fly by mentions :)  I also have gotten to meet some of the staff and everyone seems wonderful!  I think if I was a more traditional learner, or younger and less set in my ways.. LOL, it would have been where I ended up enrolling.

Good luck on your journey!