Home birth Consumer Alert

[guestmama9969]

Hello Home Birth Mommas:

I am writing to give what I think is great news for ALL Moms who home birth in America. My family fell prey to a (how shall I say this) very substandard home birth midwife. We paid the ultimate price for her lack of all things reasonable and prudent in a standard of care.
I petitioned mothersnaturally.org and MANA (Midwives of North America) to please unlist her as a provider as they had no idea of her credentials and training. It took months but this has finally happened. I will not go into detail on here but let me assure you- they were not willing to make this simple adjustment although I offered them all the evidence they needed to make a decision that was ethical and respectful for me and any Mom who may use their website to find a provider.
I encourage all mothers out there who may have had to demand a peer review in their respective state for their midwife to write to MANA and request that your provider be unlisted as well if they are listed on mothersnaturally.org. This is not a requirement for membership with MANA it is a courtesy, a benefit- they are not a sanctioning and credentialing group, they are a professional trade organization and as such have a duty to protect consumers from providers who may be substandard.
They list unscreened and uncredentialed providers from all over the United States and mothers may find their home birth midwifery provider based on a simple zip code search. This is horribly unfair to all GREAT MIDWIVES as they are listed with everyone whether or not they are safe and sound or completely sub standard. If you would like to know how I did this and would like additional information please contact me privately. The only caveat is- I obviously only want to hear from people who have valid complaints and a real justifiable complaint, and/or had to have their midwife attend (a) peer review(s). I think it is reasonable that this not be used as a "grudge match." I am only trying to protect other Moms and I think we can protect the mothers in our community in this way.
MANA has written to me and assured me that they will review how they list and subsequently unlist providers based on my request of them. This is a giant step in creating a safer referral system of Moms to credentialed, safe, and competent home birth midwives all over America!

Thanks and with utmost sincerity,

[mwherbs]

having a peer review can occur due to provider or client request or complaint- a peer review alone is not necessarily a sanction against anyone it is a way to look at a case or group of cases and how they were managed and what could have been done differently. In some places it can also be used to require certain education or practice changes. In order to be a CPM you are required to participate in several hours of peer review in order to keep your credential up- complaints or no.
and to sort of make some distinctions with these organizations--
MANA has long been an open organization where anyone can belong to it- they support midwifery in general and are not a professional union or the like. NARM is a certifying body that works to provide credentials and testing and set standards for CPMs- MEAC is the credentialing body for midwifery schools

[guestmama9969]

Home Birth Consumer Alert

Hello MWHerbs:

Yes, I fully understand this principles and the principles you bring up and all the subtle differences between these organizations. I am fully aware of these nuances.

- If it didn't put money in MANA's pocket- I would get all the names of women from the local graveyard and join in their name as a "midwife" just to prove a point that in MANA's eyes anyone is a midwife. I am talking specifically about mothersnaturally.org which is a product for lack of a better term supported by membership to MANA.


Through membership in MANA anyone who is a member can list on mothersnaturally.org which is what they have told me is an "educational tool".

I think and I am certainly not alone in this I have gained a great deal of support from home birth midwives- that listing unscreened and unknown providers is irresponsible to mothers who use this educational tool as a referral system. (ACOG has a similar disclaimer btw)

My midwife's name came down Monday and Wednesday a mother called a friend of mine who is a leader in an HB midwifer consumer group and asked why this midwife is not listed- this is the crux of the issue for me- mothers need to be able to get information that assists in informed consent. In states where midwifery is illegal or alegal- there is very little one can do after the "interview, and screening" process. If an organization lists a provider they must be okay- right?...wrong!

Additionally, when a midwive's group gathers to conduct a peer review our midwives in our state did an outstanding job- it strengthens the process for gathering objective criteria and data to support whether someone should be recommended or not in their community.

In the state where I live the CPM is NOT the recognized credential- anyone, and I mean anyone can claim to be a midwife and there is nothing the law or anyone can do about it. We learned this lesson the very hard way. We chose a DEM over a CPM because we thought experience was as good as credential. We do not want to see mothers learn the same lesson-.

If you are a mother who had a poor experience with a provider listed on mothersnaturally.org contact me if you are interested in whom to contact to ask them to remove your providers name. I am only too happy to help. I have been assured that the MANA board will be examining this issue at their Fall meeting and I think if they see that my request is not an isolated issue they will develop more of a process for screening providers listed on mothersnaturally.org.

[nashvillemidwife]

I will echo mwherbs, I think you need to re-examine your attachment to peer review as a disciplinary or punitive process. NARM requires all CPMs to participate in minimum of 5 hours of peer review every recert period. Our state association requires all members to discuss all transport cases in peer review, and we require special peer reviews in cases of client complaints and bad outcomes. I have presided over many of these peer reviews, and most of the client complaints were not substantiated. Peer review is for educational purposes and is not punitive in nature. I suggest you find some other outcome criteria for determining that a midwife is worthy of censure besides simply having undergone peer review.

[Noelle C.]

This almost comes across as very anti-midwifery. Every midwife who's been working long enough is probably going to have at least one birth where things just didn't go as hoped, not by a long shot. If one woman having a less-than-ideal birth should be enough to have a midwife outright removed from listings, and then some, then eventually every midwife is going to be knocked out of the profession.

If an organization lists a provider they must be okay- right?...wrong!

Something to understand with this is that, when an organization takes it upon themseves to do more than simply list midwives, but rather to be in charge of screening them or taking them off the list because of a complaint even though they are still certified, that organization has just accepted some measure of responsibility if something does go wrong with a midwife allowed to remain listed. There is nothing wrong at all with an organization simply listing all certified midwives. The individual patient shouldn't rely solely on one website simply listing a midwife to decide whether or not to use that specific midwife.

I'm also going to second and third what the other two have said.

[nashvillemidwife]

I never assume that because a person paid to have a listing in a directory they are being endorsed, unless the listing says otherwise.

[guestmama9969]

Correction-

I have to amend my post and correct, and clarify it to invite consumers who have had a provider who is listed on mothersnaturally.org who are interested in finidng out how they can get their provider's listing examined based on whatever mechanism it is in their state that might show that their provider is substandard and maybe shouldn't be listed there should contact me if you are interested. It has been pointed out twice now my flawed reasoning using the peer review as any basis for sanction- sorry about that. I live in a state where midwifery is not regulated by the state. I really meant some sort of objective data- to have a valid reason to ask that a provider be removed.

Thank you,

Insofar as the "anti-midwifery" comment is concerned, I am actually 100% pro home birth, pro midwife, pro regulation, pro licensing of home birth midwifery so that every mother who wants to have an out of hospital birth will know that the provider she chooses is properly trained.

I know that irks many a midwife and so be it-I hope we can agree to disagree on that one. Our family wants to see home birth recognized, paid for by insurance and to see all home birth midwives who are properly trained in the new "health care reform" and be eligible for federal insurance third party reimbursement.

[pampered_mom]

Originally Posted by Noelle C.

Something to understand with this is that, when an organization takes it upon themseves to do more than simply list midwives, but rather to be in charge of screening them or taking them off the list because of a complaint even though they are still certified, that organization has just accepted some measure of responsibility if something does go wrong with a midwife allowed to remain listed. There is nothing wrong at all with an organization simply listing all certified midwives. The individual patient shouldn't rely solely on one website simply listing a midwife to decide whether or not to use that specific midwife.

I think something like this applies to any care provider whether a midwife or not. Listings like this are imo akin to getting a recommendation from a friend. You may appreciate/trust their opinion, but you should never use that information alone to make your decision. One person's ideal caregiver is another person's nightmare. It's always a good idea to interview the person yourself, ask for references, and then check those references. If your state has additional resources available for looking them up then it's always a good idea to do so as well.

Originally Posted by Emom21109

Insofar as the "anti-midwifery" comment is concerned, I am actually 100% pro home birth, pro midwife, pro regulation, pro licensing of home birth midwifery so that every mother who wants to have an out of hospital birth will know that the provider she chooses is properly trained.

I actually don't think that any regulation/licensing laws can guarantee this. They may be a start, but they aren't a replacement for the things I've mentioned above. If all it took to guarantee that a care provider is "properly trained" or "competent" was for them to be licensed/regulated then we would never have to worry about doctors who were grossly incompetent and kept around because no one wanted to rock the boat and none of their colleagues reported them or were able to move to a different state without their past history following them.

These types of actions, like the directory listings you've mentioned should only ever be a place to start one's search, not the end.

[homewithtwinsmama]

Originally Posted by nashvillemidwife

I will echo mwherbs, I think you need to re-examine your attachment to peer review as a disciplinary or punitive process. NARM requires all CPMs to participate in minimum of 5 hours of peer review every recert period. Our state association requires all members to discuss all transport cases in peer review, and we require special peer reviews in cases of client complaints and bad outcomes. I have presided over many of these peer reviews, and most of the client complaints were not substantiated. Peer review is for educational purposes and is not punitive in nature. I suggest you find some other outcome criteria for determining that a midwife is worthy of censure besides simply having undergone peer review.

I agree that the OP does not understand the peer review process. And also, you chose a DEM. That means you knew that she had no one declaring her at a certain level of competence or skills having been tested. So it is not like OP was mislead. The potential exists for you to be equally unsatisfied with a MEAC school CPM or a ACOG affiliated doctor. I think that peer review is a wonderful tool (have participated in them personally, but if they in any way become a tool for vendettas, then midwives will avoid them to the detriment of the profession as a whole.

[homewithtwinsmama]

I know that irks many a midwife and so be it-I hope we can agree to disagree on that one. Our family wants to see home birth recognized, paid for by insurance and to see all home birth midwives who are properly trained in the new "health care reform" and be eligible for federal insurance third party reimbursement.[/QUOTE]

What you call "properly trained" I call overly regulated, restricted and unable to practice in the way that serves my needs. Many people would say that my midwife was unsafe because she and I decided to wait for labor after my membranes released for five days. A "properly trained and regulated (read restricted) midwife would have insisted I transport for a medically indicated induction. God Bless her independence (she is a CPM) and MANA for not forcing all midwives into the same practice guidelines box. I chose her because I knew she would be flexible and honor my choice NOT to do the "proper" thing and force me out of my home birth.

[Belle]

Originally Posted by homewithtwinsmama

A "properly trained and regulated (read restricted) midwife would have insisted I transport for a medically indicated induction. God Bless her independence (she is a CPM) and MANA for not forcing all midwives into the same practice guidelines box. I chose her because I knew she would be flexible and honor my choice NOT to do the "proper" thing and force me out of my home birth.

I had the same experience. My midwives are CPMs and if they had had to follow more restrictive practices I would have been transported to a hospital also for induction when my water broke and no labor followed. My midwives also do breech and twin births. I don't want their hands tied by the state.