Poll- Do you support "underground" midwives? - Page 6

[mwherbs]

Originally Posted by Imakcerka 

If attending home births as an MW is illegal in your state, lobby to make it legal.  All who want it to be legal than do something about it.  An illegal MW may not have as much experience as those who are legal.  However experience is a personal choice.  HB with an illegal MW is unfair, you're protected but they are not.  Yes they'll risk it all for you, but if something goes wrong... are you really going to stand by her?

I agree with your statements. I support midwifery, legal or not, but would prefer that it be a legal profession .

[AbbieB]

In order to answer the OP's question I think it's important to clarify how I feel about birth.

Fist off, I think birth is not automatically an medical event. It's not surgery, it's not prescribing serious medications.

Second, birth is not an assembly line, cookie cutter process. There is no one size fits all picture of what a safe, low risk birth looks like.

Third, not all situations that most midwifery laws class as too risky for home birth, in my opinion, automatically require hospital care. Age and weight come to mind. I'm over weight and 40. I'm high risk before anyone has even examined me based on state law, not my actual health status.

Fourth, midwifery laws in many states bind the hands of midwives to be as safe as they need to be. Even in low risk births things happen unexpectedly. Midwives need the training, experience and legal backing to be allowed to do something, even if the state also requires a transfer. Calling 911 is not enough.

Fifth, any women that chooses to own her birth, to take it outside of a hospital with it's promise of safety, the protection of licensing and the recourse of suing for malpractice, has the responsibility to herself to actually take responsibility for her choices. If she did not thoroughly vet her illegal midwife, and it turns out she is a quack, then it's nobodies fault but her own.

Midwifery does not come with all of the pros and cons of the current medical system, that's exactly why so many women choose it. There is a very narrow middle ground in some states, licensed CNMs, with a very narrow scope of practice that can serve women that want a little of both worlds, who happen to fit the narrow definitions of low risk. But there are plenty of women that are not served by this and need another option other than the hospital.

Every women needs to have the ability to decide how much responsibility and risk she wants to take on. Every women should have access to care to fit her needs. No one she be forced to choose between having her birth dominated by the medical model or sub standard care. Every women should be able to find the right place for her at her own acceptable level of risk. Women who want all of the bells and whistles of the hospital should have access to it. Women who want to birth at home, despite having a few risk factors should be able to find competent care to protect her health and safety.

I had my first child in a state with no laws for or against midwives. I found a wonderful midwife, who I trusted. I vetted her. I asked questions. I did my own research. Since this was a first birth, I went to a back up practice and asked more questions. I took responsibility for my actions. When I chose to do something risky, I accepted that there could be negative consequences. I was OK with that. When I chose to decline a hospital induction at 42 weeks, I understood the risk I was taking, I understood there was a chance that the baby could be harmed, even die. I weighed the risks of going post dates with the risks of induction, the risks of a failed induction and c-section. I made a decision I was comfortable with.

Had I gone home after declining the induction and the baby had gone into distress it was on me. I was fortunate to have a midwife that could continue to provide care, to continue to monitor the baby and me, to continue to help me weigh the risks. The ultimate decision rested with me. (Being of sound mind, any indication of trouble, based on my actual situation, not statistics, would of had me running to the hospital, with my midwife in tow and supporting me.) Had this happened in my current state, where midwives legally can not continue care in this situation I would have been forced to accept unwanted and unnecessary interventions or take unacceptable (to me) risks. My birth would have been given over to the medical system, it would have become a medical event. As it turned out my labor and birth went well, DD was 100% fine. I did need medical care after wards, and that's exactly why I hired a midwife! She treated me appropriately. She monitored me. I never needed to seek outside medical care.

This midwife was with me for my second birth, and she traveled across a state line to be with me, making her illegal. it did not change how safe she was.

She will be with me again for my third birth (as long as things keep going well.) Despite the fact that she is now licensed in 2 states, as added certifications and titles to her name, she is still illegal in my state.

[Storm Bride]

Originally Posted by Imakcerka 

If attending home births as an MW is illegal in your state, lobby to make it legal. 

And, what if you happen to be pregnant while said lobbying is still going on? Babies don't wait.

Yes they'll risk it all for you, but if something goes wrong... are you really going to stand by her?

Hell, yes. If I weren't going to stand by her (barring completely unethical behaviour on her part, such as if she told me she were really experienced with breech/VBAC/macrosomia/whatever, and then it turned out she'd never actually attended that kind of birth, or something along those lines), I wouldn't even consider going that route.

[Imakcerka]

Stormbride, you would stand by her side.  YOU,  will others?  Can you speak for them?  And no babies don't wait, however is your baby and your experience more important than any other women and unborn child?  I understand that you believe you would stand by her side, that's great.  I'm not saying not to have an illegal midwife, I'm just saying it's not fair to her.  And to be honest there is a lot that can be done.   Midwives should all be legal.  There should never be any fear for them or the mother.  

[Storm Bride]

I don't "believe" I would stand by her side. I've been there, done that. It was an effing nightmare, and the hospital I transferred to wanted to use my personal tragedy to aid  them in a midwife hunt.

In any case, it's really up to the midwife what risks she's willing to take, imo.

[PseudoDiva]

From a civic perspective, I believe in personal responsibility and personal freedom.  You want to hire someone who's not licensed, or maybe less experienced? Go for it, but as AbbieB said, it's on you.  You may or may not have any recourse if things go terribly wrong and you need to be ok with that.

For myself: I will never, ever hire an underground midwife.  It's not something I feel comfortable doing.  I have an excellent CNM who will be at my upcoming homebirth and I wouldn't be satisfied with anyone who has less than a CNM AND is licensed.  That's just my personal preference.  

In my experience with an underground midwife (with DS1,) protecting her and her attendants was more important than protecting us.  

[Imakcerka]

Originally Posted by Imakcerka 

If attending home births as an MW is illegal in your state, lobby to make it legal. 

And, what if you happen to be pregnant while said lobbying is still going on? Babies don't wait.

Yes they'll risk it all for you, but if something goes wrong... are you really going to stand by her?

Hell, yes. If I weren't going to stand by her (barring completely unethical behaviour on her part, such as if she told me she were really experienced with breech/VBAC/macrosomia/whatever, and then it turned out she'd never actually attended that kind of birth, or something along those lines), I wouldn't even consider going that route.

Originally Posted by Storm Bride 

I don't "believe" I would stand by her side. I've been there, done that. It was an effing nightmare, and the hospital I transferred to wanted to use my personal tragedy to aid  them in a midwife hunt.

In any case, it's really up to the midwife what risks she's willing to take, imo.

You now have me confused.  What is your stance on this really?
 

[Youngfrankenstein]

Originally Posted by Imakcerka 

If attending home births as an MW is illegal in your state, lobby to make it legal.  All who want it to be legal than do something about it.  An illegal MW may not have as much experience as those who are legal.  However experience is a personal choice.  HB with an illegal MW is unfair, you're protected but they are not.  Yes they'll risk it all for you, but if something goes wrong... are you really going to stand by her?

My state is anti-homebirth.  My midwife is very experienced and was the perfect choice for us.  She works her butt off as a midwife AND spending lots of time working with the state government trying legalize homebirth.  She's worked on that for many years.  She passed our strict interview and one of our criteria was that she come into the hospital if we had a transfer.  She said that of course she would.  It's not like she'd drop us off in the parking lot and head for the hills.  Even if I had a non-emergency transfer, she would have acted as a monitrice and doula.

Stormbride has a long, heart-wrenching tale to tell.  She knows what she wanted.  This birth "system" let her down from the first day.  I don't want to speak for her but her views come from first-hand knowledge.
 

[Imakcerka]

I don't doubt she does have first hand knowledge.  I just got two different answers which left me confused. 

[Youngfrankenstein]

Originally Posted by Imakcerka 

I don't doubt she does have first hand knowledge.  I just got two different answers which left me confused. 

I'm not trying to pick a fight....I'm sure she'll be back to clarify.  I was also just trying to chime in with my experience.

[Mulvah]

Originally Posted by Imakcerka 

I don't doubt she does have first hand knowledge.  I just got two different answers which left me confused. 

As a casual reader of this thread, you didn't get two different answers.  Storm Bride gave a direct response to you saying "I understand that you believe you would..." and her point is that it isn't just a belief, but that she already went through an experience where she stood by her (illegal) midwife. 

[Storm Bride]

Originally Posted by Imakcerka 

You now have me confused.  What is your stance on this really?

I'm not sure why you're confused. My stance is that I support underground/illegal midwives, and would (and did) stand by my own, unless they'd one something egregious (lying about their experience, physically trying to prevent me from transfer, or the like).

[jenrose]

I live in Oregon, which means that there are no "illegal" midwives where I am. One of the reasons I choose to live in Oregon is because the wide range of legal birthing options means that someone in my situation is NOT held hostage to the medical profession's so-called standards.

My first midwife, who acted as labor support for my first birth, a hospital birth, did far more to keep me and my daughter safe and healthy during the last months of pregnancy and first months of her life than ANY of the medical professionals involved in our care, despite the fact that at the time, she was a lay midwife who had not even graduated high school. She has since gone on to become a CPM. What did she do? She helped me not go in when labor "stalled" at 35, 36 and 37 weeks (I dilated, contractions <5 min apart, it was prodromal labor, not just "braxton hicks") despite the fact that the doc would have been happy to put me on pitocin at 36 weeks. I made it to 40+ weeks, with her reassurance. She helped me have an unmedicated birth in a hospital with a 90% epidural rate. Had the doctor not gotten in the way (quite literally), I might not have even torn. She saved our breastfeeding relationship. She researched and went to the mat for me.

By contrast, the perinatologists insisted that hospital birth was the only way I could birth safely, but they shoved an unnecessary tube down my screaming, healthy baby's throat, cut her cord so fast she was anemic by 4 months, literally forced me (I was lifted bodily onto the bed) into a position that put maximum stress on my perineum, which tore terribly, sewed it up so badly that it looks like it was never repaired, 18 years later, and sent me home before I even hit my period of "maximum risk". I had to fight not to have my veins violated (I have a clotting condition, and the last IV that had been started left me with clots running up and down my arm and a painful infection), not to have monitors strapped on me for the whole labor... and when they cut and clamped the cord and whisked my baby to the respiratory team because I had *faint* meconium tint in the waters, the doctor stood between me and my baby and I had to stand up and shove her out of the way in order to see my child. The "help" I was given in the hospital with breastfeeding nearly wrecked my breastfeeding relationship with my daughter, and they sent me home with blistered nipples and the message that I was "doing things right" despite agonizing pain.

My "uneducated" "uncertified" midwife fixed our latch problems in half an hour. 

My midwife did not one thing to make the process more dangerous. 

My doctor did not one thing to make the process safer.

My second child, I was going to go unassisted, but after a miscarriage, wanted a midwife for backup so that I would have some way "in" if something went wrong, because it was clear after my miscarriage that I needed someone on my side, and that things could go wrong.

The first midwives I interviewed told me dead baby stories to persuade me that it was absolutely necessary for them to be there. They clearly did not trust me to call if I needed help. The next midwife was okay with unassisted birth, but told me a dead baby story anyway and then balked when I started having bleeding and wanted an ultrasound to see if the baby was still alive because I'd miscarried not long before. She thought it should be "all or nothing" and that if I was going to get an ultrasound I should just have a hospital birth and be done with it. I don't remember who fired who.

The next midwife? Said, "I trust your knowledge of your body, and it is clear that you're willing to ask for help when things are out of your comfort zone, and I'd be honored to help you." She was a CPM and licensed, but I was not technically low risk.

She was my liaison between the low tech birth I wanted and the few medical interventions that were, in fact, appropriate. Like getting an ultrasound when I'd been bleeding for a week and had started having flashbacks to the miscarriage and just needed to know if my baby was alive.

When things got out of my comfort zone, I called her, she came, and helped reassure me that while they weren't typical, they weren't pathological either. I birthed at home, despite a situation no one knew about that would have resulted in a c-section at the hospital. Birthing at home kept us from a host of other interventions that would have made my daughter much worse off. 

The rules are such now that even a technically high risk mom like me can birth legally with a licensed midwife. None of my risk factors make the birth itself "safer" in the hospital. 

And my current midwife is a licensed CPM. I see her and a perinatologist, am on blood thinners but will go off of them and onto a safer (but more caloric) method of anticoagulation at 35 weeks. I was able to do genetic screening, have an ultrasound when I was bleeding, all without arguing with anyone. 

Does this mean that I think all unlicensed or licensed midwives are safe practitioners? Nope. But you know what? I've seen a hell of a lot of less-than-competent doctors, too. Most OBs won't touch me with a 10 foot pole. I've seen so-called specialists brutalize my daughter unnecessarily while ultimately shrugging their shoulders and passing the buck. I'm not a doctor, but I've done more for my daughter's long-term health than any licensed practitioner, because I *read* and *research* and do the friggin' homework they don't have time to do. Sometimes we need more help than I can give (I wouldn't dream of trying to put ear tubes in her, or take out her adenoids), and we get help from medical practitioners. But when it comes to the huge unknown that is my daughter's rare, rare syndrome, we're all starting from the same place. 

And while doctors may catch a hell of a lot more babies than midwives when training, and see a lot more complications, they don't have anything near the experience with normal birth, or even the concept of "trying to keep birth normal" that your average lay midwife has.

That said, midwives have a moral obligation to be honest with their potential clients about their training, background, practice philosophy, etc. And I have ZERO patience for midwives who leave the laboring mother alone when she's in active labor or who fail to listen to their clients when their clients are sure something is wrong. Just like I have zero patience for doctors who make up stupid excuses to induce women just so they can go on vacation with a clear conscience, or who tell women that because their first birth was hard, or they tore or whatnot, that their bodies are flawed and can't birth a bigger baby.

In most states my choice would be unassisted or hospital. And I've done the hospital thing. It was worse than useless. Nothing like having a nurse come in 6 hours after you've had an unmedicated vaginal birth and say, "Let's check your incision, dear?" 

"What incision?"

"From your c-section."

Tell me that someone who can't even be bothered to read a chart is a safer caregiver than a midwife who, with great skill and intuition, managed to take a freaked out first time mom from 35 to 40 weeks with many bouts of prodromal labor without getting pitocin to "help" things along unnecessarily. 

I care less about certification and more about the ability to listen, pay attention, and be honest. 

[gravida]

 I support women's choices and if that is to go with an underground midwife, then she can have at it. I had a semi underground midwife myself and wouldn't have done a thing differently.

What I do not like, and it has turned me off of supporting particular people, is the need for one side to slam the other. Doctors tearing apart midwives for being quacks and unsafe is just as bad IMO as underground midwives holding themselves above liscenced midwives and saying they are sell outs who do nothing but harm women and the sacred profession only they can uphold.

[Imakcerka]

I think it could have a lot to do with validating themselves.  The I'm this and you're that mentality.  Yuck.  I just don't like the vilifying of each other that goes on.  No need, they're all wanted and needed in some aspect of womens lives, they don't need to fight for it and talk poorly of each other. 

 

Originally Posted by gravida 

 I support women's choices and if that is to go with an underground midwife, then she can have at it. I had a semi underground midwife myself and wouldn't have done a thing differently.

What I do not like, and it has turned me off of supporting particular people, is the need for one side to slam the other. Doctors tearing apart midwives for being quacks and unsafe is just as bad IMO as underground midwives holding themselves above liscenced midwives and saying they are sell outs who do nothing but harm women and the sacred profession only they can uphold.

[pregnova]

Interesting thread. Very. 

I will absolutely 100% support 'underground' midwives. I will readily admit that I might have a different frame of thought on this though. If I'm completely honest here, I would call myself an anarchist. I do not support government regulation of any sort. Or, really, any regulation...which goes for certifications, licensure, and whatever else is needed to make one 'qualified' in a legal sense. 

I strongly, STRONGLY believe that the choice in caretaker falls on the person who is doing the hiring. I believe in asking questions, requesting information on prior births and birth outcomes, personal beliefs pertaining to the matter at hand, and then going about and verifying those responses. 

If I am interviewing midwives, it will absolutely NEVER matter to me whether or not she is 'legal' or keeping up with her state regulations. All that will matter is the connection I can make with that midwife and her history as a midwife. And, yes, sometimes you might be given faulty information and the midwife might fail you...I'm not sure I believe that this will only happen to you if the midwife is 'illegal' though. I think it's a risk that everyone takes on when choosing a caretaker...and one of the reasons why you should shoulder the responsibility of choosing said caretaker yourself...so that you WILL do the research ect... necessary to choose the best one for you and your situation. 

I also strongly believe that legality has no ethical or moral standing (for me). It's all arbitrary. What is 'legal' in one state might be illegal in another (and lets keep in mind that states themselves are just arbitrary imaginary lines that don't actually hold up the reality of physical landscapes!)...that doesn't make it inherently wrong or dangerous. 

[IdentityCrisisMama]

Yes.  I had my first birth with a licensed MW who accepted the limitations set upon her by the state.  I ended up needing an IV and transferred for that.  I also ended up bleeding quite a bit and it became important to me after that birth that a MW carry basic supplies like an IV and pitocin.  I also feel much more comfortable with a MW with LOTS and lots of experience.  These two things are far more important to me than legal status.  Though I will admit that the simple fact of practicing illegally and what that does to the issue of transferring is a serious concern and I went into the second birth with an awareness that I needed to advocate for myself and my child should the issue of transfer come up.  

ETA: license status and experience have not gone hand in hand for the midwives in either of the 3 areas of the US where I have seen a HB MW.  

[Jenga]

Originally Posted by gravida 

 I support women's choices and if that is to go with an underground midwife, then she can have at it. I had a semi underground midwife myself and wouldn't have done a thing differently.

What I do not like, and it has turned me off of supporting particular people, is the need for one side to slam the other. Doctors tearing apart midwives for being quacks and unsafe is just as bad IMO as underground midwives holding themselves above liscenced midwives and saying they are sell outs who do nothing but harm women and the sacred profession only they can uphold.

I agree with what I bolded. I don't care so much what other people choose to do, but I would not choose to use an underground midwife personally. I chose a CNM and she was actually unlicensed during the time she was my midwife and didn't tell me. Talk about a breech of trust!!  

As to the second part, I especially agree with that! I've seen on HERE how homebirth midwives have torn at a midwife who is affiliated with a hospital and works at a birth center. High and mighty, holier than thou responses and it was ridiculous!  

[naturalmontrice]

I absolutely support any choice a mother makes - licanse or not, if the knowledge and expereince is there, who cares if they went to school or got a certificate. I know midwives who have that piece of paper and aren't worth the ink used to print it out!!! Before the whole hospital phenomenon almost 100 years ago, that's all there were - women who grew up doing what women do - being the backbone of the home and family, watching and assisting their mothers, aunts and older sisters until they were capable of doing it on their own and having their own babies. All the special classes and training is nice to have (and I do attend some of them) but some of us just know and do. I have never had a complaint or issue, never had an incident that couldn't be managed. If a woman trusts and knows her body, so do I

[littlest birds]

The law protects many anti-birth anti-health forceful methods.  Thank God there are so many amazing midwives willing to work outside of the law!  It's heartbreaking that they would need to but bless them, bless them, and bless them again.  They are at the heart of the homebirthing movement and some have worked very, very hard to change the laws and we all benefit from that work.  We all benefit from their willingness to be revolutionaries, quite frankly, because those who are willing to face those kinds of risks pave the way for the next generations who will not have to do the same. 

Midwives with extensive training, even including nursing degrees, sometimes practice illegally where there is no way to be legal. 

Sometimes they practice illegally because the existing institutions make it impossible to attend homebirths with their credential.

I live in a gray area state where there have been long struggles over this, CNMs don't attend HB the last I knew, but midwives don't have to fully hide, either.  That said, their alliances with transfer doctors are constantly under threat and difficult to initiate and maintain.  

As long as everyone understands the risks they may be taking (promoting that understanding is the responsibility of everyone involved) I am so grateful for the woman's right to choose to take that risk.  Maybe someday "health care" won't feel like violation.  We'll probably have the rogues who fought and stepped out of the system first to thank for helping women demand improvement.

I find it inappropriate to tell someone they could just move to a different location to have better childbirth options.  I am a conscientious objector to the mainstream medical system (after MANY bad experiences) and I want to stay out of it as much as I can.  That means I would not look for a CNM because she would be controlled by that system and she would control my options.  I don't want to be controlled by that system.  It is dangerous and cannot be trusted.   I am not really okay with regulation in the current health care climate.  There are a lot of trade-offs either way things go and regulation takes a lot away.

You know, I always roll my eyes about people who talk about fighting to legalize smoking pot.  I mean I just can't care and I see no justification inn breaking laws and taking risks for such a thing that isn't very beneficial IMO.  It's fine with me if people do it, but fight for it?  What makes a drug that important?    However, choices to birth w/o invasion and even to take extra risks to avoid other risks according to my beliefs is a freedom of choice that is very deeply meaningful to me.  That's something worth breaking the law for.  I don't know what kind of institutions we need to protect this freedom and the ideas I hear don't sound like they would get us there.  So let's give these ladies, the CPMs and those practicing illegally, a little respect and appreciation and may every woman choose her practitioner to fit her preferences.