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Poll- Do you support "underground" midwives? - Page 12

post #221 of 285

After facing induction at 42 weeks, with my hospital midwives now talking up pit and "going for it", c-section or not, I am very thankful that I can find what I need on the black market--this time a homebirth midwife.  My boy came at 42 weeks and 4 days, all on his own.  I had 13 hours of labor and a delightful water birth in my living room, surrounded by people who love me and him.  I can't imagine having had this experience in the hospital.  I think it is close to a miracle that my midwife accepted me at 41.5 weeks.  She had faith that the baby would come on his own (and yes, checkups to make sure everything was all right in the meantime).  She let me labor, answering my questions and providing assistance when I askeed.  Otherwise, I felt like my body did what I knew it could do, even as a first-time birther at 38 years old.

 

I would love it if Illinois had licensed homebirth midwives, but the select handful on a committee in our state capital won't pass the bill on to the general assembly.  There's not enough money in private hands to overcome the medical lobby.  I don't see why this should limit my choice to have a home birth.

 

I have been amazed since the beginning at the politics of birth.  It's almost as raucous as the abortion issue.  I do find it hard to believe that it's legal to get an abortion (something highly contested as moral or immoral), but not have a skilled midwife legally assist me and my baby at the time of his birth.  I feel just as I would be very glad to have access to a black market abortionist (preferably an herbalist) if I ever were seeking an abortion, I am just as glad for my access to a black market midwife. 

 

My biggest issue with having a home birth was that I knew, should a problem arrive, I would not have my midwife assisting me through the transition.  But still, I felt I was much safer, as well as more comfortable, having my birth at home, and dealilng with it, on the occasion it might happen.

 

Yes, licensing would be great.  It is not our community that decides the legality/morality of home birth midwives; it is big money.  Our legal system is rife with hypocrisy and corruption.  I long ago decided to follow my inner voice as to what was morally acceptable, and I don't regret it.  There are so many of us who desire to maintain our autonomy, but can't legally do so. 

post #222 of 285

I saw a midwife, legally, by crossing the border 20 minutes away into the next state....who used to practice in my state.  It used to be just not legislated, then in the mid-90's I think it was, 'cease and desist' letters went out to homebirth midwives.  The letter told her to stop practicing nurse midwifery though, and that wasn't what she was doing, so she did continue and eventually went to jail.  That is when people started having to cross the border to where it is legal to see her.  So yes, I supported a former underground midwife.

 

HOWEVER.  I would not have had her attend my birth in my home in my state even if she had been willing.  Why?  In case of a problem or a need to transfer.  I would want that to go smoothly.  And I want my care provider's first priority to be the safety and well being of myself and my baby, not protecting their own butt from being caught.  That would be a stress on my mind if I did that.  I would go unattended before I would have an illegal midwife----that would mean I'm moving FAST lol because I have an excellent hospital CNM option about a 20 min. drive from me.  As much as I don't think hospitals are necessary for birth, I would also go there if I really had to have (in my own mind, I think a mother knows) a professional attendant before I would go the illegal route.  Too much mind-stress for labor with the illegality issue.

post #223 of 285

"Some of the midwives I interviewed were legal (CNMs), but in all honesty - I was not feeling them at all. Neither was my husband. I did not like what they had to say or how they answered my numerous questions (which included what will you do if ...)."

 

I also think there is a very important line between what we "want" to have happen and "what needs to happen".   And sometimes, not being experts we don't know what we actually need versus what we "want" which can set up unreasonable expectations about what a provider is actually able to do.

 

Reminds me of the thread here about fundal massage and how painful it can be and one woman posted that she would "just ask her provider to massage her gently, instead" and was sure the provider would respect the request.

 

Its like, dude, talk about missing the point.

post #224 of 285
Quote:
Originally Posted by Buzzbuzz View Post

"Some of the midwives I interviewed were legal (CNMs), but in all honesty - I was not feeling them at all. Neither was my husband. I did not like what they had to say or how they answered my numerous questions (which included what will you do if ...)."

 

I also think there is a very important line between what we "want" to have happen and "what needs to happen".   And sometimes, not being experts we don't know what we actually need versus what we "want" which can set up unreasonable expectations about what a provider is actually able to do.

 

Reminds me of the thread here about fundal massage and how painful it can be and one woman posted that she would "just ask her provider to massage her gently, instead" and was sure the provider would respect the request.

 

Its like, dude, talk about missing the point.


ugh. I read that fundal massage thread - some of the women seemed to have been saying that they didn't understand why it was done if not indicated. You can't make the call that it was necessary because you were not there at their births.

 

You seem to be of the opinion the mainstream choices, ob/gyn, nurses, cnm, etc. can do no wrong, never bully women, never push for unnecessary interventions, never lie, never abuse their power.... and then on the other hand you seem to think that all cpms only want to introduce flesh eating bacteria to vaginas, keep mom from transferring for as long as possible and risking her and baby's life. Clearly both extremes exist in some capacity... hopefully women can make their *own* choices to try to avoid those extremes. 

 

want/need is a fine line, and it is also a line that has been used against women in many abusive ways. when are we going to let women decide what they *want AND need* ??? disappointed.gif I think some have that ability.......

 

ETA: Not to mention, most medical issues are not black and white... one highly regarded Dr. may choose a different course of action than another Dr. Or an ob/gyn may choose another course of action than a highly regarded cnm. Or cnm and cpm.

So who is wrong? If experts can't always agree "what is needed"... why shouldn't a patient choose whichever hcp aligns with most of her needs and wants??


Edited by slmommy - 3/24/12 at 5:18pm
post #225 of 285

Buzz,

The more I think about it the more irked.gif I am getting about the need/want comments. While I'm assuming/hoping your comments are out of concern, you seem to have a very low opinion about the intelligence of women. (they aren't smart enough to find out if their mw is licensed or not, they could never know when they need to transfer, they don't want interventions that they need and can not possibly know the difference about whether a procedure is needed or not).

 

No one is forcing women to use unlicensed mws. Some women choose to use them, for many different reasons. While you don't have to respect their choice, you should respect their ability to make that choice.

 

If "we" were *really* concerned about birth outcomes, more options would be available to women... it is pretty clear the "mainstream" obgyn/hospital route is NOT the best or safest option for many women. Take away more options (with already limited ones), and more women will UC, and I say this as someone who chose to UC... it is probably not the best option, but women opt for it because they know they will never find a hcp to provide what they "want" or "need." We start painting broad medical strokes about what ALL women NEED and I believe it will create a lot of problems, already has, never mind totally ignoring concepts of bodily autonomy. That is precisely the problem many women have with prenatal care and birth in the mainstream setting. 

 

ETA: I think I can best object to your assertation that "experts" have a better understanding about what I "need" by showing the differences in prenatal/maternal care here in the country I am living and had my birth in (extremely high c/sec rate country). I did follow some standard pre-natal care, kinda, for a while. 

NT ultrasound at 12 weeks here are ALWAYS trans-vaginal. All obgyns, mws, and ultrasound techs thought I was nuts for saying they are normally done (at least started) abdominally in US. 

All women are given fetal echocardiograms whether a problem is indicated on u/s or not.

Of several obgyns I saw, they all wanted u/s at 22-24 weeks instead of 20.

A mainstream pregnancy mag I bought literally states "natural birth is not recommended by doctors"

Episiotomies are commonly cut, assuming you can even manage to be part of the small percent that are vaginal births.

 

Why do these experts have a different standard of care than experts in the US. Who is wrong? Who knows what I really need? I simply do not trust many hcps to do what I really *need* especially when hospital policy dictates what I *need* to avoid litigation/promote or protect industry - not what I ACTUALLY need.

 

What do I want? I want rights to bodily autonomy, informed consent, and to be treated as an individual patient with individual issues.

What I do NOT need? to be put through the wringer that is the mainstream birth factory. 

 

I know some women find awesome ob/gyns, hospitals, birth centers, good experiences in mainstream settings. But that is NOT available to all of us. Respect our ability to discern what is personally best for us in our specific situations.


Edited by slmommy - 3/25/12 at 6:49am
post #226 of 285
Quote:
Originally Posted by slmommy View PostETA: I think Valeria_vi was just trying to show how arbitrary some of the differing state legislation is. Women and uteri are the same across the country, last I knew. I understand states make their own laws. But I think there are a lot of less well intentioned interests that come about when legislating what women should and can do with their bodies and babies, particularly medical interests and paternalism.


Yes, thank you slmommy. That is exactly what I meant.

post #227 of 285

"Buzz,

The more I think about it the more irked.gif I am getting about the need/want comments. While I'm assuming/hoping your comments are out of concern, you seem to have a very low opinion about the intelligence of women. (they aren't smart enough to find out if their mw is licensed or not, they could never know when they need to transfer, they don't want interventions that they need and can not possibly know the difference about whether a procedure is needed or not)."

 

Please note that my comments have never been about intelligence -- they have been about *knowledge* which is an entirely different thing.   For example, I got my Phi Beta Kappa key in college but know that I couldn't tell you more than about 5 or 10 facts about physics or botany or the history of Botswana or any other of an enormous list of items.

 

I am concerned when certain significant health issues (for example, fundal massage is preventative against PPH which is, I believe, the #1 causation for maternal mortality worldwide) are approached as if someone is ordering this whole experience off a menu.  I am especially concerned about this where the health care provider is unregulated -- that there will be "a race to the bottom", in terms of  where certain acts that are *known* to be undesirable to the patient but necessary are avoided.

 

post #228 of 285
Thread Starter 

Bolded is so true.  In previous posts (many pages ago) people were saying that basically if you didn't know a midwife was legal or not, well, than you're just an idiot.  In my birth community, people are using loopholes to make it sound like it's legal when it's really not, and those lies get spread around.  I blame the midwives who are trying to get business and are not being upfront about it.
 

Quote:
Originally Posted by Buzzbuzz View Post

"Buzz,

The more I think about it the more irked.gif I am getting about the need/want comments. While I'm assuming/hoping your comments are out of concern, you seem to have a very low opinion about the intelligence of women. (they aren't smart enough to find out if their mw is licensed or not, they could never know when they need to transfer, they don't want interventions that they need and can not possibly know the difference about whether a procedure is needed or not)."

 

Please note that my comments have never been about intelligence -- they have been about *knowledge* which is an entirely different thing.   For example, I got my Phi Beta Kappa key in college but know that I couldn't tell you more than about 5 or 10 facts about physics or botany or the history of Botswana or any other of an enormous list of items.

 

I am concerned when certain significant health issues (for example, fundal massage is preventative against PPH which is, I believe, the #1 causation for maternal mortality worldwide) are approached as if someone is ordering this whole experience off a menu.  I am especially concerned about this where the health care provider is unregulated -- that there will be "a race to the bottom", in terms of  where certain acts that are *known* to be undesirable to the patient but necessary are avoided.

 



 

post #229 of 285

I don't know, the way I see it, you need intelligence to have good judgement. Buzz clearly does not respect women's judgement to discern whether or not they have enough knowledge to make their own health choices. Could I make a good decision about hip replacement? No, I know nothing about that. Pregnancy and birth, I think I know enough to make certain choices in regards to my care or to find a hcp I think will attend me best. I guess I am just really arrogant.

 

Lovebeingamomma, in most states I don't think it is that difficult to figure out mw laws, I think there are a few, and you are in one I think, where it is not clear and apparently some mws are lying or interpreting things incorrectly. I still don't think the vast majority of women using cpms in those states care about the legality, as many posted here saying.

 

There are tons of prenatal exams, birth interventions, and hospital protocols that are not appropriate for every.single.woman. Are they necessary or advisable for some, at some times? Yes. Yet they are applied across the board. And I should just believe it is absolutely critical to receive flu shot while pregnant, get pap smear at first appt, or do x amount ultrasounds, or have IV in place for delivery, or pitocin shot to deliver placenta just because a dr./protocol says so? I think I am intelligent enough to make my own choices based on what I know of my own health, my situation, and pregnancy and birth.

 

Women are leaving the mainstream maternal care option because maternity care is "dumbed down" - applying lots of procedures/exams/interventions to everyone regardless if indicated or not. And yet, the US doesn't really stack up that well for some outcomes compared to other developed nations.

 

 

 

 


Edited by slmommy - 3/25/12 at 5:39pm
post #230 of 285
Thread Starter 

I agree most probably do not care if it's legal or not.  But when a bad outcome happens (and it will, statistically it will happen eventually), it's going to be a real problem for that midwife who will probably be sued by the patient if they were not upfront about the legal part.  LEGAL homebirth shut down in my state in the 80's from two bad outcomes.  I can't imagine what's going to happen when a baby dies assisted by an illegal midwife.  It's going to shed a really bad light on homebirth.  I can only speak about my birth community and not any other state, perhaps it is a lot clearer elsewhere, it just seems way to easy in my state to hire an illegal midwife.  Although not anymore, they have all gotten cease and desist orders from the health department in the last year.  3 years ago legal homebirth was finally made available again, I'm happy to see that progress.  I bet it would have been pushed for a lot sooner if illegal midwives hadn't been so readily available.  
 

Quote:
Originally Posted by slmommy View Post

I don't know, the way I see it, you need intelligence to have good judgement. Buzz clearly does not respect women's judgement to discern whether or not they have enough knowledge to make their own health choices. Could I make a good decision about hip replacement? No, I know nothing about that. Pregnancy and birth, I think I know enough to make certain choices in regards to my care or to find a hcp I think will attend me best. I guess I am just really arrogant.

 

Lovebeingamomma, in most states I don't think it is that difficult to figure out mw laws, I think there are a few, and you are in one I think, where it is not clear and apparently some mws are lying or interpreting things incorrectly. I still don't think the vast majority of women using cpms in those states care about the legality, as many posted here saying.

 

There are tons of prenatal exams, birth interventions, and hospital protocols that are not appropriate for every.single.woman. Are they necessary or advisable for some, at some times? Yes. Yet they are applied across the board. And I should just believe it is absolutely critical to receive flu shot while pregnant, get pap smear at first appt, or do x amount ultrasounds, or have IV in place for delivery, or pitocin shot to deliver placenta just because a dr./protocol says so? I think I am intelligent enough to make my own choices based on what I know of my own health, my situation, and pregnancy and birth.

 

Women are leaving the mainstream maternal care option because maternity care is "dumbed down" - applying lots of procedures/exams/interventions to everyone regardless if indicated or not. And yet, our nation doesn't really stack up that well for some outcomes compared to other developed nations.

 

 

 

 



 

post #231 of 285
Quote:
Originally Posted by lovebeingamomma View Post

I agree most probably do not care if it's legal or not.  But when a bad outcome happens (and it will, statistically it will happen eventually), it's going to be a real problem for that midwife who will probably be sued by the patient if they were not upfront about the legal part.  LEGAL homebirth shut down in my state in the 80's from two bad outcomes.  I can't imagine what's going to happen when a baby dies assisted by an illegal midwife.  It's going to shed a really bad light on homebirth.  I can only speak about my birth community and not any other state, perhaps it is a lot clearer elsewhere, it just seems way to easy in my state to hire an illegal midwife.  Although not anymore, they have all gotten cease and desist orders from the health department in the last year.  3 years ago legal homebirth was finally made available again, I'm happy to see that progress.  I bet it would have been pushed for a lot sooner if illegal midwives hadn't been so readily available.  
 

So, you are saying, for 3 decades, there were many illegal mws operating without any fetal deaths?

 

What happened in your state? cnm can attend hb? but cpm still no?

post #232 of 285
Thread Starter 

Those deaths that happened in the 80's most certainly got the attention of our state, so it's hard to believe a death wouldn't be a media story from then on...perhaps any deaths that have happened (I know there have been) have happened in the state where the CPM's are legal, I'm un-clear on that, but it's not far-fetched to say that one day a death will happen in my state and it will be a huge story, the media loves to report those stories.  That's really a side-point though, that's not the reason I don't support them, I'm just saying that it concerns me, because I'm a huge supporter of homebirth and I would hate to see a bad story like that come out.  To answer your other questions- as of 3 years ago CNM's can attend hb's legally, CPM's have never been legal here.  
 

Quote:
Originally Posted by lovebeingamomma View Post

I agree most probably do not care if it's legal or not.  But when a bad outcome happens (and it will, statistically it will happen eventually), it's going to be a real problem for that midwife who will probably be sued by the patient if they were not upfront about the legal part.  LEGAL homebirth shut down in my state in the 80's from two bad outcomes.  I can't imagine what's going to happen when a baby dies assisted by an illegal midwife.  It's going to shed a really bad light on homebirth.  I can only speak about my birth community and not any other state, perhaps it is a lot clearer elsewhere, it just seems way to easy in my state to hire an illegal midwife.  Although not anymore, they have all gotten cease and desist orders from the health department in the last year.  3 years ago legal homebirth was finally made available again, I'm happy to see that progress.  I bet it would have been pushed for a lot sooner if illegal midwives hadn't been so readily available.  
 



 



 



Quote:
Originally Posted by slmommy View Post

So, you are saying, for 3 decades, there were many illegal mws operating without any fetal deaths?

 

What happened in your state? cnm can attend hb? but cpm still no?



 

post #233 of 285

I am sure there have been bad outcomes that got transferred out of state or hushed up. But 3 decades with no media reportable story - that is a pretty good record. Are there any/many cnms doing hbs?

post #234 of 285
Thread Starter 

There's just one right now, although in the next year there should be 2 or 3.  Unfortunately one of the reasons women have been forced (so to speak) to use illegal midwives is that our CNM's will not take many risks with their homebirths, such as twins, VBAC's, and breech.
 

Quote:
Originally Posted by slmommy View Post

I am sure there have been bad outcomes that got transferred out of state or hushed up. But 3 decades with no media reportable story - that is a pretty good record. Are there any/many cnms doing hbs?



 

post #235 of 285

This situation sounds a little chicken - egg to me. Bad hb outcomes = legislation ending hb. Most of the issues people are pointing out about illegal mw (want to wait longer to transfer, transfer out of state because of legality) = because of the legislation. I guess women are just gonna birth how they want until someone figures out a system to stop that preemptively. 

 

Now 1-3 cnms can do hb for a whole state. I don't think women will stop using illegal mws, if there are any practicing after the cease and desist. I guess it is a start though... 

post #236 of 285

"Buzz clearly does not respect women's judgement to discern whether or not they have enough knowledge to make their own health choices. Could I make a good decision about hip replacement? No, I know nothing about that. Pregnancy and birth, I think I know enough to make certain choices in regards to my care or to find a hcp I think will attend me best. I guess I am just really arrogant."

 

I think every woman has the right to make her own health choices and I respect that right.  However, I think there is a lot of natural childbirth activism masquerading as reliable scientific information out there on the net. 

 

I have run into people who have researched and read and who have believed things as diverse as that as long at the baby is attached to the placenta it cannot suffocate (missing that little detail that amongst other things the placenta still needs to be attached to the mother), think that placenta previa can be handled at home, etc., etc.  These women are being sold a bill of goods just as much as all those people who were told before the crash that sure, you can afford a $500,000 house with no downpayment.

 

It is because I am a feminist that I am so concerned about this issue.  In fact, I find some aspects of the natural childbirth movement to be concerning from a feminist perspective (that one must give birth vaginally to be a "real" woman, that voluntary suffering of pain in childbirth has a particular moral worth or is a test of womanliness, etc.)

 

 

post #237 of 285
Quote:
Originally Posted by Buzzbuzz View Post

It is because I am a feminist that I am so concerned about this issue.  In fact, I find some aspects of the natural childbirth movement to be concerning from a feminist perspective (that one must give birth vaginally to be a "real" woman, that voluntary suffering of pain in childbirth has a particular moral worth or is a test of womanliness, etc.)

 


I've been here for seven years. I've been talking to women in the natural birth community in other locations for about the same length of time. I have yet to run into the idea that voluntary suffering of pain in childbirth is a test of womanliness, except when people are slamming the NCB for saying it. I have run into things that are very similar to suffering that pain having a moral worth, but they're nowhere near that clear cut. What I do see is a whole lot of "mainstream" women slamming on all those women who "think they're so great" or "think they're better than everyone else", because they don't want an epi. Personally, I don't want an epi, because 1) I've never experienced labour pain bad enough to make me want a needle in my spine - I can barely stand that idea when I know they're going to cut me open, 2) I watched my sister struggle with back pain, from her epi, for weeks after my first nephew was born, and 3) numbness freaks me the hell out. I think it's a greater "test" (if one wants to look at it that way) to be able to handle the numbness than the pain.

 

I make no assessment of whether anyone else is a "real" woman - "real woman" is a stupid expression, anyway. But, I do not feel like one, largely (not entirely) because I never gave birth. I either have a defective reproductive system (ie. an evolutionary dead end) or I - not my body - completely failed myself and my children...or both. I don't appreciate other people trying to tell me that I didn't, based on their beliefs about what birth should or shouldn't look like.

 

Mind you, you couldn't pay me to self-label as a feminist, so I don't look at it from your perspective.

post #238 of 285


Edited by member234098 - 5/25/12 at 11:02pm
post #239 of 285
Thread Starter 

The bolded really has nothing to do with the topic we've been discussing, I just had to respond.  Enduring (not suffering) the pain of childbirth was all my for baby's health and my own.  Those are the only reasons I did it.  I have nothing to prove to anyone. 
 

Quote:
Originally Posted by Buzzbuzz View Post

"Buzz clearly does not respect women's judgement to discern whether or not they have enough knowledge to make their own health choices. Could I make a good decision about hip replacement? No, I know nothing about that. Pregnancy and birth, I think I know enough to make certain choices in regards to my care or to find a hcp I think will attend me best. I guess I am just really arrogant."

 

I think every woman has the right to make her own health choices and I respect that right.  However, I think there is a lot of natural childbirth activism masquerading as reliable scientific information out there on the net. 

 

I have run into people who have researched and read and who have believed things as diverse as that as long at the baby is attached to the placenta it cannot suffocate (missing that little detail that amongst other things the placenta still needs to be attached to the mother), think that placenta previa can be handled at home, etc., etc.  These women are being sold a bill of goods just as much as all those people who were told before the crash that sure, you can afford a $500,000 house with no downpayment.

 

It is because I am a feminist that I am so concerned about this issue.  In fact, I find some aspects of the natural childbirth movement to be concerning from a feminist perspective (that one must give birth vaginally to be a "real" woman, that voluntary suffering of pain in childbirth has a particular moral worth or is a test of womanliness, etc.)

 

 



 

post #240 of 285
Thread Starter 

Interesting.  I know this was a long time ago (I read your posts all the time on the vaccine forums)...so what did you midwife have for training that made you feel comfortable enough to hire her?  Just curious, no judgment.  
 

Quote:
Originally Posted by miriam View Post

I used a midwife in CA when CA did not have any legal midwives; CA did not have any midwives because the state had not proctored the eligibility test for midwifery in 30 years.  Neat!

 

 



 

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