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Did you use an unlicensed midwife? Would you? - Page 2

post #21 of 79
Thread Starter 
Awesome. This makes me feel really good.

I was totally comfortable with her credentials and experience. We discussed why she's unlicensed and all that, but with this being my first homebirth I just felt a little shakey.

Midwives here are so limited in who they can attend. Mine was telling me about a midwife who delivered surprise twins and got in a ton of trouble, even though she had no idea the mom was expecting two.
post #22 of 79
Personally, I've never much cared what the gov't thought....and that's what this boils down to. A piece of paper from the gov't does not make a midwife more skillful, qualified or anything of the like.
post #23 of 79
I live in California. They do license lay midwives. I still used a un-licensed midwife. I liked that she did not have to follow their rules. Like how long water bags could be ruptured, how much before EDD or after EDD you can be delivered at home etc. So I picked her. I had a mostly unassisted pregnancy. She was a few hours away so I only saw her 2-3 times during pregnancy. I did all the tracking and stuff by myself. She didn't do much during the labor and birth either (the perfect midwife

In the end we had to put dp's name on the birth certif. as who 'delivered' the baby. That was actually true, the midwife helped him catch our daughter. When we got to the office to get her birth certif. I was given huge crap about it. "you HAVE to have a certified midwife, you have to"
"um, no I don't HAVE TO. I don't HAVE to have anyone there, I could squat in a field if I wanted to."
If I had not known my rights they could have walked all over me.
post #24 of 79
I am going to use an unlicensed MW for my birth in Dec. I don't think the state that I live in liceneses MWs other than CNMs. However, I know a couple women who have used this MW before and the OB that I see works with her a lot so I am comfortable with her skills. I don't think that the OB that I see would work as closely with her if she were a total quack who didn't know what she was doing.
post #25 of 79
I don't think licensing should be among the criteria used for judging a midwife. There are great unlicensed midwives. Bad licensed midwives. But also bad unlicensed midwives, too, so don't just go by a bunch of people saying "I had an unlicensed midwife and she was great" alone.

I had an unlicensed midwife, and she was adequate. I don't think her being unlicensed had anything to do with her not being great. But I sure learned to be more proactive about my judgements of people I hire, as well as to not be passive just because I had hired a professional.
post #26 of 79
Absolutely, but I'm against government licensure anyway. I think it's good to know what kind of training she has had, what independent bodies she's certified with, etc, but even that I don't think needs to be a deciding factor.
post #27 of 79
None of my mw's haven't been licensed, but I wouldn't hesitate to use one, provided that she had a successful record, was knowledgable, knew what she was doing, knew what to do in emergencies...in short, be anything and everything a regular CNM/LM/CPM is without the paper.
post #28 of 79
Licensing is not available in my state. I had an unlicensed CPM with my last birth and have her partner, also a CPM for this birth. THey are both very well-trained and experienced, I'm very comfortable with it.
post #29 of 79
It's true that licensing does not make one a good midwife, but I would want some kind of validation of her abilities and know who she is accountable to for her actions.
post #30 of 79
I used an unliscenced midwife with both of my daughters' births. I was very happy with her. Several women I trusted recomended her to me so I didn't feel the need to check any references or check up on her in any way. According to the birth certificate paperwork, they were born UC.

After DS' birth, with CPS being involved after his UC, I wouldn't use an unliscenced midwife again. I don't feel I'd need any help with the birth itself- the ONLY reason I'd hire a midwife is to cover my with the legal stuff, so an unliscenced MW wouldn't do me any good.
post #31 of 79
Quote:
Originally Posted by nashvillemidwife View Post
It's true that licensing does not make one a good midwife, but I would want some kind of validation of her abilities and know who she is accountable to for her actions.
Yep. Accountability is a big deal to me. It's difficult when a client has no recourse. We talked about this a lot in my professional ethics class for counseling education. (I'm not a counselor, I just took some courses.)

I also wouldn't feel comfortable hiring someone without a license because I want my midwife to have access to things like emergency pitocin, RhoGam, oxygen, and sutures. I also want her to be able to be reimbursed by insurance or medicaid, and to be able to write me official letters for things like FMLA.
post #32 of 79
All things being equal (besides the license), I would have no qualms using an unlicensed midwife. I'm not terribly impressed with much that the government does, and licensing definitely falls in that category. I would choose my midwife on the same criteria I do now, license or no - referrals, experience and birth philosophy. If I was in a state that would not license midwives, I'd be even more likely to use an unlicensed one (and thankful that she didn't have to make compromises on her birth philosophy in order to keep the almighty license).

However, my state does license midwives, and I'm lucky enough that insurance even covers homebirth with licensed midwives here (and I'm thankful for that). All the midwives I've come across are licensed, and I'm not even sure how I'd find an unlicensed one here. That said, I gestated longer than the average last time, and the MW I used for that birth put me under the impression that she could not deliver me after a certain time due to licensing restrictions, which, if true, would have led me to definitely preferring an unlicensed one this time.
post #33 of 79
Quote:
Originally Posted by whalemilk View Post
I also wouldn't feel comfortable hiring someone without a license because I want my midwife to have access to things like emergency pitocin, RhoGam, oxygen, and sutures.
Most unlicensed midwives have access to these things. The question is whether they know how or choose to use them. I don't know any midwives, licensed or not, that don't have pitocin or oxygen. I do know licensed midwives who don't know how to suture.
post #34 of 79
Do they have access to them legally, though? Because if they don't, I wouldn't consider it reliable that they will always have access, since I would imagine obtaining them isn't as simple as calling in an order and picking it up if you don't have legitimate access to those drugs.
post #35 of 79
I think for most midwives it is pretty much that simple. They get it from a backup doctor or from another licensed midwife, or they may even simply buy it from a source with a lax drug retail policy. It is not difficult to get the drugs. The question really is, does your unlicensed midwife choose to take the risk of illegal possession and/or administration of the drugs?
post #36 of 79
And would she be more reluctant and hesitant to use one in an urgent situation, being torn between doing what the client needs and possibly getting caught?
post #37 of 79
Quote:
Originally Posted by whalemilk View Post
I also wouldn't feel comfortable hiring someone without a license because I want my midwife to have access to things like emergency pitocin, RhoGam, oxygen, and sutures. I also want her to be able to be reimbursed by insurance or medicaid, and to be able to write me official letters for things like FMLA.
Yeah, that.

Also, I want a midwife who is able to prescribe, order tests and do things like the PKU/Multiscan and Hearing test. Without those sorts of things, it seems like I'd pretty much either have to accept a standard of care I'm not comfortable with (mainly because I tend toward hyperemesis and rely on Zofran for survival when pregnant...), hope I have a very compliant primary care doc who will order tests, or have "shadow care" with an OB, and pay copayments and insurance payments for my "shadow care" as well as midwifery fees.
post #38 of 79
Like I said, my midwives are unlicensed in my state, but they are both certified CPM's through NARM. The midwife I am having for this birth did not go to school, she became a midwife through apprenticeship. She has been practicing for about 30 years now and most of her clients are Amish. She is very very experienced. THe midwife I had w/ ds3 went to school for midwifery, not nursing school, though. They are both very knowledgable and have excellent stats, which they share freely. They also carry emergency equipment, including oxygen, pitocin, and sutures. The safety of the mother and baby are far more important to them than the small chance that they would be charged with practicing without a license. They will also accompany you to the hospital in case of transfer, both to pass on your medical info to the doctor, but to support you through your birth. That is also a chance that I've heard some unlicensed midwives won't take.
post #39 of 79
Oh, and even though my midwife is unlicensed, I had an u/s during this pregnancy (obviously, if you read my sig ) and they will do any other testing you want done: GBS, GD, whatever. They also do the heel prick testing to send in after the baby is born. I peed on a stick, heard the baby's heartbeat, and had my bp and bely measured at every prenatal appointment, just like I did when I had an OB.

I'm really surprised that people assume that a midwife won't be able to get you these things just because she cannot be licensed in a particular state.
post #40 of 79
Well, there are a lot of people who only have experience with midwives who don't do those things.
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