Did you use an unlicensed midwife? Would you? - Mothering Forums

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#1 of 79 Old 07-21-2008, 09:43 PM - Thread Starter
 
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Arkansas has some pretty wonky laws about midwives attending homebirths, so I was unable to hire a licensed midwife to attend me. There are 2 doctors w/i an hour of me in any direction that will attend a VBAC and they weren't very enthusiastic about it. I didn't want someone who would be looking for any reason to roll me back to the OR, so I counted them out.

My only other option was an unlicensed midwife. I found 2 in my area; one wouldn't take me b/c my c-section was closed with a single layer suture.

So, I did manage to find an attendant, but she is unlicensed. I am very happy with her so far, but sometimes I have sneaking worries about her not being licensed.

Have you used an unlicensed midwife? What was your experience? Would you use an unlicensed midwife?

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#2 of 79 Old 07-21-2008, 10:08 PM
 
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Yes ! I had an unlicensed midwife at my last birth. Our province,in the last few years, has legalised midwifery and there are some midwives that choose not to go through the process.

My amazing midwife : was practising before and after 'legal' midwives. She had a lot of experience and I felt very safe with her.

If we had to transfer to the hospital she would not have been able to be there however I was willing to take that risk.

I was very happy to have this midwife. My labour was very long and if it had been anyone else my labour would've been pushed along with pitocen or other means to get that baby out. Instead I pushed my 10 lb face presentation baby out in my dh's arms on our bed at home.

As a matter of fact my sister had this same midwife at her birth and she had to transfer. ( she had been in labour for a very long time and wasn't progressing ) All went very well in the hospital. It was early morning and we had a fresh set of staff. The Doctor on call was very kind and she pushed the baby out on her own within a couple of hours of arriving at the hospital. ( maybe it was the drive ) I was her Doula and her dh was there with her so she didn't feel too alone or bothered by the new set of 'caregivers'.

If you like this midwife and she has the skills, and experience go with her. Licensing doesn't always mean the best of care. . . if that makes sense . .
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#3 of 79 Old 07-21-2008, 10:27 PM
 
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We dont have licensing in our state, so thats all I had to choose from. I did hire a MW who has her CPM, though.

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#4 of 79 Old 07-21-2008, 11:46 PM
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My state doesn't license CPM unfortunately. But I did use one for my last baby and she was wonderful. I plan to use her for any future babies we have. I really can't say enough good things about her.

 
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#5 of 79 Old 07-21-2008, 11:57 PM
 
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btw, another reason I choose this midwife was/is because she is a bit of a renegade in the birth community and I knew she would be on my side to have a safe, natural delivery.
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#6 of 79 Old 07-22-2008, 12:08 AM
 
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PA only provides liscences to CNM's and most do not attend homebirths (which is just as well because Nurse Midwives have been trained by the medical system to function as a part of that system...as opposed to seeing labor and birthing as a non-medical event).

I'd consider discussing your potential care providers's education, apprenticeship, and experiences with births. These things will give you an idea about how she has come to know and trust the birthing process. Midwives often have their fingers on their state's political pulse.

Best of luck and congrats on your pregnancy!
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#7 of 79 Old 07-22-2008, 12:13 AM
 
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I have used two lay midwives for my births in two different states. I really dont know much about anything different than that. They were amazing, and very experienced.

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#8 of 79 Old 07-22-2008, 12:27 AM
 
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I had an unlicensed, CPM and I loved her. I think if you are comfortable with them, their experience and competency a state piece of paper is unimportant.

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#9 of 79 Old 07-22-2008, 12:48 AM
 
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If I lived in a state where licensed midwives could not attend homebirths or that did not license midwives, I would surely hire an experienced, qualified, unlicensed midwife that I was comfortable with.

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#10 of 79 Old 07-22-2008, 01:10 AM
 
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I definitely would. Just because she's not licensed doesn't mean she doesn't know what she's doing.
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#11 of 79 Old 07-22-2008, 01:20 AM
 
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One of my MWs is licensed, the other is not. She needs to attend X number of births as a primary caregiver under the supervision of a licensed MW in order to get her license, so I am one of those births.

If it were a choice between a licensed MW who I didn't feel at ease with, and an unlicensed one that I clicked well with and trusted, I would choose the unlicensed one. I feel much more comfortable with my unlicensed MW than with the CNM who attended my last birth who had decades of licensed practice under her belt!
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#12 of 79 Old 07-22-2008, 01:41 AM
 
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I used a licensed CNM with my first, and an unlicensed CPM with my second. Both were competent. The CPM seemed more confident and calm while dealing with a shoulder dystocia than the CNM did (both kids had shoulder dystocias). They both used the same methods to get the baby out. Both administered oxygen. I mean, really, there were few differences. I was more comfortable with the CPM.

Hope that helps!

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#13 of 79 Old 07-22-2008, 01:43 AM
 
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I did. She is not licensed because she doesn't feel it adds anything valuable to her practice, and her standards are not necessarily the government's, so why should she accept them as an authority? For that matter, my standards are not the necessarily the government's, so its approval is not necessarily important to me. I was impressed with her training, experience, and philosophy of birth, more than any of the other midwives I knew about at the time, including those that were licensed. So her licensure status was irrelevant to me.
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#14 of 79 Old 07-22-2008, 02:00 AM
 
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I live very close to a state that offers voluntary licensure. All of the midwives I've ever worked have been licensed but it was not something I sought out. I would have happily worked with an unlicensed midwife.
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#15 of 79 Old 07-22-2008, 06:42 AM
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it really depends upon the midwife and the whole situation.

i'm really of the mindset that the more medicalized midwifery is, the more likely it is to be licensed. and, i don't really see birth as a medical event, and so i'd likely be better off--philosophically and otherwise--with a non-licensed midwife.

of course, i am planning a UC, so i'm perhaps not the best person to ask.
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#16 of 79 Old 07-22-2008, 08:26 AM
 
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I have had to consider this twice now, as the nearest midwife to me is underground. She is only 20 minutes away. The nearest legal midwives are nearly 2 hours away. Not an option for us.

Ultimately, I did not feel comfortable putting someone else's life at risk to ask them to assist me. Yes, she chooses that risk herself willingly, but *I* am not willing to be complicit in anything that may end up with her behind bars.

We have had midwives in our area arrested and jailed, so that is very real here. There is no *wink,wink* midwife didn't arrive conversation at the hospital if a transfer is needed. They will hunt down, arrest and jail an illegally practicing midwife here.

The level of her expertise was not the question for me; I could not ethically participate in anything that might end in punishment for that woman, even if she chooses to take that risk herself. It just did not feel right to me. I would have a terrible time living with the guilt were something to happen to her as a result of helping me.

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#17 of 79 Old 07-22-2008, 08:31 AM
 
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Yeah, what 4littlebirds said! If you totally agree with what the gov't says about midwifery/homebirth, then you go with the licensed mw....but it sounds like you DON'T agree with AR gov't regs on homebirth midwifery.

I am really not a fan of licensing for any profession. Licensing is not proven to be any sort of guarantee at all. There is a saying I've heard a few times lately: You know what they call a Dr who passed med school with straight A's? 'Doctor'. You know what they call a Dr who passed med school by the skin of his/her teeth? 'Doctor' For me that kind of sums it up.

Licensing is a failed attempt by the government to save ppl from themselves and life, IMO. Licensing does nothing so much as 2 things, as far as I've ever been able to tell:

1. It helps people NOT THINK about their care providers--'oh, s/he's licensed, MUST BE GOOD/SAFE/HONEST AT THIS WORK'. Uh....yeah right! Do you have any idea how many complaints there are against licensed Drs each year? Complaints about lack of skill, lack of integrity, lack of respect, kindness and common decency....Instead, people DO need to think, explore, ask questions, feel out a provider, know their own desires and values in choosing health care. They need to maintain awareness instead of blindly trusting based on a license, be willing to speak up, leave a doc if they get a bad feeling, and so forth.

2. Licensing helps providers make more money and gain more control over their field...because licensing provides an automatic 'peer group' which can band together (all legally) for self-promotion in advertising AND for self-promotion in legislatures (lobbying, that is). Do you have any idea how rich and powerful the AMA is?????? And how much control they have over our lives....never mind just our health care--drs have an incredible influence and legal control over ppl's lives in general. This is partly psychological, based on the Dominant-Submissive (essentially S&M) power dynamics of the dr.-patient relationship. But it is also real world legal/political power.

But no, licensing does NOT protect people from themselves, life, or licensed professionals....not that it's really the gov't's job to do this, anyway.

Uh....off rant now, and back to your question

I would listen to my intuition about a mw, WAY more than I would be concerned about whether she had a license. Not sure I would consider the license issue at all.
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#18 of 79 Old 07-22-2008, 09:15 AM
 
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My state does not recognize the certification of my CPM, and I have used her 3 times.
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#19 of 79 Old 07-22-2008, 10:37 AM
 
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I think its terrible that the government has put you in a situation where you have to make that kind of decision. Its a shame and its just wrong.

I think its a judgement call that you need to make yourself based on your specific midwife. I think I would use an unlicenced midwife if her credientials were enough to make me comfortable.

I would still want her to be able to carry oxygen & pit and all of the emergency equipment for mom & baby, and I don't know how difficult it is to get all that stuff without a licence.

Best of Luck.
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#20 of 79 Old 07-22-2008, 11:14 AM
 
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I am using a CPM. She is licensed in a neighboring state, so I'm not sure she qualifies as truly unlicensed. She is not recognized in our state as legal to birth babies - and I trust her more than any doctor I ever saw. So yes, I would use an unlicensed midwife.

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#21 of 79 Old 07-22-2008, 12:54 PM - Thread Starter
 
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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.

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#22 of 79 Old 07-22-2008, 01:37 PM
 
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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.

- Kim
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#23 of 79 Old 07-22-2008, 01:47 PM
 
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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.
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#24 of 79 Old 07-22-2008, 02:24 PM
 
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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.

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#25 of 79 Old 07-22-2008, 03:19 PM
 
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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.

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#26 of 79 Old 07-22-2008, 05:42 PM
 
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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.
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#27 of 79 Old 07-22-2008, 07:33 PM
 
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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.

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#28 of 79 Old 07-22-2008, 10:45 PM
 
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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.
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#29 of 79 Old 07-22-2008, 11:41 PM
 
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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.
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#30 of 79 Old 07-22-2008, 11:48 PM
 
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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.

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