The thing that I don't think the CNM understood was that it is precisely that midwife's relationship with the physician that caused this woman to switch to the birth center.
I get that question frequently, along the lines of "how involved is your consultant?". I think that women who have had an unnecessary C/sec., or other traumatic birth, are very aware that the midwife may have wanted to do one thing but had to answer to the doc who wanted to handle things differently.
In my state (Michigan), CNM's are independent practitioners other than prescriptive privileges which are a delegated medical act. I have a DO who delegates that ability to me, but most of the time it is just for giving Pit, occ. antibiotics for mastitis, etc.
Personally, I like being independent because I know that how I handle any given situation is based on what I know, not someone else's time constraints or other needs.
It was just eye opening and it's not the first time I've seen a note like this.
I almost want to label it as fear on her part that she doesn't place enough trust in her own ability to manage normal birth. But then she worked L&D for a lot of years before becoming a CNM and maybe she really does believe that birth OOH is dangerous.
Wife, mother, midwife, triathlete