Certified vs Traditional Midwives

I'm going to go against the popular opinion here, and I really, truly hope not make too many people angry, but I personally would only attempt a HB with a licensed midwife. My rationale is that I want to be as confident in my mw as possible so that while I'm in labor, I don't totally freak myself out about "omg you're so stupid, everything every mainstream person you know said about this being a bad idea is right, for the love of God she's not even CERTIFIED..." When I pictured myself giving birth at home, this was an unaccpetable scenario to me personally - as much as the hospital setting scares me, I'd rather be in the hospital than having that particular fight with myself at home.

I'm actually super mainstream myself. I'm picking HB because to me, the facts and the research point to HB being safer in my case. So that's probably a big part of it for me too - and may be the same deal for your DH, you know? I totally see your point about not wanting to turn him off to HB for good.

Good luck!

Quote:
I hear what your saying but here in Ohio NO midwive is recognized as licensed at all so they all practice as "lay people".

Quote:
Or that she doesn't agree with the politics behind it, or that she doesn't want the cost burden because it's not cheap or free, or that she just doesn't find it necessary, or a ton of other reasons that have nothing to do with experience or education.

Just to balance things out.

our m/w with dd1 was a "traditional" midwife. she apprenticed with another midwife for years and practiced her art in many different countries and settings before i met her. she was more skilled and more educated on birth than anyone i've ever met in the field to be honest. we trusted her 100%. our second dd was born in a different state and the m/w we had here was also just as knowledgable and skilled, but she had more formal education and is licensed by the state. she too was wonderful, just a bit more clinical. both have been practicing for 20+ years, and both are now very dear friends to us.

i really think it just depends on the m/w in question and how much trust you have in her experience, regardless of whether she is certified or not...

Quote:
CatBallou, I agree with you on this.

OP, I had a CPM for my first homebirth. She had studied and taken a test for the certification, and had done tons of births so she had experience with a wide variety of situations and clients. But, she was intensely busy (too many clients at one time on her own...she barely made it to catch the baby as he crowned and then ran off as soon as the placenta was out, practically). And she gave me very little support for the post partum period, and had little training in breastfeeding support, didn't even refer me to La Leche League or a lactation specialist. I didn't expect that of a CPM or how it would make such a negative impact on the first few weeks, not having the MIDWIFE able to help at all!

I chose a lay midwife for my second and third children's births. She had about 350 births under her belt when I met her. Not as many as the CPM, but then, I was looking for someone who took less clients so she could focus on me. That is something to consider--how capable the mw is in how many clients she can handle, if she has a reliable backup mw or partner or if she has assistants to aid her.

I asked her all the questions I would for a CPM and her answers satisfied the part of me that needed to feel that she would be able to watch out for complications during pregnancy and labor and handle anything that came up, or know when and how to transfer to a hospital, if that should arise. She also had been a La Leche League leader for manu years, and breastfed all 7 of her children, so I was confident she was "qualified" to help me with any breastfeeding problems that arose. I also found, most importantly, that she had great "bedside manner", that I felt she took her time with me and cared about me and respected me, all things my previous experienced with that particular CPM could not offer me.

I think that no matter how a midwife received her education, it's imperative to have an idea of her knowledge and experience, and most of all, how comfortable you feel with her. IME, there are some terrific CPMs and some terrific lay midwives, and some that are really lacking.

It must be difficult, especially for some men and in our culture, to understand the wisdom of midwifery. It's not just the "paper" that counts as showing if they are qualified and makes someone a good attendant for labor and birth. There's an art and science to it.

Quote:
I agree with this. I have found a strange code of silence from many women--they felt they would be disloyal if they disclosed what they didn't like about a certain midwife's care. I have found asking specific questions, without placing judgment on Mom or Midwife helpful in getting the answers I needed. For instance, I would ask how the midwife handles the post partum care. Did she come for home visits or did she require the Mom come to her? How did the Mom feel about the post partum care she and her baby received? If she could have had something else from this midwife, what would it have been? How was she during the labor? Did Mom feel supported and respected by the mw? Did Dad?

You find out some pretty interesting stuff, some you take with a grain of salt sometimes, but it all can help you make the best decision for yourself and you baby regarding the midwifery care you receive.

My midwife has chosen to remain un-certified because she believes she can best determine the appropriate care for each individual client without licensing/certifying restrictions. She has been a midwife for over 30 years, ran a midwifery school for a portion of that time, works with Traditional Midwives in Africa every year, and is every involved in teaching/talking at midwifery conferences. She is very educated, very experienced - she just does not believe certification regulations help the individual woman giving birth.

For instance, according to the regulations, I should have been risked out of home birth due to my anemia. My numbers were too low and for someone who was worried about their certification that would have had to have been it. For my midwife, she was able to look at my vitality, energy, and overall obvious health and decide that my body was different than what the regulations would allow for health... and she didn't risk me out. She was very prepared for the chance of pph, however, and didn't screw around when I did start to bleed and everything was fine. She looked at our situation in a holistic way and was able to trust her own judgment, without being careless; if I'd chosen any of the other midwives we interviewed I'd have been forced into a hospital birth at 39 weeks.

All that to say, I would definitely interview the TM in your area. You don't have to choose her if your Dh and you don't feel comfortable with her, but you'd be surprised. Dh was deadset on a CNM in our area.... all the way up until her met our lay midwife, whom he instantly loved and felt more comfortable with than he ever expected to feel with a midwife.

I should have been more clear that every state has different criteria for licensing, and there are states where it would be an obviously unappealing option to endure the paperwork and red tape.

We do not have licensing in our state yet, so I don't have that perspective. But most of our midwives are CPMs. One who isn't certified that i know of continually jeopardizes the climate here for progress with bad practices. Were she a CPM, there would at least be a better process for the consumers who have had bad experiences with her to have had better recourse. I don't mean suing, but some sort of suspension until she retrained in certain areas that were leaving her clients at risk, to protect the next mom and baby. Reasonable stuff to me.

I had nothing but the best experiences with my own midwives, but it wasn't until I started getting more involved in the advocacy of midwifery did I start coming across the rare, less than ideal story, and I now approach it where consumers need more information about training, certification, licensing, etc. just to know what they are getting involved in in their selection of care provider. Informed consent applies here, too, not just with OBs.