Medicine Vs. Midwifery: Divide & Conquer

The stage:  North Carolina.

The background: Women have just lost the opportunity to birth legally with midwife attendants at home.

The scene:  One midwife, CNM Deb O’Connell, shuts her doors. It’s a sad day for women of her state, she laments. With no doctor to back her practice, she is moving on. But what you may not know is that Deb did this to herself.

Deb is associated with an infamous retired OB who spends her days blogging about how stupid homebirth is. Deb is a member of a group that proudly claims they are fed up with natural birth. And Deb chased down loss mother Michelle on my page just to dig into her about her own homebirth loss, and her peaceful attitude toward it, because it really irked the hell out of her clique friends.

Before I go any further, this is not a post to pick on Deb. I’ve seen that happen for others already at the hands of Deb and her friends, and I think it’s ugly and it sucks. I certainly don’t want to be mean or unfair, but I also think it’s something I should talk about, so I’ll try to do it as civilly as I can. If you want to understand the political climate of birth today, you have to discuss the players, who they align with, and what they profess to believe. I’ll be accused of picking on her, or delivering a low blow, but I promise I will be kinder than I’ve seen them extend to others. Unfortunately, the group I mention often lays mercilessly into anyone they disagree with, but the moment a single one of their own comes under scrutiny or criticism, suddenly they become the morality police. All things considered, I assure you this is not about retribution. I’m examining something I find peculiar and shedding light on what is really going on here. That’s my intent.

I understand that the internet gives most of us a disconnect from who we speak to plus an extra set of balls, but care should be exercised with our words, particularly by professionals who are supposed to have sensitivity and compassion. I think sometimes tone is misunderstood, too. Let me apologize in advance, in case I misunderstood anyone’s words or intent, and I welcome the opportunity to be corrected.

North Carolina recently lost a number of babies during homebirths, I understand. This caused alarm and attentiveness in the medical community. Although, they were itching for a reason; the Board of Medicine was reportedly seeking reports of homebirth horror stories. Just days before her own birth, Michelle’s midwife dismissed herself from Michelle’s care, resulting in a horrifying birth— repeat C-section hospital experience she felt forced to endure.

Michelle has had both CNMs and CPMs. These are two classifications of midwifery. The first requires one to have nurse training first. It is arguably more “educated”. Some consider it only more medicalized, and thus less desirable. The latter requires independent midwifery training, typically lasting several years. Different states vary in their requirements for that credential, and some people consider the credential a joke. Others are thankful for the option to use someone who is more naturalistic, holistic, and not a “medwife”. To each her own. Due diligence, follow your instinct, and all that jazz.

Now this is the part where I remind you that I am not even a “fan” of midwives. Why? Read my book and you’ll see why. My most horrific birth was under the care of homebirth midwives. But I’ll tell you what I am a fan of:  choice. Just because I want every woman to be spared of the horror that I felt in my second birth does NOT give me the right to crusade against removing a woman’s right to birth with a midwife– ANY classification of midwife– if she so chooses.  I have the right to tell my story, to have a Facebook page and a book explaining my point of view, and let women make their own choices from there. What you do with that is up to you. Either I move you or I don’t. Either you believe me or you don’t. I’d be taking it too far and wasting my time if I picketed against midwives or hospitals. So, although I’m not promoting midwife use at all (CNM, CPM, at home, or in hospital), I sure find myself defending them all the damn time against staunch anti- groups.

You could say the removal of legal homebirth midwifery was a “win” for me, the UC “evangelist”. More appropriate would be to say it’s a win for the infamous retired OB. Although neither one of us promotes the use of homebirth midwives, one main difference between she and I is that I strongly feel that loss of choice and options is not the way to keep people safe. The best way to keep people safe is to provide them as many safe and healthy and legal options as possible, try to put the information out there, hope they educate themselves, and let them make their own choices. Neither Amy nor I can make anyone feel what we feel. And it is about feeling, not fact. When you break things down enough, the line between fact and opinion becomes really blurry (after all), doesn’t it? Forcing anyone into anything is more likely to lead to true recklessness and rebellion, panic, illegal and less safe means, etc. Eradicating any form of midwifery then is, in my opinion, foolish.

So, Deb and Amy and all their closest internet friends storm the web talking about the dangers of homebirth, how natural birth ain’t all that, and make fun of people who are “anti-science” (read: not automatically faithful of and loyal to pharmacy, technology, and medicine— in other words, questioners), yet now there is an upset because Deb in particular is forced to close her doors. After I’ve seen the way she has treated women, I would think this is actually a positive that she is no longer in a position to serve. To me, the utter lack of respect I have seen from those with the title of midwife, doula, nurse, grief mentor, or doctor leaves me in indignant disbelief.  Those people don’t need to be “serving” women, if that’s what you call serving. But to not put 2 and 2 together and figure out that one’s own attitude led to one’s own downfall is beyond me!

A lot of generalities and assumptions are flying around, and they are really only divisive. CPMs are shitty. Homebirth is stupid and reckless. Michelle’s loss was preventable. CNMs are good. I think it’s obvious after seeing what happened in North Carolina that when you sweepingly say that one type or one practice is unsafe, you’re condemning a hell of a lot of people you know nothing about. Stillbirths happen, tragic births happen, but we already know that. It doesn’t change the fact that people deserve the right to choose their birth, anyway. It doesn’t matter if you agree or not. Deb is a CNM and doesn’t approve of CPMs from a professional or ideological standpoint. That’s fine, she’s entitled to that, and I don’t care about that. Amy believes that all homebirth is stupid and reckless. She’s entitled to that, and I don’t care about that. Forcing your beliefs, your ideology, on others is what I care about. What I care about is the intense rallying I keep seeing against either homebirth, natural birth, or CPM birth. When you rally your support behind people who are so against the removal of a choice, do not be so surprised when your own goes, too. When you play with fire, expect to be burned. Duh!

To Deb O’Connell, formerly of Carrboro Midwifery, she probably feels that the baby got thrown out with the bathwater. Her buddy Amy, who thinks homebirth is for morons, I can only assume feels North Carolina finally got something right. Then again, she also feels that gays are selfish to parent and that women should stay with men who beat them (for the children!) or they are selfish, so I don’t know why anyone puts much stock in her “professional” 1990s OB opinion. It’s slanted, anti-woman, and frankly, passé.

Let me let you in on a little secret… most normal, average women choosing a midwife have no real preference or concern over which letters follow their names. I know I didn’t even know the difference when I first started with midwives. What I cared about was that I could tell they were professional, compassionate, and a good fit for my family. I had to think they deserved my trust and respect, and a lot of that is instinctive (believing whether or not you can count on someone). I can tell right away if someone is unprofessional or lacking education. It’s part of the reason I dumped a new set of midwives on pregnancy #3 (ironically, they were CNMs). It doesn’t matter whether I was right or wrong to choose the midwives I did (that’s on MY head, anyway), because how I felt about my births has nothing to do with their midwife classification. It was about me, Elizabeth, the person, and who they were as people. Letters after a name cannot tell you whether someone is competent, caring, or respectful. That can only be ascertained on an individual basis. Michelle realized that, too, about her loss, and she has been hounded about it ever since (by this group).

So, most natural birthers really do not worry nor care what classification their caregiver falls under. Both credentials come with immersing education. Yet, a war is being manufactured pitting CPM against CNM. The real war is big medicine versus midwifery. A common tactic in any war is divide and conquer. You pit them against one another and let them do the work of unraveling themselves. “A house divided against itself will fall.” And so, now when the inevitable happens– a loss of all types of (legal) homebirth midwifery– why were any involved foolish enough to believe they were exempt from the chopping block? Didn’t they recognize that this was the goal all along? I argue that midwives are being played like pawns, and this is the result. They’ve had to struggle so long to be viewed as professionals in their own right, and now their weakness is being used against them. It’s pitiful.

Know your real enemy, because if you aren’t careful, next time it could be you losing your rights. So, North Carolina, I am so terribly sorry for your removal of legal choice. I know that in some regards, you were done a favor… someone(s) who was misrepresenting herself and aligning with people who are enemies of choice is taken out of the equation. However, so was everything else. Now it’s a doc, UC, or a renegade midwife. Which will you choose?

 

 

 

 

 

 

“Don’t waste your time, Elizabeth.”… So I put it all in a delightful blog! 🙂
CLICK this image to sign this petition: North Carolina Medical Board: Allow Physicians to continue supervising homebirth CNMs in NC

 

A Midwife With the Right Idea

The following was taken from an anonymous comment left on a popular blog many years back. I enjoyed the perspective so much– especially in a stand-alone sense– that I wanted to share it with you. The conversation is midwife to midwife. 

Truth is, your hands are not skilled enough to prevent death. None of ours are.

You seem to want to “save” those unassisted birthers. You put out a booklet to “show” them the “right” way to do things, the “danger” signs, the “correct” way to handle complications.

The fact of the matter is that women need to hone their instincts. The UC community does not lie about death. However, fewer women have been hurt by birthing alone than by birthing with someone who has energy around danger (and some of your posts point to your nervousness with various situations) and expecting complications. We, as midwives, all bring fear that has come from our experiences. Some women just don’t want that.

I cannot count the number of complications I’ve seen caused by “non-interventive, liberal” midwives. Shoulder dystocias, hemorrhages, etc. We are not all knowing. We are not as safe as a woman’s instinct.

So, what? birth is as safe as life gets – but only with a midwife in attendance? Bunk. There are hardly any mws that practice on faith and openness – but women/mothers can birth their babies with their instinct guiding them. That’s more than I can say for many midwives.

As a whole, we are a profession that is not honoring women or birth. We bring fear, judgment and a feeling that we know best to our clients. We do not serve women the best way we can.

I will, and do support UC couples because they are informed and responsible. Granted, deaths happen. As they will at home with midwives and in the hospital. However, if a person is unwilling to look THERE, they only have themselves to blame.

 

This was written before I ever even knew I would be having a midwife homebirth, nevermind an unassisted birth.