Wasn't sure whether I should post this on my mommy blog or here. Ended up here. Pennsylvania is trying to outlaw lay-midwives (i.e. mid-wives who don't have nursing degrees and learn through apprenticeship instead). Now, on reading this my initial reaction was "here we go again..." but then when I read further down the article I was surprised by a quote by Sarah Kilpatrick, head of ob-gyn at the University of Illinois and vice chair of The American College of Obstetricians and Gynecologist's obstetric practice committee, who said "Why don't we have direct-entry doctors who don't want to go to medical school? We wouldn't tolerate that for physician basic care. Our standards for care for women should be the same,". She preempted this statement by saying that she was a "big fan" of nurse-midwives, it's just the lay-midwives she was concerned about.
I thought her statement was interesting. The problem is two-fold though: a) she assumes in her statement that women (in particular pregnant women) receive the same care that men do. Well, as my law professor used to chant at us "reverse the sexes and compare!"- unfortunately there is no comparable situation here for male patients, so in the case of pregnant women v. men, we can't see a comparison. But it is clear that pregnant women often do not receive care that is of an acceptable standard. Furthermore there is no similar history either of how women's bodies have been medicalized, especially in terms of the medicalization of pregnancy and childbirth. And b) she assumes that the medicalization of chidbirth (which is clear in her comparison of mid-wive care with physician care) is always the best option.
But nonetheless by stating that standards of care should be the same for women as they are for men she is highlighting that at the moment they are not!
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3 comments:
Apparently you don't know that Certified Nurse Midwives are not pushing to medicalize birth, as a matter of fact CNM's provide quality care to normal and healthy women and attend births with a healthy NON medical attitude. Just because we are certified, it does not mean we are "mini doctors" but CNM's are in fact Midwives! We cling to the standard that birth is a normal and healthy function, not a disease that requires treatment! CNM's are educated to a standard and pass a national certifying examination. Lay midwives may not have ANY education of what is or is not normal...many are very skilled, but I feel the public would be better served by having someone that can PROVE they know what they are doing in a situation where most of the time everything is normal, but when it's not normal the outcome can be a tragedy!
I am a CNM and I have been precepting some lay midwives, the education can not be compared and is far from equivalent and unless we standardize the education we will never have the respect that MIDWIVES deserve. It was not easy to become a nurse midwife it took me 5 years of undergrad and 2.5 years of graduate school. Now I am recertifying and it really shows me the difference in education and professionalism....lay midwives are not equivalent. They can be safe but I think it is best if they pair up with someone of a Higher education....
First of all. I want to agree that certified nurse midwives are wonderful and competent providers. Also, I want to say that there are many doctors who also encourage natural births in hospitals. There is a lot of misinformation out there. The wonderful part about having your baby in a hospital with a certified nurse midwife or doctor is, is that it can be natural and you are also neer an operating room or have the necessary tools with skilled providers in case of emergency. I am a labor and delivery RN at a large hospital in the Twin Cities area. I am writing this comment as I lie awake tonight thinking about the dead baby that was delivered 2 days ago while I was working. I can't get his sweet face out of my mind. A mother came in with her lay midwife after pushing for 2 hours. Her cervix was only half way dilated. Her lay midwife also told her that her amniotic fluid was clear when in fact her membranes hadn't ruptured. She was urinating. When we ruptured her membranes there was thick meconium- a sign of fetal distress. The baby was a beautiful 7 pound boy with blond hair. He was perfect and it was obvious that he hadn't been dead long. I can't sleep because I am so sad for the family and this baby, but I am also so angry. Lay midwives are skewing statistics and information to uninformed people. The death rate is high here because we try to recussitate 22 week babies. We count different gestation(ages) of babies. Comparing our stats to theirs is like comparing apples to oranges. HAVING A HOME BIRTH IS NOT THE SAME AS EATING ORGANIC OR SHOPPING AT CO-OPS OR WORRYING ABOUT THE ENVIRONMENT. You are a selfish woman if you care more about YOUR birth experience than your babies birth experience. Your baby needs oxygen to live in utero. This patient's need for a "natural" birth experience hurt her baby. We do not live in a third world country and do not have to take risks. This poor baby has no rights. Please know that doctors and nurses do not want to CONTROL your birth experience. We are not coming into the room to INTERRUPT you. We are checking on you to make sure you both live and your baby has all of its brain cells after the birth process. Yes, many births can be completely normal and natural, and if that is you, you can have that in a hospital(which it is not up to you (or your dr.) If you are healthy, you can have no medication, intermittant monitoring, and a quiet, darkened room birth with calming music and incense. I've coached many women and have had natural births with them. Nurses prefer this. We don't want to hook you up to lines. Besides, how your baby comes is not up to you. It is up to something greater than all of us. You are a mother. It is no longer about YOU. It is about your baby. Start acting like it. Please don't have a home birth. Your precious baby should not be gambled with. If things go wrong at home, it is too late. I hope that one person reads this and changes their mind. I want to prevent one more unneccesary death. How can I change your minds? Please have a birth with a certified nurse midwife in a hospital. Your baby will thank you and will live to know you.
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