What do those who oppose licensing homebirth midwives actually oppose?

Two weeks ago I wrote about yet another needless, senseless, utterly predictable, totally preventable homebirth death in Oregon. Now the mother has come forward to tell her story.

According to Margarita Sheihk:

I didn’t know that I was in danger…

I didn’t go into this thinking, ‘Oh, there’s going to be a chance that my son’s going to die.

But baby Shahzad did die, during labor, with unlicensed midwives Darby Partner and Laura Tanner in attendance and completely unaware of it.

Now Sheikh says she wants to fight for licensing requirements.

I don’t want the baby’s death to be for nothing … I’m just looking to have things changed here in Oregon so that it doesn’t happen again.

Who’s leading the opposition to licensing midwives? You’ll never guess … Melissa Cheyney, the very person responsible for overseeing the licensing of midwives! That’s right, the individual who chairs the Oregon Board of Direct Entry Midwives, which oversees licensing homebirth midwives, is publicly on record as opposing licensing homebirth midwives.

Why would anyone oppose the licensing of homebirth midwives?

According to Cheyney:

There are many, many issues involved with mandatory licensure and barriers to training, issues of paying the high cost of a license, and just the general concern that making something that was formerly legal illegal doesn’t necessarily make it safer

That incomprehensible response hides the real reason that Melissa Cheyney opposes the licensing of homebirth midwives. The real reason is to avoid the four pillars of responsibility ensured by professional licensing.

  • Educational requirements
  • Practice standards
  • Reporting requirements
  • Accountability

American homebirth midwives are not really midwives. They do not meet the educational and training standards for American nurse midwives, and they do not meet the educational and training standards for midwives in the United Kingdom, the Netherlands, Canada or Australia. In fact, they do not meet the educational and training standards for midwives in ANY first world country.

American homebirth midwives are women who couldn’t be bothered to obtain the college education and training required by midwives in EVERY other industrialized country, but they want to call themselves midwives anyway. So that’s what they did and the state of Oregon has obliged them.

Licensing would very quickly put an end to this game of make believe, by mandating that homebirth midwives meet the very standards that have already decided they cannot or will not meet.

Educational requirements

American nurse midwives are required to hold a master’s level degree in midwifery. A European, Canadian or Australian midwife is required to hold a university degree in midwifery. A homebirth midwife in Oregon has NO educational requirements at all. You might be a 4th grade drop out, but by the laws of Oregon, you are legally entitled to call yourself a midwife.

Practice standards

ALL healthcare providers in first world countries are held to practice standards. That’s how we ensure consumers a minimal level of safe practice. Every practitioner must adhere to these agreed upon standards, based on scientific evidence, and consistent with the education and skill levels of specific types of providers.

Oregon homebirth midwives don’t want to adhere to practice standards. That would certainly restrict them from doing whatever they want to do regardless of their skill level and regardless of the risk status of the patient. They don’t want to adhere to consumer protections, because that would constrain midwives’ actions.

Reporting requirements

Licensed health providers of any kind are subject to a variety of reporting requirements that allow state and national officials to review outcomes and identify unsafe practitioners. In other words, reporting requirements are just another form of consumer protection.

Homebirth midwives have a very serious problem, though. Too many babies die preventable deaths in their care. Instead of discussing, analyzing and taking responsibility for these deaths (like all other healthcare providers), homebirth midwives prefer to bury them … both figuratively and literally.

Accountability

If you are merely pretending to be a midwife, the last thing you want is to be held accountable in the way that real midwives are held accountable. That’s the best part of pretending; there are no consequences. Oh, there are consequences for the patients and their babies: babies die preventable deaths, mothers risk their health and lives. But there are no consequences for homebirth midwives. It’s such a drag to take responsibility for your actions, so they don’t, and the state of Oregon abets them in their desire to shed any and all responsibility.

Licensing requirements are consumer protections, no more and no less. Of course Oregon homebirth midwives oppose licensing requirements. When you think that all you need to do to be a midwife is to call yourself a midwife, licensing requirements could really harsh your mellow. Education, standards and accountability? That’s for everyone else.

And what about the mothers and babies of Oregon?

Let the buyer beware.

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