How pathetically inadequate is the homebirth midwifery CPM “credential”?
Requiring a high school degree or (its equivalent) constitutes “tightening.”
The CPM (certified professional midwife)is the pretend “credential” fabricated by Ina May Gaskin and colleagues, and awarded to themselves. Its purpose is to trick lay people and legislators into believing homebirth midwives are trained. It is not recognized by any other first world country because it does not meet even minimal education and training requirements in the UK, the Netherlands, Australia, Canada or anywhere else.
In keeping with its purpose of awarding a “credential” to anyone who wants one, the Midwives Alliance of North America (MANA), the organization started by Gaskin and colleagues, refused to create formal educational requirements. Or as euphemistically explained, MANA:
embraces multiple educational routes of entry into the profession of midwifery including institutionally-based programs, university-based programs, at-a-distance learning, and apprenticeship
As Professor Katherine Beckett acknowledged:
… Many in the midwifery community have been concerned that the extensive educational requirements associated with professionalization will exclude midwives already trained through apprenticeship, as well as aspiring midwives who are unable to relocate and/or pay for a formal education. In order to include such women, MANA acknowledges ‘‘multiple routes of entry’’ to the profession and allows applicants for the CPM degree to acquire their knowledge and skills through either formal education or apprenticeship; a woman whose education ends with high school can therefore be certified as a CPM. In public and political forums such as state capitol buildings, most midwives do not stress that they may be certified without extensive formal education …
But now, in an effort to bring rigor unseen heretofore to the CPM credentialing process, the North American Registry of Midwives (NARM), the sister organization of MANA, has declared:
All applicants will be required to submit evidence of a high school diploma or equivalent.
That’s right. In an age in which 92.7% of American women graduate from high school, homebirth midwives have taken the unprecedented step of instituting the requirement for a degree that everyone already has.
Why the change? There are two possible explanations that I can think of.
First, it may have finally occurred to MANA that awarding credentials to women who don’t even have high school diplomas has the potential to undermine the legitimacy of the CPM in the eyes of the general public.
Second, they may have been required to do so by the National Commission on Certifying Agencies (NCCA).
Homebirth midwives like to boast that the CPM is accredited by the NCCA. The NCCA accredits:
… a variety of certification programs/organizations that assess professional competence. Certification programs that receive NCCA Accreditation demonstrate compliance with the NCCA’s Standards for the Accreditation of Certification Programs…
NCCA accredited programs certify individuals in a wide range of professions and occupations including nurses, automotive professionals, respiratory therapists, counselors, emergency technicians, crane operators and more.
The NCCA does NOT evaluate the validity of the certification, whether that is the CPM or a license to operate a crane. It merely evaluates the credentialing process to ensure that it is impartial, properly administered, and includes relevant requirements. I would not be surprised if NARM’s Portfolio Education Process (PEP) ran afoul of Standard 8 of the NCCA Standards for the Accreditation of Certification Programs:
Once a program is accredited, “grandfathering,” or any other procedure for granting a credential in the absence of evaluating the knowledge and/or skill of an individual, is not acceptable…
Grandfathering is generally seen as a conflict with stakeholder interests. It is used from time to time in licensure as a means of protecting the rights of individuals who entered a profession prior to its regulation and should not be excluded from the right to practice…
One of the fundamental purposes of the PEP is to grandfather in self proclaimed midwives who practice without ever completing the basic certification requirements. Indeed, in 2000, when Johnson and Daviss conducted their famous study, more than 90% of the CPMs in the study had obtained the CPM through PEP. That might have been reasonable then since the requirements for certification had been codified only in 1994. But now, more than a decade later, as many as 2/3 of CPMs obtain the credential through PEP. According to the NCCA, that is unacceptable.
In other words, NARM may have been forced to institute the requirement for a high school diploma (or its equivalent) or risk losing the accreditation of its credentialing process.
The CPM credential is a joke perpetrated on unsuspecting lay people and legislators. The fact that a high school diploma represents a “tightening” of the requirements makes that quite clear.