From a letter sent to me by Mindy Wolfe, CPM. I found her commentary to be so powerful that I asked permission to reprint it:
In full disclosure, I was trained in the United States at a “college” of midwifery and then did nearly all of my clinical hours at a maternity clinic in the third world. I was not certified through the PEP process, but instead went from high school to a five month intensive course on basic health care and maternity care (everything from how to remove a tape worm to setting broken bones to suturing to resolving shoulder dystocia to manual removal of placentas to breastfeeding problems) and then spent one year at a charity maternity center in Davao City, Philippines. I then came back to the US and passed the NARM exam and the licensing exam in New Mexico.
Shortly after graduation, I moved back to Indiana, where CPMs are not licensed and midwifery is practicing medicine without a license and a felony. If for no other reason than that I have a young family, (although there are other reasons I’ll outline) the idea of being charged with a felony was enough such that I have never practiced in Indiana. I did, however, have opportunity to meet other women here in Indiana who do practice without a license. These encounters have opened my eyes to how poorly educated, dangerous and deceived most nearly everyone in the homebirth community truly is.
Some examples to further illustrate:
“What would you do in case of postpartum hemorrhage?”
“First, I would make sure the baby was breastfeeding well, then I would ask you to stop bleeding”
“You have a heart murmur and a strange heartbeat, but that’s not uncommon during pregnancy. You should be fine.”
“I prefer to use leeches for postpartum infections, I feel it’s a more natural approach”
“Twins that share the same placenta and same sac are just a variation of normal. It’s just that there are two babies”
I could go on but don’t suppose it’s necessary. For whatever underlying psychological reasons, these women are extremely dangerous practitioners who should be locked away. But, they continue on their sparkly path of destruction and misinformation. I wish it was as easy to call the police about a homebirth midwife as it is to call about the local drug dealer. Both should be out of business, for the sake of the well being of the community.
I did, for a time, work as an assistant to a CNM who provides homebirth services in Central Indiana, but actually ended up leaving, in part, because I feel that she is a reckless health care provider who has a martyr’s complex. Commonly accepted, mainstream medicine is all about the conspiracy, and every one is out to get her.
My last birth with her, the patient lived more than three hours from my house, and I was called to attend her birth alone because the two CNMs who were in the practice at the time were attending a disaster of a birth of mono/mono twins that was previously undiagnosed (the CNM did not require an ultrasound, even though the woman was measuring incredibly large for dates). The CNM’s protocol stated that the patient would not be further than 15 minutes from the hospital, but this woman lived in a very rural area at least 30 minutes from the nearest hospital. I handled her birth without any knowledge of her history (I had never even seen the chart), no medications at all, and an “assistant” who was a former vet’s assistant who had never seen a human birth in person. By grace we did not deserve, the woman’s labor and delivery were largely unremarkable and without incident, but after that point, I could not in good conscience work for this particular CNM any more.
After processing what has become something of an internal moral conflict, I have come to the belief that, with our system as it is, in Indiana, homebirth is not a safe option for anyone. Even the legal options are not well supervised, and any illegal option is the equivalent of Russian Roulette at best. From what I have seen and experienced, I believe that most birthing parents who pursue homebirth think they are doing the best for their families, and most homebirth midwives simply are not educated enough to know what they do not know. It’s dangerous, dangerous business; and if I had an effective platform for disseminating that information, I’d happily put my name on it.
My education, although more extensive than the PEP process that so many midwives use, was insufficient to the task of being an independent health care provider, and that being the case, I do not and will not practice, even if licensure was an option in Indiana. For whatever it’s worth, I took the Hippocratic Oath, too, and hang my hat on “do no harm”. I have come to accept that an extension of my promise to “do no harm” is to not remain silent.