It’s no secret that I am strenuously working for the abolition of the CPM (certified professional midwife credential). And it’s no secret that I am confident that the bogus “credential” will be abolished eventually. The only outstanding question is how many babies will die at their hands before they are put out of business.
Why should the CPM credential be abolished?
I have given many reasons in the past including the fact that CPMs have less education and training than ANY other midwives in the first world and the fact that they would be ineligible for licensure in the Netherlands, the UK, Canada, Australia or any other industrialized country. In fact, if you’d like to know all of the many reasons, you can watch the video in the sidebar of this blog.
Today, though, I want to give the simplest possible answer, one that legislators, doctors, public health officials and even homebirth advocates can understand:
CPMs don’t have any safety standards of any kind.
- The American Congress of Obstetricians and Gynecologists have published 152 Clinical Bulletins to establish parameters for safe practice for all obstetricians.
- The American College of Nurse Midwives has published 11 Clinical Practice Bulletins to establish parameters for safe practice for all real midwives.
- The Midwives Alliance of North America (MANA) has published ZERO bulletins to establish any parameters, safe or otherwise.
Can you think of any other group of professionals that has never published a single guideline for safe practice? I can’t.
MANA is not a professional organization. It is a special interest lobby and special interest lobbies don’t concern themselves with safety.
It would be bad enough if MANA and CPMs ignored safety, but the truly chilling fact is that MANA and CPMs actually OPPOSE parameters for safe practice.
Consider the recent paper published by MANA executives, Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009. Let’s leave aside for the moment the fact that the authors lied about the fact that their data show that homebirth increases the risk of perinatal death by at least 450% and probably a whole lot more.
Let’s look at the appalling death rates that the authors didn’t lie about.
Of 222 babies presenting in breech position, 5 died either during labor or the neonatal period.
So the homebirth death rate for breech was 20/1000 compared to approximately 0.8/1000 in the hospital. That’s a breech death rate 25X higher (2400%) than the hospital.
MANA has known about this astronomical death rate for 5 years. What have they done to mitigate it? NOTHING!
At no point during those 5 years did the executives at MANA let women know about the extreme risk posed by breech homebirth.
At no point during those 5 years did MANA publish a clinical practice bulletin to inform their own members about the extreme risk posed by breech homebirth.
In fact, homebirth midwives continued to lobby to extend scope of practice to INCREASE breech homebirths.
And even today, in the face of publication of the exact magnitude of the extreme risk posed by breech homebirth, homebirth midwives and their allies are CONTINUING to lobby against an efforts to restrict breech homebirth.
Typical of these efforts in this Change.org petition:
The Arizona State Legislature is considering adopting a new bill that would make it illegal for home birth midwives to attend breech, VBAC, and multiple births (SB1157)…
A recent study published in the peer-reviewed Journal of Midwifery and Women’s Health shows that current science supports home birth for breech and VBAC patients.
I don’t know if the author of the petition is a liar or a fool, but the study showed that science (current or otherwise) does NOT support breech homebirth because the death rate is an appaling 20/1000.
Where is MANA and its executives in this attempt to void any safety regulations in Arizona? They are nowhere to be found. Even though MANA knows that its OWN DATA shows breech homebirth has a hideous mortality rate, they are silent.
The CPM should be abolished because CPMs are not health professionals; they are business women who don’t give a damn about safety and care only about their bottom line. They have literally NO standards for safe clinical practice, which is unfathomable for a purported health care organization, but entirely predictable in an economic lobbying organization.
The CPM credential is a public relations ploy designed to trick legislators and laypeople into believing that homebirth midwifery a profession. It’s not and the sooner the CPM is abolished, the sooner the deaths at their hands will end.