MANA makes a movie on homebirth safety and it’s pathetic

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We haven’t heard much from the Midwives Alliance of North America lately.

That’s not surprising since it has been a bad couple of years for pretending that homebirth is safe.

In January MANA published their landmark “study” (actually a non-representative survey of less than 30% of their members completed 5 years ago) claiming that homebirth is safe but ACTUALLY showing that homebirth increases the risk of perinatal death by 450%.

Hospital vs MANA

Why did the Midwives Alliance of North America wait 5 years to publish its statistics?

Their failure to publish the death rates had led everyone to the obvious conclusion that the death rates were hideous. Therefore, I suspect that they gambled that they had nothing to lose by publishing the data and then pretending it shows something different than what it actually shows. Everyone already knew that the death rates were horrible so the only way to combat that impression was to publish them and slice and dice the data in a million ways to confuse readers, while simultaneously misrepresenting what the death rates mean.

Simply put, MANA refused to release the death rates until 2014, because they know and have always known that these death rates are horrific. If the death rates were even close to demonstrating safety, MANA would have been shouting them from the roof tops since 2006, when the first analysis was complete. Instead they waited until they were pressure to release the data and are now hoping to hoodwink their followers by declaring that a 450% increased risk of death at homebirth is an indication of safety.

In March 2013, Oregon released an analysis of homebirth deaths prepared by Judith Rooks, CNM, MPH that showed that PLANNED homebirth with a LICENSED Oregon homebirth midwife had a death rate 800% higher than comparable risk hospital birth.

In June 2013, Grunebaum et al. demonstrated that homebirth increases the risk of a 5 minute Apgar score of zero by nearly 1000%.

In January of 2014, Wasden et al. demonstrated that the risk of anoxic brain injury is more than 18 times higher at homebirth than comparable risk hospital birth.

And those are just the highlights! Other papers and datasets were also published and all, without fail, showed that homebirth has a death rate 3-9 X higher than low risk hospital birth.

But now the MANA has struck back with a movie, Why is Midwifery Care and Home Birth Safe?

It’s nearly 7 minutes long and contains MANA’s definitive statement on homebirth safety, to wit:

Homebirth is safe because I AM A MIDWFIFE, and I said so!

Wow, talk about a compelling argument … NOT.

You might have thought that MANA would have emphasized it’s safety guidelines, but it couldn’t do that because it has LITERALLY no safety guidelines.

Instead, according to Ida Darragh, CPM, LM, homebirth is safe because: I am a midwife, and I said so!

You might have thought that MANA would present the data from its own study, but it couldn’t do that because the executives at MANA know that THEIR OWN DATA show homebirth increases the perinatal death rate.

Instead, according to Maria Iorillo, CPM, LM, homebirth is safe because: I am a midwife, and I said so!

You might have thought that MANA would present a compelling rebuttal to the multiple papers and datasets published in the last several years showing that homebirth increases the risk of perinatal death, but it couldn’t do that because it has no rebuttal for those studies and datasets.

Instead, according to Laurie Foster, CPM, LM, homebirth is safe because: I am a midwife, and I said so!

Okay, is it just me? Or does this seem remarkably pathetic and disparaging of the intelligence of their followers? I realize that homebirth advocates aren’t the brightest bulbs in the chandelier, but are they really going to fall for “because I said so.”

Yes, MANA does sprinkle a few keywords in here and there: Intuition! Fear! Homeopathics!, but is that doesn’t seem particularly moving to me.

I’m going to go out on a limb here and suggest that even homebirth advocates are going to notice the woeful lack of data, statistics, empirical claims and rebuttals in this video.

“Because I said so,” might be compelling to a 4 year old, but not many pregnant women are going to buy it.

  • Truthful taco

    Your bullshit stats look like they don’t include MORBIDITY in hospitals. Or most of the mortality for that matter. You’re brainwashed. You paid a quarter mile to become that way, so it’s tough to break out of. Guess what. Do it anyway.

  • BLARGH

    A cord around the neck is just a necklace, not a noose? Forgive me, but the necklaces I wear aren’t attached to the wall of the room I’m in. My oldest had the cord around her neck twice and my OB got VERY calm as he told me to stop pushing so he could clamp and cut it. It was tight enough to make him snap at the nurse who tried to intervene so my husband could cut the cord. He was NOT messing around.

    • Truthful tacos

      Oh, he was SERIOUS. he was NOR MESSING AROUND. he was totes FOUR ON THE FLOOR. I bet you feel very important thinking about it. And relieved. Because you have nothing to second guess; you COULDN’T have given birth at home. Off the hook for that one! Whew! But news flash- nuchal cords are not that big of a deal. You unwrap it. Midwives dont “GET SO UBER SERIAL U GAIS1!1!” they just unwind the cord without all that silly drama. Done.

  • attitude devant

    Not very surprising, when you realize that among hardcore NCB the midwife functions more as a shaman than as a healthcare provider.She is a spiritual figure, not a rational one. She’s the repository of special knowledge, of arcane wisdom. She does not need to support her assertions; she speaks from priest(ess)ly authority.

  • Lisa from NY

    OT: Are crunchy parents more likely to invent false allegations of molestation? My friends daughter babysat for a crunchy 3-yr-old boy. He says that a group of boys cornered him in the bathroom. The child was never left unattended and my friend has no boys. Could the crunchy mother have coached her 3-yr-old son?

    • Elaine

      I have a 3-year-old as well. They are not super reliable reporters. I would be willing to bet that some incident that bears some resemblance to what he described did happen at some point. But he could be talking about something that happened some other time (several kids were in the bathroom at the same time at preschool, say, which wouldn’t be unlikely if it’s anything like my daughter’s preschool), or something he saw on TV, or …? Accusing someone of making a false accusation of child abuse is pretty severe. It seems more likely to me that someone has misinterpreted this kid.

  • Ardea

    This is magical thinking. “Moms know what is happening with their babies, and we also trust our intuition.”

    • fiftyfifty1

      Yep. The philosophy of NCB is based largely on magical thinking—that and sexism and racism.

      Magical thinking:
      Birth Affirmations
      Negative thoughts cause negative outcomes
      Mama intuition
      Midwife intuition (real education not required)
      Homeopathy
      Visualizations (cervix opening like a flower blooming)
      “Other Ways of Knowing”
      Birth is a liminal state/access to magic powers

      Racism:
      Grantly Dick-Read/women of color don’t have labor pain
      Co-opting spiritual rituals (e.g. Birthingways)
      Referencing what “indigenous cultures” supposedly do
      The myth of the Noble Savage
      CPMs who use African or Latin American women as guinea pigs to rack up numbers

      Sexism:
      The pain is all in your head
      Suffering in labor is good/necessary for women
      Women are irrational in labor and what they say shouldn’t be trusted
      A woman’s worth= how well she performs in labor
      Rational thought and science is for men, intuition for women
      Your body is not your own-you MUST use your breasts for milk
      Your body is a lemon if you had a C-section
      A mother’s mental health comes last
      Not choosing NCB = we must “re-educate” you
      Desire for medical interventions = hysterical
      Difficult birth=sexually uptight
      Concerns about sexual function/pelvic floor= slut/man’s plaything
      Female OBs can’t think on their own/brainwashed by men

      I’m sure I’ve missed a bunch

      • Amy M

        Futhering the “Your body is not your own” concept, the entire “The biggest martyr is the best mother, and the one who refuses to sacrifice her whole self is selfish and lazy” thing that Sears style AP is built on.

        • fiftyfifty1

          Yes. It reminds me of the self abnegating Mother Mary/Virgin Mary theme present to a greater or lesser extend in different branches of Christianity. Not surprising as Sears style AP is Christianity based.

        • The Computer Ate My Nym

          Hmm…I wondered at first how this works with the “birth is all about a fulfilling experience for the mother, no matter how badly it goes for the baby” thing. I think it might be a bit like the bridezilla thing again: Bridezillas seem to be more common in cultures where the woman is expected to be subservient to her husband after marriage and so the wedding is her last chance to get her own way and sometimes her only chance to have people do what she wants for once. I wonder if something like that isn’t going on with the NCB movement: After the child is born the mother is expected to sacrifice herself utterly to the child’s needs. But until then, she gets to be the special snowflake and, very briefly, have her own way.

      • Samantha06

        And sadism: “Just work through the pain” and stalling an epidural until it’s “too late”.

        • fiftyfifty1

          Yep. Because pain in labor is good for women, and when they ask for pain relief it is only because they are irrational and what they say shouldn’t be trusted.

          • Samantha06

            And because the midwife maintains control of her patient when she denies her pain relief.. *shudder*

  • Amazed

    The video struck me as so incredibly stupid and inconvincing that I really cannot muster much sympathy for the women swayed by it. Stupid has to do some limits and to be influenced by THAT… well, such women must not be functioning too well in real world at all. I mean, the place we have to have jobs, family planning, expenses planning and so on. These are skills I cannot see walking hand in hand with believing this video.

    But I have to admit that those who will take this video into account will contribute to the growing problem with overpopulation. True, it’ll be at their own expense and their babies’ expense but hey, they aren’t seeing themselves as individuals anyway. If I hear the “nature intended for us to have our babies naturally” and “how on earth jas humankind survived giving birth OOH for eons”, I’ll throw up.

    Want to let nature have its say? Want to live like the women who gave birth OOH because there WAS no hospital birth? Don’t include the “only 10 minutes away from the hospital!” part. Die at home. Have your baby die at home. Oh, I mean, be born “peacefully” (as if! Those dumbies probably believe it, though.) at home. And for fuck’s sake, don’t snivel all over the internet, “But I didn’t know!” later.

    • Samantha06

      Amen to this! They truly are idiots. And hypocrites to boot. One of them posted this on Mana’s FB page:
      “I’ve enjoyed competent care from three different midwives and have had two healthy homebirths so far, planning my third. I could not be paid to set foot in a hospital for birth (unless an emergency arose, of course).”

      I wanted to say, I’ll pay you NOT to come to the hospital so I don’t have to put up with your whining about why your birth just didn’t go as planned. Then I won’t have to waste my time documenting your refusal of care and every statement you make to cover my butt in case you sue.

      • Bombshellrisa

        I will contribute to that fund. What burns me is that when these combative women come in, dehydrated and in agony, they still write down the names of their caregivers so they can complain about the nurses who “poked them four times” before they could get an IV started and who insisted on taking vital signs “too many times” not to mention the doctor who “threatened” them with a c-section.

        • Samantha06

          They are truly unbelievable. It would be a lot easier on us if they just refused everything. One thing I have started doing is making sure I ask their permission, with a witness, before I even touch them or do anything and document every little thing they say and do. It’s a pain in the ass but it’s worth it.

        • Dr Kitty

          Yep.
          Nobody is trying to punish you by deliberately failing to get a line in.
          If you are clapped out ( the technical term 🙂 ) your veins will have collapsed. If you are also on the zaftig side these tiny collapsed veins will be buried in layers of fat.
          That makes for a hard stick.
          It just does.
          If someone who puts lines in many times a day is struggling, it is much more likely that there is something wrong with you, than that their skills have suddenly deserted them. There is almost no chance they are being “mean” and doing it on purpose.

          If you want to be an easy stick, you need to have a low body fat percentage, be well hydrated and genetically blessed with big bouncy veins.

          • Bombshellrisa

            Yes! I have crap for veins and I am rather curvy. I am a hard stick on a good day. I sympathize with people who are hard to get a blood draw from or whose veins can’t tolerate an IV start. I remember it was four or five times when I went in to have my son and I understood how important that IV was so I didn’t mind.
            The midwives in the video brag about how they have equipment with them, I wonder someone who isn’t medically trained and doesn’t do it often could actually start an IV in a crisis.

          • Amy M

            I’d like to think I could get a needle in, if the veins were easy to see and close to the surface—I’ve never stuck a human, but I put needles in mouse tail veins all the time. But, no way would I be able to do that on a person whose veins are hard to get to, collapsed, person is moving around or under anything less than 100% ideal conditions. Other than animals, I have no training, and I suspect most CPMs aren’t signing up for phlebotomy courses. I guess that’s why they rely on cinnamon candy and telling the woman to stop bleeding so much.

          • Mishimoo

            I think it also depends on what they’re trying to do. I’ve been told several times that my right arm, despite it’s visible veins, is next to useless for putting a line in because they’re all superficial.

          • Ash

            And in a hospital, if you miss, you ALWAYS have other people to help! If stuff goes down, you could possibly bring ina venous access team w/ ultrasound, or even put in a central line if you REALLY need to !

          • Bombshellrisa

            Exactly-all those “strangers” that home birthers complain about walking into their room. When they were trying to get a line in me so I could get some antibiotics, when the nurse tried twice, she called another nurse. It took a couple of them to get that line in, but they finally got it. At home I would have been left to wash with hibeclens and become terribly dehydrated.

          • The Bofa on the Sofa

            I remember when my wife was in for her appendix and watching them digging around trying to get a needle in her hand. However, the vein just kept rolling over on them.

            I always assumed it was because her hand were freezing cold. I didn’t realize they were punishing her for having appendicitis.

          • The Computer Ate My Nym

            Not to mention that it’s harder to get a line in someone who is dehydrated and delirious than someone who is well hydrated and able to cooperate. Also, physical skills are harder when someone’s glaring at you and practically daring you to make a mistake or have difficulty so that they can disparage your ability.

          • Bombshellrisa

            Or worse, saying we get “one chance to get it right”.

          • Samantha06

            But, hey, if they tell us that, if we don’t get it on the first stick, we can just throw up our hands and say, “oh well, so much for that, we tried”… I wish..

          • The Computer Ate My Nym

            But they still have to get IV fluids and meds somehow…so it escalates. You have to get interventional radiology to put in a PICC line or start a groin line or an intraosseous if you’re really out of options. Meanwhile, the patient’s condition is worsening…

  • Eskimo

    Geeeezzzz! I’d say it was propaganda but it’s so unconvincing it’s more like parody.

    • Eskimo

      Oh my god! They basically say the hospital is better. Oh man this is bad.

      We have intuition but not a NICU. What a fucking joke.

  • Amy

    I didn’t even get the sense that most of them were actually saying homebirth is safe. It was worse. They were just saying that safety is important to them. Well I should hope so! It’s important to me, too……but I’m not going around charging women to attend their births.

    • CrownedMedwife

      Well obviously if they prat on about how much they value safety, they don’t have to address the reality of their own statistics. The warm, cozy and seductive connection the video uses to connect to viewers while prattling on about safety…ugh, it’s disgustingly unethical. Of course, the average viewer won’t see the deception if they’re too busy feeling the message, just as they intended.

      • Trixie

        Intuition+Homeopathy+intricately tied scarves=safety

        • Elaine

          Don’t forget about beaches. What was with all the beaches?

          • Who?

            To bring to mind the surges of labour, like the tides rolling in and out….

          • Mishimoo

            They were like that for me – being caught up in the huge swell, cresting the wave, dropping down into the calm and floating while waiting for the next. As always, I just lucked out. (Also, I can see how the lack of control could be really frustrating)

          • fiftyfifty1

            It really is a pity that labor and delivery isn’t always this way! Too bad we can’t clone it like this for the other 98-99%. And then on top of that, we should have L&D actually be as safe for both mother and baby as NCB pretends it is. It would be like a day at the beach, body surfing with a group of your closest loved ones. Pausing for delicious refreshments in the shade. Hair tangled by the power of the wind. Cheeks rosy from the effort and excitement. And all the while knowing it was 100% safe. And best of all, at the end of the day, the miracle of getting to bring a new tiny loved one home from the beach.

            Ok, back to reality…. After that, reality is a bit of a disappointment. But modern obstetrics is a fine replacement. It took my excruciating constant pain and made me pain free. There was no way in hell I wanted to eat and drink, but at least the Zofran took away the need to vomit repeatedly. My hair didn’t get tangled, but my cheeks did get rosy. And my baby and I were closely monitored and I rested easy knowing the safety was as close to 100% as is humanly possible. And best of all, actually the ONLY important thing really, is that when it was all done my husband and I did get our BABY.

          • Mishimoo

            If only! It’d be awesome to feel refreshed afterwards instead of exhausted, to not need the monitoring or the augmentation, to have a baby with 10/10 APGARS, and so on. Modern obstetrics might not be perfect, but I am so grateful to be able to access it.

            Maxolon is my favourite, it works really well for me and I don’t think I could have coped without it during my last pregnancy.

          • Cobalt

            And at the hospital, there is no risk of getting a bunch of sand where it doesn’t belong.

          • Who?

            I only got the connection after labour, since if there was any ocean based simile for me it would have been tsunami!! But I do get the simile of the tide, where each wave brings you closer to high or low tide.

          • Sue

            Oceans of PPH, maybe?

        • CrownedMedwife

          All this nonsense and the facade of safety and how they’ve trained just for this. They “carry 3 out of uterotonics, homeopathics and herbs” for PPH? Can someone please show me what phamacology courses CPMs have taken and what research they use to to support the ‘safety’ of homeopathics or herbs to treat a PPH? A true uterine atony with PPH is likely not going to respond to pitocin alone. How do they decide when and how to use herbs vs ‘3 of 4’ approved uterotonics? Do they realize the contraindications to hemabate or methergine or is it just luck of the draw that you don’t happen to carry the medication for the mother with a true contraindication?

          Notice how she mentions being ‘confident’ of transferring for low FHTs to have a ‘supportive staff’? Says just enough to appease the viewer and stops shy of mentioning the ‘supportive staff’….with EFM, IVs, OBs, Neos, Anesthetists, RNs, RTs, ORs, Blood Banks? Oh THAT kind of supportive staff.

          Thanks Trixie, was so busy seeing red that I didn’t notice the fancy scarves! Among the many other reasons I’m not that kind of midwife, I have no sense of style…oh and I really like safety, the real kind of safety.

          • Trixie

            That’s code for, the local hospital I used to dump my transfers on isn’t “supportive” of my train wrecks anymore, so you’ll be driving 45 minutes to the next county

  • Amy

    Okay, I see, Patrisia Gonzalez, “traditional birth attendant” who’s too woo to even call herself a midwife. It’s my clinical depression that made me unable to have a vaginal birth. Couldn’t have been my daughter’s asynclitic presentation.

    • Trixie

      If your homebirth didn’t work out, it’s because you’re a mentally I’ll drunk! Not Patrisia’s fault! See what she just did there?

  • Stacey

    Just watched it and can say that was the worst crock of shit. Laurie, towards the end, actually dared to say that the stats are the same for low risk moms but complications are higher in the hospital! She is the only one that even mentions evidence. Good thing, since there isn’t any showing HB as even a little safe.

  • Monica

    Lets remember hospitals just want to make money, of course then you have to wonder what was this video all about if not an attempt at selling you on their services. Keep misleading. Gotta make money somehow after all, right?

  • no longer drinking the koolaid

    Love the comment from the CPM/CNM who starts out with a very quiet “If”, followed by the statistics are the same for low risk women out of hospital and in, but the complication rate is higher in hospital, then home birth is safer. Most people are probably going to miss the initial “if” and only hear the rest of what she said. She is starting out with an incorrect premise because the statistics don’t show that the outcomes are the same, and not all midwives are choosing to only care for women who remain low risk.

    • Guest

      That part made me so mad. They’re so deceptive!!!

  • staceyjw

    These HB “MW”s have seriously overstepped by trying to push this into the
    mainstream. They should never have tried to push the whole “safer, better” angle, and stuck to moms that reject the system regardless.

  • Trixie

    Now might not be a bad time to repost the Not Buried Twice video. http://www.notburiedtwice.com | Home Birth | Not Buried …: http://youtu.be/CRhkZKUNyMY

    • Guest
      • Karen in SC

        that is such a powerful video. I get goosebumps and tear up every time I watch it 🙁

      • Guest

        Wow. The women on that post are a piece of work! I especially loved the picture quote someone recently posted quoting Kelly Brogan, MD, a holistic psychiatrist. Sigh. Just because there’s an MD behind their name and they’re saying something all nice about homebirth doesn’t make them a credible source.

        • Bombshellrisa

          What no “Dr” for her? They must save the air quotes for the doctors who don’t agree with them

    • Bombshellrisa

      Also a link to “From Calling to Courtroom”. Sure, these midwives are great at whispering affirmations and reassuring you to trust birth, but if something goes wrong the only thing they care about is their own well being and right to continue maiming and killing http://www.fromcallingtocourtroom.net

  • mythsayer

    Well hey… to be fair, a lot of them DO in fact transfer when an emergency occurs. So they aren’t lying about that. They just lie about the fact that the emergency started hours before.

    But see… transfer. So it’s safe. If the baby dies in the hospital, it wasn’t meant to live, of course.

    • Bombshellrisa

      I guess they view dump and run as “transfer”.

  • Ellen Mary

    I hesitate to get into it, but did you notice all the overt features? Like of COURSE they let the CNM do a lot of talking. They also intentionally over-represented CNMs as a percentage of their membership in the video. They were also IMO consciously hitting demographic notes.

    Also did you notice that 2 of the women refused to actually self-indentify as midwives?

    • Guest

      I also thought it was strange that a few had both CNM and CPM as their “credentials.” The CNM seems to eclipse the CPM, so why even include that? It seems to me to be a way to further confuse women and to make the CPM seem like it’s on the same level as the CNM.

      • Trixie

        It’s just a shorthand for woo CNM.

      • Bombshellrisa

        There is a local CPM who has recently gotten her RN so she can become a CNM. She seems less woo then most and had a reputation for transferring care during pregnancy if there was any variation of normal (this did not win her any points from patients), she also wrote a scathing article for the MAWS newsletter about why it’s so important to get vaccinations and encouraging clients to get flu and whooping cough vaccines. Hopefully she will drop the CPM when she becomes a CNM.

      • Sue

        Exactly. It;s a bit like “High School Diploma, PhD”

    • yarnbarf

      It’s reasonable, though. Calling oneself a “traditional birth attendant” doesn’t try to capitalize having a similar acronym to CNMs, real midwives. It’s an accurate title, at least.

      • KarenJJ

        I think it would be a good thing for CPMs to use “traditional birth attendant” and drop the “midwife” part of their description.

        • Sue

          Or, even better, Amateur Birth Attendant

  • Kq

    It’s been a long time since you’ve had a four year old if you think “because I said so” works on them…

    • staceyjw

      It still works on average 4 yr olds, but not genius ones :).

      • mythsayer

        It wouldn’t work on MY 4 year old… The only lie she buys now is “[insert place here] is closed… we can’t go”. But if she remembers it being open at 8pm 6 months ago, she’ll tell me I’m wrong and it’s open and we have to go.

        • staceyjw

          Mine still goes along with it. Whew!

    • Trixie

      It doesn’t work, but at least they’re small enough that you can carry them off to their rooms when necessary.

      • Amazed

        If you’re their mom. Not so much if you’re their elder sister. They look at you and say, “Why are you the boss? I’ll be the boss instead!” Sadly tested.

      • mythsayer

        Not all of them unfortunately 🙁 Mine is stronger than me by far.

        • Medwife

          I am forced to negotiate with my terrorist, too. Only 3 and freakishly strong.

  • Zoey

    You’d think if they were going for the “appeal to authority” tactic, they’d at least try to find an actual authority to appeal to instead of just themselves.

    It’s still just as much of a logical fallacy, but at least they would have put some effort into it.

  • Helen

    That was entirely devoid of any useful content. It was vacuous. I just lost nearly 7 minutes of my life that I won’t get back (which is my own fault, I shouldn’t bothered with it!)

  • Life Tip

    I don’t think you are being fair to four year olds. In my experience, four year olds question everything.

    You have to be willfully ignorant to buy what those midwives are selling.

  • Briar

    This goes perfectly with your article from yesterday. I spotted all five.

  • guest

    The Laurie Foster part – she does appear to be a CNM as well as a CPM.

    • manabanana
    • staceyjw

      For shame. A CNM into this shit.

    • Elaine

      I don’t get why someone who’s a CNM would even bother with a CPM, or put those letters after her name if she got the CPM first and then decided to go for the CNM. You’d think in training for the CNM she would realize how inadequate the CPM training was.

      Since home has fewer resources than hospital, you want a provider who’s better able to cope with emergencies. Having someone less qualified at home is so bizarre and counterintuitive. (I know, this is obvious to everyone who reads this page, but still.)

      • Bombshellrisa

        Unless she wants to practice her low intervention technique in the hospital.

    • yarnbarf

      One of the prominent homebirth midwives where I live calls herself a CNM, NYS LM. Just the first should be sufficient, but apparently isn’t.

  • Anonymous

    Wow..finally tried watching that. Believing that something is safe and actually being safe are two very, very different things. Case in point: Dad and I are both deep-water dive certified. This requires special training, equipment, and a large amount of supervision before you can even think about doing it alone. Recently we had someone with us on vacation that wanted to do it with us and had the equipment but zero training. She got a decisive “hell no” from both of us because she lacked the requisite training. She tried this “but I’ll be safe.” line. The problem is that without knowing the possible issues, there is no possible way you can know what safety for that situation is. This is the same with CPMs. They don’t have the course of study to know what that actual definition of “safe” is during birth, which does not qualify them to deal with it.

    • Cobalt

      I teach horseback riding, and have people show up thinking they’re going to just hop on my nice event horse and get to gallop about and go over 4 ft jumps in the first 5 minutes. They don’t want to ride the boring looking reliable horse (that I can control with ground cues), and they certainly don’t want me hooking the reins to the halter to save the horse’s mouth. Luckily, the protests typically stop after a few trot strides, so things don’t get out of hand.

  • Sara Lucy

    What a ridiculous myth (around 5:35) that you either get individual attention from a midwife at home, or you get machines. There are no humans in hospitals.

    • Amy M

      I had my babies in the hospital. We were surrounded by robots.

      • Young CC Prof

        Definitely no humans at my son’s birth. The OB, her assistant, and the two baby nurses all were machines, not women. So were the wonderful postpartum nurses.

      • Sara Lucy

        Well I give birth to cyborg children anyway, so it only makes sense to have them greeted by their own kind when they enter the world.

        • sdsures

          I’m picturing the Terminator.

          • Cobalt

            I’ve always wished my kids, especially in utero and as babies, came with indicator lights.

          • KarenJJ

            Ha – my husband and I said that same thing – as well as level indications for being full and for the other end.

          • The Computer Ate My Nym

            Mine came with a sonic alarm. Unfortunately, it was a little nonspecific for the first few years, but she now utilizes it with reasonable percision.

          • sdsures

            “Hungry” vs “not hungry”? “Diaper full”?

    • Zoey

      No humans at all. I must have hallucinated the nurse that was specifically assigned to my high risk labour and never left my side. It’s too bad, because she was awesome and taught me several German swear words.

      • sdsures

        My paternal Grandpa was Belgian, and spoke a little Dutch, but mostly Flemish, plus English as a first language. “Potverddeke!” would be a great Flemish word to scream in the middle of labour. https://www.youtube.com/watch?v=Mrl6r0fsT1U It’s a curse word, roughly translated as “Damn it!” I love this song.

      • The Computer Ate My Nym

        Verdammte diese kniefickenende geburtweh! Sound familiar?

        • KarenJJ

          I love the German language. I always feel like if I just listen hard enough it would start to make sense to me (English only speaker).

      • namaste863

        Ooooooh, teach us!

    • Liz Leyden

      That would explain 15 or so very realistic-looking cyborgs in the OR during my C-section.

    • The Computer Ate My Nym

      Oddly enough, I was just reflecting the other day that the day that they replace all of us in medicine with robots who don’t get tired, bored, frustrated with the patients, or able to miss potentially important labs or physical findings can’t come soon enough! Perhaps I’m a weirdo, but I’d rather have a robot overseeing my labor and my fetal monitor than a person who might miss the significant findings on the strip, nod off at the wrong moment, or otherwise miss things.

      • Ash

        I understand Japan is making a lot of progress on developing robots that can help with things like patient transfers. Better machines to assist with moving patients can save a lot of workplace injury.

        • KarenJJ

          There’s a new hospital being built near me that has trolleys that can carry lunch carts around the hospital, manouvre to a setpoint and sound an alarm. Then one of the ward staff can remove the lunch cart and the trolley can take itself back base station.

          • Sue

            Is it the ”Princess Fiona Hospital”, Karen?

          • KarenJJ

            Yup. Over here in Shreksville. I did a tour with my daughter.

      • yarnbarf

        I don’t know. Padme Amidala delivered Luke and Leia with robot attendants in the last “Star Wars” prequel, and she died.

        • Amy M

          Yeah, but it was a double footling breech homebirth, post dates. Some mothers just aren’t meant to live.

        • MaineJen

          But you gotta remember…she was running around with her little volleyball belly just hours beforehand, flying starships and getting force-strangled by her husband. And there’s probably not a lot of kale available in space.

      • Young CC Prof

        One thing that does exist is a “spellcheck” software for mammograms. Typically, a doctor reading mammograms will see 1 cancer in every 1,000 films. Unfortunately, due to fatigue at reading the other 999, he might just miss it. So, they actually came up with a software to spot suspiciously dense regions. When the doctor looks at the film, runs in through the software and then looks again, the results tend to be more accurate.

        • KarenJJ

          I remember projects like that being available to undergrads when I did my engineering degree *mumble* years ago for those interested in image processing.

          • FormerPhysicist

            I was in an optics program, and some colleagues were working on just this. 🙂

    • Sue

      ANd they don’t use ”machines” to measure blood pressure at home? Do they just ”intuit” the blood pressure (sadly, many probably do).

  • GiddyUpGo123

    I tried to watch it, I really did … But the bullshit was way too smelly.

  • Ellen Mary

    Oh babies, I am so glad I could bring you a mommy that didn’t say things like ‘what is safety, really?’

    And I love how they are talking about how often they will go to the hospital. Well that doubles the bill . . .

    • Ellen Mary

      The folksy music and the fire are definitely overtly condescending . . .

    • Sue

      “I love how they are talking about how often they will go to the hospital.”

      Yep – HB is not as dangerous as it could be cos the hospital doctors, nurses and robots will rescue us. Fixed.

  • Ash

    If CPM organizations are so proud, I invite them to stand before legislatures (especially Oregon) and ACOG meetings and present their breech mortality rates. 5/222! Attendance with these CPM quacks is so safe, right?

  • Anj Fabian

    The one thing that I found so startling about almost every midwifery organization in the United States is that none of them definitively state what are the acceptable standards of care and scope of practice AND what consequences midwives who violate those standards face.

    A CPM can do what they like for the most part. There’s no motivation for them to adhere to any practices that would decrease the risks for their clients.

    • The Bofa on the Sofa

      Remember, at one point the ACNM thought it might be a good idea to create a set of standards for its members to follow. So it created a task force, who went through and created a list of minimum based on the common guidelines used by midwives throughout the world.

      The midwives balked at it, because it would get in the way of their “autonomy.” IOW, if they have guidelines, they aren’t going to be able to do whatever the hell they want, and that is unacceptable.

      • Amy M

        And they might have to buy insurance to cover their uneducated asses.

        • anonymous

          Which they can’t because there’s no standard of care.

      • Roadstergal

        And if there were standards, there would be the possibility of not meeting them and being unable to be a midwife.

        • KarenJJ

          They’d lose a lot more of their business to obgyns than obgyns would lose of their business to homebirth midwives.

          • Amazed

            They don’t know it. I really think some of them don’t. Maths is hard, arrogance is bad for self-awareness, and the combination of both is fatal to knowledge of the reality of the situation.

      • MaineJen

        Wait a second. Not even the ACNM has practice standards?

        • The Bofa on the Sofa

          Not for those doing homebirths, at least

        • CrownedMedwife

          ACNM has a few practice standards, but there are a few points of contention on those that do exist. I have a hard time referring to practice guidelines provided by an organization that allies itself with MANA. Maybe a difference between a midwife and a medwife. Maybe I’m just a bitter realist in that if pregnancy complications are going to be screened, diagnosed or managed, I’d prefer to keep up to date on the Green and Grey journals while referring to ACOG for actual practice guidelines.

          Sorry, it’s been a really long week and I am quite frustrated with this concept that ‘natural’ is better in all realms of women’s health and pregnancy. Spending time discussing implications of recent diagnoses of deleterious gene mutations, realities of bilateral mastectomies, prophylactic BSO’s and frequent colonoscopies has seriously limited my patience to hear patients decline immunizations, refuse standard GBS prophylaxis, treat abscesses with raw vegan diets or delay evaluation or delivery of an at risk fetus while they ‘take time to do my own research’. If I hear the ignorance of believing in nature one more time this week, I will explode. Nature has plans to kill a few of my patients long before they get through middle age and you want to tell me you TRUST her? Yeah, I’ll take ACOG guidelines for direction every time to be sure my patients are getting the evaluation and management they deserve. My apologies, rant over.

    • anonymous

      Standard of care=standards and measures=training. Since all you need is a GED to become a CPM do you really think that standards are something that they want?

      My dad just spent another week in training as an MD and he’s been at it for over 30 years.

      • Ash

        There are traditional birth attendants who don’t even want to complete an apprenticeship. http://www.midwiferyandmore.com/community/forumdisplay.php?f=6

      • MaineJen

        But school is HARD. And expensive. Why bother when you can get by with 30 (!) births as primary attendant and a correspondence course?

        • Amy M

          Hey! I’ve seen at least 10 births! Oh wait, those were various farm animals and a few videos of human births…still, only 20 more, and I can be a midwife! Who wants to be my first patient, when I open my own practice?

          • fiftyfifty1

            Here’s the thing. Very seriously, you could be a better than average home midwife starting right now with only the little experience you have and committing yourself to following these 3 rules:

            1. refuse twins, vbac and breech
            2. refuse to do homebirths before 37 weeks and after 42 weeks.
            3. Use a partogram during labor and transfer accordingly.

            The state of homebirth midwifery in the US is bad enough that these extremely minimal commonsense guidelines could cut mortality in a big way.

          • Trixie

            How about
            4) don’t prevent anyone from going to the hospital or calling 911 when they want to.

          • fiftyfifty1

            I thought about that one, but then I decided it wasn’t needed, because you would still be safer than the average homebirth midwife even without it.

          • Amy M

            Man, that is sad. Apart from giving birth myself, I really don’t have any experience and I wouldn’t trust me to deliver a baby. The fact that if I said the right words and dressed the part would convince a bunch of loons in southern CA to pay me to sit in their living rooms, and do nothing while they give birth, is just so wrong. And clearly we see that people with no morals or sense of ethics do just that, hence the thriving community of homebirth midwives. I don’t know how they live with themselves.

          • MaineJen

            That depends…are you also a placenta encapsulation specialist? 😉

          • Cobalt

            I watched my dog have eight puppies. Does that count as eight births?

          • Echidna Lactation Consultant

            Yes.

          • I can award you the Certified Hamster Midwife credential if it helps.

      • Sue

        Not only do MDs have the insight to continue their education, but they are REQUIRED to do so.

    • Melissa

      I suspect it is to prevent litigation. Violating a standard practice can help show malpractice or negligence. If there is no standard it’s harder to hold a midwives actions as negligent.

      • CrownedMedwife

        I find it ironic that Obstetricians and Medwives are accused of practicing to prevent litigation, yet there is an ACOG guideline for pretty much everything you’re likely to encounter in the average practice environment. You know, like guidelines for breech, VBAC, GDM, Preeclampsia, IUGR and silly stuff like that. I suppose if Midwifery organizations lack practice guidelines and scopes of practice for the aforementioned diagnosis…well, they’re just a variation of normal. Yet, even without guidelines, they manage to evade accountability or litigation.