The ugly message sent by North Carolina’s homebirth march

There’s more than the breathtaking cynicism of Russ Fawcett and the North Carolina Friends of Midwives (NCFOM) behind today’s planned “Birth Freedom March.” The cynicism, of course, is glaringly obvious: homebirth advocates are rallying to support a midwife arrested in connection with the death of one baby and the potentially fatal injury of another, yet they refuse to support the families devastated by these tragedies. Indeed, as I detailed two days ago, NCFOM has made it official policy to avoid any mention of the babies at all.

But that cynicism partly obscures the ugly truth at the heart of the march, indeed at the heart of all homebirth advocacy. Certified professional midwives refuse to be held accountable to anyone for any reason. It doesn’t matter who dies at the hands of a CPM; it doesn’t matter how the baby or mother dies; it doesn’t matter that the deaths could be prevented. All that matters is the ability of homebirth midwives to do whatever they want and get paid for it.

Here we have the specter of a midwife literally arrested for violating the law, trailing one dead and one dying baby in her wake, and it apparently has never occurred to homebirth advocates to investigate her conduct. It is IRRELEVANT to them whether she was incompetent, negligent or possibly practicing in violation of supposed standards of CPM practice. There has been no attempt, nor has anyone even pretended that there will be an attempt to hold the CPM accountable.

The absolute refusal to hold CPMs accountable extends from the lowest to the highest echelons of homebirth advocacy. In the state of Colorado, where the tally of babies dead at the hands of licensed CPMs is appalling and rising, the President of the Colorado Midwives Association acknowledge that the death rate was double that for the state as a whole (including premature babies and babies with serious medical problems) and then utterly dismissed it:

I don’t believe we have a poor perinatal mortality rate, but if solid data shows we do, then I will be at the forefront of the effort to improve our practices and lower the perinatal mortality rate for homebirth in Colorado.

That was written almost two years ago. Since then the homebirth death rate has risen further, but there has been no attempt to investigate the extraordinary death toll or to hold anyone accountable. Quite the opposite. Colorado homebirth advocates appeared before the Legislature to declare the program a success and lobby to extend it. If a death rate that is 100% higher than the state death rate is a success, one shudders to think what a failure would look like.

There is no more egregious attempt to deny accountability than that being perpetrated by the organization that represents homebirth midwives, the Midwives Alliance of North America (MANA). MANA is aware and has been aware for some time that homebirth has an unacceptably high rate of neonatal death. Their own data makes that clear and that’s why they are hiding it.

MANA has collected data on the safety of approximately 18,000 planned homebirths attended by a CPM. The number of babies who died at the hands of CPMs is known to the leaders of midwifery, but the rest of us cannot find out how many babies died. That’s because MANA’s official policy says that the data will be released only to those who will use it for the “advancement” of midwifery. Even the leaders of homebirth midwifery understand that acknowledging the number of dead babies is unlikely to “advance” the cause.

And that gets to the heart of the ugly message being sent by today’s planned march in support of “birth freedom”:

There has not been and there will not be any attempt to hold CPMs accountable in any way. It does not matter who has been hurt; it does not matter if professional negligence is involved; in fact, it doesn’t even matter how many babies have died. CPMs have no intention of being held accountable and homebirth advocates have no intention of holding them accountable.

*American midwives who hold a post high school certificate (CPMs and LMs), as opposed to American certified nurse midwives and European, Canadian and Australian midwives who have university degrees. American homebirth midwives have less education and less training than ANY midwives in the industrialized world.