Melissa Cheyney: feeling the heat, but still not telling the truth

Melissa Cheyney has been under intense pressure since the debacle of publishing an op-ed in the Register-Guard touting Oregon’s strict licensing standards while failing to mention that no license is required (Melissa Cheyney, have you no shame). She came across as dishonest and duplicitous. She had to do something.

According to OregonLive:

For years, Melissa Cheyney, a licensed midwife and Oregon State University medical anthropologist who chairs the state Board of Direct-Entry Midwifery, has not taken a position on mandatory licensing even as she’s studied mortality rates and pushed for better reporting of birth outcomes.

Now, however, she thinks it’s time to make licensing required. Sheikh’s options to hold her midwives accountable are limited because the state can’t investigate unlicensed midwives, says Cheyney, and “I can’t really accept that anymore.”

While the women of Oregon can be pleased that Cheyney and colleagues have dropped their official opposition, no one should become complacent. Licensing can protect consumers ONLY if the requirements for education, practice standards, reporting and accountability are strict. Let us hope that Cheyney and colleagues will have not dropped their opposition to mandatory licensing because they plan to fall back to the position of opposing any meaningful requirements for obtaining a license.

I’m not optimistic because Cheyney, who already oversees the licensing authority, continues to lie. She says whatever she thinks she has to say (she hasn’t taken a position on the issue, she never opposed it), without considering that teeny, tiny problem that she has already been quoted publicly saying exactly the opposite.

A March 2011 Lund Report, available on the web to anyone who cares to look, reported on the bill sponsored by Rep. Mitch Greenlick (D-Portland) that would require a license in Oregon for direct entry midwives. In the article, Cheyney publicly opposes the requirement:

“I don’t think licensure guarantees safety…”

In 2008, Cheyney did a study [on Oregon midwives]. “I looked at [birth outcomes] for licensed and unlicensed midwives, and there was no big difference,” she said.

Cheyney is opposed to the bill for several reasons. She pointed to the new administrative rules governing direct entry midwives that the Board adopted in January. These rules “protect a mother’s right to choose while also protecting her safety,” she said.

More importantly, Cheyney is concerned that requiring licensure could actually have an adverse effect on home birth safety by “driving midwives underground, and not voluntarily participating in peer review and other things they currently do.”

Does Cheyney think Oregon women are stupid? Cheyney herself, and the organizations she chairs (Board of Direct-Entry Midwifery) has been one of the biggest roadblocks to mandatory licensing. She is on record, in a variety of publications over a number of years, as opposing mandatory licensure as both unnecessary and restrictive.

In her role as chair of the state Board of Direct-Entry Midwifery, Cheyney has loudly and publicly opposed ANY regulation on midwifery of any kind. She worked tirelessly to enshrine the ridiculous lack of standards into statute:

687.415 … Nothing in [Oregon Statutes] is intended to require a direct entry midwife to become licensed …

In her role as Director of Research for MANA (a direct conflict of interest with her role as Chair of the Board of Direct-Entry Midwifery), Cheyney has withheld every scrap of information on homebirth death rates. Cheyney oversees the records collected by MANA on 23,000 midwife attended homebirths. Though MANA told its membership that the data on outcomes was being collected specifically to be used to demonstrate the safety of homebirth to lawmakers, Cheyney has persistently refused to release the death rates to the public. The data is available, but only to those who can prove (through an elaborate vetting process) that they will use the data for the “advancement of midwifery” and sign a legal non-disclosure agreement prohibiting them from sharing the death rates with anyone else.

Cheyney also refused a request by Oregon legislators to release only the Oregon death rates. The publicly available minutes from the Board Meetings have Cheyney on record “explaining” why she will not release the information:

Cheyney explained that MANA suspected that, due to some state regulatory boards having very hostile relationships with midwives, the quality and quantity of data submitted might be adversely affected if regulatory authorities were provided access.

Hmmm, she refuses to report the death rates because if homebirth midwives knew that the number of babies who died at their hands would be reported to regulatory authorities, they might stop reporting the number of babies who died at their hands?

A board staffer asked why, if the goal is to protect midwives as individuals, MANA would not provide aggregate data so that the Board could evaluate the safety of direct entry midwifery in general.

Cheyney explained that there is a critical review of data entered into the MANAstats database performed by a group of trained individuals. These individuals assist with correcting data collection errors. This review process results in a lapse in time between the aggregate data and true accurate data, which is completed after the aggregate data.

So they can’t provide the aggregate data because it takes time to ensure that the aggregate data is correct? No excuse for hiding the death rates is acceptable, but that isn’t even a remotely plausible excuse.

I’m on record as recommending that Cheyney resign or be removed as Chair of the Board of Direct-Entry Midwifery:

Dr. Cheyney should resign from the Board, or failing that, be removed by Oregon officials for an irreconcilable conflict of interest. he has already demonstrated her contempt for patient safety by refusing to release MANA homebirth death rates. She should not be responsible for monitoring homebirth practice, where patient safety is supposed to be the highest priority.

But I am beginning to reconsider. No, not because anything has changed. Melissa Cheyney still has an irreconcilable conflict of interest and always places the protection of homebirth midwives over the health and safety of Oregon women and babies. I’m reconsidering because Cheyney is quickly becoming the poster child for the hypocrisy, mendacity and duplicity of homebirth midwives.

Cheyney displayed utter contempt for the women of Oregon in writing an op-ed piece entitled “Oregon has some of the strictest guidelines on midwifery” without mentioning that none of those guidelines are mandatory. She was skewered for that behavior. Under intense public pressure she has backed off her vociferous opposition to mandatory licensing, but once again, she cannot resist displaying contempt for Oregon women by lying about her previous opposition. She should be skewered for that display as well.

Melissa Cheyney embodies much of what is wrong about homebirth midwifery in Oregon: placing the interests of midwives above the safety of patients; hiding information about the dangers of homebirth; and mendaciously misrepresenting the lack of patient safeguards and her role in opposing those safeguards.

At this point, she makes the task of highlighting the dangers of homebirth much easier. Women may not understand the details of various regulatory measures, but everyone understands retracting previous positions and then lying about it.