What should Navelgazing Midwife call herself now?

Barbara Herrera, CPM, Navelgazing Midwife has found that her beliefs have evolved over the years to the point where she no longer feels comfortable in the natural childbirth community.

Suddenly … I notice I don’t fit in the Natural Childbirth Community (NBC) anymore. This is probably a “duh” moment for many folks, but it wasn’t until I was invited into a Natural Birth Professionals group in Facebook that I really caught up that I just don’t belong anymore.

This post is to express my dismay at the Natural Birth Advocates (NBAs) and their continued insistence on evidenced-based care and then going completely against what evidence there is! From homeopathy to acupuncture … from not acknowledging anything being too risky to deliver at home to the blasé acceptance of babies dying or being damaged in homebirths… I just can’t take it anymore.

What should Barb call herself now?

I’ll have to find a name for myself. I embrace “Medwife” now, but think there’s a place for us middle-of-the-roaders … Realistic Birth Advocates? I kind of like that. It’s taken nearly thirty years to get here, but here I am. And perhaps for the first time, I feel at peace with my place in birth.

How about PCM: patient centered midwife?

The evolution in her thought (and there is nothing wrong with that, by the way; lots of great thinkers evolve in their thinking) has occurred gradually over the years. But for me, watching from afar, it seemed to crystallize around one central insight.

All too often, [homebirth midwifery] has zero to do with what is truly safer for the baby, but is all about the midwife.

Homebirth midwifery, in my judgment, has always been about what’s good for the “midwife.” The focus of homebirth midwifery is not babies, not mothers, not even birth. It is about a group of high school birth junkies who want to attend births, but don’t want to do the hard work necessary to make them qualified for this important role.

Women like Ina May Gaskin, who couldn’t be bothered with getting an actual education, simply declared themselves to be midwives. The CPM credential was conjured out of thin air to increase their perceived legitimacy among an unsuspecting public. Gaskin and her colleagues have been adamant all along that the CPM credential should be awarded to anyone who can take the test and pay the fee. The credential has one and only one purpose: to provide faux legitimacy, not to ensure competence. Most women would undoubtedly be shocked to learn that the majority of CPMs have never attended ANY midwifery program at all.

The CPM is a “midwife-centered” credential.

The recommendations of CPMs are often based on what they know how to do, and have nothing to do with what is safe for babies and women.

Consider midwifery “treatments” for Group B strep. Until recently, Group B strep was the leading infection killer of babies. The bacteria itself is harmless to children and adults, and is ubiquitous. However GBS is uniquely lethal to newborns and they are extremely vulnerable if the mother is carrying GBS in her vagina. Routinely testing pregnant women for GBS and giving them antibiotics in labor has reduced the death rate from GBS by 70%, saving approximately 700 newborns each and every year.

But homebirth midwives have a problem; most of them do not know how to start an IV and cannot administer antibiotics at home even if they were able to get them from a pharmacy. Solution? Most homebirth midwives either deny that treatment is necessary, or recommend “treatments” that they can provide (but are ineffective). That’s the origin for alternative “treatments” for GBS, either washing the vagina out with soap (Hibiclens), the “high tech” alternative, or putting garlic cloves in the vagina in the weeks prior to delivery, the “low tech” alternative.

In other words, because midwives cannot administer antibiotics, the treatment backed by high quality evidence and shown to save hundreds of lives each year, they deny that the treatment is necessary or substitute “alternatives” that have never been shown to work, and whose only virtue is that midwives can buy them over the counter.

The recommendation for Hibiclens douches or garlic in the vagina is a “midwife-centered” recommendation.

Consider the ongoing debate in Oregon over midwifery licensure. No license is necessary to call yourself a midwife in Oregon and midwives like it that way. But who could possibly be harmed by a requirement to have a license to practice midwifery?

Midwifery advocates claim that a licensing requirement would deprive women of “choice,” but that’s false. Women have the right to give birth at home and they have the right to surround themselves with whomever they choose during labor and birth. A licensing requirement would not change that. The real effect of a licensing requirement is that high school graduate birth junkies could not CHARGE for attending a birth. A licensing requirement hurts untrained self-proclaimed midwives and that’s why it is opposed.

The refusal to demand licensing as a requirement for practice in Oregon is a “midwife-centered” refusal.

Navelgazing Midwife is rightfully fed up with putting midwives at the center of homebirth midwifery. She wants to put patients at the center, where they belong. That’s why I suggest that she call herself a PCM, a patient-centered midwife.