Jill Duggar Dillard is not a real midwife; she’s a CPM, a counterfeit professional midwife

Rooks quote

Cosmopolitan Magazine reports Jill Duggar Adds an Impressive New Job to Her Résumé.

According to her husband, Derrick Dillard:

It’s official; my wife is a midwife!

Not exactly.

Jill Duggar Dillard did not become a midwife. She became a counterfeit midwife. She was awarded an ersatz credential (CPM, certified professional midwife) designed to fool the public into believing that lay people who can’t be bothered (or can’t hack) the education and training needed to become a real midwife are “midwives” nonetheless. The CPM really means “counterfeit professional midwife.”

The CPM credential is a public relations ploy, not a medical credential and it is a testament to its effectiveness as a public relations ploy that most Americans don’t realize it is a counterfeit midwifery degree. It is not recognized by the UK, the Netherlands, Canada or Australia because it doesn’t meet the international standards for midwifery education and training. Indeed, the US is the only country in the industrialized world that has a second class of counterfeit midwives in addition to real midwives (certified nurse midwives).

Consider:
[pullquote align=”right” color=”#e7c7a1″]Why are the minimum standards so low, especially in comparison to counterparts around the world?[/pullquote]

It’s hard to become a doctor.

It takes four years of college, followed by four years of medical school, followed by 3-5 years of internship and residency. That’s challenging.

Imagine if you couldn’t be bothered (or couldn’t handle) the necessary preparation but wanted to masquerade as a doctor anyway. I don’t mean simply pretending that you are a doctor when you are not, but rather awarding yourself a counterfeit MD degree (CMD) that involved only a correspondence course and trailing around after another counterfeit MD for a while. Would a CMD be a real medical doctor? Of course not; but with a “CMD” after your name, you might be able to fool the gullible and less knowledgeable into thinking that you were a real doctor and into paying you as if you were.

It’s hard to become a certified nurse midwife. CNMs are the best educated, best trained midwives in the world. They have an undergraduate degree in nursing, a master’s degree in midwifery, and extensive hospital training in diagnosing and managing birth complications. European, Canadian and Australian midwives are also well educated and well trained; they have an undergraduate degree in midwifery and extensive hospital training in diagnosing and managing birth complications.

Imagine that you couldn’t be bothered (or couldn’t handle) the necessary preparation but wanted to masquerade as a midwife anyway. You could simply take a correspondence course, attend a few dozen deliveries outside the hospital, pay money for an exam and voila: you are a CPM. Actually, you don’t even have to complete even those minimal requirements. You can simply submit a “portfolio” of births that you have attended, pay the money and take the exam, and voila, you too are a CPM.

The CPM (any similarity to CNM is unlikely to be coincidental) was created by a group of lay midwives who promptly awarded it to themselves. How do they justify calling themselves midwives, and charging thousands of dollars for their services, when they have no midwifery training? They insist that they don’t need real midwifery training because they are “experts in normal birth.”

That makes as much sense as a meteorologist who’s an “expert in sunny weather.”

No one needs an expert in normal birth; if the birth is uncomplicated a taxi driver can do it and legions of taxi drivers have done it successfully and for free. The only reason to have a professional birth attendant is to prevent, diagnose and manage complications. CPMs cannot do that because they aren’t real midwives, they’re counterfeit.

Judith Rooks, CNM MPH, a highly respected leader in the world of real midwifery was interviewed in 2013 about the CPM credential.

She noted that the CPM is a way to avoid the rigorous midwifery training required everywhere else:

…[M]any young women who want to become midwives seem to think it is too much bother, time or money to complete an actual midwifery curriculum and think it is enough to just apprentice themselves to someone for a minimal number of births, study to pass a few tests, and become a CPM that way.

Rooks gets to the heart of the matter:

The lingering questions then become why are the minimum standards so low, especially in comparison to counterparts around the world? Why is it acceptable for midwives to aim for the cheapest, quickest route instead of striving to be their best? Why are the “certifying” bodies (ie NARM/MANA) keeping the bar so low…as in only requiring a high school diploma as of 2012 instead of requiring a college level education to deliver our babies?

Why are the minimum standards so low? Because the CPM isn’t an academic credential; it’s a public relations ploy designed to falsely reassure women that CPMs meet the same international standards as midwives in the Netherlands, the UK, Canada, Australia and all other first world countries. It’s been an incredible success as a public relations ploy, but it is been a horrific failure by the measure that really counts: safety.

EVERY study conducted on American homebirth (including studies by homebirth midwives themselves) has shown that homebirth (planned, with a licensed midwife) has a death toll up to 800% higher than comparable risk hospital birth.

That’s just what we would expect if we were to replace real midwives with counterfeit midwives.

The CPM ought to be abolished, but until it is, it is literally a matter of life and death that women understand that CPMs like Jill Duggar Dillard aren’t real midwives, they are counterfeit midwives. They are women who couldn’t be bothered (or could not manage) to meet the international standards for midwives.

If some women want to hire counterfeit midwives, they are free to do so, but they must never forget they are hiring lay people masquerading as midwives, not real midwives and their babies may pay the price.

1,175 Responses to “Jill Duggar Dillard is not a real midwife; she’s a CPM, a counterfeit professional midwife”

  1. kmeinig
    April 18, 2018 at 11:59 am #

    I don’t know where you are getting your information from, or if you have been burned by an incompetent CPM somewhere along the way, but your statements are derogatory and your statistics are incorrect by a long shot.

    CPM’s must undergo quite extensive training to become eligible to sit for the national exam. They can’t just make up their “portfolio” and submit it. Stating that these women chose the CPM route over becoming a CNM because they “couldn’t be bothered” in today’s world of skyrocketing secondary education costs is downright classist. Many CPM’s serve lower-income communities, and several do so because they came from those very communities themselves. Telling those women that their credential sucks because they could not afford 4-5 years for a bachelor’s in nursing and then another 2-3 years of graduate school just showcases your privilege and elitism.

    I am proud to work for a large birthing center that employs both CNM’s and CPM’s. I have seen these women save lives based on the personal relationship they develop with clients – my old GYN never even got my name right from appointment to appointment. Sure, there are bad CPM’s out there, just like there are bad doctors, bad nurses, bad attorneys, etc.

    I would also like to point out that abolishing midwifery would work quite a bit in your favor financially as an OBGYN…but surely that didn’t influence this article at all…

    • April 18, 2018 at 12:50 pm #

      Dr. Tuteur is retired and has no financial interest in birth attendants.

      Really? They saved lives with personal relationships? Do tell more. Glad you have some CNMs on staff, but if a birth goes south about all a competent provider can do is transfer to the hospital, where there’s lifesaving equipment and trained personnel.

      You can toss terms like “privilege” and “elitism” around all day long, but providers who are literally responsible for the lives of laboring women and babies had better be properly trained and equipped–otherwise, they are screwing over the population they’re supposedly serving.

      Lower-income women should not have to put up with a pretend midwife who will charge them thousands out of pocket, be unable to do squat in case of emergency, and carry no insurance and take no respnsibility in case of screwups that lead to death or disability. Saying otherwise is a disservice to these families.

      There are bad obs. But look who saves lives–it ain’t the CPMs.

    • LaMont
      April 18, 2018 at 12:51 pm #

      Save lives based on relationships? So, if one of my best friends is a doctor (and she is!), does the fact that she has an education cancel out our relationship, should she need to advise me in an emergency? I’m curious…

      Also, why do you want women to put their lives in the hands of laypeople during the most medically dangerous thing a young woman is likely to do?

    • swbarnes2
      April 18, 2018 at 1:47 pm #

      I have seen these women save lives based on the personal relationship they develop with clients

      So you are claiming that your colleges are incapable of properly practicing on patients they don’t know well? That they literally can’t diagnose problems if they aren’t bosom buddies with their patients?

      We all read about Caroline Lovell’s CPM, who discouraged her client from calling 911 as she was bleeding to death in a birthing pool. Lovell likely would have survived if she had had no attendant, because she likely would have called 911.

      Sure, there are bad CPM’s out there, just like there are bad doctors, bad nurses, bad attorneys, etc.

      Bad nurses and doctors get fired and lose their licences. Bad CPMs brainwash their clients into covering up for them. We know this, because they write about how to do it. Worst case, they just slide into another state and start up again. We know this because that’s just the kind of practitioner who taught Jill Duggar, and her training from a woman that incompetent was considered by CPMs to be a good and solid foundation for her to be a CPM herself.

    • Empress of the Iguana People
      April 18, 2018 at 3:06 pm #

      I’m sorry your ob couldn’t get your name right. Mine knows my name, my spouse’s name, and both my kids’ names. I wouldn’t trade him for the best cpm in the world. He has the skills to deal with my pre-eclampsia

    • Who?
      April 18, 2018 at 6:02 pm #

      So selling rubbish training to poor people is ‘giving them an opportunity’?

      Rubbish. These cpm students are getting ripped off by their ‘trainers’. It’s shameful to sell crap masquerading as gold to people who through no fault of their own know no better.

      You are the elitist, thinking people who can’t afford a proper education deserve to be sold a junk one.

  2. QuiteContrary
    November 23, 2017 at 8:28 am #

    It undermines your argument to say “Consider: It’s hard to become a doctor.” It *is* hard to become a doctor, but then are CNM’s also counterfeit doctors?

    She’s pretending to be a nurse.

    Then this:
    “EVERY study conducted…home birth…has a death toll up to 800% higher than comparable risk hospital birth. That’s just what we would expect if we were to replace real midwives with counterfeit midwives.”

    What? Those are the statistics *including* “real midwives.”

    You can’t make the point that all midwives are shit medical professionals, AND ALSO that it matters if Jill Duggar is a real or counterfeit version.

    Pick. Is a CNM a worthwhile profession and credential, or isn’t is?

  3. Andrea
    November 8, 2017 at 7:56 pm #

    You are being ridiculous. She is a real midwife . You mean that she is not also a nurse. She has full training in midwifery. Furthermore no one thinks a darn things about the thousands of babies that die evert year in hospital! Study Ina May Gaskins. Delivered over 1009 lbabies at home.97% success rate. A woman is far more likely to have Complications dang it from all the interventions in hospitals. The US has a terrible track record.

    • Amy Tuteur, MD
      November 8, 2017 at 9:55 pm #

      No she is not a real midwife. Certified professional midwives (CPMs) do not meet the international standards for midwives in ALL other industrialized countries. They would not be eligible to practice in the UK, the Netherlands, Canada, Australia or anywhere else.

    • thejungle137
      November 21, 2017 at 1:04 pm #

      She is NOT being ridiculous. She is being truthful and factual. Jesus, NOTHING the Duggars do is genuine. You don’t know this? They’re not real anything, not even real missionaries.

  4. Liza
    June 14, 2016 at 3:17 am #

    http://www.bmj.com/content/330/7505/1416
    What’s sad is the misinformation given in this article. Wake up people, smh.

  5. Erica Lea
    November 16, 2015 at 10:00 am #

    Actually, did you know in the state of FL, LICENSED midwives have the
    SAME level of education as any CNM? In fact, we Licensed Midwifery
    students receive more hands on training (in the form of clinical hours
    with a CNM or LM) than a CNM student when it comes to midwifery,
    pregnancy, birth, postpartum and newborn care. Did you know that we
    have to attend more births in order sit for our STATE BOARDS than a CNM
    is required to? Did you know that we are REQUIRED by the state of FL to
    carry malpractice insurance? Did you know that our protocols are
    directly written into our governing LAW? I think Women on this board
    need to do a *bit* more research if they are going to attack a fellow
    woman. No wonder you people talk the way you do… You’re just as
    uneducated as you are projecting LICENSED midwives to be. And just so
    we’re clear, I attended clinic under a very respected CNM in FL… who
    practices out of hospital births. I also attended clinic alongside
    several other midwives (one with over 35 years in the field) *while*
    completing my didactic work as well… CNM’s finish their didactic work
    before going to clinicals, a time where they are cramming so much
    information it’s hard to actually remember the material. And then they
    are sent off to clinic where they then have to learn what real-life
    midwifery is all about. Licensed Midwives in the state of FL have to
    attend over 1200 clinical hours, 80 births with a preceptor who has been
    licensed for at least 3 years and manage an exponential amount of
    prenatals, births and newborn exams. Please stop staying that we are
    uneducated.

    • Megan
      November 16, 2015 at 10:36 am #

      80 births is nothing. It’s telling that you think that’s adequate training given that complications of birth are measured per 1000 births. And when the shit hits the fan at home, none of your training matters at all when you have minutes to save a baby’s brain function or prevent mom from bleeding out and lack the resources to do so. Even if I were willing to take the time to check your assertions of CNM vs. CPM training int he state of FL, it wouldn’t change my mind because home birth with a US home birth midwife is less safe than a hospital birth.

      • Bombshellrisa
        November 16, 2015 at 11:52 am #

        There is no minimum listed in the CNM curriculum because a student will easily see more than that at a teaching hospital, especially since a CNM will have already done L&D as an RN student.

        • Dr Kitty
          November 16, 2015 at 1:40 pm #

          Yup.
          I saw 20 births as a student in the single week I was on L&D. There were also midwifery students there, doing 8 week placements. Every year of their four year degree…

          Even if they saw fewer births because they were with women from start to finish of labour, they would still see 5-7 births/week.

          80 over 3 years is NOTHING.

          I’ve probably been at well over 100 deliveries, and I still wouldn’t have the necessary skills or experience if it all went pear shaped, which is one of the many reasons I don’t attend births.

    • Dr Kitty
      November 16, 2015 at 10:38 am #

      You have a nursing degree like a CNM?

      You think it is a good idea to do the didactic alongside the practical. It isn’t.
      Far better to learn the theory underpinning the practice and then learn how to put that into practice rather than spend hours in a clinic not understanding what is going on around you, because you haven’t got to that chapter in the book yet. I’ve done clinical rotations as a medical student both ways. The one where you already know what is going on and why and where you don’t waste time with stupid questions or misconceptions is better.

      Midwifery isn’t rocket scuence, but the reason Florida wants you to have more hours and more births is because your knowledge base isn’t as broad or as deep as someone who has already done a nursing degree and spent hours on hospital wards before she starts her midwifery training.

      I attended 20 births in a WEEK as a medical student. 80 births over many months doesn’t impress me.

      • Bombshellrisa
        November 16, 2015 at 11:54 am #

        They are attending 80 births in 3 years, that is how long the program is. I would think that attending only 3 births a months would leave a midwife quite rusty but I guess “trust birth”.

    • demodocus
      November 16, 2015 at 10:39 am #

      They have both a bachelors and a masters in a biology related field?

      • yugaya
        November 16, 2015 at 11:02 am #

        Methinks this is either Abby with a vengeance or one of her equally butthurt ( and ignorant) classmates.

    • yugaya
      November 16, 2015 at 10:53 am #

      “Actually, did you know in the state of FL, LICENSED midwives have the SAME level of education as any CNM.” No they don’t.

      And if you really want to learn about the abysmal education and training that Florida CPMs are getting, check out Leigh Fransen’s blog: http://www.honestmidwife.com/ She’s a former Florida-educated CPM.

      Let me know if you need help navigating it in order to read about how she was trained to illegally administer cytotec without consent or informing the clients, or the one about illegal use of vacuum and how (usually first time) mothers were separated from everyone else, locked in a room and blindfolded to enable that illegal practice.

      • yugaya
        November 16, 2015 at 11:00 am #

        ” Did you know that our protocols are
        directly written into our governing LAW?”

        Yes I know there is regulation in place. I also know that the OBs in Florida are nowadays after per regulation required consultations about risks writing in medical records “valid for hospital birth only” to prevent widespread abuse by homebirth LMs of their credentials and that regulation in order to take on insanely high risk homebirth clients.

        I can name a dozen LMs who have taken on clients they should have risked out. I can also tell you which CPM who is banned for life from practicing midwifery in the state of Florida was earlier this year “catching babies” pretending to be just a doula in an unregistered birth center. I can also tell you which Florida midwife currently under investigation boasts on her website about accepting HBA3C clients, and which one advises women with recent surgery and a bunch of other automatic risking out factors that she is an acceptable client for a homebirth in her center. And so on and so on….

        I wish that this excellent protocols of care regulation written into the law in Florida was enforced more often.

    • Daleth
      November 16, 2015 at 11:25 am #

      I’m actually really sad for you that you have been fed such ignorance by people who were supposed to be giving you an education.

      There is no state in which CPMs are required to have even close to the same level of education as CNMs. Here is a handy chart–what it says is true in every state:

      http://www.midwife.org/acnm/files/cclibraryfiles/filename/000000001031/cnm%20cm%20cpm%20comparison%20chart%20march%202011.pdf

      If you can point me to a link that shows the situation is different in Florida, I’d be glad to look at it. The problem is, though, that you can’t–you’ll find that out when you start looking for such links–because the situation in Florida is as bad as it is in the other 28 states where CPMs are allowed to practice.

    • Bombshellrisa
      November 16, 2015 at 11:45 am #

      https://nursing.uw.edu/sites/prod/files/wysiwyg/NM-DNP-Grid.pdf
      Education required for a CNM. Since the University of Florida no longer offers the CNM program, I had to go with the curriculum from another school. The prerequisites for entering a CNM program would be to already have a bachelors in nursing.

      http://midwiferyschool.org/admissions/prerequisites/
      The requisites for entering midwifery school include a high school diploma, doula training and being a child birth educator. Having college level biology is not required.
      http://midwiferyschool.org/pdfs/curriculum-glance-2015.pdf
      Compare the two curriculum side by side, there is no comparison.

    • PrimaryCareDoc
      November 16, 2015 at 11:58 am #

      80 whole births! Wow! That’s amazing!!

      Oh, sorry. The word I was looking for was pathetic, not amazing.

      The risk of severe PPH in a low-risk woman is 1.3%. That means that you likely will not see it in your 80 births. The risk of shoulder dystocia in a low-risk woman is 0.5%. You almost definitely won’t see that in 80 births. Risk of cord prolapse in low risk women is 1 in 1000. Definitely won’t see that.

      Tell me again about how educated a prepared you are.

      • Life Tip
        November 16, 2015 at 12:17 pm #

        But she’s a fellow woman and making such a compelling use of ALL CAPS. Maybe we should just all be supportive, mkay? School is hard.

        • PrimaryCareDoc
          November 16, 2015 at 12:28 pm #

          Does she think she gets brownie points for being a “fellow woman”? Incompetent practitioners don’t get a pass from me, no matter their gender.

          • demodocus
            November 16, 2015 at 12:54 pm #

            As a doc, you, like Dr. T, automatically belong to the boys’ club that is modern medicine. You’ve probably lost touch with your own inner ancient wisdom or something. Natch.

          • Roadstergal
            November 16, 2015 at 1:03 pm #

            A naturalwisdomectomy is a requirement for any modern medical program, you know.

      • yugaya
        November 16, 2015 at 12:21 pm #

        And she thought she made such a solid point by smugly advising people on this blog ” to do a *bit* more research if they are going to attack a fellow woman”.

        Burnnnnnnnnnnnn stupid!

      • Annitte
        November 16, 2015 at 10:23 pm #

        Well a bit more likely than you would see it in the 20 births you observe in the CPM course. I would further add that That is in addition to being a registered nurse.
        A normal birth, anyone can deliver. 6 year old children have delivered their siblings, women have given birth alone. To be a person who has watched 20 births is no training especially when you consider that they have no other medical training,

        If I and hiring a midwife I am hiring her to know when something goes wrong and what to do about it.

      • s pag
        August 12, 2016 at 6:22 pm #

        I’ve managed all of the above complications as a student midwife. Under the supervision of senior licensed midwives, as per our state law.

        • Amazed
          August 12, 2016 at 8:28 pm #

          Really? Let me doubt it. It’s statistically very unlikely that you have encountered all of the abovementioned complications. You didn’t even know that cord prolapse in non-hospital environment means an almost certain death, or else you would not have bragged about it. But please keep enlightening us at how well they teach you to blow air off your rear end. Hint: they aren’t doing a very good job.

          • PrimaryCareDoc
            August 12, 2016 at 8:41 pm #

            Oh, man, I forgot about this thread. I’m gonna re-read it. It’s better than sex.

          • Amazed
            August 13, 2016 at 5:19 am #

            That’s because you’re a doctor. I guess I would have thought it better than sex if it had something to do with literature and translations.

            It’s amazing anyway.

          • Valerie
            August 12, 2016 at 9:08 pm #

            The odds of seeing at least one of each PPH, shoulder dystocia, and cord prolapse in 80 births is about 1.6%, by my calculations. Not reassuring.

    • Bombshellrisa
      November 16, 2015 at 12:53 pm #

      http://www.midwife.org/ACNM/files/ACNMLibraryData/UPLOADFILENAME/000000000076/Mandatory%20Degree%20Requirements%20Position%20Statement%20June%202012.pdf
      As of 2010, completion of a graduate degree program became a requirement for certification and entry into clinical practice as a Certified Nurse Midwife

  6. SweetBabyJesus
    October 28, 2015 at 8:47 am #

    The part where Dr. Amy Tuteur says that I am WRONG with my stats, then gives me the very same figure that I have already given her. She just doesn’t want me to apply it to any real case and see how women are ACTUALLY affected by childbirth. But I did it anyway and I’ve gotta say guys, it’s a good day for educated homebirth midwives everywhere.

    And just to go on record, she is backing up my calculations so any of you who told me I was wrong or came up with your own bobo figures–SUCK IIIIIT! And to anyone that I brought the word “fuck” out of–way to lose your cool dude. That’s what happens when an egomaniac has their shit thrown up in their face. All the fucks in the world can’t salvage your erroneous blabber.
    —————————–
    (Here’s the rest of my response too:)
    So anyway it’s all about applying that relative risk to the case at
    hand. Saying that something is 1.2 times more likely to cause neonatal
    death is relative to the baseline risk of the person you are So if we
    have a mother who is (just going to make up a number here) at a 10% risk
    level for giving birth because of her complicated medical and
    obstetrical history, we are going to multiply the relative risk of
    homebirth (1.22) to her risk level and get the figure 0.122 or 12%. Now
    this woman’s risk level has gone from 10% to 12% based on the decision
    to have a homebirth. A 2% increase is quite a jump and of definite
    statistical significance!

    Of course this is all
    hypothetical–someone at an initial risk level of 10% would not qualify
    for safe homebirth anyway–I just wanted to show the significance of how
    when someone’s baseline risk is higher then that added risk of
    homebirth is going to increase exponentially. Conversely, if a woman is
    considered uncomplicated/low-risk and only has a 0.13% baseline risk of
    giving vaginal birth then they move to a 0.16% increased risk when
    choosing homebirth. That’s a mere 0.03% increase in risk by choosing
    homebirth. If you apply the risks of having unnecessary medical
    interventions that might come from being managed by OBs that practice
    the way you think, then she might just decide that it’s worth bumping
    her risk 0.03% to avoid all of the things that come with those
    interventions.

    This is why I have said that homebirth
    should only occur with LOW RISK WOMEN and should utilize OB BACK-UP.
    Once they risk out of care (and we have a stringent risk screen in the
    state of Florida midwifery law CH 64B24) then it is safe to say they
    need to have their baby in the hospital. And I am ok with that, Dr. Amy.
    The hospital is for people who need it–just not the ones who decide to
    accept the fractional risk of homebirth and choose another route.

    Again,
    please feel free to check my math on this, or provide another argument
    such as I have that utilizes scientific facts and figures, not an Ad
    Hominem arguement where you try to discredit my intelligence. You know I
    am proving myself.

    • PrimaryCareDoc
      October 28, 2015 at 8:55 am #

      Again…you’re not using the right formula. You’re not interpreting anything right.

      I think we’re all pretty much done with you, Abby Reichardt. You have demonstrated that you’re incapable of understanding, and your response to being told that you are wrong is to dig your heels in, put your hands over your ears, and say, “LaLaLa I can’t hear you!!”

      In other words, you’ll make an excellent home birth midwife.

      • yugaya
        October 28, 2015 at 9:03 am #

        Abby Reichart? Jesus fucking Christ, apparently she is an edmucator in the cesspool of ignorance that is Florida School of Traditional Midwifery ( how appropriate). Also:

        “$158USD
        Name Abby’s baby
        Abby Reichart, our Academic Director, is expecting her first child mid-October. For $158, Abby will consider naming her baby after one of the donors- unless the name is too crazy- in which case she will have to check with her husband.”

        http://webcache.googleusercontent.com/search?q=cache:HosdvaSJBfsJ:https://www.indiegogo.com/projects/midwifery-is-catching+&cd=4&hl=en&ct=clnk&gl=hu#/

        • PrimaryCareDoc
          October 28, 2015 at 9:07 am #

          I wonder how Abby Reichardt’s school feels about her using her real name and school/workplace email to demonstrate her ignorance.

          • yugaya
            October 28, 2015 at 9:16 am #

            Given what a lot of idiots they are, they will think this is good marketing. I mean, she thinks this exchange makes her look smart. :)))

          • MaineJen
            October 28, 2015 at 9:23 am #

            Is she going to include the “fuzzy math” part of the conversation?

        • MaineJen
          October 28, 2015 at 9:22 am #

          WTF? Really?

        • Megan
          October 28, 2015 at 9:28 am #

          Academic Director? I don’t know whether to laugh or barf.

          • yugaya
            October 28, 2015 at 9:30 am #

            In a village full of idiots, it is to be expected that the idiot of her size gets to play teacher.

          • Squillo
            October 28, 2015 at 11:48 am #

            I doubt “Academic Director” is a teaching position. In most schools, it’s purely administrative.

          • yugaya
            October 28, 2015 at 12:19 pm #

            She is in charge of evaluating course materials, curriculum, faculty members and students: http://www.midwiferyschool.org/pdfs/faculty-handbook.pdf

            God help those who end up giving birth with Florida School of Traditional Midwifery fake midwives in attendance.

          • Squillo
            October 28, 2015 at 12:23 pm #

            Well, that’s kind of frightening.

          • yugaya
            October 28, 2015 at 12:25 pm #

            Agreed.

          • PrimaryCareDoc
            October 28, 2015 at 12:30 pm #

            From the linked document:

            Use of a FSTM e-mail or IP address to engage in conduct that violates FSTM policies or
            guidelines. Posting to a public newsgroup, bulletin board, or listserv with a FSTM e-mail or
            IP address represents FSTM to the public; therefore, you must exercise good judgment to
            avoid misrepresenting or exceeding your authority in representing the opinion of the
            company.

            Uh oh.

          • Roadstergal
            October 28, 2015 at 12:32 pm #

            She was insulting OBs and denying that there are any risks to homebirth or vaginal birth. I’m thinking that they consider that to be good judgment.

          • yugaya
            October 28, 2015 at 12:35 pm #

            Ouch.

          • Bombshellrisa
            October 28, 2015 at 12:31 pm #

            It says she is the coordinator not director.

          • Squillo
            October 28, 2015 at 12:31 pm #

            Even more likely to be administrative, I imagine.

          • Charybdis
            October 28, 2015 at 5:23 pm #

            Both. You could larf.:P

        • Roadstergal
          October 28, 2015 at 11:08 am #

          Is ‘Innumeracy’ worth $158?

          • Who?
            October 28, 2015 at 9:17 pm #

            Harsh.

            But funny,

        • The Computer Ate My Nym
          November 16, 2015 at 11:01 am #

          All she actually promised was that she’d consider naming the baby after the donor. She never said she would name the baby after the donor. For $158 I’ll consider changing my name yours. I won’t do it, but I’ll consider it.

      • Amazed
        October 28, 2015 at 9:10 am #

        How did you find out her real name? Did she give it?

        • PrimaryCareDoc
          October 28, 2015 at 9:11 am #

          The idiot posted a screenshot of her email convo with Dr. T. Her real name is on it. I’d never dox someone. The fool did it herself.

          • Amazed
            October 28, 2015 at 9:13 am #

            Oh I didn’t mean that you would. And Dr Tuteur never gives up names. I figured it would have been her. I was just curious how.

          • yugaya
            October 28, 2015 at 9:13 am #

            She is the gift that just keeps on giving. Hopefully all of her potential clients will end up reading this blog before they run in the opposite direction.

          • PrimaryCareDoc
            October 28, 2015 at 10:39 am #

            Well, it’s too bad for Abby Reichardt that Dr. T’s blog ranks so high in search engines. It’s sure to come up.

        • yugaya
          October 28, 2015 at 12:24 pm #

          She posted on this public forum of her own accord this SS at the end of that long comment of hers on top ( I’m repeating it in case she manages to somehow come to conclusion that at his point she can just limit further damage by deleting her entire account):

      • Megan
        October 28, 2015 at 9:11 am #

        This would all be funny if it wasn’t so sad.

      • Barbara Delaney
        October 28, 2015 at 12:14 pm #

        From The Florida School of Traditional Midwifery’s most recent catalogue;

        “Professionalism: Students should act professionally in dress, speech, and demeanor (see Appendix for specific information). Public opinion of midwifery and related professions is shaped through impressions of individual practitioners and students. Common sense standards of behavior and appearance are expected of FSTM students. Care providers are sensitive to the impression clients receive from students associated with their practices. A student’s failure to meet behavioral expectations could result in dismissal from a preceptor site or from the program.”

        How do you suppose her colleagues would asses Abby Reichardt’s professionalism based on her comments on this site over the past several days? Would her attacks on physicians meet with their approval? Would her use of language including “STFU”, “stuff it”, addressing other people as “dude”, “bucko”, her braggadocio and demonstrable mathematical errors concern them?

        • monojo
          October 28, 2015 at 9:16 pm #

          “Braggadocio”, that’s EXACTLY the word. Thank you!

        • Bombshellrisa
          October 29, 2015 at 2:48 am #

          One can only hope screen shots were sent. The only thing is I don’t think that anyone there would do anything but praise her for her antics here.

    • yentavegan
      October 28, 2015 at 9:02 am #

      The average mother contemplating a homebirth trusts ( because she has been socially conditioned to trust) the midwife she hires. Here in the USA homebirth midwives practice their profession without liability insurance and homebirth midwives often lack the university level education to recognize when they are practicing outside their scope of expertise. Yes in the perfect world midwives would work collaboratively with medical professionals. MIdwives would be legally permitted to transfer her patients to a hospital/ob/gyn seamlessly if need be. But this is not the case so all the risk statistics are useless.

    • Daleth
      October 28, 2015 at 11:05 am #

      Abby Reichert, oops, Abby Reichardt–sorry for the misspelling–you’re doing the math wrong, as multiple people have explained.

      If you can’t even accept that you have made a mathematical mistake when people point it out to you, it’s no wonder you believe yourself incapable of making a medical mistake.

      As a midwife, you’re going to kill someone someday.

      • Roadstergal
        October 28, 2015 at 11:32 am #

        When it comes to her clients, they probably haven’t had enough math to prevent her from baffling them with bullshit. The way she falls back on Attack Mode when corrected is all you need to know about her ‘education’ when it comes to pregnancy and birth.

        With all of her comments about being a Proper Medical Professional, however, I can’t help thinking what a hoot she would be at Grand Rounds.

      • Sue
        October 29, 2015 at 2:10 am #

        And with logic like that, how could she manage to schedule ANYTHING?
        http://midwiferyschool.org/pdfs/student-handbook.pdf

        • Daleth
          October 29, 2015 at 10:24 am #

          I bet everyone there has an AMAZING GPA, if she calculates it…

    • Cartman36
      October 28, 2015 at 1:05 pm #

      Dear Abby,

      Lay midwives are the dangerous equivalent to what a lay pilot would be. Imagine if you had to get in a commercial aircraft with a pilot and co-pilot who had only ever trained in a simulator in “normal weather conditions”. You wouldn’t do that right. But now imagine that the airline went to great lengths to ensure you were fooled into thinking that they had as much experience as a pilot who had actually flown this type of aircraft. You would feel deceived and angry. If the flight (flown by lay pilots) crashed and the airline said some people are meant to die in aviation accidents or this crash isn’t even “a blip” on their radar you would be outraged.

      That is what the regulars here at SOB understand about lay midwives. NOTHING that you say and no “evidence” you present will convince us that ANY lay midwife could POSSIBLY be a safe choice for pregnant women and babies.

  7. SweetBabyJesus
    October 27, 2015 at 10:16 pm #

    It’s been fun kids. Feel free to math-check me on the stats. I sent it over to Dr. Amy too. I’m sure she’ll just tell me something insulting and explain that having an 8-year degree means that she is a better human being. Or whatever. See you soon! I’ll be around–this is just too good to pass up.

    • Amazed
      October 27, 2015 at 10:18 pm #

      Big girl! Don’t go away! I’ve been waiting breathlessly for your mighty brain to make the research on baby Gavin Michael’s death! You promised you’d look it up since you were so open to the truth about unqualified CPMs.

      What are you going to say about this baby and the droves of CPMs, you great human being?

    • PrimaryCareDoc
      October 27, 2015 at 10:29 pm #

      In case you missed my calculation downstream, your decimals are off. I get that there is a 10% increased risk for home birth in our theoretical woman.

      That risk is enough to make me go running to the nearest hospital.

      Now, my numbers might be off. Let’s say I’m off by a factor of 10. Even a 1% increased risk would make me run to the hospital. That’s 1/100.

  8. SweetBabyJesus
    October 27, 2015 at 8:39 pm #

    Best yet?

    Midwife? Burrrrrn herrrrr! BURRRRN HERRRR!

    • Bombshellrisa
      October 27, 2015 at 8:44 pm #

      Katie, is that you? If not, you aren’t the first person to say it but the only people who have ever said it here have been CPMs.

      • yugaya
        October 27, 2015 at 8:46 pm #

        No, she’s not Katie dearest. Katie is a sociopath, not an idiot.

      • SweetBabyJesus
        October 27, 2015 at 8:49 pm #

        Don’t memes make it so much funnier?!

        • Bombshellrisa
          October 27, 2015 at 9:27 pm #

          You just insulted yourself. You have stated that we have had the experience of dealing with isolated cases of bad behavior by CPMs. That might be true, but you haven’t made a case for being the exception. I would like you to think about this very hard: you are aspiring to provide healthcare to women. In that capacity, you will be in the position to have to be the bearer of bad news and also inform women about things they may not want to hear. You have said you are going to adhere to a very strict risking out process and so there will be women seeking your care who are going to disagree with you, who are going to hurl insults at you and who are going to have unhappy family members too. Are you going to react in the same fashion you have to the people on this board? It only gets harder from here.

          • SweetBabyJesus
            October 27, 2015 at 9:33 pm #

            How can I make my case to a brick wall mortared with hate-filled zealots like you all? HOW? What else can I say?

            I am willing to take on the responsibility of caring for women and family because I know how to stay in my lane, practice within my scope and receive advisement from backing physicians who we work with DAILY. I will see heartbreak and death at some point–all birth workers inevitably do–but it will not happen as a result of my own ignorance or poor practice.

            You won’t believe a word I am saying–you don’t have to. You will watch it play out year after year as more states legalize midwifery and make stringent standards that keep the Duggar idiots out of practice. And I will smirk and think back to this time we’ve all had together.

            Oh and I kinda just want to say to you personally: STUFF IT.

          • KeeperOfTheBooks
            October 27, 2015 at 9:36 pm #

            Will you say the same thing to a mother who wants to know what you have to say to the fact that her baby died in your care, but would have survived in a hospital? A mother who’s angry and hurting and wanting to know why you didn’t tell her that her risk of losing her baby was twice as high in your care as it would be in a hospital?
            Because from what I’ve seen, that would be standard CPM practice. I genuinely hope that won’t be yours, but if this is how you respond to one of the more courteous people here, I can just imagine how you’ll handle a tearful, hysterical woman who wants to know why you killed her baby.

          • SweetBabyJesus
            October 27, 2015 at 10:05 pm #

            The mother’s informed choice involves her assuming the risks that I will clearly lay out from the start. She will know that her choice comes with risks and that as long as I have done my due diligence then I am not the one at fault. And I will not dump her off or abandon her, I will stand by her side and process the grief with her.

            I apologize if I was rude. If you’re associated with this crew then I assumed you were full of acid like everyone else here. For two days I have been fighting off these wolves, and even when I admit fault they make fun of me.

            I did not mean to hurt your feelings. I am sorry for that @keeperofthebooks:disqus .

          • fiftyfifty1
            October 28, 2015 at 8:03 am #

            “as long as I have done my due diligence then I am not the one at fault”

            You don’t think it’s possible you could make a mistake?

          • DaisyGrrl
            October 28, 2015 at 8:06 am #

            She’s setting her patients up for the classic “she knew the risks” gambit.

            Classy.

          • PrimaryCareDoc
            October 28, 2015 at 9:45 am #

            Impossible, fiftyfifty! She never makes mistakes. No CPMs do.

          • Daleth
            October 28, 2015 at 9:43 am #

            The mother’s informed choice involves her assuming the risks that I will clearly lay out from the start.

            Will you really? So that means you’ll show her the Cornell study, for instance, that looked at all low-risk full-term babies born in the US over a three-year period (almost 10.5 million babies) and found that they were four times as likely to die in a midwife-attended home birth (which almost always means a CPM) as in a midwife-attended hospital birth (which always means a CNM)?

          • Bombshellrisa
            October 27, 2015 at 9:46 pm #

            I live in a state where midwifery is legal, the biggest obstetrical malpractice case was actually involving CPMs. As the law is written, everything is pretty clear about how midwives can practice. There is even provisions for petitioning for hospital privileges but as yet, nobody has been granted that. I don’t know what that will lead to, time will tell. But I will say this, I have seen CPMs practice in perfectly legal and strict ways and be called out by clients who believed something they read on the internet, who saw fit to insult the midwife (who was beyond correct about something) and continue to make her life hell long after she transferred care. It comes with the territory of practicing within your scope and you will not be able to insult those people or even answer back in a respectful way.

          • SweetBabyJesus
            October 27, 2015 at 10:02 pm #

            That’s unfortunate. If the CPM is found in the court of law to practice within scope and make good decisions, then they will be released from litigation. The same thing happens to OBs. This is not a perfect system and babies just… die sometimes. (<–how many times will THAT be taken out of context!?) That is why we need to hone the system and develop fail-safe ways of seamless transfer.

            You're just taking a journey into the hypothetical without knowing a single thing about how I will or will not communicate with my future clients. In short, please be quiet and move on to something more concrete.

          • Bombshellrisa
            October 28, 2015 at 12:15 am #

            These are actual situations that have happened. More than once the mother wouldn’t transfer during a labor that the midwife could see was going to need more care than she could give but she couldn’t make the woman transfer and she couldn’t abandon the woman. The midwife was on the hook for that despite the fact that she was doing the right thing. Also have seen women who won’t agree to hospital birth when it’s likely their baby will need immediate help. You might be doing everything right, but it’s not all about the care that you give, it’s about the care that your client agrees to.

          • PrimaryCareDoc
            October 28, 2015 at 7:05 am #

            See. Here’s the thing. If a doctor is sued and in a court of law is found not-liable…the issue doesn’t just go away. His malpractice rates will go up. He will have to report that lawsuit to everyone for the rest of his practicing years. Jobs, hospitals where he wants to get privileges, states where he wants to get licensed, insurances that he wants to get contracts with. That lawsuit, where he was found in the court of law to be not liable at not at fault, will haunt him to the end of his days.

            Still want to be held to the same standards as a doctor???

          • fiftyfifty1
            October 28, 2015 at 8:01 am #

            “develop fail-safe ways of seamless transfer”

            The fact that you think this is possible says a lot about what you don’t understand about birth. Certainly it’s possible to improve a transfer protocol. But creating a system that *cannot fail* and is “seamless” where seams exist? No.

            If women labor separated from lifesaving experts and technology, some will inevitably not make it in time.

          • Roadstergal
            October 28, 2015 at 11:14 am #

            The most fail-safe way to have seamless transfer is to have the woman present in the hospital with her blood typed and matched, heplock in place, etc.

            Again – I thought ‘an ounce of prevention is worth a pound of cure’ was a folksy saying perfectly in tune with Ancient Wisdom Granny Midwives?

          • MaineJen
            October 28, 2015 at 9:26 am #

            Here’s the thing, SBJ: CPMs HAVE NO standards of practice. They don’t want them.

            Previously healthy babies do NOT just die without anyone noticing in a hospital. That is what monitoring is for.

          • Sarah
            October 28, 2015 at 9:05 am #

            You could start by not calling an older woman you don’t like a witch, and doing enough research to understand that the WHO don’t have a recommended section rate. You know, just as preliminaries.

          • Daleth
            October 28, 2015 at 9:39 am #

            I will see heartbreak and death at some point–all birth workers inevitably do–but it will not happen as a result of my own ignorance or poor practice.

            That is a terrifyingly arrogant attitude, Abby Reichart. Even doctors sometimes “see heartbreak and death” as a result of their own mistakes. For instance, a doctor might be ignorant of some extremely rare problem, or on one occasion engage in a poor practice–surgeons’ mistakes sometimes kill people, for instance; it even happened to Virginia Apgar, who saved so many babies’ lives by inventing the Apgar score.*

            It can happen to DOCTORS. To people with vastly more knowledge of their field than you will ever have.

            So what on EARTH makes you so convinced it could somehow never happen to you?

            * You can read this article to find out how the Apgar score saved lives, and also what the mistake was that she made that killed someone–pay close attention to how she handled that, BTW, because she was scrupulously ethical about it, and hopefully you will be too: http://www.newyorker.com/magazine/2006/10/09/the-score

          • yugaya
            October 29, 2015 at 12:47 pm #

            I loved reading that article, thank you for posting it.

          • Daleth
            October 29, 2015 at 9:50 pm #

            Wasn’t it great? You’re welcome.

          • Roadstergal
            October 28, 2015 at 11:12 am #

            “but it will not happen as a result of my own ignorance or poor practice.”

            No, it will come about as a result of your arrogance, and your inability to learn a blessed thing.

    • Who?
      October 27, 2015 at 8:52 pm #

      These are really nice photos of Dr T.

      Thanks for sharing.

      • SweetBabyJesus
        October 27, 2015 at 8:57 pm #

        Eh, good one?

      • SweetBabyJesus
        October 27, 2015 at 8:58 pm #

        Thank google. And for the fact that it’s a high res image. Gotta love the internet!

    • Sarah
      October 28, 2015 at 9:04 am #

      Ah yes, an older woman saying something you disagree with must be a witch. Your ageism is showing dear.

      • Roadstergal
        October 28, 2015 at 11:10 am #

        Sexist, too. Just like all of the midwives and doulas who are all “I am here to empower women!” and yet are the first to yell ‘witch’ and ‘cunt.’

  9. SweetBabyJesus
    October 27, 2015 at 8:29 pm #

    Ooo and this one! Because every balanced conversation where we discuss differing views and takes on the literature and come up with ideal practice models for all starts with… INSULTS!

    • Daleth
      October 28, 2015 at 9:44 am #

      She gives respect where respect is due. Not necessarily where you personally might WANT respect, but where you are actually DUE some respect because of your knowledge, skills, experience, wisdom, thoughtfulness, etc.

    • fiftyfifty1
      October 28, 2015 at 10:13 am #

      But it’s not FAAAAIIIRRR that nobody here respects me!! I came here to badmouth Jill Duggar for her totally fake midwifery education, but you didn’t praise me for that!! It’s not FAIR because MY fake midwifery education is gonna look so much more CONVINCING than Jill’s. I’m gonna be a WAY better snakeoil salesman than her. Don’t I get ANY respect for that!???

    • Roadstergal
      October 28, 2015 at 11:16 am #

      SBJ: It’s so _totally_ not fair that respect has to be earned!

  10. SweetBabyJesus
    October 27, 2015 at 8:25 pm #

    Just a few reminders: Jill Duggar is an idiot. And Dr. Amy is as zealous at the clay-mug toting patchouli spritzing woohoos out there–just in the opposite direction.

    • yugaya
      October 27, 2015 at 8:29 pm #

      ” Jill Duggar is an idiot.”

      Pot. Kettle.

      How many times have we seen CPMs come in here and tell us all about how “there are some other CPMs who are indeed dangerous, ignorant, idiots, reckless and killers”… only to discover that the quack dissing her colleague frauds was just as bad if not worse?

      • SweetBabyJesus
        October 27, 2015 at 8:30 pm #

        Do you find that out or is that your assumption. You know what assuming does @yugaya:disqus … I don’t even have to say it…

        • yugaya
          October 27, 2015 at 9:02 pm #

          I know what answering self-talk rhetorical questions does – provides further proof just how substandard your CPM education was in all aspects.

    • PrimaryCareDoc
      October 27, 2015 at 8:54 pm #

      Are you aware Dr. T is retired? She’s not pulling in a quarter million.

      • SweetBabyJesus
        October 27, 2015 at 8:55 pm #

        I think you’ve missed the point here. But thank GOD she is retired! Phew! No more extreme-o training being passed on to the new OB gen. Hopefully they can get a more balanced view from someone who isn’t on a holy crusade against midwives.

        • Fallow
          October 28, 2015 at 9:36 am #

          Dr. Amy’s views are pretty close to mainstream conventional. They only seem extreme to you because you want to feel like a martyred birth revolutionary, when you’re really just a narcissist birth junkie.

        • Daleth
          October 28, 2015 at 9:52 am #

          If you think following ACOG guidelines is “extreme-o,” you are the one who is extreme.

      • Who?
        October 27, 2015 at 8:56 pm #

        So what if she was? It’s no one’s business but hers; and whatever she is making it doesn’t involve killing anyone, so there’s that.

        • SweetBabyJesus
          October 27, 2015 at 9:29 pm #

          Oh OBs have killed people. They don’t carry the hefty malpractice that forces most doctors into a different specialization because their practice is risk free, ya know? They also see a much higher risk level and a wider patient pool than a CPM so it makes sense.

          I wasn’t the one to bring up money first–Dr. Amy did that. And MWs out there are banking people. They make less than teachers or garbage men in many cases. Hence the humor in the meme–you’ll catch up.

          And don’t feel bad if you smirked. We can all laugh at ourselves a little, eh?

          • fiftyfifty1
            October 28, 2015 at 8:10 am #

            ” They make less than teachers or garbage men in many cases. ”

            That’s because there are actual standards for those professions.

            Teachers need, at a minimum, a bachelors in teaching, strictly supervised classroom experience and a teaching license. They can’t just grant themselves a made up credential CPT, Certified Professional Teacher, because they went to school themselves, have always loved kids, and read Summerhill (twice!).

            And for garbage men, garbage is more than just a hobby. There are criteria for what they can and can’t collect. And unlike CPMs, they can’t just dump it anywhere and run if they don’t like what they have on their hands. There are actual standards.

          • Amazed
            October 28, 2015 at 8:15 am #

            As I wrote far down the thread, my grandmother moved her whole family to the town she was attending a teaching program in. She didn’t wail, “But there are no teaching programs in our village! I just have to become a CPT and I’ll teach’em fine, you’ll see!”

            That was 50 years ago. Cars were almost nonexistent in my part of the road. Methinks that SBJ would have howled in anguish, had she found herself in my grandmother’s shoes. Grandma? Meh. She wanted to be a teacher and she didn’t want to leave her family behind, so she found what worked for her.

            I guess that’s why she was a teacher and SBJ will be just a Certified Pretend Midwife.

          • KarenJJ
            October 29, 2015 at 9:19 am #

            Plus you need a licence to drive that truck. You don’t just get to make up one from the back of a weetbix packet and award it to yourself.

          • Fallow
            October 28, 2015 at 9:34 am #

            What a slimy thing to say about garbage collectors. They keep our society running, while performing a Sisphyean, dangerous, disgusting job. All the while, people talk about them like they’re jokes or rhetorical crutches. Sanitation workers deserve to be paid well. They definitely deserve to be paid more than fraudulent medical practitioners.

          • The Bofa on the Sofa
            October 28, 2015 at 9:36 am #

            You know, if being a garbage collector is such a great job and makes so much money, why doesn’t she want to do that? And if she doesn’t want to do it, then she can’t really complain about how much they get paid.

          • Daleth
            October 28, 2015 at 9:45 am #

            Word.

          • Roadstergal
            October 28, 2015 at 11:17 am #

            Garbage collectors show up on time when they’re supposed to. Every week. CPMs seem to struggle with that part.

          • Bombshellrisa
            October 28, 2015 at 11:59 am #

            The ones in my area make $100,000 between pay and benefits. They do work very long hours and are punctual. All the ones here wave and honk the horn at my son when we take him out to see the truck. So they are polite and kind to strangers, they understand they are setting an example as an adult doing a job that helps others.

      • SweetBabyJesus
        October 27, 2015 at 9:36 pm #

        Oh and you make money on the ads that you have on your blog. Dr. Amy still is getting that c-c-cash and you guys get the fortune of padding her pockets with targeting marketing from amazon and one of her extremist books! She’s really got a pretty good thing going if you ask me…

        Except for the extreme part. That really sucks for everyone, mothers who want transparency and choice after all.

        • KeeperOfTheBooks
          October 27, 2015 at 9:36 pm #

          Like the transparent fact that they’re twice as likely to lose their babies in your care than in a hospital?

        • lilin
          October 28, 2015 at 1:31 pm #

          She makes money off ads. You make money by putting babies in danger.

          Let me think about who I should trust. Oh, it’s a tough one!

    • MaineJen
      October 28, 2015 at 9:29 am #

      Claims retired doc is in it for the money.

      Accepts money in exchange for some random stranger naming her baby.

    • fiftyfifty1
      October 28, 2015 at 10:17 am #

      It’s pretty clear what your motives are. You know who your competition is. You have to convince your clients to give YOU their money. To do that you have to demonize both OBs and other fake midwives like Jill Duggar.

    • Azuran
      October 28, 2015 at 10:09 pm #

      Everyone is paid to do their work. Doesn’t mean they are in it for the money. Those who have higher paying job are not necessarily more in it for the money than others. Harder, more stressful jobs and jobs with higher stakes are usually paid better. It is entirely normal for an OB, who went through a long, expensive and hard training, who must keep her training up to date all the time, and who is now responsible for the well being of pregnant mothers and their babies (babies who are often more precious to the mothers than themselves) during one of the most dangerous time of their lives, is paid accordingly.

  11. KeeperOfTheBooks
    October 27, 2015 at 9:47 am #

    Related: have any of you been following Navelgazing Midwife’s (Barbara Herrera’s) blog at all? It’s rather interesting. Back when I was neck-deep in woo, I’d read it religiously. Then I didn’t for several years, but got curious and googled her a few weeks ago.
    She’s a CPM/LM of some kind who has been practicing for decades. However, she’s gradually, over the last 3-5 years, been evolving in her thinking about homebirth safety, and that was quite interesting to watch.
    She’s calling for much better training of midwives in medicine in general, particularly in CPR/first aid, and is actually calling out the idiots who are against this or who don’t take it seriously. She used to be very pro-HBAC, now she thinks it’s a stupid idea. Used to support minimal monitoring, now thinks that’s a bad idea. Etc. Heck, she specifically called out Christy Collins et all.
    It’s interesting watching her thinking on this stuff change as she looks at the studies, and it’s extremely refreshing to see someone with her level of intellectual honesty confront things that have to be difficult for her to face. I still disagree with her on a number of issues, but she strikes me as the sort of person I’d enjoy sitting down and having a good intellectual argument with about them, rather than someone who’ll just scream “nasty oppressive person who doesn’t trust birth!” at you before running screaming for the nearest “Peaceful” essential oil blend, y’know?

    • fiftyfifty1
      October 27, 2015 at 2:40 pm #

      I find her less idiotic than previously, but still pretty idiotic.
      It seems to me that when a person holds a cherished belief and then circumstances force them to really question it and reject it (e.g. when her daughter needed a CS), that this should make a person ask themselves “If I was so wrong about this belief, could I also be wrong about other similar cherished beliefs?”. But no. She is just a blinded by Dunning Kruger as ever before with her other beliefs.

  12. Stacy48918
    October 26, 2015 at 11:04 pm #

    Sweet baby jesus….. what an appropriate handle.
    That’s all I’ve got. 😛

    • yugaya
      October 27, 2015 at 8:33 am #

      Holy shit! is what I’m left with.

    • attitude devant
      October 27, 2015 at 6:14 pm #

      I just wish she’d stick the flounce…..

      • Bombshellrisa
        October 27, 2015 at 6:18 pm #

        Oh, but how else would we know that we are fear mongering meanies who don’t know how CPMs practice without her?

        • attitude devant
          October 27, 2015 at 6:19 pm #

          I just keep hearing the Pirates of Penzance:
          “We go, we go!” (“But they’re still here!”)
          “We go, we go!” (“But they DON’T go!”)

          • KeeperOfTheBooks
            October 27, 2015 at 7:32 pm #

            Mega bonus points for the G&S reference. 😀

          • Roadstergal
            October 28, 2015 at 11:18 am #

            “Dammit, they DON’T go!”

            *loves you*

          • attitude devant
            October 28, 2015 at 11:58 am #

            backatcha, babe!

    • SweetBabyJesus
      October 27, 2015 at 8:13 pm #

      Lame, at best.

      • Stacy48918
        October 27, 2015 at 8:22 pm #

        How about this one:
        Jesus H Roosevelt Christ!

        • SweetBabyJesus
          October 27, 2015 at 8:22 pm #

          now THAT’S what I’m talking about!

  13. moto_librarian
    October 26, 2015 at 5:18 pm #

    Every single time that a CPM shows up here, it merely hardens my resolve to see their fantasy credential legislated out of existence. No other developed country would allow a CPM or DEM to practice midwifery. The fact that OBs do not want to collaborate with CPMs has nothing to do with ego, but everything to do with liability. Why should they agree to back-up women masquerading as health care professionals knowing that they are the ones who will be sued since their midwife colleagues don’t carry malpractice insurance. In fact, if anyone has an ego problem, surely it is CPMs with their delusions of grandeur and persecution complexes.

    • attitude devant
      October 26, 2015 at 6:14 pm #

      I think the thing that makes my hair stand on end is her blithe assertion of statistics….that seem to come from nowhere, such as the claim that most maternal mortality is due to suicide, or that OBs only do 75 vaginal births in training.

    • Megan
      October 26, 2015 at 6:34 pm #

      I get as angry as I do because these people con women and play with their safety and the safety of their babies. It is infuriating that they can do this with no consequences and still dismiss/rationalize that what they are doing is harmful. The fact that they can’t understand why we get angry about the issue and the safety of mothers and babies just disgusts me. They are terrifying.

    • SweetBabyJesus
      October 27, 2015 at 8:15 pm #

      So many OBs ARE collaborating. Just not the ones who follow this hospital birth crusader. You don’t see what you don’t want to see. And if you want to do something about it…

      DO IT.

      • Daleth
        October 28, 2015 at 10:54 am #

        Really? Point us to some OBs who collaborate with CPMs. Better yet, point us to some CPMs who have hospital privileges.

      • moto_librarian
        October 28, 2015 at 12:00 pm #

        Oh sweetheart, I am indeed doing my part to see that these faux credentials go the way of the dinosaurs.

      • lilin
        October 28, 2015 at 1:42 pm #

        That’s kind of like saying that people negotiating a hostage crisis are collaborating with the people taking hostages.

        “Yes, Moon Dragon! A woman giving birth in a pool of water that she’s just shit it is a great idea. Do you think you could let me see if the baby’s heart is beating now? Thanks. Good collaboration, buddy!”

    • SweetBabyJesus
      October 27, 2015 at 8:22 pm #

      Oh and OBs won’t collaborate with idiots, like the Duggar lady. So behind that decision.

      Oh and OBs also have their hands tied in so much hospital policy that their free will in that is often non-existent. Godlike as they may be!

  14. SweetBabyJesus
    October 26, 2015 at 4:47 pm #

    http://www.acog.org/Resources-And-Publications/Committee-Opinions

    /Committee-on-Obstetric-Practice/Planned-Home-Birth

    I would like to end on a high note with everyone and I must say that we’ve had some fun today. I will leave you with some stats on homebirth from ACOG, the governing body of OB/GYNs (as most of you know–except Bofa maybe). They say that although the safest place for birth is in a hospital or home birth, that the choice rests with the mother. The real risks associated in Homebirth vs hospital birth, according to ACOG, are as follows:

    Neonatal death—all newborns
    Homebirth: 2.0/1,000
    Hospital Birth: 0.9/1,000
    (increased risk with Homebirth is 0.1%)

    Neonatal death—nonanomalous
    Homebirth: 1.5/1,000
    Hospital Birth: 0.4/1,000
    (increased risk with Homebirth is 0.1%)

    Episiotomy
    Homebirth: 7.0%
    Hospital Birth: 10.4%

    Operative vaginal delivery
    Homebirth: 3.5%
    Hospital Birth: 10.2%

    Cesarean delivery
    Homebirth: 5.0%
    Hospital Birth: 9.3%

    Third- or fourth-degree laceration
    Homebirth: 1.2%
    Hospital Birth: 2.5%

    Maternal infection
    Homebirth: 0.7%
    Hospital Birth: 2.6%

    I will end with this: The perinatal risk of having a homebirth over a hospital is 0.1% greater. The cesarean rates, 3rd/4th degree laceration rates, and maternal infection rates are lower in a homebirth setting. ACOG admits “The relative risk versus benefit of a planned home birth remains the subject of current debate. High-quality evidence to inform this debate is limited. To date there have been no adequate randomized clinical trials of planned home birth”, meaning that more research on homebirth could shed more light on the safety of the practice. With what knowledge we do have here, we can see that the overall real risk associated with having a homebirth is only slight and can in turn help the mother to avoid many medical interventions, a few of which are demonstrated here. I am not anti-hospital (or anti-cesarean), I am not anti-medical. I am pro-collaboration and pro evidence-based care. For those that want to paint me into a wacky free-birther category, pop off the blinders and accept that people are not so black and white as you would comfortably like to believe.

    For anyone who is vehemently against out of hospital birth, I urge you to consider these numbers and also to consider the risks that mothers and babies may be exposed to in a hospital when they receive unnecessary intervention under non-emergent circumstances. This fault does not rest solely with the OB community but the OB community has more tools than any to unravel the stringent hospital protocol that uses fear to mitigate all risks and therefore costly litigation (impossible!). We all have our own path to walk and our own truths to find, and mine will always lie with the evidence. Birth is not zero risk, life is not zero risk. Personally attacking midwives who are choosing this profession for the right reasons and the right goals is a travesty to obstetrical care at large. Diminishing maternal choice in healthcare options is a function of an outdated system where women’s choice overall is the subject of a patriarchal debate about “what’s best for her”. Women are deciding what is best for them, and many are deciding that the abuse and coercion that happens in some hospital settings is not their ideal way. Saving a life is exceedingly important to the birth process and no one can rightfully disagree. Quality of life is another story and one that deserves more than a brief thought. Breastfeeding, bonding, perinatal mental health, maternal choices and low-cost access to healthcare are strong reasons to question the status quo every step of the way and to consider that there is more than one way to approach obstetrical care.

    We have all of the evidence we need in the practice of several leading European countries that can work and DOES work. I charge you birth care providers out there to exit your comfort zone and train the midwife that you want to see practice. To expand your own awareness without judgment so that you can get in the heads of your patients and out of the doctor’s mindset. I am asking for your help in allowing me to do the same and several of you today have shared things that I have learned from. Do not be afraid to be impacted in the face of going against everything that you were taught. This is the evolution of evidence-based practice and your responsibility to uphold as a birth care professional.

    Thanks for listening and thank you to the very, very few who did not personally attack me but provided their own research-based evidence and logic (Houston mama you were kind in your approach and that kindness makes learning from you or anyone far more palatable.). Dr. Amy–I’ll still be around and I will still be questioning, as long as I live. Worlds are turned by such folks and we are in this together, polarized as we might be.

    • Karen in SC
      October 26, 2015 at 4:54 pm #

      I urge you to take off your blinders and become a CNM if you feel so strongly.

      The risk is real and translates to real babies that were healthy and alive before labor and dead at the end since their mothers were conned by women who don’t know what they don’t know.

      Do you think the mothers of the babies listed on this shirt would have cared if their nurse was mean? or they had to wear a hospital gown.

      • Karen in SC
        October 26, 2015 at 4:55 pm #

        Or the mothers in this video? https://www.youtube.com/watch?v=CRhkZKUNyMY

        • Karen in SC
          October 27, 2015 at 8:42 am #

          Can’t even acknowledge these babies, can you, Sweet? I think deep down you are afraid this will happen to you someday when you miss a breech, fail to test for GBS, take on a home vbac and the uterus ruptures, lose the second twin. Even if you risk out as you claim, how can you predict a PPH, notice if your client is having a stroke during labor, handle a tough shoulder dystocia without the resources of a hospital team, do proper neonatal resuscitation?

    • KeeperOfTheBooks
      October 26, 2015 at 4:54 pm #

      Neonatal death—all newborns
      Homebirth: 2.0/1,000
      Hospital Birth: 0.9/1,000
      (increased risk with Homebirth is 0.1%)
      Wait, what? Unless I’m missing something here, and that’s always possible, surely that’s a more-than-doubled risk, and an increase of 1.1%, not .1%?

      • SweetBabyJesus
        October 26, 2015 at 4:57 pm #

        0.0011 is 0.1%, no?

        • Karen in SC
          October 26, 2015 at 4:58 pm #

          Percent increase would be the difference in the two, divided by the base number, so 1.1/0.9 , times 100.

          • Amazed
            October 26, 2015 at 4:59 pm #

            Gods! And she thinks herself educated. I fear for any pregnant woman and baby that might cross her path.

          • The Bofa on the Sofa
            October 26, 2015 at 5:01 pm #

            This just goes back to the “it’s a tiny percentage” that we heard yesterday. Bah, deaths don’t matter, they are rare.

          • Megan
            October 26, 2015 at 5:04 pm #

            I guess basic math isn’t in the CPM curriculum.

          • moto_librarian
            October 26, 2015 at 5:21 pm #

            Remember, they weren’t even required to have a high school diploma or GED until recently.

          • SweetBabyJesus
            October 26, 2015 at 5:23 pm #

            I have a Bachelor’s. But thanks for the reminder.

          • moto_librarian
            October 26, 2015 at 5:25 pm #

            I have two masters degrees. What’s your point?

          • SweetBabyJesus
            October 26, 2015 at 5:27 pm #

            Your comment “Remember, they weren’t even required to have a high school diploma or GED until recently.” is what I referring to….

          • The Bofa on the Sofa
            October 26, 2015 at 5:31 pm #

            Yeah, we know. Based on your comments, however, it is not so evident…

            If you don’t want to be mistaken as a high school dropout, stop talking like one.

          • PrimaryCareDoc
            October 26, 2015 at 5:53 pm #

            Did you study basic math for that Bachelor’s?

        • The Bofa on the Sofa
          October 26, 2015 at 5:00 pm #

          Yep, in the same way that drunk driving increases the risk of death by 0.0002%.

      • KeeperOfTheBooks
        October 27, 2015 at 10:14 am #

        Nice to know that I’m only 50% incompetent when it comes to math; it would seem I was right on the “more than doubling” claim, but the increase would be 1.1% *of the total*–more correctly stated as an increase of over 100%. Ha! I learned something today! Thanks, commenters. 🙂

    • An Actual Attorney
      October 26, 2015 at 5:02 pm #

      The fact that you think 1/1000 is rare is terrifying.

    • attitude devant
      October 26, 2015 at 5:06 pm #

      Good Lord. You have no clue, do you? You don’t understand even fairly basic math and yet you think you understand these issues better than those of us who’ve devoted decades to studying and practicing. Please, find a teenager taking remedial math and have them explain these stats to you.

    • Roadstergal
      October 26, 2015 at 5:07 pm #

      I have been spending some time trying to be kind and respectful, to ask questions, and give you the benefit of the doubt, and not use phrases such as ‘dumb as a sack of hammers.’ Now I am glad I did not inadvertently insult hammers. No amount of information will make you stop and consider that _maybe_ you don’t know as much as you think, and maybe it would behoove you to step back from your firmly held beliefs for a moment and listen to those with a lot more education and experience.

      I’m glad that most births go pretty sorta kinda okay without much help, so the overt damage you will wreak will likely be minimal, and luckily for you, substantially downstream from your involvement. Still, you could be a taxi driver in New York and do more good to pregnant and delivering women than you would as a CPM.

      • SweetBabyJesus
        October 26, 2015 at 5:13 pm #

        Really? A taxi driver? REALLY?

        • Amazed
          October 26, 2015 at 5:16 pm #

          Really. A taxi driver. REALLY. A taxi driver won’t write the editor of a lay midwifery journal to ask what to do aboyt a life and death situation. A taxi driver won’t take this question and post it on Facebook in real time asking other taxi drivers about their anecdotes about the same situation. Taxi drivers won’t flood the page with nonsensical “remedies” as the baby dies inside his mothers.

          CPMs did.

          • Bombshellrisa
            October 26, 2015 at 5:24 pm #

            #gavinmichael #notburiedtwice
            A taxi driver wouldn’t write a poem to the mother of a baby who died because of their insisting on taking the long route. Yet that is what Christie Collins did, and she made it all about her feelings. I hadn’t read it until Gavin’s mom mentioned it and helped me find the link to it and reading it made me cry and then get angry.

          • SweetBabyJesus
            October 26, 2015 at 5:27 pm #

            Whatever case you are referring to seems awful and tragic. It also seems like an isolate example of one idiotic midwife. That doesn’t speak for the whole. I am sorry for their loss.

          • moto_librarian
            October 26, 2015 at 5:29 pm #

            It’s not an isolated case in the United States! And we don’t have any idea of the morbidity surrounding home birth. Once that’s factored in, the picture will get even uglier.

          • Bombshellrisa
            October 26, 2015 at 5:30 pm #

            It would be sad, especially if she hadn’t been run out of another state for doing the same thing. She was on Facebook crowd sourcing this and to some very prominent midwifery advocates. The whole discussion got deleted, but there were screen caps. The Facebook page is In Light of Gavin Michael. The list of midwives who make a regular practice of killing and injuring babies and mothers can be found at sisters in chains dot com.

          • Who?
            October 26, 2015 at 6:14 pm #

            They’re all ‘isolated’ examples, which is to say that without a system to keep track of them, the true stories don’t come out.

            Doctors or hospitals make a mistake, the system knows it, their insurance company knows it, before long the media knows it.

            Midwives-or as I like to call them, birth hobbyists-make a mistake, they block the family on facebook, call for support in their suffering, say the baby wasn’t meant to live, and get their victim face on.

            I know who I’d rather deal with.

          • Bombshellrisa
            October 26, 2015 at 6:24 pm #

            Sentinel event. There is no brunch and feelings talk at those investigations

          • Who?
            October 26, 2015 at 6:28 pm #

            So that’s like a meeting without coffee in corporate world? Where, it has to be said, usually no one has died.

            People talk about the arrogance of doctors, but to me they are exposed to their peers in a way most professionals aren’t, every day of the week.

          • Bombshellrisa
            October 26, 2015 at 9:38 pm #

            Exactly, near miss situations are commonly swept under the rug by home birth midwives. Near misses are considered just as serious by doctors and nurses and aren’t easily excused.

          • fiftyfifty1
            October 26, 2015 at 8:04 pm #

            No. A whole host of CMP midwives. Multiple CPMs including leaders like Christie Collins.

          • Megan
            October 26, 2015 at 8:45 pm #

            Bofa’s law…

          • Amazed
            October 26, 2015 at 6:02 pm #

            No, no, Bomb. You got it wrong. She wrote the mother a letter. That poem about babies not being library books, she posted it on Facebook mere days after this post-date baby died.

            I know it looks even more disgusting. But it’s the truth. Let’s share it in all its ugliness.

          • Bombshellrisa
            October 26, 2015 at 6:06 pm #

            Omg, that is worse. I didn’t see it go down in real time, I had a newborn at the time. The only reason I knew about any of it was that Danielle shared it and then it was referred to in the group and I didn’t have a clue what she was talking about so she directed me to both. The part about her holding her baby and having him sleep in the bed with her after he died ripped me apart, because weeks before the nurses had tucked my son and I into the bed together (baby friendly hospital).

        • Roadstergal
          October 26, 2015 at 5:28 pm #

          They can get women to prenatal appointments while pregnant, and to the hospital while in labor. That’s a valuable service in areas where many cannot own a car. And research has shown that when it’s an easy, uncomplicated delivery, untrained attendants, including taxi drivers, have pretty decent outcomes when oops-the-baby-comes-on-the-way. Because when it’s an easy, uncomplicated delivery, you don’t have to do much, which is the bedrock of the CPM business model.

      • SweetBabyJesus
        October 26, 2015 at 5:17 pm #

        Nah, you’ve been pretty nasty all along. This is just par for the course.

        • Amazed
          October 26, 2015 at 5:19 pm #

          Oh cry me a river! If a 1/1000 babies can die without it being a blip on your radar, you, as serving (and exploiting) the tiny 2% of women can take a blow on your poor heart without it being a blip on mine.

          • SweetBabyJesus
            October 26, 2015 at 5:20 pm #

            That is a blip on my radar. That is also a trade-off for some of the things that can happen when only-hospital birth is enforced. And you are nastier than he is btw

          • moto_librarian
            October 26, 2015 at 5:21 pm #

            I wouldn’t trust my care or that of my unborn child’s to someone who views preventable deaths as a “blip on my radar.” You are revolting.

          • SweetBabyJesus
            October 26, 2015 at 5:22 pm #

            Those were @disqus_sW7nel5lNp:disqus ‘s words, not mine. I was repeating in sarcasm. Ya knowwww, sarcasm?

          • moto_librarian
            October 26, 2015 at 5:23 pm #

            No, I don’t believe that you really are concerned about preventable deaths. You have written nothing that convinces me that you understand how sub-par the CPM credential truly is.

          • SweetBabyJesus
            October 26, 2015 at 5:25 pm #

            Well obviously I don’t believe that so I am not going to write it. I am VERY concerned about perinatal death. It is a really deeply painful insult that you would suggest that I am not. But that’s the fear-based side of you speaking I am sure. There are so few stats on homebirth that are reliable. We will all find out more as this practice grows and is properly studied.

          • moto_librarian
            October 26, 2015 at 5:27 pm #

            Perinatal mortality rate 2-3 times higher among home birth compared to all hospital birth is a remarkably robust finding. It holds up in the Netherlands and the UK. We don’t really need more studies to prove it. We need to figure out how to prevent it.

          • Bombshellrisa
            October 26, 2015 at 5:52 pm #

            I guess it’s better than the baby being compared to poop, like what usually happens

          • Roadstergal
            October 26, 2015 at 5:56 pm #

            The thing is, it would be fine (for a given definition of fine) if he/she explained that to her clients. “You are increasing the risk of death and injury to your baby by birthing with me. The statistics are fairly clear, across multiple studies and countries, that although the absolute risk is low, the majority of babies that die in a homebirth would have lived in a hospital, and also suggest that nonfatal negative outcomes, such as hypoxic injury, are also increased by delivering at home with me.” And let mom and dad and any other stakeholders decide based on that information. But I haven’t enough delusions in my various pockets to think he/she’s actually going to inform his/her clients of that.

          • The Bofa on the Sofa
            October 26, 2015 at 5:35 pm #

            We saw your list of the risks of c-sections below. Most of them are readily treatable, none of them included perinatal death, and the risks of maternal death is much, much lower than .1%.

            For that you would sacrifice babies?

          • Amazed
            October 26, 2015 at 5:52 pm #

            Again about your tiny hurt feelings. Are you ever going to get it into this thick head of yours that it isn’t about you, your whining that people are being nasty to you and your precious comfort which won’t let you to get the tiniest bir inconvenienced in order to be the safest practitioner possible? It’s about life and death. It isn’t about you and your fellow narcissistic CPMs and CPMs wannabes. IT ISN’T ABOUT YOU!

          • Who?
            October 26, 2015 at 6:04 pm #

            Death as a trade off for discomfort? Nice.

          • Roadstergal
            October 26, 2015 at 6:12 pm #

            The thing is, hospitals don’t have to be uncomfortable. Some of them are downright swanky! Why not push for more well-appointed birthing suites – especially in hospitals that serve low-income women, who get the shaft on so many things – instead of more HB? That would be a great use of money and effort.

            Or a van service so that CNMs can bring proper pre- and post-natal care to low-income women who struggle to find time to make hospital appointments.

          • Who?
            October 26, 2015 at 6:16 pm #

            Oh I agree. But SWB and her appalling mates sell the line that they are-and somehow get far enough into people’s heads that they don’t find out the truth until it’s too late.

            But even if hospital was horrid, if death was the sole alternative, you’d go to hospital.

          • Roadstergal
            October 26, 2015 at 6:20 pm #

            I have to admit, I love hospitals. I love how clean and professional the good ones are, how they’re full of people who are so knowledgeable and have so many good stories. I love that they are full of people getting needed care. I don’t pretend they always do great, and I love initiatives like Choose Wisely that are trying to make them work better. But whenever I’ve had something I needed dealt with, I’ve always liked the hospital. I wish that it was standard doula practice to walk women through the hospital and show them that it isn’t this scary boogy place of suffering.

            (Heck, maybe that sort of thing would help with policies around not delaying requested pain relief. Women screaming bloody murder doesn’t go over well as PR.)

          • Who?
            October 26, 2015 at 6:26 pm #

            When you need hospital, it is awesome.

            My daughter broke her arm a few weeks ago, and the staff at emergency were amazing, so gentle and so forthcoming with the morphine.

            Call the Midwife was on yesterday and it was the episode where the gas and air was introduced. Even the old nun/midwife who didn’t approve of it at first was won over when she had it to help with the pain of her dislocated shoulder.

          • KeeperOfTheBooks
            October 27, 2015 at 4:21 pm #

            It’s funny, in a kinda-not-funny way, but I actually feel happy and at home in hospitals. I grant that my experience isn’t exactly the norm, though. Grew up in a seriously crazy family. Started volunteering at my local hospital as soon as I turned 14, and transferred to the ER when I was 16. To teenage me, the hospital was a safe place I could go where adults not only gave a crap about me, but respected the work I did. (I make no pretensions that getting rooms cleaned and linens/supplies stocked saved lives, but I do like to think that that helped the people who did. The nurses and techs certainly seemed to appreciate it, and helping others helped me more than anything else.) To this day, I can feel myself physically relax when I walk into a hospital, like “oh, someone else really competent is in charge, I can sit back and let them take it from here.”

          • Bombshellrisa
            October 27, 2015 at 5:01 pm #

            From what I have read, your early life and mine were a lot alike. The homeschooling, the way my parents treated me. It was actually something that factored into me wanting to be a doula and a midwife. I completely understand the feeling you are talking about. Having worth beyond my being the unpaid constant babysitter and doing the housework and having dinner ready at home meant so much to me.

          • fiftyfifty1
            October 27, 2015 at 5:43 pm #

            Clean rooms and well stocked supplies do indeed save lives.

          • Monkey Professor for a Head
            October 27, 2015 at 7:53 pm #

            When I did an antenatal class, the midwife took us on a tour of the labour ward. She took us into the assessment room first and was telling us basically how inferior it was due to being clinical and non homely. I remember looking around and thinking “No, this is familiar, I like this!” But I guess spending a good chunk of my life in hospital since graduation would skew my reaction.

          • Bombshellrisa
            October 27, 2015 at 5:05 pm #

            Remember the list we compiled here awhile back, how people without any medical background could really help make a difference and improve birth for women? The overwhelming response was help with transportation or be willing to act as a postpartum doula without charging the $28/hour, 4 hour minimum fee. If someone is passionate and wants better outcomes for all women, something like that would be a better start than trying to “change the world” by becoming a CPM

          • KeeperOfTheBooks
            October 26, 2015 at 6:08 pm #

            “Sure, Mary, you and/or your baby will die, but at least Sally, Ashley, Tricia, et all will have their babies at home, not in those nasty hospitals, so it’s all worth it! Why don’t you understand that?”

          • Who?
            October 26, 2015 at 6:09 pm #

            You’ll hurt her feelings talking like that. And having your feelings hurt is just as bad as being dead, in SWB world.

          • Amazed
            October 26, 2015 at 6:12 pm #

            Not so sure. Having SBJ’s feelings hurt seems to be worse than a BABY being dead.

          • Who?
            October 26, 2015 at 6:16 pm #

            Fair call.

            The caffeine hasn’t hit the brain this morning, no idea who I thought SWB was?

          • An Actual Attorney
            October 26, 2015 at 6:16 pm #

            What is a dead baby worth trading for? A lesser chance of an infection? How many infections?

          • Bombshellrisa
            October 26, 2015 at 7:50 pm #

            Remember the one doula who said here that it’s worth it to have a dead baby if the mother has a healing vaginal birth? You can’t make this stuff up.

          • An Actual Attorney
            October 26, 2015 at 8:08 pm #

            I try very hard to block that sh*t from my memory. The psychopathy is hard to process.

          • MaineJen
            October 27, 2015 at 3:52 pm #

            Did you actually just say that 1/1000 infant mortality rate is a blip on your radar?

          • The Bofa on the Sofa
            October 27, 2015 at 4:39 pm #

            Just a little hiccup, right?

          • Bombshellrisa
            October 27, 2015 at 4:57 pm #

            You mean “hickup”. It probably has something to do with a “social moray”.

        • Roadstergal
          October 26, 2015 at 5:50 pm #

          Alas, it’s always disappointing to know I could have just started with “Dear shitferbrains.” Well, it’s good practice.

          I would be laughing and baiting and having fun with this exchange, if it were not for the idea of you caring for pregnant women who are in a physically and mentally vulnerable state, and giving them incorrect data and misinformed consent. That is chilling. It’s just like if I hear that a friend of mine is out driving drunk. Yes, it’s more likely than not that nothing bad will happen, but it’s nonetheless chilling.

          Are you totally okay with moms driving drunk? It’s very low-risk, by your own stated standards.

    • SweetBabyJesus
      October 26, 2015 at 5:16 pm #

      Edited for my poor math skills–HB risk is increased by 1.1%.

      • attitude devant
        October 26, 2015 at 5:23 pm #

        Um, you still don’t have that correct. For instance, looking at your leading stat on risk of neonatal death, if homebirth rate is 2/1000, and hospital birth rate is 0.9/1000, the HB risk is more than 100% higher.

        • SweetBabyJesus
          October 26, 2015 at 5:29 pm #

          So all babies die out of hospital, or the majority?

          • moto_librarian
            October 26, 2015 at 5:30 pm #

            Quit being willfully obtuse.

          • SweetBabyJesus
            October 26, 2015 at 5:31 pm #

            After you.

          • Houston Mom
            October 26, 2015 at 5:33 pm #

            http://mathforum.org/library/drmath/view/58166.html

            “There are situations in which a percentage greater than 100% makes no sense. For instance, “The Math Doctors answered 146% of the questions received last month.” This makes no sense because if we received 5061 questions, we couldn’t possibly answer more than all of them. It’s just as nonsensical as saying “I ate 4/3 of the cake.”

            On the other hand, sometimes percentages are used like this: “The number of questions received was up 15.7%, from 5450 in February to 6305 in March.” In other words, the increase from February to March
            was 6305-5450 = 855, and 855 is 15.7% of 5450.

            Now, what if the number of questions received went up to 14000 in April? (It didn’t.) This would be an increase of 122% from March to April. There is nothing wrong with this – no law says that the number
            of questions can’t do more than double from one month to the next.”

          • LibrarianSarah
            October 26, 2015 at 5:33 pm #
          • The Bofa on the Sofa
            October 26, 2015 at 5:33 pm #

            Nice strawman.

            2 out of 3 babies that die in homebirth would survive in the hospital. That’s what the data show.

            And just like c-sections, we don’t know which are the ones that would die and not die, so don’t take the risks.

          • Roadstergal
            October 26, 2015 at 5:34 pm #

            Babies die at home that would have lived at the hospital.

            You are quite callously dismissive about that in a way that makes us think you will not be letting women in your ‘care’ know this datum.

            In other words, your grasp of informed consent seems as tenuous as your grasp of math.

          • PrimaryCareDoc
            October 26, 2015 at 5:50 pm #

            Are you really that stupid?

          • The Bofa on the Sofa
            October 26, 2015 at 5:51 pm #

            Hey, hey, hey. She has a bachelor’s degree. Not sure how many math classes she took, but on the whole, it’s not clear. She might actually be really that stupid.

          • Bombshellrisa
            October 26, 2015 at 5:53 pm #

            Oh geez. I think that even the Pablo Certified Midwife certificate would require some QSR or math classes….right?

          • The Bofa on the Sofa
            October 26, 2015 at 5:54 pm #

            The math of a PCM is limited to 867-5309. However, advanced programs will have access to 1-2-3-4 by Gloria Estefan from the summer of 1989, but that’s rare.

          • Roadstergal
            October 26, 2015 at 5:59 pm #

            You’ve blinded me with science.

          • The Bofa on the Sofa
            October 26, 2015 at 6:28 pm #

            A very important lesson in the PCM curriculum: you tidy up, and you can’t find anything. It’s because of our extensive science training that we tend to be messier than most.

          • Bombshellrisa
            October 26, 2015 at 6:00 pm #

            Is it bad that I loved that song in fourth grade? Maybe the PCM can have a credit course in musical appreciation that highlights songs with numbers and songs that spell words out. Extra credit if each song can be turned into a ditty to help remember steps to take if extra care is needed. Just promise me that any science class will ban the song “It’s Raining Men” as a explanation for anything (it’s playing here right now, my IPod picked it for me)

          • The Bofa on the Sofa
            October 26, 2015 at 6:26 pm #

            Is it bad that I loved that song in fourth grade?

            Which one? Tommy Tutone? Or Gloria Estafan?

            Maybe the PCM can have a credit course in musical appreciation

            PCM doesn’t have a “credit course” in music appreciation. Music appreciation is embedded into the curriculum. Mostly, 80s, of course, but cheesy 70s music is also part of the program. Things like ABC by the Jackson 5 is a good combination of english and math.

          • Bombshellrisa
            October 26, 2015 at 6:28 pm #

            Gloria Estefan. A group of friends and I worked out a little dance routine to it and showed it off on “Bring your boom box to school day”

          • The Bofa on the Sofa
            October 26, 2015 at 6:29 pm #

            Just keep on counting, until you are mi-ine…

            That you know 1-2-3-4 by Gloria Estefan is to your PCM credit. I don’t even have it on my iPod, because it’s hard to find.

          • Roadstergal
            October 26, 2015 at 6:30 pm #

            I have it stuck in my head now, you horrible people. *pulling up some Lyle Lovett to try to exorcise it*

          • The Bofa on the Sofa
            October 26, 2015 at 6:32 pm #

            The song you are looking for is “Forever and Ever, Amen” by Randy Travis.

          • Who?
            October 26, 2015 at 6:33 pm #

            No one is ever deliberately looking for a Randy Travis song, surely?

          • The Bofa on the Sofa
            October 26, 2015 at 6:37 pm #

            To get Gloria Estefan out of your head, yes.

            Alternatively, you could go with Behind Closed Doors by Charlie Rich. Or anything by the Silver Fox, in fact.

            Hey, did you happen to see the most beautiful girl in the world? And if you did, was she crying, crying? Hey, if you happen to see the most beautiful girl who walked out on me…tell her I’m sorry. Tell her I need my baby. Oh, won’t you tell her that I love her.

          • Who?
            October 26, 2015 at 6:45 pm #

            Fair point.

            I love that song! Though I hope she knows that she should stand firm.

          • Roadstergal
            October 26, 2015 at 7:04 pm #

            Right, I’m switching over to John Hiatt’s Cry Love. I like a song that says, yes, you did the right thing in leaving that bastige, even if it sucks at first.

          • Charybdis
            October 26, 2015 at 7:02 pm #

            Hello, Darlin’. It’s been a looong time…..

            or

            Happy Birthday Darlin’. I got no presents, no fancy cake. But I hope to make you happy, with everything I take…

          • The Bofa on the Sofa
            October 26, 2015 at 8:23 pm #

            Conway Twitty is too Family Guy

          • Bombshellrisa
            October 26, 2015 at 8:25 pm #

            My husband just suggested “Wake me Up Before You Go Go”, which would work for the midwives who nap during their time with laboring women.

          • Bombshellrisa
            October 26, 2015 at 7:03 pm #

            To get Gloria Estefan out of your head you need the Spice Girls. Or Tim “Booty Man” Wilson and the “Booty Song”

          • Megan
            October 26, 2015 at 6:40 pm #

            That was one of my favorites to dance to! That and Belinda Carlisle’s “Heaven Is a Place on Earth (I think my dance routine to that one involved baton twirling).”

          • Bombshellrisa
            October 26, 2015 at 6:47 pm #

            Belinda Carlisle! We went out to lunch after the pumpkin patch on Friday and that was playing at the restaurant. My 21 month old son was dancing to it and all the other 80’s hits.
            No baton twirling here, so you have earned some PCM credits more than me there.

          • The Bofa on the Sofa
            October 26, 2015 at 6:52 pm #

            Baton twirling to 80s music is certainly PCM credit! Flaming batons is a little too “Miss Congeniality” kitsch to count though. Unless you specifically do it to be “like that Miss Rhode Island in Miss Congeniality” in which case you have to get drunk on test tube shooters beforehand.

            Although if you are going with Belinda Carlisle, the Go-Gos version is better.

          • Who?
            October 26, 2015 at 6:54 pm #

            Love the Go-Gos.

          • The Bofa on the Sofa
            October 26, 2015 at 6:56 pm #

            Of course. Why wouldn’t you?

          • Who?
            October 26, 2015 at 6:57 pm #

            Exactly.

          • Bombshellrisa
            October 26, 2015 at 7:11 pm #

            What about a glitter baton?

          • The Bofa on the Sofa
            October 27, 2015 at 9:58 am #

            What about a glitter baton?

            Only if it has tassles, like we had on our bike handles.

          • Roadstergal
            October 26, 2015 at 6:27 pm #

            I am going to suggest a new hashtag war to @midnight – #ChildbirthSongs

          • Bombshellrisa
            October 26, 2015 at 6:50 pm #

            Now I am probably going to spend the evening with my iPod, figuring out what cheesy music can be turned into something about idiotic things CPMs and wannabes say. Maybe the Spice Girls song can be the start?

          • Roadstergal
            October 26, 2015 at 6:52 pm #

            Thanks to the cheese below, I can only think of Total Eclipse of the Fetus sung to a breech. “Turn around…”

          • Who?
            October 26, 2015 at 6:53 pm #

            No no no. That poor mother has enough going on without having to hear that as well.

            Though I grant it is relevant.

          • Roadstergal
            October 26, 2015 at 6:54 pm #

            Roxette: “Listen to your fetal heart tones”

          • Who?
            October 26, 2015 at 6:55 pm #

            You’re killing me.

            Actually that would be an apt lyric…for some of our visitors.

          • Roadstergal
            October 26, 2015 at 7:00 pm #

            Berlin’s Take My Breath Away is Right Out.

          • Who?
            October 26, 2015 at 7:02 pm #

            Hmm apt but a bit crass-though that is no barrier where our visitors are concerned, or so it seems.

          • The Bofa on the Sofa
            October 26, 2015 at 6:55 pm #

            I heard yesterday that Total Eclipse of the Heart was originally going to be called “Interlude of the Vampire” or something like that. Something with vampire in the name.

          • Roadstergal
            October 26, 2015 at 7:02 pm #

            The video does look like some high schoolers trying for Anne Rice cosplay.

          • The Bofa on the Sofa
            October 26, 2015 at 8:22 pm #

            That’s just how Bonnie Tyler looked in the 80s

          • swbarnes2
            October 27, 2015 at 6:48 pm #

            Yes. And then it got dragged into a hilarious bomb of a musical about a vampire ball. The wikipedia entry about behind-the scenes clashes in “Dance of the Vampires” is highly amusing.

          • Bombshellrisa
            October 26, 2015 at 7:15 pm #

            What about Toby Keith’s “As good as I once was” when talking about placentas and women going post dates? Also applies to grand multiparas.

          • Charybdis
            October 26, 2015 at 7:05 pm #

            C’mon. “Push It” by Salt and Pepa has got to be a shoo-in. Push it real good!!

          • Roadstergal
            October 26, 2015 at 7:06 pm #

            Oooh, baby, baby!

          • Megan
            October 26, 2015 at 7:31 pm #

            “Let’s wait awhile” by Janet Jackson? Or perhaps “Control” would be better?

          • Megan
            October 26, 2015 at 7:36 pm #

            (DD and I are now totally rocking out to this album for bath time. )

          • Bombshellrisa
            October 26, 2015 at 7:45 pm #

            My son is currently dancing to “Biscuits” by KC Musgraves. That one is more appropriate for lactivists.

          • An Actual Attorney
            October 26, 2015 at 8:06 pm #

            When figuring out BFing, I used to sing “you and me baby ain’t nothing but mammals; let’s do like they do on the Discovery channel.”

          • Bombshellrisa
            October 26, 2015 at 11:40 pm #

            Probably “Jesus Take the Wheel” as well, since “some babies aren’t meant to live”. And “Larger Than Life” by the Backstreet Boys for all those babies whose mothers had uncontrolled GD. “Let’s Get it Started” by the Black Eyed Peas for when they are drinking a castor oil concoction when they are post dates. “Material Girl” for the midwives who suggest bartering to be able to pay for their services or who expect a meal be provided for them at home birth.

          • KeeperOfTheBooks
            October 27, 2015 at 7:43 pm #

            Late to the party, and all that, but might I suggest “Ultraviolet,” by the B-52s, as a nod to Ina May?
            “There’s a rest stop, let’s hit the g spot!”

          • Chi
            October 28, 2015 at 9:20 pm #

            I LOVE that show!

          • An Actual Attorney
            October 26, 2015 at 6:27 pm #

            It is bad, because I won’t even say what grade I was in when that song was popular.

          • attitude devant
            October 26, 2015 at 5:53 pm #

            Personally, I’m gathering evidence on the hypothesis that she is indeed that stupid…..

          • yugaya
            October 28, 2015 at 1:43 pm #

            Two days later and the verdict is in – she is indeed even more stupid than anyone anticipated.

          • Karen in SC
            October 26, 2015 at 7:33 pm #

            Oh my. 100% higher means that it’s double the original, 100% of the amount is added to the base number. 2 is 100% higher than 1.

            50% higher means that half of the base is added, 1.5 is 50% higher than 1.

      • Monkey Professor for a Head
        October 26, 2015 at 6:07 pm #

        Are you talking absolute risk or relative risk? Either way you’re incorrect. But thanks for trying to educate us!

      • fiftyfifty1
        October 26, 2015 at 7:52 pm #

        Poor math skills indeed. Inexcusable.

    • Bombshellrisa
      October 26, 2015 at 5:19 pm #

      “Do not be afraid to be impacted in the face of going against everything that you were taught. This is the evolution of evidence-based practice and your responsibility to uphold as a birth care professional.” This works both ways. I have read your answers. I was a doula and trained to be a home birth midwife. When I started questioning what I was learning, I found out very fast that tradition and the warm fuzzies are much more important to CPMs. My preceptor taught at a MEAC school. I had college classes before that experience. I didn’t end up following the path I had worked so hard to get to. Do read Judith Rooks CNM (who is very home birth friendly) analysis of the home birth injury and death rate in Oregon. I have talked to the Vice President of MANA. You will find that the answers run from a script when it comes to the philosophy that CPMs have.

      • SweetBabyJesus
        October 26, 2015 at 5:41 pm #

        I work with practitioners where warm fuzzies don’t mean a thing and the health of the mother and baby do. I am sorry you had a bad experience with a CPM. The ones I work with are in direct contact with a physician and have excellent outcomes.

        • Bombshellrisa
          October 26, 2015 at 5:51 pm #

          Then why would the idea that being comfortable and relaxed at home helps labor progress even be a thought if warm and fuzzy doesn’t matter? Why are prenatal appointments an hour long? Nobody who believes that outcome is more important than feelings would ever highlight the risks of c-sections while not doing the same for vaginal birth. It might be just that you will come to realize this as you attend clinicals and births, but when women are seeking home birth it’s because they believe home to be safer because they will be able to move around without an IV and fetal monitor, they can eat, ect. They are afraid of pitocin and C-sections and home birth midwives are feeding into that by highlighting the risks associated with these things. So what will you do when it’s clear that your client needs a higher level of care than you can provide and you tell her? She is going to be resistant to that because she doesn’t want anything other than an intervention free birth. You can’t just dump her because she won’t comply. If it’s during a birth, you are going to have to work very hard to convince her quickly that everything you have said all along doesn’t apply.

          • SweetBabyJesus
            October 27, 2015 at 7:31 am #

            That’s just not how any of the CPMs I work with practice. So sorry, try again.

            We transfer with our patients and assume the doula role, working alongside our BACKING PHYSICIAN. We transfer long before the trainwreck starts because that is was is ethical and safe and it is in our law. We don’t get paid shit–and if we transfer it’s even less. It seems like everyone hear would really benefit from having a sit-down with a qualified CPM who can explain their practice style and work to you. So much cluelessness and fear mongering. It really makes you look idiotic. Pathetic.

          • Amazed
            October 27, 2015 at 7:34 am #

            Stop lying. Stop pretending that this is the norm, even if it is for your practice which I highly doubt. Each of the murderer midwives dropping by here has spewed the same vomit.

            Did you check the story I and Bomb mentioned to you? I guess you didn’t. After all, it does make droves of your beloved CPMs look like a bunch of dumb murderers. Of course, that’s because that’s what they are.

          • SweetBabyJesus
            October 27, 2015 at 7:40 am #

            It is. I am here telling you it is. And you still won’t believe me. Because you believe what you want to. That’s fine, ignorance seems to be the standard here. I am going to seek out a thread where care providers treat each other like decent human beings and discuss things with a solution-oriented approach. This shit is juvenile.

            “Murderers”, an emotionally loaded statement and full of shit. I have not checked the story yet–I will do so. It is based on ONE shitty midwife, or a handful? Is that the sum up of all midwives in the united states? I have said that we could definitely make more stringent training and laws but noooooo, no one wants to hear that it will get better. Because that is threatening to you. Go ahead and hide out here and spew this nonsensical banter. I’m off to find those who are gonna do something. Change something. Make a difference and address the abysmal stats that y’all seem to like to ignore (“outside of the birth it’s not our problem!”)

          • Amazed
            October 27, 2015 at 8:35 am #

            Waiting breathlessly as you check. But I must tell you I’m touched how you automatatically think that everyone who cares about preventable deaths works in medicine and is threatened by mightily qualified birth junkies.

            I guess you haven’t checked the studies I linked you to either? I can tell you right now an OB who won’t be thrilled to work with any CPM: Amos Grunebaum. You know, the one who conducted one of the most damning pieces of CPM-related research. After MANA’s own “study”, of course.

          • Bombshellrisa
            October 27, 2015 at 12:19 pm #

            Here is a list of them, although there are a fee CNMs mixed in: check the Sisters in Chains website, a CPM compiled the list.

          • DaisyGrrl
            October 27, 2015 at 8:03 am #

            What’s your practice’s transfer rate? Is it different for first time mothers versus mothers who have previously given birth?

          • Amazed
            October 27, 2015 at 11:33 am #

            Perhaps you’ll explain to us how people are supposed to tell unqualified CPMs from the qualified ones when they’re all CPMs? Plus, no one here is impressed by the CPMs talking points. They all say the nice thing you blabber – and at the end, unqualified midwives prevail hard enough to yield those terrifying mortality and morbidity rates that you still haven’t commented on. But I gather it’s fine and peachy for you since it’s just the unqualified midwives, so they don’t count. No matter that they’re the vast majority of CPMs, else their results would have been much better – and they aren’t.

            Your lack of humanity overshadows and supersedes your lack of basic maths that is taught when one is 12.

          • Bombshellrisa
            October 27, 2015 at 12:17 pm #

            I would hope that is how it works, because in every state that is how the law is written. But it’s not how it’s practiced. If you look at any contract of care between a CPM and a patient, payment is required to be done before week 34. Which means any transfer in late pregnancy or labor Will not prevent you from getting paid. If you accept insurance, midwives use the emergency transfer fee which has no code, but is still billed to the patient at about $1000. Most midwives will stay with a patient during transfer but they bill a doula fee because they are spending even more time. I have talked to many CPMs from around the country, including some who write curriculum and consult with instructors at MEAC schools and MANA Vice President Serena Bennett. This is just how it is.

        • An Actual Attorney
          October 26, 2015 at 6:25 pm #

          What are their morbidity and mortality rates?

          • Roadstergal
            October 27, 2015 at 11:27 am #

            “It was my understanding that there would be no math.”

          • Squillo
            October 27, 2015 at 12:18 pm #

            That’s why I became a writer. I was misled.

        • fiftyfifty1
          October 26, 2015 at 7:50 pm #

          “The ones I work with are in direct contact with a physician ”

          CPM: “Hi, I’m sending you a lady who has been pushing for 4 hours and I I swear the head was right there. But now it’s gone backwards. And maybe she seems a little warm?

          OB: (biting tongue). Thanks SO much for referring. Please never hesitate to send a patient our way. So nice to work with you. [gets off phone and barfs].

          • Bombshellrisa
            October 26, 2015 at 7:53 pm #

            It’s probably more like CPM runs ahead of laboring woman being pushed into the ER in a wheel chair and tells someone she assumes is the doctor that there is a woman who needs to be admitted.

          • fiftyfifty1
            October 26, 2015 at 7:59 pm #

            Oh Bombshell you silly goose! CMPs don’t show up at the hospital. They are long gone far before that. You are lucky if they are willing to even make a phone call.

          • Bombshellrisa
            October 26, 2015 at 8:14 pm #

            Some will if you pay them extra $$. But those are in the minority!

    • The Bofa on the Sofa
      October 26, 2015 at 5:22 pm #

      We have all of the evidence we need in the practice of several leading European countries that can work and DOES work

      To the extent it “works” in those European countries, it has nothing to do with CPMs in the US. At best, it is an argument for increased use of CNMs, which would the equivalent to the midwives there.

      No European country would allow the equivalent of a CPM any where near their system.

      You just made an argument against yourself.

      • moto_librarian
        October 26, 2015 at 5:24 pm #

        It’s also worth mentioning that we are discovering that midwifery-led care in the UK, New Zealand, and the Netherlands is problematic. The perinatal mortality rate is higher for midwives, even when they deliver in the hospital. Something isn’t right there either, and I’m not convinced that we want to emulate them.

        • The Bofa on the Sofa
          October 26, 2015 at 5:26 pm #

          That’s why I said “to the extent it ‘works.'” Indeed, the Netherlands is rapidly abandoning it’s homebirth model given the poor outcomes.

          • moto_librarian
            October 26, 2015 at 5:26 pm #

            I know that you already know that, Bofa, but I’m guessing that SBJ does not.

          • SweetBabyJesus
            October 27, 2015 at 7:28 am #

            Source on that? You still haven’t produced one. Don’t worry, someone who actually works in this field might come to your rescue. Again.

          • Amazed
            October 27, 2015 at 7:30 am #

            Do your research, sweetie. It isn’t this hard. And you don’t need to work in that field to find the information. I hope you never do.

          • SweetBabyJesus
            October 27, 2015 at 7:43 am #

            Wasn’t talking to you, but as I predicted you rescued him! Man is this the place people without real human friends go to feel better about themselves? I’ll do my research SWEETIE, I’m doing it all the time.

          • Amazed
            October 27, 2015 at 8:09 am #

            No, sweetie, you didn’t predict anything. You predicted that someone working in the field would rescue him. By definition, not me. Although I’ll give you a finger to suck on: I might not work in anything related to healthcare, but I know how percentages work, although I don’t need it in my everyday job like you will. Which elevates me about 10 levels above you.

          • The Bofa on the Sofa
            October 27, 2015 at 9:13 am #

            ou predicted that someone working in the field would rescue him. By definition, not me.

            And you didn’t actually rescue me. Saying “look it up” doesn’t really address the point. Now HoustonMom did, and she linked the article that I had in mind. But she’s not “in the field” either. She’s a mom. In Houston.

            Or at least pretends to be. As far as I know, she could be a guy in San Antonio.

          • Amazed
            October 27, 2015 at 9:16 am #

            Hey! “I” want to be the guy in San Antonio!

            She’s hard to believe, isn’t she? At least, that’s what I would have said three or four years ago. After we’ve had Kim Mosney. Elizabeth of the Calling to Courtroom and whatnot, I can totally believe she’s real.

            And I totally rescued you. I gave her someone else to bite at with her superior knowledge. Now we’re friends, right? As your friend and savior, I want a PCM credential NOW, although I’ll undoubtedly fail the 80s music test again.

            EDIT: Not HoustonMom, of course. I meant SBJ.

          • The Bofa on the Sofa
            October 27, 2015 at 9:19 am #

            Has anyone ever seen Amazed and me in the same room at the same time?

            Hmmm? We aren’t friends, I’m just a sock puppet.

          • Amazed
            October 27, 2015 at 9:21 am #

            Why are you doing this to us! Exposing us for what we are!

            Or would it be “exposing me”? *scratches head*

          • The Bofa on the Sofa
            October 27, 2015 at 9:56 am #

            “And you don’t want us EXPOSING OURSELVES!” – Lewis Tully, Ghostbusters 2

          • Amazed
            October 27, 2015 at 10:00 am #

            But WHY are you doing it? It was so cozy around here! Now everyone will know that I/we am not/aren’t a doctor/doctors!

            Why, oh why!

          • The Bofa on the Sofa
            October 27, 2015 at 10:02 am #

            I have earned the right to be called Doctor. I prefer Professor, out of respect for The Great One (Russell Johnson), but Doctor is acceptable.

            Alanis Morrisette, however, is Not the Doctor. And it’s not at all Ironic.

          • Amazed
            October 27, 2015 at 10:43 am #

            OK, your part of us is a doctor. Mine isn’t. Where does that leave the awesome not-medicine being that we are? Are we a half-doctor now?

            Perhaps I should be your sockpuppet? Would that make me a doctor?

          • The Bofa on the Sofa
            October 27, 2015 at 4:16 pm #

            Perhaps I should be your sockpuppet? Would that make me a doctor?

            No, that would make you Lambchop.

          • demodocus
            October 27, 2015 at 10:48 am #

            Everyone knows Who the Doctor is! Currently Peter Capaldi.

          • MaineJen
            October 27, 2015 at 3:45 pm #

            Please, there are ladies present.

          • Bombshellrisa
            October 27, 2015 at 12:54 pm #

            Also she who will not be named and isn’t a felon. We have also had a run in with the VP of MANA and any other number of passionate dolts who can’t do math.

          • Houston Mom
            October 27, 2015 at 8:06 am #

            http://www.dutchnews.nl/news/archives/2011/07/insurers_not_worried_about_cos/
            This is a news story that Dr. Amy linked to a few years ago. It is about declining rates of homebirth in the Netherlands.

          • The Bofa on the Sofa
            October 27, 2015 at 9:12 am #

            Calling my bluff? Really?

            Here’s your problem: you have put a lot of stock on your characterization of me as a clueless idiot, because I “don’t work in the field.” So you have an awful lot riding on me bluffing. Because God help you if you try to call me out as a clueless idiot when, in fact, I am right.

            Unfortunately for you, I don’t just make shit up. When I say things, it’s because I know what I’m talking about. HoustonMom posted the link below

            (actually you can find it linked in this blog post

            http://www.currystrumpet.com/2013/02/pregnancy-in-the-netherlands-home-or-hospital.html)

            http://www.dutchnews.nl/news/archives/2011/07/insurers_not_worried_about_cos

            Ten years ago, 37% of babies in the Netherlands were born in hospital but that had risen to 75% by last year. Professor Jan van Lith of Leiden University’s teaching hospital told the paper media reports about the high perinatal death rate in the Netherlands were driving women to chose hospital births.

            Whoops. Interesting, apparently the Dutch know the difference between perinatal and infant mortality.

            Now you can slink away knowing that you have been completely schooled by an idiot like me.

            Or you could hang around and learn. I know that I learn a lot here. There are a lot of really smart and experienced people here who have taught me a lot over the years. To the point where even I know more about it than you.

          • Nd:YAG
            October 29, 2015 at 6:29 pm #

            Actually, although the percentage of homebirths in The Netherlands is declining, it is not at the astonishing rate the above numbers suggest – which appear to be based on an incorrect English translation of the original Dutch text published by the Dutch CBS (“Central Bureau of Statistics”).

            Please compare http://bit.ly/1PTtA5E (Dutch) and http://bit.ly/1M0igyM (English).

            https://uploads.disquscdn.com/images/f855b956661d1d0a162b168576c64e4e27e87fad99d9489ae76f422dcbc11a13.gif

          • Roadstergal
            October 27, 2015 at 11:17 am #

            Since you like anecdotes – I work with three women from the Netherlands, and at a little get-together a few weeks ago, one of them brought up the horrific Dutch perinatal mortality (we were talking about a soon-to-be-mom co-worker) and how the new research about the negative outcomes with midwives is causing quite a bit of noise and calls for reform. Dead and damaged babies make for bad politics, it turns out.

            Also, the way the midwives work to delay or deny epidural pain relief. That’s not going over well.

        • Bombshellrisa
          October 26, 2015 at 5:27 pm #

          Thank you for mentioning NZ. When hundreds of people are seeking answers to the bad care they got, it’s really not working. One severely injured child or woman should make people take notice, the fact that so many are coming forward says so much.

          • moto_librarian
            October 26, 2015 at 5:28 pm #

            I am quite familiar with AIM. It makes me physically ill to see what midwives are getting away with.

          • Chi
            October 28, 2015 at 9:05 pm #

            Especially since the Royal NZ Council of Midwives (basically their governing body) is supposed to hold them accountable for bad outcomes.

            Guess I got lucky with my midwife.

    • SweetBabyJesus
      October 26, 2015 at 5:44 pm #

      I truly am bowing out of this now. There are no words to say how
      aggressive this community is and how little room there is for any
      differing view on the research or ANYTHING, even in the face of various figures and facts (even in
      the face of me recanting any mistakes I’ve made along the way, humbly
      so). So sad for your community but I think I just gained a exacting and
      clear understanding of why many choose to run screaming in the opposite
      direction from OBs who think and act such as you. If the
      increased risk that is associated with homebirth isn’t enough to make the mother
      subject herself to your care, perhaps you should ask yourself what you are doing wrong?? As the
      homebirth rate rises, we shall see what the real numbers show. As
      consumers inform themselves they will vote with their dollar. And as we
      learn more of the risks of unnecessary obstetrical intervention over time maybe
      someone will start considering the opportunity costs that come with
      conventional OB practice, rather than screaming murder when someone
      decides they would rather assume the mild risks of one thing to avoid the moderate/life-long
      risks of another.

      • The Bofa on the Sofa
        October 26, 2015 at 5:48 pm #

        how little room there is for any differing view on the research

        Differing view? You dismiss preventable deaths as the cost of doing business.

        You damn right I don’t accept that “differing view”

        • SweetBabyJesus
          October 27, 2015 at 7:27 am #

          No–a differing view that takes all of the risks surrounding infant, maternal and perinatal mortality into consideration. Where midwives/OBs/CNMs/Peds/PCPs etc. are able to collaborate more and hone the best practice and best skills to do right by their patients from start to end. But I already knew you’d come back with that Bofa. You really are an excellent groupie on this thread–a charming example.

          • Amazed
            October 27, 2015 at 7:30 am #

            Would you stop blabbering about infant mortality already? It just make you look even dumber. Not the right statistics. Not the right statistics. The fact that you love it so much doesn’t make it the right one.

          • SweetBabyJesus
            October 27, 2015 at 7:42 am #

            No it didn’t. You want to say it did so idiots like Bofa think I look dumber. That is a stat that DOES matter. It is a part of the bigger picture. Not the biggest part but to ignore it is folly. Of course maybe you just don’t give a shit what happens after the baby is out. Send them on, let it be someone else’s problem. It’s probably your feeble understanding of the midwife’s role in the community that makes you think it’s insignificant. We care much beyond the clinic or OR–and it’s the reason our client base is growing.

          • DaisyGrrl
            October 27, 2015 at 8:00 am #

            Infants are usually cared for by pediatricians. Or are you saying the midwife’s role extends beyond the first few weeks of life? Are you also a lay pediatrician?

          • Amazed
            October 27, 2015 at 8:06 am #

            She just wants to exclude stillbirths and basically everything that goes wrong with a midwife prenatal care, I think.

            Or perhaps she is really dumb enough not to know what infant mortality excludes.

          • Sarah
            October 27, 2015 at 10:48 am #

            Of course not, you turn them over to the homeopath and chiropractor then.

          • Chi
            October 28, 2015 at 9:01 pm #

            Well, here in New Zealand, our Primary Care Provider (PCP) for our pregnancy, be they midwife, OBGYN or specialist usually looks after the woman and baby for 6 weeks post-partum. They’re the ones who do the well checks, weighing, asking about feeding habits etc.

            After 6 weeks the baby is then turned over to their secondary care provider, which is from one of 3 organizations (I chose Plunket) and their pediatrician of choice (it’s a joint effort, though the Plunket nurse is more growth and development and the ped is for health issues).

            So yes in SOME cases the midwife’s role extends beyond the first few days (sorry misread your post as days, not enough coffee today).

          • DaisyGrrl
            October 28, 2015 at 9:22 pm #

            Yup, here in Canada midwifes provide well-baby care to 6 weeks post-partum too. After that babies are turned over to other primary care providers.

            No worries about the days/weeks part. My main point was that midwives don’t see the babies for very long beyond the neonatal period.

          • Chi
            October 28, 2015 at 9:26 pm #

            Yeah it’s like ‘oops my part’s done now, see ya, here’s the bill.’

          • yugaya
            October 27, 2015 at 12:30 pm #

            ” You want to say it did so idiots like Bofa think I look dumber. That is a stat that DOES matter.”

            You don’t have a clue about stats, and there is no need for anyone here to make any effort to portray you as being any dumber than you already are.

          • Roadstergal
            October 27, 2015 at 12:42 pm #

            “Of course maybe you just don’t give a shit what happens after the baby is out. ”

            That’s quite ironic, given the established tendency of CPMs to bail once the baby is out – or even before.

            Science-based practitioners, including most CNMs and OBs, care more about a baby’s brain function than an empowering birth experience for mama. The CPM business model is based around the empowering birth experience for mama, and refusing interventions regardless of the risk of long-term deficits to the baby. This philosophy is the reason why, now that people are starting to collect good-quality data on homebirth, they are starting to see results like this:
            http://www.ajog.org/article/S0002-9378(13)01604-9/pdf

            “Women who delivered at home had 16.9 times the odds of neonatal HIE compared to women who delivered in a hospital (p¼<0.01). The odds remained significant after controlling for maternal age, ethnicity, education level, primary payer and prepregnancy weight (aOR 18.7, 95% CI 2.02-172.47). After controlling for mode of delivery the odds of HIE increased for home birth compared to hospital birth (aOR 32.9, 95% CI 3.52-307.45)."

            You're telling me homebirth midwives care SO MUCH about the baby after it's delivered? If that's so, why do they consistently warn women against practices designed to preserve long-term brain function, and why do they have such poor outcomes when it comes to brain damage to babies?

          • The Bofa on the Sofa
            October 27, 2015 at 9:40 am #

            Where midwives/OBs/CNMs/Peds/PCPs etc. are able to collaborate more and hone the best practice and best skills to do right by their patients from start to end.

            I’m all for better collaboration of OBs/CNMs/Peds/Internists.

            In fact, I would add that you could do things like having more “postpartum doulas” (for lack of a better name) to help improve postpartum care for all moms.

            But what does that have to do with CPMs doing homebirths and “unnecessary” c-sections?

      • Megan
        October 26, 2015 at 6:06 pm #

        Gotta make sure to play the victim card before you leave, huh?

        What’s really sad here is that there will be women who entrust you with the safety of themselves and their babies and you have no interest in actually learning the science needed to help them. Dead babies are just a “cost of doing business” for CPM’s.

        Easier to talk about how MEEN we are than to deal with the cognitive dissonance that comes with knowing what you do isn’t the safest option. If you truly care about the safety of women and babies, ask yourself why you aren’t pursuing a real midwife degree (CNM) that would be respected by medical professionals.

        Going to medical school wasn’t easy or convenient but I didn’t go to homeopathy school instead just because I didn’t feel like doing the work of medical school. Women and babies deserve caregivers with the most knowledge and best credentials.

        Oh and by the way, stick the flounce this time, will ya?

        • Bombshellrisa
          October 26, 2015 at 7:05 pm #

          Future sister in chains right there. At least we know she is going to fit in.

      • Who?
        October 26, 2015 at 6:18 pm #

        Can you stick the flounce though?

        • attitude devant
          October 26, 2015 at 6:36 pm #

          We live in hope…

          • Who?
            October 26, 2015 at 6:47 pm #

            Her talent was stats, wasn’t it? I can hardly spell statistics, but I know that her interpretations (or the one she learnt from whoever taught her what it is she knows) are way off.

          • SweetBabyJesus
            October 27, 2015 at 7:25 am #

            Please don’t talk to me about correctness when you use words like “learnt”. I am no special hand at math but I’ve got the english language on lock.

          • DaisyGrrl
            October 27, 2015 at 7:58 am #

            Apparently not, since “learnt” is a commonly used word outside North America. It is especially common in the UK, which you may recognize as the place where English originated.

          • Sarah
            October 27, 2015 at 10:49 am #

            Probably not.

          • attitude devant
            October 27, 2015 at 6:17 pm #

            (when all else fails, troll on tone, grammar, and spelling)

          • Fallow
            October 27, 2015 at 9:54 am #

            “Learnt” is fine. Dialect and regional differences are still perfectly “correct” English. No, you don’t have the language on lock. Not if you think there are inherently correct ways to speak it, no.

            I get that your career choice is meant to serve a very pampered, egocentric, privileged, largely white population. But you really prove those biases when you can’t deal with minor dialect differences.

          • The Bofa on the Sofa
            October 27, 2015 at 9:54 am #

            http://grammarist.com/spelling/learned-learnt/

          • Amazed
            October 27, 2015 at 9:57 am #

            In my language high school, we were given both “learned” and “learnt” as correct forms. Had to learn both too.

          • Roadstergal
            October 27, 2015 at 11:41 am #

            I learnt both. 🙂

          • Grace Adieu
            October 28, 2015 at 7:58 am #

            Dear God, when did British English become a “dialect”?

          • Linden
            October 27, 2015 at 12:01 pm #

            Wait, “learnt” is wrong? Colour this Brit surprised!

          • Roadstergal
            October 27, 2015 at 12:21 pm #

            https://www.youtube.com/watch?v=dz4Ps55Rx40

          • Barbara Delaney
            October 27, 2015 at 4:25 pm #

            No, it’s correct. Learned and learnt are both past tenses of learn. Learnt is more common in British English. Here are some other examples, Spell – spelled, spelt,
            Leap – leaped, leapt, Burn – burned, burnt, Spill – spilled, spilt, Spoil – spoiled, spoilt,
            Dream – dreamed, dreamt, and Kneel – kneeled, knelt.

            So Sweet Baby Jesus doesn’t particularly excel at math or English. I’m stunned.

          • Barbara Delaney
            October 27, 2015 at 4:17 pm #

            Actually, you don’t. “gained a exacting” That should be “an” exacting since it’s before a vowel. And in your last run-on sentence you failed to use commas where they were needed.

            “And as we learn more of the risks of unnecessary obstetrical intervention over time maybe someone will start considering the opportunity costs that come with
            conventional OB practice, rather than screaming murder when someone
            decides they would rather assume the mild risks of one thing to avoid the moderate/life-long risks of another.”

            Can you see where the commas are needed?

          • Daleth
            October 27, 2015 at 4:56 pm #

            Seconding what Barbara D. wrote. Learnt is correct English (capital E for that, by the way). It’s how basically everyone but Americans spells it: the British, the Canadians, the Irish, the Australians…

          • Who?
            October 27, 2015 at 6:40 pm #

            You might like to avail yourself of the services of an atlas, to check out the countries the posters below mention. Turns out there’s a whole world that isn’t the US!!!

            And your maths (we say ‘maths’, not ‘math’ here in some of the rest of the world) (see ‘atlas’ above) isn’t ‘not special’ it is atrocious. That you use it to try and lull women who don’t know better into your deadly trap is shameful.

          • Who?
            October 27, 2015 at 6:51 pm #

            Oh, and to my question about sticking the flounce, this is a ‘no’?

            Knew it, no staying power.

          • Taysha
            October 28, 2015 at 2:35 pm #

            No, you don’t. Your English (note – it’s capitalized) is about as accurate as your math.

            http://dictionary.reference.com/browse/learnt?s=t
            Learnt –
            verb
            1.
            a simple past tense and past participle of learn.

      • Bombshellrisa
        October 26, 2015 at 7:42 pm #

        Consumers already overwhelmingly show that they prefer to get their care from OBs and CNMs in a hospital setting. Home birth appeals to a privileged few and the midwives who provide it know that.

      • Daleth
        October 27, 2015 at 1:32 pm #

        And as we
        learn more of the risks of unnecessary obstetrical intervention over time maybe
        someone will start considering the opportunity costs that come with
        conventional OB practice, rather than screaming murder when someone
        decides they would rather assume the mild risks of one thing to avoid the moderate/life-long
        risks of another.

        Hospital birth risk, according to you: “unnecessary” interventions, such as epidurals, induction and c-sections.

        Home birth risk, according to you and everyone who pays attention to the facts: the baby is 3-4 times more likely to die. (Also, though we haven’t discussed that much on this thread, 17 times more likely to suffer permanent brain damage).

        Which one of those risks is a “life-long risk”? Which one is going to affect you badly for the rest of your life? Getting induced? Or having your beloved, much-wanted baby DIE?

    • PrimaryCareDoc
      October 26, 2015 at 5:46 pm #

      “Neonatal death—all newborns
      Homebirth: 2.0/1,000
      Hospital Birth: 0.9/1,000
      (increased risk with Homebirth is 0.1%)”

      You don’t understand math. At all.

    • Who?
      October 26, 2015 at 6:08 pm #

      So homebirth midwives in your world do cs? Or do you mean that once transferred to hospital, they get a cs?

      Because if that’s how you’re counting, I hope you’re putting deaths in hospital after homebirth transfer on the homebirth account not the hospital account.

      • Charybdis
        October 26, 2015 at 6:19 pm #

        Now, now, she can’t do that. Those babies died IN THE HOSPITAL, so clearly that is where the stats should be places/counted. They died on the hospital’s watch, not at home with the CPM,, so they CAN’T be held responsible for that.

        This is dripping with sarcasm, by the way.

        • Who?
          October 26, 2015 at 6:31 pm #

          These people make my brain hurt.

        • SweetBabyJesus
          October 27, 2015 at 7:24 am #

          I disagree with you @Charibdys:disqus. I would want to be held responsible for that the same way any OB would be–that’s called accountability and I am all for it.

          And the irony of sarcasm is you don’t have to actually tell someone it’s sarcasm. (Unless you suck at it)

          • PrimaryCareDoc
            October 27, 2015 at 8:19 am #

            So, you’re going to carry malpractice insurance with suitable limits? And tail coverage, because in Florida you can be sued until a kid is 12 for any sort of birth injury? It’ll cost you a minimum of $33,000 a year.

          • fiftyfifty1
            October 27, 2015 at 9:00 am #

            ” I would want to be held responsible for that the same way any OB would be–that’s called accountability and I am all for it.”

            So that means you will carry liability insurance to protect your patients. If you screw up and harm a child, you need to have a policy so that parents can get money to pay for their disabled child’s care for the rest of his or her life. Millions of dollars. Do you promise to carry such liability insurance? If you don’t, your claim that you want to be held responsible like an OB (or CNM) is just so much hot air…like everything else you’ve written so far. Ask your mentors whom you respect so much if they carry liability insurance. I think you will find that they all say they “don’t need it” or “can’t afford it”. They like to pretend they are responsible but in reality, they are all too glad to leave their patients high and dry if it will put more money in their own pockets.

          • Amazed
            October 28, 2015 at 9:00 am #

            “Do you promise to carry such liability insurance?”

            Ah, fifty! No one can give you what I can promise you.

            Even if she promises and intends to do good on her word, I suspect the first time she has to choose between paying the bills and paying for insurance, good intentions will fly right out the window. As we saw, she’s so sure that nothing will ever go bad on her watch. Why waste money on insurance then? And it’s the mother’s choice anyway! As Ina May put it, “the parents saw no reason to be punishing”.

            I throw up in my mouth each time I see a midwife embroiled in a preventable death or injury praising the lovely parents who took their full share of responsibility for their birth choices. If they demand to know what midwife’s share in this is, they are turned into greedy monsters.

            Beauty!

          • moto_librarian
            October 27, 2015 at 10:15 am #

            Do you plan to carry malpractice insurance? If you really want to be held responsible in the same way as an OB, this is a huge part of it.

          • Charybdis
            October 27, 2015 at 11:27 am #

            It needs to be clarified for some, the sarcasm. Some people believe the craziest things; things that sound like they SHOULD be sarcastic, but they are completely and totally believed as true. Stuff like “homebirth is as safe or safer than hospital birth”, for example.

          • Bombshellrisa
            October 27, 2015 at 12:05 pm #

            The point is that as a CPM, you couldn’t be. Ask any of the women here who have had babies injured or that died due to a midwife missing something very simple like treating GBS. The most they could do is try to sue in civil court. Make no mistake, there is a whole process that home birth midwives are advised to take when they face “persecution” aka people attempting to hold them responsible for injury or death. It’s outlined in “From Calling to Courtroom” written by an RN non nurse midwife turned lawyer who practiced home birth. She isn’t sorry for the families, she feels sorry for herself. Serial killer midwives like Brenda Scarpino are featured in that ebook, documenting the “persecution” she has endured and how to lie to families so they don’t know the real risks of home birth.

          • areawomanpdx
            October 27, 2015 at 8:57 pm #

            And they can’t even sue in civil court unless they’re willing to pay for the entire case out of pocket, unlike people who are cared for by providers with malpractice insurance. And then when they do spend the cash and win in court (Like Magnus’s parents), the midwives declare bankruptcy and start a new birth center under another name. Zero accountability.

      • SweetBabyJesus
        October 27, 2015 at 7:22 am #

        I think that is valid and the stats should be considered that way, where transfers and subsequent deaths count. I also think that the homebirth stats should be gathered in states where it is regulated and compare that to states where it is not regulated. I am willing to be there would be a difference in the results.

        • DaisyGrrl
          October 27, 2015 at 7:56 am #

          You clearly haven’t seen the stats for Oregon, where they’re collected based on intended place of birth and CPMs are (marginally) regulated. They’re horrifying.

          As far as regulation, most CPMs (and pretty much any organized group of CPMs) resist any real regulation because they view it as an infringement on their autonomy. I’m not saying you’re one of them, but it is a very pervasive view.

          I’d personally have far fewer problems with CPMs if they agreed to malpractice insurance and refused all twins, breech and VBACs. But since even this basic level of regulation appears to be unacceptable to the majority, the only reasonable way forward is to remove recognition of the CPM credential and join the rest of the developed world in terms of midwifery regulation.

    • Squillo
      October 26, 2015 at 7:59 pm #

      If you are truly pro-evidence-based care and pro-collaboration, and want to give women the best choices for both in- and out-of-hospital birth, I would suggest getting the best education you can and actually contributing to those things. CNMs do collaborate with MDs and they do participate in research. CPMs as a profession appear to this observer to be incredibly complacent, with a distinct lack of interest in quality improvement or adding to the evidence base. You can do better.

      • fiftyfifty1
        October 26, 2015 at 8:00 pm #

        “You can do better.”

        Don’t flatter her. It’s clear she can’t.

        • SweetBabyJesus
          October 27, 2015 at 7:42 am #

          I can and I will. Thanks for the vote of confidence.

          • fiftyfifty1
            October 27, 2015 at 8:45 am #

            You haven’t written a single thing that gives me confidence that you have either the intellect or ethics to do better.

          • Anj Fabian
            October 27, 2015 at 8:56 am #

            Reading this, I’m left with the assumption that she’s accepted everything her teachers and preceptors have told her. How home birth midwives don’t need all that stuff nurses and doctors learn. How that gets in the way of hands on midwifery. How CPMs specialize in home births so they need a different skill set. How doctors don’t understand that or appreciate it. How placentas are almost magical and how babies can tolerate long periods of oxygen deprivation without harm.

            How doctors think that everything is an emergency and overreact. Some babies take longer to breathe and pink up. Sometimes women take longer than we like to stop bleeding or deliver the placenta. As long as no one actually dies, it’s good. Happy endings all around!

            It’s mostly bullshit. It’s a mythology created to cover up the gaps in their care and their knowledge. If you don’t understand something, make up a story about it. It’s what humans do.

          • PrimaryCareDoc
            October 27, 2015 at 8:59 am #

            Let’s not forget that VBAC, breech, twins…all a variation of normal.

          • moto_librarian
            October 27, 2015 at 10:14 am #

            Oh, so you’re going to admit that the CPM is a substandard credential and go and become a CNM instead?

        • Squillo
          October 27, 2015 at 11:58 am #

          I don’t know if she can or she can’t, but it’s clear she prefers not to, which is the entire problem with CPM midwifery.

      • SweetBabyJesus
        October 27, 2015 at 7:20 am #

        I think that if OBs, CNMs and other care providers were to come together with CPMs to refine the education and training and make those standards higher for all. It’s so easy for everyone to pick me apart here because that is what you all seem to be here for. Ranting and tearing someone down doesn’t change a damn thing that you seem to feel to adamantly about. Put your money where your mouth is, make it better, work with us, make a change.

        • Amazed
          October 27, 2015 at 7:28 am #

          Indeed? It’s up to OBs to say that CPMs are dangerous – and they have started to do so. It’s up to CNMs to say that CPMs give them bad name and refuse to give them the title “midwives”. It’s up to CPMs to realize that they need to change and become real midwives – CNMs.

          The only ones who need the CPM “credential” are people like you – those who want to be perceived as midwives but their personal circumstances comes first, so they knowingly choose to endanger patients by striving towards a dangerous “credential”, instead of walking the hard road thousands of people walk every day in order to be the best practitioners possible.

          You are the problem, SBJ. Don’t expect of OBs and CNMs to fix it in a way that will be most comfortable for you, letting you retain this murderous credential of yours.

          • SweetBabyJesus
            October 27, 2015 at 7:35 am #

            “Started”?? No no no, it’s been said since the beginning. The establishment snuffed out the old granny midwives back in the early 1900s who had been birth attendants their entire lives. Should change happen? Yes. Should it be the function of elitism, apathy and gentrification? I don’t think so.

            I am not knowingly endangering anyone. I am not the problem. I am the solution–I am having these conversations and I am making the system better. I’ll do more than sit my fat ass behind a keyboard and ridicule the little person like you. I will work alongside the practitioners that have more than half a brain and half a heart to get women the care they need. I am walking a harder road than you will ever know and my training exceeds nursing school by at least a year. You will continue to drink your koolaid and ship women down the line under the guise of “choices in healthcare” but you don’t care about that. You want to offer no choice. It’s OB all the way and no other option. That’s where the scary stuff happens and comes the ONLY MATERIAL any of you can conjure against midwives–the rogue ones who practice with shitty training and no experience. Step up to the plate and shut your mouth until you’ve got something to say.

          • Anj Fabian
            October 27, 2015 at 7:43 am #

            “The establishment”

            Hospital care began to become more accessible and the outcomes improved to the point that women CHOSE to birth in hospitals.

            The typical home birth back in the day was usually the family bringing in a friend, neighbor or relative to help out. Only when the situation looked bad would they fetch a midwife. Midwives want paying after all and if you can do it yourself for free, so much the better.

          • SweetBabyJesus
            October 27, 2015 at 7:46 am #

            Go on and tell yourself that. It doesn’t feel better, doesn’t it? And I am saying that women still have CHOICE to go where they want. But who will be with them at home if that type of birth is demonized? CNMs and OBs won’t. Midwives will and then will STILL be ostracized. Go ahead and have your cake, but you can’t eat it this time. You’ve already thrown it to the dogs with the midwives you pretend to hate but refuse to help or teach.

          • Anj Fabian
            October 27, 2015 at 7:55 am #

            You retreat to “birth choice!” ?

            Why not refute my claims? Tell me that there were enough granny midwives back in the day to attend every woman who needed them. My friend from WV had a grandmother who was a “granny midwife” up in the mountains. She bragged that she never lost a mother. Babies? Well…they didn’t all make it. She did the best she could.

            That was the old days when child birth was understood to be perilous for all parties. Now we have people talking about “birth choice!” as if the dangers don’t exist.

          • Amazed
            October 27, 2015 at 8:05 am #

            A few years ago, I watched a video with a 80 yo former midwife who had worked in the mountainous region she had been born in. She had nothing but praises for the hospitals. She worked in communities that normally disdain OBs and anything to do with women pelvic care and she was like, “They’re all good people but they just don’t GET it.” The best she could convince them to do was to have the husband keep the car ready in case something went shady.

            She had nothing but contempt for midwives’ “knowledge”. She lost her own mother in birth. She was very proud that she had managed to be trained in a big hospital (those were the 50s and it was very hard for a poor girl from a very backward region to receive education). And yes, she was very clear that “During childbirth, a woman is looking into a grave” was not a thing of the past. She was so thrilled that we have hospitals – safety and less motherless children. Without talking about “low risk” and “high risk”. To her, childbirth was an inherently risky business.

            And yes, she thought that she, herself, had been a good and safe practitioner. She did see herself as savior. She just saw herself as the savior of those whose culture wouldn’t let them seek the most competent care, not the savior of women from big bad modern medicine. She thought she was a pretty good thing. Just vastly inferior to hospitals, that’s it.

          • PrimaryCareDoc
            October 27, 2015 at 8:14 am #

            I have patients who chose to smoke. Doesn’t mean I go out and buy them their cigarettes. Health care providers have no obligation to enable their patients’ poor choices.

          • fiftyfifty1
            October 27, 2015 at 8:52 am #

            “But who will be with them at home if that type of birth is demonized? ”

            The data from Oregon show that having a birth with a CPM is no safer than having a planned UC (freebirth). So if CPMs get drummed out of business, women are no worse off than before.

          • Monkey Professor for a Head
            October 27, 2015 at 10:24 am #

            Sure women should have a choice. But they deserve to make an informed decision. As a health care provider, it is your responsibility to give them accurate information to help them make that decision. Do you tell women that there is a higher chance that their babies will die at home compared with hospital?

          • Amazed
            October 27, 2015 at 10:35 am #

            Even if she does – and remember, she told moto she doesn’t believe it, so it’s rather doubtful that she does, – she will present it as “It’s just 1/1000, that’s so tiny that it’s practically nonexistent and it will not happen to you.” That’s what she believes – that 1/1000 is very tiny when we’re tallking birth. And we know that homebirthing mothers believe 300 babies delivered mean a huge amount of amassed knowledge, just like PolyAmethyst here is in awe of the “dozens if not hundreds of burths” she needs to get her CPM degree. SBJ will just reinforce this opinion.

          • Charybdis
            October 27, 2015 at 12:21 pm #

            Maybe if they stop at 999 births, they will never encounter that 1 in 1000. Because they math so well.

          • Squillo
            October 27, 2015 at 11:17 am #

            Healthcare professionals are hardly refusing to teach or help midwives. In fact, there are national organizations dedicated to interprofessional education –the Interprofessional Education Collaborative, the National Center for Interprofessional Practice and Education–not to mention the schools of medicine and nursing that provide collaborative education, often alongside pharmacists, physical therapists, dentists and others.

            The difference is that all those groups already have established practice standards and have accepted regulation and accountability, which is why they are able to integrate into the system in the first place. When non-nurse midwifery does that, maybe they’ll have a place at the table. You seem to think the onus is on others to do the heavy lifting.

          • Amazed
            October 27, 2015 at 7:56 am #

            Yeah, yeah. And once upon a time, doctors didn’t wash their hands, dontcha know? So, dig off your appendix alone.

            I knew that at one moment, you’d start sniffling over the fate of the poor midwives from 120 years ago. I knew it.

          • PrimaryCareDoc
            October 27, 2015 at 8:12 am #

            You are not “knowingly” endangering anyone, because you are not educated enough to know what you don’t know. Your training does not exceed nursing school. Don’t continue to make shit up. Just because it’s going to take you longer to do less, doesn’t mean that you have more training.

          • Karen in SC
            October 27, 2015 at 8:46 am #

            The fact that CPM was only a temporary credential, to be given to those granny midwives, got lost along the way as women saw an easy way to get their birth junkie fix and get paid.

          • yugaya
            October 27, 2015 at 8:44 am #

            “I am not knowingly endangering anyone.”

            With your complete lack of basic numeracy skills that you so ignorantly displayed here you most certainly are. FFS, you’re supposed not only to provide adequate information on rates, percentages and odds to your clients but also to administer medications. You are going to kill someone because you can’t do numbers at all.

            What a parody of your own arguments you are. You are illiterate, ignorant, and arrogant enough to claim otherwise based on a fake credential that makes you a substandard care provider anywhere in industrialized world.

          • Amazed
            October 27, 2015 at 9:11 am #

            I am currently taking vitamins for hair and nails. The number of pills I can safely take is there, on the label. Vitamins for hair and nails, I must say again, so this fact isn’t lost on anybody. By definition, non-emergent and presumably not able to cause a great damage even if I take the wrong dose.

            At homebirth? With those oils and whatnots meant to help a mother “naturally”? The wrong dose can and will kill someone.

            Another anecdote: I am at the doctor’s. She takes my blood pressure, although I am there for a totally unrelated problem, so I don’t have any issues with blood pressure (yet). It’s great, she says, just where it should be, it’s perfect. Me: ah great. After 3 coffees in the last hour or so… She changes face and starts questioning me. Turned out that I’ve been lowering my blood pressure for months by eating yoghurt with cinnamon and honey in proportions that were recommended for people with high blood pressure.

            Totally natural. Incredibly tasty. And likely to give me some trouble if I had kept it for a year or two since I rarely change my breakfast.

            Natural can be freaking dangerous. And yes, maths is important in nature too!

          • fiftyfifty1
            October 27, 2015 at 9:22 am #

            “I am not the problem. ”

            You are the problem. People who think they can substitute their passionate feelings and Rebel Without a Clue personalities for real medical training. Women and babies pay the price.

          • Squillo
            October 27, 2015 at 11:44 am #

            And somehow, midwifery managed to survive and even become part of the system, starting in 1955, developing practice standards, QI initiatives, collaboration, and accountability. Elitism and gentrification? Maybe. Apathy, no. If anyone is apathetic, it is lay midwifery. CMs/CNMs may have a long way to go to be able to practice as they wish as equal partners with MDs, but they are at least 30 years ahead of CPMs.

            I can’t speak for others here, but I certainly don’t want OBs to be the only option, and my anecdotal discussions with OBs suggest they don’t either. There are certainly arguments over appropriate scope of practice and oversight, which increasing collaborative practice might resolve.

            Why are there midwives with “shitty training and no experience?” Because midwives permit it. There are certainly bad OBs and CNMs, but not because of lack of training or experience (although these could certainly be improved, and there are national groups focused on just that), but there are national baseline standards for education and training, and a regulatory framework for accountability, that non-nurse midwifery has rejected.

          • Roadstergal
            October 27, 2015 at 11:47 am #

            “It’s OB all the way and no other option”

            You truly are dense, in a way neutron stars would envy. Many women on this board, in this very conversation, have commented about their positive delivery experiences with CNMs. Many OBs have talked about their collaborative relationships with CNMs.

            For someone who claims to listen to women and mothers, you’re doing a terrible job of doing it just in this little discussion, where there’s no panic and no lives are at stake. How quickly will you fall apart when faced with an actual emergency?

          • Who?
            October 27, 2015 at 6:30 pm #

            ‘I am not knowingly endangering anyone.’

            Exactly. Your ignorance and hubris, that you can’t, by definition recognise, is what makes you dangerous in environments where it is the norm.

            Life is not a suffering competition. Good on you if you’re trying to improve your circumstances-for your own sake, make sure you don’t back a loser, which is exactly what CPM ‘qualifications’ are.

          • Amazed
            October 28, 2015 at 8:51 am #

            She is knowingly endangering people, though. She admitted that she chose CPM to CNM not because she believed in CPM = Better but because it suited her better. If that isn’t a “I know what’s best but it’s haaaard, so I am not choosing it”, I don’t know what it is.

          • Squillo
            October 27, 2015 at 11:52 am #

            Thing is, it’s NOT up to OBs. It’s up to midwives to improve their own practice.

          • Amazed
            October 27, 2015 at 12:48 pm #

            I am not saying that it’s up to OBs to imporve CPMs’ practice. I am saying that it’s their job to say, “Those are not midwives, I am not working with them, I am not cleaning their shit, they’re fucking incompetents (I use the word as a noun).” Which they do. It’s up to CPMs to improve their own practice, indeed, and since every “study” they do is aimed to show how peachy it all is, nothing needs to change and they’re simply the best, needing no stinking standards, they should go away.

          • Squillo
            October 27, 2015 at 1:04 pm #

            Fair enough.

        • Karen in SC
          October 27, 2015 at 8:36 am #

          The higher standard is already there – the CNM.

        • fiftyfifty1
          October 27, 2015 at 9:25 am #

          CPM leadership has rejected each and every attempt to improve their training requirements or define their scope of practice. CPMs are snake oil salesmen.

          • The Bofa on the Sofa
            October 27, 2015 at 9:33 am #

            But why are OBs and CNMs responsible for increasing the standard of the CPM in the first place? The CPMs can do that all on their own, but choose not to.

            And the reason why is because they don’t want to! If CPMs were to try to raise to the standard of, say, a CNM, they would actually do things like be responsible professionals, and be held to professional standards.

            Remember when they tried to write homebirth guidelines for midwives, by looking at the fundamental common standards that were being used by foreign midwives (you know, the ones that keep getting held up as something to strive for?)? They couldn’t get them accepted, because it put too many restrictions on midwives! Midwives don’t want to be held to any standards, they want to play on their own.

          • Roadstergal
            October 27, 2015 at 11:03 am #

            “If CPMs were to try to raise to the standard of, say, a CNM,”
            …then they would just be CNMs to start with! The CPM credential exists because some folk wanted to be midwives, but didn’t want to do all of that bothersome and difficult schooling. The real credential exists, and they chose not to get it. As you say, fuck ’em.

        • The Bofa on the Sofa
          October 27, 2015 at 9:28 am #

          I think that if OBs, CNMs and other care providers were to come together with CPMs to refine the education and training and make those standards higher for all.

          I agree, kind of. CNMs have been WAY too accommodating toward CPMs, treating them like “sisters” instead of calling them out as the incompetent posers that they are. The ACNM needs to be clear that they expect all midwives to be held to the same high standards, and that the CNM is what everyone should strive for.

          The ACOG has also been too soft, and need to make it clear that the CPM credential is unacceptable.

          The CPMs have all the power in the world to refine THEIR education and make the standards higher. They choose not to. So fuck’em.

        • Squillo
          October 27, 2015 at 10:27 am #

          I don’t see the value in propping up a fourth category of maternity care provider to bring them close to where the other three are in terms of education, accountability and integration into the system. Especially since the leadership has fought against the first two. I’d rather see CM/CNM capacity expand (alongside obstetrics) to provide better access to care in underserved areas. I think we’ll get a far better bang for our healthcare buck.

        • Megan
          October 27, 2015 at 10:41 am #

          Couldn’t stick the flounce, huh?

        • Daleth
          October 27, 2015 at 4:51 pm #

          All we need to do to make the standards higher is legislate CPMs out of existence. The standards we need already exist: they’re called “being a CNM.”

    • yugaya
      October 27, 2015 at 8:34 am #

      “Homebirth: 2.0/1,000
      Hospital Birth: 0.9/1,000
      (increased risk with Homebirth is 1.1%)”

      Wow, what a math fail we have here.

      • The Bofa on the Sofa
        October 27, 2015 at 9:52 am #

        And remember, this is her CORRECTED version.

        • yugaya
          October 27, 2015 at 12:15 pm #

          “And remember, this is her CORRECTED version.”

          Well, in that case, Christ Pantocrator himself wouldn’t be able to fix all that is wrong with someone like SweetBabyJesus delivering babies.

      • Linden
        October 27, 2015 at 11:50 am #

        WHUT.
        There, in a nutshell, is the ignorance of NCB advocates.

      • SweetBabyJesus
        October 27, 2015 at 8:16 pm #

        So what is the correct figure? Please do share.

        • yugaya
          October 27, 2015 at 8:25 pm #

          “So what is the correct figure?”

          ^^^ You can’t make these CPM idiots up, that’s how stupid they are all over.

          • Who?
            October 27, 2015 at 8:27 pm #

            I was beginning to think SBJ might be interested in learning something. It would take 2 mins to look up how to do this calculation, or she could read the excellent summary provided earlier.

            But no! Bat on in ignorance, and be proud of it.

            A budding sister in chains, for sure.

          • SweetBabyJesus
            October 27, 2015 at 8:28 pm #

            Your turn to look it up. Up to the challenge? I’ve already done my home work.

            Your.Turn.

          • Who?
            October 27, 2015 at 8:30 pm #

            I don’t need to look it up, I’m not claiming to be any good at statistics, nor am I quoting incorrectly calculated figures. Smart people who know way more than I do on this topic tell me, and I believe them, just like they believe me when we’re talking about my area of expertise.

            You think you have nothing to learn, which is why you are so very dangerous.

          • SweetBabyJesus
            October 27, 2015 at 8:32 pm #

            I have so much to learn. This learning environment is about as welcoming as a cactus on fire. Y’all don’t want to teach, you want to witch burn. Admit it. You’d never treat a person like this to their face, whatever you believed of them. So hide behind your keyboard and tell me I can’t calculate things while you prove you have no skills of your own. Go on!

          • Who?
            October 27, 2015 at 8:36 pm #

            This is a blog, not a learning environment.

            When I am unfortunate enough to come across an arrogant moron who would benefit from my correction, they get it, in real life way more often than on the internet, because in real life it makes a difference. I also don’t pull my punches-figuratively speaking-in real life as I do here, because that doesn’t help. Clear, concise, in the moment correction is a powerful tool.

            I’ve acknowledged I know nothing about stats. Smart people who know all about stats say you’re wrong.

            You don’t know you don’t know.

          • SweetBabyJesus
            October 27, 2015 at 8:37 pm #

            So you still can’t answer me. That’s cool.

          • Who?
            October 27, 2015 at 8:40 pm #

            Blah blah meeeeaaaan blah blah I’m so humble blah don’t tell me things I don’t want to hear blah blah sob, sigh, moan, blah, one in a thousand is not many dead babies blah moan sob bleat.

            Rinse and repeat.

          • yugaya
            October 27, 2015 at 8:43 pm #

            Notice how she still has no fucking clue. So she’s left with resorting to ad hominem memes and repeated attempts at asking us to fill her in. Now who would have expected that? 🙂

          • Who?
            October 27, 2015 at 8:45 pm #

            It’s not kind to mock the afflicted, but sometimes it’s just fun.

          • Monkey Professor for a Head
            October 27, 2015 at 9:24 pm #

            I would be extremely wary of any healthcare provider who thinks that internet blogs are a suitable place to get an education. I would also be very wary of a healthcare provider who does not know basic statistics (such as the difference between absolute risk and relative risk).

          • Who?
            October 27, 2015 at 9:29 pm #

            Quite so.

            I’d also be wary of any provider so obviously emotionally needy, and with such a very thin skin.

          • SweetBabyJesus
            October 27, 2015 at 9:55 pm #

            Say it to my face!

            You wouldn’t DARE.

          • Daleth
            October 28, 2015 at 11:04 am #

            Are you 12 years old?

          • SweetBabyJesus
            October 27, 2015 at 9:55 pm #

            It’s not the only place I’m getting an education, but then those in the older generation are still wary of new-fangled things like the internet. I mostly am here to make sure you people’s opinions aren’t the only ones getting out there. Because they are inflamed and erroneous.

          • yugaya
            October 27, 2015 at 8:38 pm #

            “I have so much to learn.”

            Couldn’t agree more. Start here or somewhere similar, that’s your level: http://library.bcu.ac.uk/learner/Numeracy.pdf

          • SweetBabyJesus
            October 27, 2015 at 8:27 pm #

            You haven’t shown for shit. And I’m the idiot. Don’t be skeered, show me what ya got stats wizard!

          • yugaya
            October 27, 2015 at 8:33 pm #

            You obviously still have no clue what mistakes several people pointed out to you.

            Ironic how you keep providing more and more evidence of your own ignorance.

          • SweetBabyJesus
            October 27, 2015 at 8:36 pm #

            I’ve made every attempt to honestly and humbly correct my mistakes. You obviously don’t care about whether or not I learn anything. You want me to crash and burn and you want to laugh while it happens. Shame, shame. I hope if you are in some way involved in academia that this is not your standard!

          • yugaya
            October 27, 2015 at 10:25 pm #

            “I’ve made every attempt to honestly and humbly correct my mistakes.”

            Honestly? Humbly?

            I’ve missed all that in between you trying to school everyone who corrected you and you bragging at the top of your lungs how smart you are. Mah gawd, you even got to school a DOCTOR!!!

            (I wish you were just a parody but alas, you are not.)

        • PrimaryCareDoc
          October 27, 2015 at 8:53 pm #

          If the mortality rate at home birth is 2.0/1000, and the rate in the hospital is 0.9/1000, that is an increased risk of over 100% not 1.1%.

          Keep in mind that home birth should be all low risk births, while the hospital group includes all high risk groups- obese patients, diabetes, VBACS, other chronic diseases, prematurity, IUGR, and congenital deformities. So the home birth group should have a much, much, much lower mortality risk, but instead it is 100% higher.

          • Who?
            October 27, 2015 at 8:54 pm #

            Someone’s going to either completely ignore you or be really rude, very soon.

            Anyone want to start a book on which way that might go?

          • SweetBabyJesus
            October 27, 2015 at 8:56 pm #

            Wait–this isn’t being rude? Sheesh! What’s coming? death threats on my son? Wouldn’t put it past this bunch.

          • Who?
            October 27, 2015 at 8:57 pm #

            Oh honey, take it easy.

            If you can’t take it, don’t dish it.

          • SweetBabyJesus
            October 27, 2015 at 8:59 pm #

            I’m still here and your dishing hasn’t touched some of the other assholes prowling this thread. Soooo step your game up?

            And don’t be redundant. I already realize that I’m a idiot-can’t-do-math-baby-mama-killing-machine-with-zero-education-and-no-respect kinda person. That much has been made clear.

          • Who?
            October 27, 2015 at 9:01 pm #

            My work here is done then! Thanks for the positive feedback, it really keeps me going!

            Oh and keep at the maths, you’ll get it one day.

          • SweetBabyJesus
            October 27, 2015 at 9:54 pm #

            Did you see yet, did you see it? Oooo so many more memes coming this way, just watch and wait!

          • PrimaryCareDoc
            October 27, 2015 at 8:59 pm #

            Are you saying I’m being rude? I gave you the damn answer you were asking for.

          • SweetBabyJesus
            October 27, 2015 at 9:00 pm #

            Nah that was for @who? not you @PrimaryCareDoc:disqus

          • Who?
            October 27, 2015 at 9:00 pm #

            But it wasn’t the one she wanted-she wanted validation. And now you’ve hurt her feelings.

          • SweetBabyJesus
            October 27, 2015 at 9:54 pm #

            See above. My math skills > @PrimaryCareDoc:disqus

            Can you dig it?

          • PrimaryCareDoc
            October 27, 2015 at 9:56 pm #

            No. You don’t calculate relative risk by just dividing the two numbers the way you did. So, you know, nice try and all.

          • Who?
            October 27, 2015 at 10:00 pm #

            I’m starting to think SBJ is a satirist.

          • The Bofa on the Sofa
            October 28, 2015 at 8:37 am #

            Ha. I was thinking it’s more that she’s 12.

          • Sue
            October 29, 2015 at 2:27 am #

            Nah – a smart twelve yr old can do math better than that.

          • SweetBabyJesus
            October 27, 2015 at 10:14 pm #

            Dude that’s not how I did it and you know it. You just don’t wanna believe that I may have something here and that you’ve been drinking Dr. Amy’s shit-flavored koolaid. Watch this video:

            https://www.youtube.com/watch?v=FZzm3-RRlI4

          • Barbara Delaney
            October 27, 2015 at 11:08 pm #

            You are so loathsome. No one has made any type of threatening remark towards you. You’re pathetic with your “dude” and “bucko” and your immature boasts.

            There are eyes on this discussion that you know nothing about it, suffice it to say that you’ve convinced a lot of bystanders that all CPM’s are unqualified hobbyists, and that Jill Duggar is far from an outlier in your group. As a matter of fact after the exhibition you’ve put on here, she may well be one of the leading lights in your group of rank amateurs.

          • Who?
            October 27, 2015 at 11:29 pm #

            So true.

            The callousness about deaths, the absolute confidence, the careful hedging around who actually takes responsibility, the maudlin self-pity.

            A great testament to who you wouldn’t trust.

          • Bombshellrisa
            October 28, 2015 at 12:09 am #

            I know you aren’t a regular, but I do hope you stick around.

          • Who?
            October 28, 2015 at 12:39 am #

            Upvote that.

          • SweetBabyJesus
            October 27, 2015 at 8:57 pm #

            Oh and you can ignore. All the people here who come looking for answers will still see my posts. Some of them will want to see more answers than y’all can offer.

          • Roadstergal
            October 27, 2015 at 9:20 pm #

            The question remains – will these accurate numbers be part of the informed consent you provide to your clients?

            Will you carry malpractice insurance equal to that carried by OBs?

            I really don’t care if you want to help women take risks with their babies in excess of the risks of driving drunk with them. I feel bad for the kids, but that’s bodily autonomy. I do care if you’re lying, by omission or directly, to encourage them to do so, and if you are free to run off with the other Sisters in Chains after presiding over the preventable death of a baby.

          • SweetBabyJesus
            October 27, 2015 at 9:53 pm #

            Yep, I am all for informed choice. And for not misleading mothers who want transparent choice (DR. AMY!!!!). I’ve even given an example of someone who should never be given the chance for a homebirth, to accentuate my point.

            Sounds like you are trying to apologize. I accept!

          • DaisyGrrl
            October 27, 2015 at 9:17 pm #

            Also, the numbers are per thousand, not per hundred, so the 1.1% she’s thinking of would be better expressed as 0.11%. The mortality rates, expressed in percentages, are 0.2% and 0.09%. And yes, as you point out, that’s over a 100% increase.

            SweetBabyJesus: when discussing percentages you need to remember that percent means “per hundred” and thus if the rate of something is expressed in some other form, you need to convert to /100 to express it as a percentage (ex: 1/4 = 25%)

            When talking about an increase in something, the percentage increase is based on the value of the lower number and the proportion of the lower number to the higher number. Thus, if we’re looking at something that happens 1/x, then 1.5/x represents a 50% increase, 2/x represents a 100% increase (or happens twice as often), and 5/x represents a 400% increase.

            If I screwed up my explanation, hopefully someone will jump in. My math skills aren’t the sharpest, but I’m pretty sure that’s the gist of it.

          • SweetBabyJesus
            October 27, 2015 at 9:52 pm #

            Percentages are always expressed the same way. I did my conversions and will be contacting a friend solid in stats to confirm. My calculations hold and you’re afraid to admit it. Sorry bucko, I’ve got you cornered.

          • yugaya
            October 28, 2015 at 5:24 am #

            “Percentages are always expressed the same way.”

            No, they are not.

            A helpful resource for someone with the lack of basic adult numeracy like yours: https://www.mathsisfun.com/percentage.html

          • DaisyGrrl
            October 28, 2015 at 8:00 am #

            It’s amazing when you think about it. I go shopping, and I see three stores have a sale. One offers 1/3 off, the other offers 33% off, still another offers buy 2, get 1 free. They all mean roughly the same thing (provided I buy 3 items at the last store) but they’re expressed differently. I wonder what SBJ would say they are.

            I’m having real difficulty understanding how anyone can go through life without basic numeracy. SBJ’s foundation is so shaky…I just don’t even know where to start in pointing out what’s wrong with her math.

    • Daleth
      October 27, 2015 at 1:25 pm #

      I will end with this: The perinatal risk of having a homebirth over a hospital is 0.1% greater

      You do realize that that means if even 10% of US births happened at home, at least 400 healthy full-term babies would die every year because their mom went for a home birth?

      More than one baby every day.

      And if 50% of US births were home births, a good 2000 babies a year–healthy, full-term babies–would die, just because their mom tried a home birth.

      So that’s your goal, then?

      And BTW, studies that compare babies with similar risk profiles find that the numbers are much higher: low-risk, full term, head-down singletons weighing at least 2500g/5.1lbs are 3 to 4 times more likely to die in a home birth than in a hospital birth.

      http://www.ajog.org/article/S0002-9378%2813%2901155-1/fulltext

    • SweetBabyJesus
      October 27, 2015 at 9:27 pm #

      Going to show off my stats learning skills (seriously was my worst subject in school–not a math person and fine admitting it)!!

      Relative Risk of homebirth vs. hospital birth: 2.22
      Relative Risk Interpretation: 122% increased risk or 1.2 times as likely to have adverse risk.

      NOW let’s apply this RELATIVE number to the situation at hand. If a healthy, normal mother presents with, let’s say for the sake of argument, with a 0.09% risk level (0.9/1000 risk level birthing in the hospital) and they chose to do a homebirth (2.0/1000) they will move to a 0.11% risk level. That’s an increase of 0.02% in absolute risk–not a 100% increase in risk which is easy to confuse because of the whole 122% business, until you apply it to a real situation ( @PrimaryCareDoc:disqus –it’s ok, I know math isn’t a prereq for med school so don’t feel bad dude, happens to the best of us.). This is a number that some may consider “inconclusive” or “unimpressive”.

      Let’s also remember that ACOG admits that homebirth data is scanty and inconsistent, and the recommendation is for more research on the matter to increase accuracy.

      And BOOM GOES THE DYNAMITE. Ok, I’m ready. Let me have it. How did I eff up? How are you going to take these simple numbers that overly prove my point, and twist them in a way that suits you. Come on takers, come on.

      • DaisyGrrl
        October 27, 2015 at 9:33 pm #

        Relative risk interpretation: 122% increased risk or 1.2 times as likely to have adverse risk.

        Wrong. 122% increased risk. 2.2 times as likely to happen.

        I can’t even begin to untangle where you go from there. I just can’t.

        As for ACOG, the best evidence for now is that homebirth is 2-3 times more likely to result in death of baby (300%-400% increased risk). There are suspicions among many of us here that the number is higher (see Judith Rooks’ work on Oregon), but confirmation is slow in coming because the best way to gather stats is intended place of birth at onset of labour and birth certificates don’t collect that data (and we can’t currently trust midwives to properly self-report).

        • Who?
          October 27, 2015 at 9:34 pm #

          It’s maths, DaisyGrrl, but not as we know it.

          • DaisyGrrl
            October 27, 2015 at 9:35 pm #

            Certainly not as I have ever learnt it!

          • Who?
            October 27, 2015 at 9:37 pm #

            I don’t know anything about maths, but how .9 per thousand is not just under half of 2 per thousand defeats me. I ran out of fingers and toes, even with the dog to help, but it keeps coming back as about half.

          • KeeperOfTheBooks
            October 27, 2015 at 9:53 pm #

            Right. My math knowledge is faulty, I’ll be the first to admit, but it’s well beyond me how 2 is .011% bigger than .9.