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10 Truths Your Midwife Won't Tell You

Updated on August 7, 2011

Disclaimer: This is an article addressing the shortcomings and pitfalls of the current American midwifery system- most notably, laypersons such as Direct Entry Midwives (DEMs) and Certified Professional Midwives (CPMs). I fully support women who dedicate themselves to TRUE education and birth safety like CNMs (Certified Nurse Midwives).

I'm not required to obtain any education- not even a GED.

All I have to do is find a preceptor, observe 20 births, 20 initial prenatal visits, 20 newborn exams, 55 other prenatal exams, and 40 postpartum exams- which is why I typically start my career as a doula- I can get paid to observe while I intern! I also have to pass a written skills test to obtain my license. After I pass, I am considered to have achieved an "education" equal to the Midwifery Education Accredited Council training. I'm all for less work and the equal priviledges!

I do not have to carry malpractice insurance, even though it is available.

Malpractice insurance is expensive! And although it only takes one phone call to find an insurance company who offers to accept midwives, if state law doesn't require me to have it, I ain't gonna pay for it! Plus, it really benefits ME not to have malpractice insurance. Good luck finding a lawyer who will accept your malpractice case against a care provider who has no malpractice insurance!

I am an independent care provider- I have NO legal requirements for physician backup or oversight.

That emergency plan we have in case of a need to transfer from the home to the hospital? Yea, it's really just to make you feel better and to protect myself. There is no physician back up for you whatsoever- save the OB who is already on call at the hospital. The hospital is really just my dumping ground. Our emergency plan is just to get you there.

I could be lying about my emergency transfer and cesearean rate and you would not know the difference.

When interviewed by clients, I'm always asked about the transfer rate. Eh, "about 10%," is typically my response. But really, I'm not required to keep track. I can submit data to MANA, but only if the expecting couple sign a consent form. Otherwise, no one else is keeping track of me!

I don't have to complete any form of continuing education in midwifery.

Not surprising, considering I'm not required any formal education in the first place. It's birth- what could possibly change when I have no access to technology outside of a fetoscope or doppler anyway?

I typically don't have access to sterilizing equipment such as an autoclave for my birth instruments, so don't think my instruments are clean.

I like to boil things, bleach them, bake them- but don't ask me to spend the money and time on an autoclave. Bloodborne pathogens and OSHA got nothin' on me!

I do not have to adhere to HIPAA guidelines or the Privacy Act.

Only health care providers who "transmit any information in an electronic form in connection with a transaction for which HHS has adopted a standard," are considered covered entities. So don't be surprised when I tell all my other clients that you pooped while pushing! Or if you happen to file a complaint against me, I can rally my troops against you!

I can still practice midwifery if someone has filed a complaint against my license- even while I'm being investigated by the state.

Yep- it's great for me, because it's possible that after the investigation is completed, I may lose my license. But being able to still practice while being investigated- that investigation can take years! Sounds like a retirement plan to me!

The state will only investigate a homebirth loss or injury if a complaint is filed.

And I make sure to maintain the ultimate friendship with my clients. Since I'm not required to have insurance- I make my relationship with my clients my insurance! Typically, they harbor so much guilt, they don't think of ruffling too many feathers. It's great to work in a field where there are social networking sites that ostracize birth loss mothers for not trusting their bodies enough. Mrs. Birth Without Fear is GREAT insurance- if you keep the blame on mothers, DORA can't scrutinize my actions- after all, it's the mother who wanted a homebirth in the first place!

I can still practice midwifery with blood on my hands.

I may have contributed to a few deaths, but hey- death is a part of life and birth is as safe as life, right?


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      Shea 15 months ago

      It is very sad that you are using this platform to mislead women about home birth based on your own, unsupported biases. You have included NO statistics or evidence for or against the safety of home birth. Maybe that is because if you were to read a scientific journal or the Word Health Organization website, you would find the data works against your claims? Anyone can get on a soapbox. Include some hard evidence for your readers and maybe let them make up their own minds? I can not take this seriously.

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      Student 16 months ago

      Ah, you describe my training so simply! I guess I am done now and ready to practice, based on this! Not!!! I have been studying for almost 2 years, and not even close to being done. And not only done, not even close to wanting to practice on my own. There is an academic portion involved in this, and it takes two years, not including the apprenticeship which takes 3-5 or more. I study under a midwife who has delivered over 3200 babies, and has been practicing for 42 years. We are VERY skilled and trained in emergency medical techniques. I was not even considered for an apprenticeship until I obtained many emergency certification, including neonatal resuscitation which was 10 hours of studying and a grueling test, plus another 5 hour of hands on course and skills practice. We have to recert every 2 years. Midwives DO have to complete continuing education hours every 3 years. We have a back up hospital and while we do use whoever is on call, we are very well known by them, and the director of OB at the hospital is our primary when we have anything out of our scope of practice during prenatal appointments. We spend a minimum of an hour with each client at each appointment, and give comprehensive care that you will never see in an OB's office. We do all of our labs, and don't take on high risk pregnancies. We are very careful to practice within our scope. We even give out the info to file a complaint if they wanted to. We are skilled in all emergency situations, carry medicines for hemorrhage, IV fluids, suturing. We carry 175lbs of equipment to births. We do abide by HIPPA. We do abide by the CDC standards for medical equipment sterilization. We don't want to hurt people or put them at risk. We all got into this because we LOVE people. Birth is NOT a medical preocedure until it has to be. I will train for years and years and years if that what it takes to known everything I could ever know. I don't want to put women at risk. No one wants that. We take this very seriously.

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      Georgina 20 months ago

      It would be greatly appreciated if you could define this midwife a little bit more. I'm hazarding a guess you're talking about an American midwife, so please, do me a flavour and be specific, as I feel this article brings me into disrepute and I am proud to be a Registered Midwife.

      I am a Registered Midwife in New Zealand. I completed a three year Bachelors Degree and am required to undertake further training annually to maintain my registration, in addition to maintain indemnity insurance. I am accountable to the Midwifery Council of New Zealand and under the Code of Rights, anyone can complain about me and I can lose my registration. I am bound by privacy laws of New Zealand and must protect personal information of people I work for. Although I am an independent practionner I work in a group of midwives and have backup for my regular days off, annual holidays, sick leave and when I need to sleep after a birth. Around 10-20% of my clients choose homebirths and thank you, but my equipment is all sterilized in an autoclave on hospital premises.

      I have invested heavily - financially, spiritually and emotionally in my profession and I work my hardest to ensure my clients have good outcomes.

    • profile image

      gepeTooRs 2 years ago

      IÕve a presentation subsequent week, and IÕm on the look for such information.

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      nope 2 years ago

      this article is scare tactic. it's not working. nice try.

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      Elliott Cisneros 3 years ago

      This is ridiculous and sad - yes there are bad homebirth midwives - does that mean they are all bad? There are bad doctors- are they are all bad? Is the practice of medicine bad? Generalizations like the above do nothing but hurt people.

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      GG 3 years ago

      Doctors can also still practice obstetrics with "blood on their hands." That is not a valid argument against midwives. Sometimes complications arise and are severe enough that a doctor/midwife is not able to prevent death. Most of these happen in high-risk pregnancies (diabetes, multiples, etc.). Midwives see mostly low-risk clients, and transfer care to doctors if complications beyond their scope arise. The risk of complications is lower for births with midwives for several reasons: midwives restrict their clientele to lower-risk pregnancies, and they are less likely to jump to invasive medical interventions as quickly as many doctors in the US. In the US, doctors perform excessive c-sections. The use of pitocin, for example, which is drastically overused in hospitals to speed up birth (sometimes for the doctor's convenience), increases the risk of complications.

      As for the sterilization of "instruments"...what do you imagine they are using? Midwives don't use forceps and other invasive tools. They do, however, have sterile gloves, sterile oils for lubricating you to help keep you from tearing (as opposed to doctors who just cut you open instead--research long term problems from episiotimies if you are interested), sterile pads..etc. the same prepackaged stuff the hospital has. They don't need an autoclave.

      As far as education level, it can vary between midwives. You must research, interview, and select your care provider carefully, just as you should a doctor. There are lay midwives with thirty years of experience. There are nurse-practitioners that love the medical/science part of it. Shop around. Ask how many babies they've delivered as primary midwife. Read online reviews from previous clients. And interview-ask lots of questions--including personal questions regarding your pregnancy. Very important. The first midwife I interviewed was twenty minutes late to the appointment and vaguely brushed aside my concerns. The second one I interviewed was happy to give me an hour and a half of her time, going into detail about my health concern, and pulling up graphics to show me about it. All in a free consultation. Midwives can really be great. Find one that listens to you, gives you the time of day. And gives you full, complete answers to your questions. If possible, also find one that has privileges or at least a good relationship with a doctor/hospital in case you need to be transferred.

      Regarding the comment about midwife Toni Kimpel. If you research the topic: the state of Alabama was altering its laws for certification requirements and was doing a very poor job of applying it. They were inconsistent with it and many midwives in the state were practicing illegally for a short while as it unfolded. The state finally made its mind up and made an example out of Toni Kimpel. Lay midwives are not allowed to practice in some states, so she moved to Texas where she is able to practice legally. It doesn't look to me like she was intentionally breaking the law. As for the "blood on her hands", I can't find a reference to the death you are referring to, so I can't comment on that. Also, there are certification groups that can help you find an accredited midwife that has met certain important requirements.

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      Janelle 4 years ago

      Hi, I am a CNM in hospital practice but I have worked with many CPMs. It is true that some are not safe practitioners, just as some doctors and CNMs are not safe. The point I would like to make is that some of your information is incorrect. CPMs must have a high school diploma, they can't just observe births--they must be the "primary" midwife for a specified number of births, not an assistant--and they do have other specific requirements for licensure. Your remarks about midwives not having legal requirements in states, or not having to carry malpractice, etc., are different on a state-by-state basis. In my state, CPMs can and have had their licenses restricted or revoked based on their actions. They are not required to carry malpractice insurance, but that does not stop lawsuits. You can easily investigate that online. I would be interested in knowing the validated sources you have for your information, because much of it contradicts information I can provide for you from reliable sources.

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      Lizzie 4 years ago

      Omg r u serious!!! I'm studying to be a midwife in the uk I have 3 yrs of collage then 4 yrs of uni...I also have to have high gcses and it's still hard to get on the courses without extensive extra cariculer AND I'm in a class of 20 and only half of us are likely to get on the final course first time let alone the first uni we choose...I thought it would be harder in the USA and was going to train there after but now it seems almost 2 easy!!!!

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      Heather 4 years ago

      I am sad to hear all of the information that obviously was not researched here on this post. I have been an OB nurse in the hospital for 12 years and am now training to be a home-birth midwife (CPM and not CNM). I have seen more atrocities occur in the "protected" hospital setting than I have ever seen or heard of in the home setting. There are always going to be individuals practicing midwifery, or medicine for that matter, that provide less than optimal care. You are being ignorant if you believe that the medical world does not protect and hide their own downfalls as well. The overall outcomes of midwifery care in the home-setting is far superior to the hospitals when you look at the outcome statistics and there are regulating bodies that do overlook them as well. Why is the US one of the few industrialized countries that homebirth is not the main avenue of low-risk birth? Does this correlate with out poor OB outcomes? If we are so great why do we rank 30th in the world for infant mortality? European countries have a higher homebirth rate than hospital birth rate and their outcomes are far superior to ours.

      Do your research before you cast the stone please.

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      Alison 4 years ago

      Critical thinking and skepticism are the most important parts of being a human. You have no research, quotes, or any references at all. I am skeptical of you. If you choose to add to the information of the world, you must reference where you information comes from.

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      tracey 4 years ago

      while this is your "hub" and you can write what you please, most doctors in the US rather give you a csection because they have a weekend planned or dont want to be there late. homebirths are less risky than hospital births, especially when its a hospital not specializing in births. most other countries around the world perform homebirths with no complications, and have hospitals to back them up if needed. thats what the hospital is there for. the US is ass backwards, doctors get paid big bucks to cut people open for a living, and midwives get the bad rap. ha, this hub is a joke, and sad to see how many uneducated women liking this particular post. i was a fan of this place, but after all the posts AGAINST midwifery, im out. i have had two almost three births with midwives and never had an issue. and sorry to say but every midwife i have ever researched has gone to school of some sort, they dont just catch a baby and call themselves midwives. they are loving and tender people.

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      concerned 4 years ago

      Toni Kimple is a midwife in College Station, Texas. My understanding is that she does have blood on her hands. She didn't have a license in Alabama- and an infant died! I am sure this is why she is sooo religious. But, ask her how many probono cases she does? Would you let her be a midwife for your daughter? She puts the baby scale on the floor to weigh them- yeah! think about it

      In the early 90’s, an appeals court ruling set a grim precedent for midwives and the mothers they served. Toni Kimpel was charged with 5 misdemeanor counts of practicing nurse-midwifery without a license. The trial judge threw out the charges on the grounds that the law regarding “lay” midwives was unconstitutionally vague. The state appealed, and the higher court overturned the trial judge’s dismissal of the charges, finding further that Toni Kimpel had, in fact, violated the nurse-midwifery statute. Toni Kimpel’s appeal to the Alabama Supreme Court was denied. Within a year she moved to Texas, where she is able to practice legally.

    • NiaLee profile image

      NiaLee 4 years ago from BIG APPLE

      I really believe that people should make the choice that is the best for them: health, age, environment, country will require different choices. I love midwives, mines were wonderful but my decisions will be mine after wise research.

    • holly-turner profile image

      Holly Turner 4 years ago from Falmouth

      I understand why you did this but it really is sold as "all midwives could be like this". Midwives are incredibly important, in the UK they're who a pregnant woman will traditionally see throughout in a low risk birth. Birth in the UK is cheaper and safer for this very reason, in my opinion.

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      Mylindaminka 4 years ago

      Так же приобретите заранее стойкий лак для волос и много шпилек, невидимок, маленьких резиночек (их точно не бывает слишком много). А еще лучше ? узнайте у парикмахера, что ему будет необходимо, и запаситесь в двойном объеме;)

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      Midwife and midwifery client 5 years ago

      Sorry, but you really need to research a bit more. Different states have different regulations regarding licensure of midwives, some being more stringent than others (and illegal or allegal in certain states, too). I am a licensed midwife in the state of Florida, and had my babies with licensed midwives, both before and after my training were completed. Here it is required that a candidate complete a 3 year direct-entry midwifery program, which includes classroom instruction, as well as a lot of practical experience; culminating in the management of 50 deliveries acting as "primary midwife" under the supervision of an experienced preceptor, which may be another licensed midwife, or a CNM. In my program I had the opportunity to work with both, along with observe several births with an Ob/Gyn. I received a lot of hands on training... more than some medical practioners do with regards to pregnant/ birthing women. Florida also does require that its L.M.s answer to the state regarding birth outcomes, follow HIPPA, have an emergency back up plan, complete continuing education requirements, and yes, carry malpractice (which incidentally it does not require of its medical doctors...). Licenses can be verified as can any complaints.

      As some others have provided links, the (unbiased) research shows that midwifery care, and yes, homebirth, are safe, even safer alternatives to doctor and hospital based care for women who are low-risk.

      There are bad midwives, sure. There are also bad medical doctors. Its not fair to judge the masses by a few. In the end it is up to each mother (and her partner or family) to do their homework, to make sure the provider they have chosen is a reputable one, to ask questions, and to feel comfortable with their decisions whatever they may be.

      In short- you really should do your homework, too.

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      BisbeeStudentMidwife 5 years ago

      I'm sorry, but this list is really biased, and some of it is blatantly false. In Arizona, at least, our laws are VERY strict. You can NOT practice without a license. Period. There are three levels of midwifery here. A licensed midwife (LM), Certified Professional Midwife (CPM), and Certified Nurse Midwife (CNM). LMs have the requirements you list here, as far as education. Those numbers you listed for number of births attended? That amount of births can take YEARS to accumulate. During this time, you are studying with a midwife who is very experienced. You have to get your certification in Neonatal Resucitation. You learn by doing. You also probably are reading textbooks, doing formal lessons with your midwife, learning about the laws of your state, and learning how to spot risk factors in pregnancy to rule out high risk clients. As a CPM, you're required to have proof of education to be certified by NARM (the North American Registry of Midwives). This is the certification most midwives aspire to, since it is proof of not only experience in the field, but also of a formal education, whether it is led by a preceptor (in which case a completed portfolio must be submitted to the NARM board for approval), or through a MEAC-accredited program. CNMs typically practice in high volume birth centers or hospitals, and have an RN before beginning their midwifery training. They tend to be more medically oriented, and some even administer epidurals and induce labor artificially. This is better for a mother who is nervous about an out of hospital birth, but wants a natural birth. Best of both worlds. I, personally, am in the process of attaining my Bachelor's level degree from Midwives College of Utah while simultaneously working with a preceptor here in Bisbee, AZ, with the intention of becoming a CPM. Please don't mislead women with this nonsense you have posted here. Of course there are midwives who don't follow the rules and who practice on the edge of legality. It is important for any woman pursuing a birth with a midwife to ask these questions. You can look up your midwife and her credentials on this site if she is a member of Midwives Alliance of North America:

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      iris 5 years ago

      I'm sorry in my previous post I meant . Epidural can stall labor leading to C-section which increase the mothers and infants chance of dying by 7-9 times,

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      iris 5 years ago

      None of what you're saying is true where I live. I've just started midwifery school and had to transfer in two years of college credits just to get in. The program will take three or four years and I will have to attend at least 100 births and complete extensive course work before I end up with my degree which will be a federally recognized Bachelors in Midwifery. I'm sure there are inexperienced and unqualified midwifes out there, but you as a client and do your homework, find a midwife with a real degree and who can prove her credentials to you. Fact is that homebirth is statistically safer than hospital birth. The 1st world countries with the very lowest infant and maternal mortality also have the highest rates of home births. Fact: doctors kill babies through their mistakes more often then midwifes. Interventions like pitocin can cause uterine rupture and death ect.. Epidural can stall labor leading to C-section which increase the mothers and infants chance of dying by 7-9%, babies and cut out prematurely for no reason at all other then convenience and mis-calculation of due date leading to higher chance of death and other complications. These things are very, very common, but the statistics are ignored and anytime a midwife makes a mistake there is a witch hunt. Why? Money, power, ect.... Don't go by what I'm saying do you're own research and find out the facts rather then just trusting some very biased and unsubstantiated article. But please if you want a home birth, find a qualified midwife. There is no shortage of them.

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      Futamarka 5 years ago

      Теплопроводность шиньона зависит от вещественного состава, завивания и характера пористости, дамы и влажности шиньона. Особенности структуры оказывают значительное влияние на теплопроводность. Например, если шиньон имеет волокнистое завивание, то тепло вдоль волокон передается быстрее, чем поперек. Так, теплопроводность древесины вдоль волокон равна 0,30, а поперек – 0,15 Вт/(м?К). Мелкопористые шиньоны менее теплопроводны, чем крупнопористые; шиньоны с замкнутыми порами имеют меньшую теплопроводность, чем шиньоны с сообщающимися порами. Это объясняется тем, что в крупных и сообщающихся порах возникает движение воздуха, облегчающее перенос тепла.

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      Brianna 5 years ago

      You are completely wrong. Just because some midwives may be negligent doesn't mean they all are. Midwifery and childbirth is a beautiful thing. This article is one persons opinion not factual evidence to how midwives run their businesses. If you are looking for a midwife you must do your research on that particular midwife, talk to other people she has worked with. Don't base you opinion on a biased article.

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      Jade 5 years ago

      I think you should do your research more carefully..One of the main problems we have in the birthing community is that people are always writing hateful articles that provide no actual facts. Women, especially pregnant women need to be able to make informed, factual decisions, not based on fear or biased opinions. A women should birth where she is most comfortable, with whom she is most comfortable, without being made out to be an evil parent. Women have been having babies for centuries and will continue to do so.

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      Janelle Komorowski 5 years ago

      Greetings! I just stumbled across your post and wanted to say that I am a certified nurse-midwife. I have worked with a number of certified professional midwives in the past (these are the non-nurse midwives you are talking about in this post) and have found them overall to be like any of my other health care colleagues, including physicians: some are conscientious and careful practitioners, and some are not. I also wanted to clarify that much of your information regarding CPM regulation, education, and practice parameters is incorrect. A high school education is required. There are specific educational requirements, including a length of clinical preceptorship that is required in addition to specific numbers of births/prenatal visits, etc. that must be attained. This is very similar to the numbers/hours required for certified nurse-midwives. Your statement about malpractice insurance is not accurate. It is not available to midwives in many areas and various practice venues. This problem extends to nurse-midwives as well. Where it is available, it is very expensive, and midwives generally do not charge prices that permit them to spend thousands of dollars each year on malpractice insurance. Particularly if you accept Medicaid, which I do, my revenues from each Medicaid client to not even cover my expenses for that client. I do it as a labor of love, but I have to make up for it with my clients who have private insurance. Midwives are not the only ones dropping malpractice insurance--the entire state of Florida is famous for its obstetricians as a united group dropping their malpractice insurance. The other things you mention--such as being able to continue practicing even if an investigation is underway--are standard for all providers in this country, depending on what the investigation involves. In the USA, you are innocent until proven guilty. I have never worked with or been acquainted with a midwife who had a cavalier attitude about a baby's death. Having attended several women (in the hospital) who delivered still born babies (and no, I was not investigated for negligence in any of these situations) I can assure you it is a painful and heart-wrenching experience for the midwife as well as the family. It is true that death is a part of life, but certainly one that we do everything within our power to prevent. When it does happen, it is not something that we take lightly, and I know that I have spent many sleepless nights with my hearts aching for these women and reviewing over and over in my mind if there was anything I could have done differently. Sometimes, even when you did everything right, you still have a bad outcome. True for midwives, true for doctors, true for just about everyone. Thanks for your thumbs up for nurse-midwives, and please do a little more research before you lump all non-nurse midwives into the same negative category.

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      Alisa~ 5 years ago

      I know this article was written a while ago, but I want to put my two cents in. :)

      Lisa Letzelter re-wrote this article the way it SHOULD have been written (her comment is 13 above mine). She took the 'facts' written by the OP and actually added some truth to it. Way to go Lisa!

      I agree that the problems with birthing as a whole are just terrible in the US. I myself have yet to give birth, but as a woman who is looking forward to having quite a few children in the future, this subject is something I look up regularly. I'm horrified by the issues women are having in hospital births. The fact that so many drugs are used terrifies me. While I agree that our advanced medicine helps a massive amount of people, it's insane to think that the push of having babies in the hospital is not based on money. Sorry, but I want to be more than just money to the person helping me to deliver.

      The problem with this article is that these issues are on both sides, not just the home birth side, and unfortunately, people just don't do enough homework to really understand how it works. A lot of people are scared to ask the questions that need to be asked for fear of being insulting or looking stupid or having conflict. If you're not asking questions you're going to be in a potentially dangerous situation.

      SkeptiMommy, I agree with the others that say this article was written in bad taste. Very biased and very angry (I know, I know, deal with it, it's just how you write, you've said these things to other commenters above). If you truly wanted to help woman you would be giving us both sides of the story. Like doctors can still practice medicine while being investigated, and that they won't be investigated at all if there's no complaint filed. AND that they still continue to practice, even though they have blood on their hands.

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      Dawn 6 years ago

      If your going to have a home birth with a midwife... wouldn't you do your own research before allowing a woman to deliver your baby. We have had two babies with a CNM. It was a fantastic birthing experience. A mother who does not educate herself on the most important day of her life....well, then there is no one to blame but themselves.

      And there are shady individuals, running all over America, in every Profession. You have to be smarter than them.

    • Time Spiral profile image

      Time Spiral 6 years ago from Florida


      You're trying to spin again, but that's fine, it's your mission to do so. Read her profile. She states her objectives plainly.

      I am going to respond to you point by point.

      (1) The first recorded caesarean section (c/s) was performed circa 320 BC. So what? The c/s rates in this country are a direct result of big-medicine propaganda efforts. There is a direct relationship between the rise of (c/s)'s and the percentage of hospital births in this country. That is bad.

      (2) Yes, you can be educated by taking a class on birthing. I am not sure what your point is here. You're suggesting anyone expecting value from a birthing class as pitifully ignorant? And you want people to listen to you for advice about pregnancy and birth? You are WAY off base.

      (2.[a]) Suggesting the only way to be "truly" educated on the matter is to attend college in a nursing or medical field is a slap in the face to so many people. How can you actually stand behind such an asinine statement? If you're seeking to practice professionally, then yes, that path is required, but to be educated on the matter you can do many things. One of those things is to attend a class (most of which are a series of classes. Mine was ten weeks long, 2.5 hours each.).

      (3) I find it hard to believe that you "wish me the best." It seems far more likely, from your tone, that you're attempting to belittle me. You basically verify this suspicion with your continued character attacks.

      Trying to appear tough, and "bully me away" is not going to enhance your position or your credibility here. Especially when you're making assumptions about me that are so detrimentally inaccurate.

      If you think you're dealing with a small-minded individual, you've got something else coming your way.

      (4) I did not think refuting your post, point by point, would be worth it (nor did I feel it was warranted) because when I read it, it was so poorly put together, and so obviously spun to lean in favor of your argument, that I automatically assumed you were trolling for publicity. Maybe I'm wrong? Maybe you believe your article to be objective and credible?

      (5) I can concede that maybe I was wrong about you being a troll. Unfortunately for you, and so many future readers of your article who may not know better, the reality of you being serious is much, much worse.

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      Sandi 6 years ago

      I had all my babies at a hospital and I can honestly say that hospital/ob births have same if not more risks. My doctor whom I had deliver my last baby took so long in arriving to the birth, the nurse literally restrained the baby from coming out by where the heartrate dropped dangerously low and once he got there he was almost panic stricken. I now have a midwife who is actually none of the above statements. Am I saying there are no risks in having a homebirth, of course not but there are risks in hospital settings too......Thankfully my midwife is very experienced and comes highly recommended in our community and if we are going to slam midwifes we might as well talk about the negatives when it comes to hospital related births.

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      Misha 6 years ago

      Wow, Anonymous. Way to think for yourself! Impressionable much??

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      Anonymous 6 years ago

      After reading this article I no longer like midwives. In fact, I used to know a midwife. If I ever see her again I'll tell her that I don't want to be friends anymore, and point her to this article as the reason why.

      Thanks for exposing this fradulent pseudo-science, pseudo-medicine.

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      tara 6 years ago

      Haha timespiral, and women have been dying in childbirth for just as long. It's only since the surgeons stepped in that we could reasonably expect to survive childbirth, with live children no less. Read some history.

    • profile image

      ucuz şişme bebek 6 years ago

      Doozer- what state do you live in again? I saw that you posted some links but you still didn't answer my question.

    • SkeptiMommy profile image

      SkeptiMommy 6 years ago

      Time spiral- please research the history of c/s. They have been a part of childbirth since the beginning of time. The first recorded c/s was around 320 BC and the first woman to survive a c/s was in the 1500s.

      If you think you can be truly educated by attending A birthing class, then you my friend, are pitifully ignorant. The only way to be truly educated in the matter is to attend college in a nursing or medical field.

      I wish you the best, because your small minded views of the world hold no weight here- you cannot refute anything in this article (your childbirth class didn't cover that, did it? too bad.) because it's all true so you have sputter around lame insults like "troll." Sad.

    • Time Spiral profile image

      Time Spiral 6 years ago from Florida

      This is an obvious, and bitter, troll article designed to get hits based on controversy.

      This is pure spin.

      If you're considering having a child, or are pregnant now, do some research, go to a birthing class and weigh your options. Midwifery has been the standard for all of human existence. Only until very recently have people been starting to give births via surgeons.

      Educate yourself.

    • profile image

      Kimberly 6 years ago

      I don't know about every state, but in Florida, where I had my babies, Doctors are not required to carry malpractice insurance - and midwives are. Interesting.

    • profile image

      Ahsan 6 years ago

      sad but based on fact.

    • profile image

      Misha 6 years ago

      Rain- First of all, in no way did you prove that the Amish don't bring up homebirth death rates, if anything you helped prove it. I let it go because really it is too insignificant to keep going back and forth about, you seem to forget the other points I brought up- unplanned pregnancies.. This means birth that takes place on a bathroom floor or the back of a car, high risk pregnancies- because although CPMs are only supposed to take low risk you know perfectly well that they DO in fact take many high risk patients. I believe they do this because many women would choose UC over going to a hospital. And lastly, congenital anomalies. From what I have heard, the congenital anomalies were not removed from the homebirth group. But despite all that, we are still only talking about ONE year. ONE year does not give us a definitive answer. So, again, anyone claiming homebirth is dangerous, is lying.

      SkeptiMommy- You were trying to claim homebirth is dangerous and that is why I had to explain that this is simply not true. Please, if you are going around the internet telling women homebirth is dangerous, stop. That is spreading false information and the internet is chock full enough of it anyway. I would also like if you provided links that proved CPMs are as terrible as you claim. Not information from one state but all the states in the US. If you are going to make such a huge generalization about all CPMs, you are going to have to have a lot of factual information to back it up with. This all just sounds like Amy Tuteur's words regurgitated over and over again. She is the only person on the internet that repeats this false information, ad nauseum. So, usually when I see the same things being said, that person that can be connected back to Dr. Amy. And I was right. If you would have had no idea who Amy Tuteur was, I would more apt to believe these were your own thoughts but alas, Dr. Amy seems to have misled another mom with a bad experience.

    • profile image

      Lisa Letzelter 6 years ago

      In response to 10 truths your Midwife won’t tell you

      August 13, 2011

      I’d like to address this post, not because I believe it is false, but because some of the “truths” need to be expounded upon for full understanding. In the interest of full disclosure, I’d like to add that I am not a midwife or professional of any kind in the medical field. I’m just a mom who’s done some research and wanted to express my views.

      Terms used:

      CPM – Certified Professional Midwife

      NARM – North American Registry of Midwives

      OB – Obstetrician

      HIPAA – Health Insurance Portability and Accountability Act

      1. I’m not required to obtain any education- not even a GED.

      The CPM apprenticeship is education. Apprenticeship is a widely accepted model of education for many, many different fields. The NARM program requires preceptors to meet certain standards. A CPM in training is required to attend a minimum of 20 births as a participant, 20 births as primary care provider (if your preceptor has to step in at any time, the birth you are attending does not count towards this number), 75 pre-natal exams including 20 initial exams, 20 newborn exams, and 40 post-partum exams in order to qualify for certification. Because each of these categories has requirements the birth must meet in order to be counted, most midwives attend considerably more before they are certified.

      2. I do not have to carry malpractice insurance, even though it is available.

      In certain states, midwives are required to carry malpractice insurance. In other states, midwives choose to do so. You need to ask your midwife. Malpractice insurance has nothing to do with whether or not you can sue for malpractice. If anything, it protects the midwife more than the client. Without insurance, if she is sued, the midwife is not simply facing a rise in premiums. She is facing the loss of her business and possibly her personal assets such as the home or any other property she owns. Further, insurance costs range from 7,000-32,000 dollars a year depending on experience, education, and location. According to University of Missouri Career Center, Midwives earn on average 41,000-52,000 dollars annually. Midwifery practices can not typically support this cost without making their care unaffordable to many clients. Finally, having malpractice insurance does not make you a better midwife.

      3. I am an independent care provider- I have NO legal requirements for physician backup or oversight.

      Midwives want physician care backup. They want to be able to smoothly transfer care if necessary. Unfortunately many hospitals and OBs make it difficult to attain this. Ideally, the midwife has an OB practice that she works closely with. Not only are these the OB’s on call if she has to transfer care in labor, but they are the ones she refers her clients to if any complications arise during pregnancy. While I believe that corroboration between OB’s and midwives should be mandatory, it needs to be made mandatory on both sides.

      4. I could be lying about my emergency transfer and cesearean rate and you would not know the difference.

      This varies from state to state as well. For CPMs, NARM does keep track of their statistics. Research your midwife as you would an OB. Many OBs will give you their practices average stats instead of their individual stats.

      5. I don’t have to complete any form of continuing education in midwifery.

      NARM requires continuing education for CPMs as well as re-certification every 3 years. A good midwife will try to gain access to better technology an resources, but again, it is very cost prohibitive.

      6. I typically don’t have access to sterilizing equipment such as an autoclave for my birth instruments, so don’t think my instruments are clean.

      Some midwives do have an Autoclave. Ask your Midwife. In addition to methods such as boiling, bleaching, and baking, many midwifes use Amerse or other cold sterilants for their equipment. Dry heat sterilization(oven) is OSHA approved. Steam sterilization(Autoclave) can be achieved via home methods. It is possible to purchase disposable plastic speculums through medical supply stores. Ask your midwife about her sterilization techniques and process. She may even let you observe.

      7. I do not have to adhere to HIPAA guidelines or the Privacy Act.

      This also varies from state to state. For those states where Midwives are not required by law to adhere to HIPAA, NARM requires its CPMs to adhere to their privacy guidelines.

      8. I can still practice midwifery if someone has filed a complaint against my license- even while I’m being investigated by the state.

      While this is unfortunately true, it is also true for doctors. In fact, filing a complaint against a doctor does not even guarantee investigation. It depends on the severity of the complaint. The specifics vary state to state, but usually the complaint is simply filed in the doctors permanent record. A doctor can still practice while being investigated in many instances. Again, it depends on the severity of the complaint filed. We need to hold both doctors and midwives to a higher standard in this regard. NARM does peer review the CPMs that have complaints filed against them, and the CPM may lose their certification as a result of this peer review.

      9. The state will only investigate a homebirth loss or injury if a complaint is filed.

      This is also true for doctors. Only a family member can file a wrongful death/medical malpractice suite. Midwives do cultivate friendships with clients, but not to avoid litigation. It’s simply the nature of the profession. Relationships are more intimate than the kind you would have with an OB. It’s one of the reasons people choose midwives. Unfortunately, there have been cases where midwives have attempted to “guilt” a mother out of litigation. I find this practice abhorrent, but it is certainly not the norm. And there have been cases where doctors have attempted to guilt or harass the family to avoid litigation. It is, again, a problem that exists on both sides of the field.

      10. I can still practice midwifery with blood on my hands.

      Yet another item that is true for both midwives and doctors. The longer a midwife or doctor has practiced, the more births they have seen, the more likely that one has ended in tragedy. The death of a mother or child is not in and of itself something that will make you lose your license or certification. In both instances, the death will be investigated to determine liability.

      Both models of care are broken. Mothers on both sides go into labor/birth not knowing all the facts and risks. I do not argue that the facts presented in the original article are untrue, but that many of them are true for both models of care. There is a significant amount of change that needs to take place on both sides.

      “You must be the change you want to see in the world.” -Mahatma Gandhi

    • profile image

      Rain 6 years ago

      @Misha You insisted the Amish are what brings up home birth deaths rates. I proved it doesn't. We hear so many great stories because statistically speaking those women would have had great stories if they had birthed completely alone. The standard of care is to ensure all women even those who do develop complications have a competent care provider there to assist them. The majority of CPMs and DEMs are under-trained, under-qualified and should be ashamed for taking women's money for their "service" It's not the other way around. Other competent midwives should speak up when this incompetent women are dangerously practicing in their profession. Well, I should say MORE should speak up because some finally are thank goodness and they are being ostracized for daring to question the training requirements of their profession. There can be no progress if no one can admit there is a problem with the current midwifery care model.

    • SkeptiMommy profile image

      SkeptiMommy 6 years ago

      Doozer- what state do you live in again? I saw that you posted some links but you still didn't answer my question.

    • SkeptiMommy profile image

      SkeptiMommy 6 years ago

      Also, the HIPAA requirements for covered entities...notice how these are the law for EVERY state:

    • SkeptiMommy profile image

      SkeptiMommy 6 years ago

      ChristinS- I appreciate your concern, but typically, even when I'm nice and calm, I still get banned from sites like Made to Birth, etc. I was banned from Birth Without Fear without even commenting on anything! I'm sorry you don't like the tone, but it's not demeaning- it's direct. If I wanted to be polite about it, I would. It's my writing style and it is what it is. And if you're dissappointed that this was selected as hub of the day, I suggest you take it up with the Hubpage team editors, as I have no control over that. I also, I never said or implied that women who choose to homebirth are dumb. That is what you are assuming, when this article is NOT directed towards the WOMEN who choose to homebirth but the CPMs and DEMs who feel they should be able to practice without education. Simply because you "would never do this that and the other" has nothing to do with me, my writing style, approach, opinion, and the tone in which I chose to write this particular hub.

      Furthermore- Misha, "The woman who wrote this and the majority who supported her, are all just regurgitating what they have heard Amy Tuteur spew, over and over and over again," is quite the ad hominem. My article is not affiliated with Dr. Amy, nor was she mentioned whatsoever, and I am not acting on her behalf. Funny how you think, "Omg, she's against homebirth! She's just copying Dr. Amy!" What an oversimplification. I'm not assuming you are a Ricki Flake drone or Ina May clone simply because you support birthing choices with uneducated care providers. Nor am I against birthing choices that involve formally educated and regulated CNMs.

      I didn't say that MANA stats are the answer. I said it's extremely fishy that they are bogarting data- if you had the numbers to prove that homebirth is not dangerous, wouldn't you want to share it with the world and prove me wrong?

      I will say though, that I don't feel Dr Amy "exploits" women. She gives them a space when no one else will. Many, many, many birth loss mothers and homebirth injury mothers try to tell their stories other places, first- like Birth Without Fear, Made to Birth, etc and are deleted, banned, and censored for "fear mongering" or playing the "dead baby card." Dr. Amy doesn't censor anything and for that, I respect her. Here are the requirements to become a midwife in my state, straight from the horses mouth.

      "Registered Midwives in Colorado practice as independent care providers, with no requirement for physician backup

      or oversight."

      "The biggest challenge you will encounter is finding a preceptor. There are about 60 Registered Midwives practicing in Colorado; many of them do not feel they’ve yet had enough experience to train another midwife."

      "A more traditional approach to Homebirth Midwifery is through apprenticeship: the student apprentices with an experienced midwife, learning everything there is to know about midwifery from her. There are no formal rules about how apprenticeships work; it is up to the preceptor and apprentice to work out the expectations and requirements for their particular partnership...NARM requires performance by the Intern of 20 Initial Prenatal Exams, 55 Additional Prenatal Exams, 40 Postpartum Exams, 20 Newborn Exams and management of 20 Births...Once the evaluation is complete, the student may be approved to take the hands-on Skills Test administered by a Qualified Evaluator. Once the Skills Test is passed the student may be deemed by NARM to have achieved an education equivalent to that obtained through a MEAC-approved midwifery training program."

      Here are mana definitions for the confused:

    • profile image

      Misha 6 years ago

      Rain- I don't want to be insulting because I would like to have a civilized debate but the points you brought up were really off topic from what I am trying to say. Out of everything you wrote, ultimately, you agreed with me. Nobody, not Dr. Amy, not skeptiMommy or anyone else can go around telling people homebirth is dangerous. Period. They have nothing to back up that claim. One year of CDC statistics, no studies and what they "think" MANA is hiding. I do not agree with you, I think it is insignificant to ASSUME what the MANA stats will reveal. Until the information is released, and eventually they will be, no one can surmise what those numbers are. In the mean time, using MANA as an arguing point is totally irrelevant. Anyone who claims to be a skeptic must understand that!

      I never said the standards for midwives could not be improved, I think they can but I also don't believe all CPMs are the way SkeptiMommy makes them out to be. If that were true, we wouldn't be hearing so many wonderful stories and happy experiences from mothers having home births. There will be negligent people in any profession and unfortunately some people are going to run into those people. For them, there should be higher standards. But just from the increase in homebirths alone, we can gather that the majority are having good experiences and professional midwives are the norm not the exception. The truth is, when you search out the bad, you will find it. If I had an awful experience in the hospital with a completely unethical OB, I too would probably spend all my time bashing OBs and searching out others with similar stories. Before too long, ALL I would be hearing about are the bad doctors and the bad experiences and me and my friends would form a little group and be anti-hospital, doctor bashing women. Because we would always be sharing our horror stories with one another, because we would ONLY be looking for the bad stories online, we would really believe that all OBs were bad and that the vast majority of people should birth at home. Is that true, though? No. If you seek it out, you will find it. Amy Tuteur and the fans or people who frequent her website, do just that. They search out tragedies- and of course they will find them! There are BILLIONS of people in the world and we have a connection to almost everyone in the US through the internet. They seek out high risk mothers, attempting homebirths and when those babies die, everyone feels secure that homebirth is dangerous. Her website is enticing to those who have lost babies at home or had a bad birth experience because they are angry and Dr. Amy gives them someone to blame. She gives them an outlet for their anger. There is nothing wrong with that but I think it is pretty obvious she is exploiting these women. They want so badly to place the blame somewhere and when Dr. Amy seeks out women who have just lost babies they can say, "SEE! Homebirth is bad!! Midwives are bad!!" In the end I am angry that the homebirth loss mothers get taken advantage of by everyone- Dr. Amy and their incompetent midwives.

      Next time you see someone going around telling others homebirth is dangerous, I hope you will correct them. Women need to stop telling women how to birth, where to birth, how to feed their babies and how to parent. It s getting so ridiculous. Let's all support each other instead.

    • profile image

      Rain 6 years ago

      @rebekahELLE Unfortunately Florida's regulations are the strictest and best in the country. That means it's more common to run into the untrained CPM or DEM for the whole rest of the country. She does say in the disclaimer at the beginning she fully supports CNMs and since CNMs do home births she's not completely denouncing home birth. I think at this point people do need to be pretty harsh in speaking out about the lack of care standards across the board! It shouldn't be so difficult to know you're getting a good midwife which ever state you're in. The majority of people have no idea the difference between CNM, CM, CPM, LM, DEM etc. It's a confusing system that is harmful to the consumer. As all other medical professions it should be monitored and controlled on a national level with some state involvement as far as per state medical boards go. Right now a midwife can be thrown out of one state for negligent practices and jump right over to the next state and pick up were she/he left off. The true insult to the entire legitimate midwifery profession isn't this blog piece, the true insult to the profession are the undertrained CPMs and DEMs hurting mothers and babies! Those are the people insulting and endangering the profession! I also find it disturbing that national news sources are posting articles like this without identify the credentials of the midwives involved. The midwives in this story are CNMs but in the written portion of the story they are only referred to as midwives. At least this blog is clear about the differences and gives individuals a chance to look up the differences themselves.

    • rebekahELLE profile image

      rebekahELLE 6 years ago from Tampa Bay

      @Rain, yes, I am aware that Florida has stricter regulations than the rest of the country, and I was making sure that readers are aware of this. The hub is written in a manner that badly reflects the entire midwifery profession, which is an insult to those who are dedicated professionals. Those who are interested in tighter regulations and professional training/board exams in their states can get involved by first finding out their states regulations and requirements for midwifery. Write letters, get involved. But authors should be more balanced in their approach to controversial topics rather than simply voicing biased opinions. People wanting to know answers search for information and stumble upon an article like this and get the wrong impression of an experience that may be the very best for their pregnancy/birthing experience.

    • profile image

      Rain  6 years ago

      I agree with you to some degree, ChristinS, and myself thought this article could have touched more people if it was written differently but presented the same information. However, perhaps that wouldn't have ignited the ensuing debate which has been productive I think.

      Continuing my response to Misha I wanted to add:

      Because if natural birth is why Japan is so successful in their care of women and babies then we want more women having natural births, right? The greatest chance to have a natural birth right now in the USA is at home! Why wouldn't we want women to have access to well trained midwives at home then? In Japan in the hospitals they have a less then 10% csection rate and 80% of women don't use epidurals or any form of painkiller and they have the lowest perinatal and neonatal death rate! Pretty cool huh? However, pushing women to birth at home with under qualified practitioners isn't the answer for the United States! Japan has a perinatal death rate of 2.6/1000 and ours is 6.7/1000. Our rate is right around the same as the UK and only slightly higher then Canada. We rank between 15 and 17th in the world. It's quite a different statistic and ranking then our dismal 47th place infant mortality rate which supporters of CPMs and DEMs like to use as proof that hospital birth is dangerous. Yes our perinatal death rate could improve and needs to improve. I'm sure we could learn a thing or two from Japan, but we are still in line with most European countries. It certainly not bad enough for women to start believing home births with CPMs or DEMs is safer then birth in a hospital with an OB. Any study you can find supporting the midwifery model as being as safe or safer then hospital births in other countries can't be applied here as it's a very different qualification of midwife being represented. What we really need in this country is for MANA to release their data so we can figure out how to make home births safer and for us to figure out what Japan is doing right in it's hospitals. Because if natural birth is why Japan is so successful in their care of women and babies then we want more women having natural births, right? The greatest chance to have a natural birth right now in the USA is at home! Why wouldn't we want women to have access to well trained midwives at home then? In Japan in the hospitals they have a less then 10% csection rate and the lowest perinatal and neonatal death rate! Pretty cool huh? However, pushing women to birth at home with under qualified practitioners isn't the answer for the United States! Japan has a perinatal death rate of 2.6/1000 and ours is 6.7/1000. Our rate is right around the same as the UK and only slightly higher then Canada. We rank between 15 and 17th in the world. It's quite a different statistic and ranking then our dismal 47th place infant mortality rate which supporters of CPMs and DEMs like to use as proof that hospital birth is dangerous. Yes our perinatal death rate could improve and I'm sure we could learn a thing or two from Japan, but it's still in line with most European countries. It certainly not bad enough for women to start believing home births with CPMs or DEMs is safer then birth in a hospital with an OB. Any study you can find supporting the midwifery model as being as safe or safer then hospital births in other countries can't be applied here as it's a very different qualification of midwife being represented. What we really need in this country is for MANA to release their data so we can figure out how to make home births safer and for us to figure out what Japan is doing right in it's hospitals.

    • ChristinS profile image

      Christin Sander 6 years ago from Midwest

      Just my two cents - but if you want to make an argument for a cause - try being less condescending and snarky. I doubted the information in this hub due to the immediate confrontational tone taken. It was "demonizing" the other side instead of presenting two sides and saying "this is what I believe and this is what backs up my point" Pieces that are sarcastic and demeaning don't have the sway you expect them to have, in fact it is only "preaching to the choir" at that point, because people who agree with you will cheer for you and those who don't will dig their heels in..

      This hub and its comments have done a great job of igniting "debate" - but discussion is more productive than debate and ultimately "arguing". If someone argues with me I won't listen. If someone tells me what they are passionate about in a way that sounds educated and intelligent then I am more inclined to consider their position and further research it on my own. Ultimately I am my own person and I am going to make up my own mind.

      For this reason I am really surprised, and frankly disappointed, that this was chosen as a "hub of the day" because it was very unprofessional, rudely toned and frankly sounds like you have an agenda to demonize a whole group of people. Venting anger is rarely the way to win people over to your side. Your responses to those who disagree with you also reflect this "tone" and it's not helping your cause.

      That being said, I could agree on some points of tightening regulations or increasing certain training perhaps - but to imply through your "tone" that everyone who opts for midwives and home birth are somehow being stupid, ignorant, or beneath you is very non-productive. I have never taken a condescending or nasty tone with women who chose to birth their children in ways that I don't necessarily agree with. I share my opinion and then allow them to decide through their own research what is best for them.

      I understand you mean well and that in your eyes you are trying to help babies etc. I appreciate that about you, and your passion for your subject is even admirable even if I don't happen to agree, but your approach leaves a lot to be desired.

    • profile image

      Rain 6 years ago

      Well, Misha, just as you pointed out that I didn't respond to your questioning about raw CDC data, you didn't not respond to my assertion that we don't have this data available to us because MANA will not release it. The truth is not that nobody can answer the question about the safety of home birth in the USA. The truth is the people who can answer that question are refusing too. As far as the Amish goes again, there are different sects within the Amish religion. The largest of these groups have 3/5ths of their women delivering in hospitals with prenatal care and the rest delivering at home but with prenatal care. The most traditional of these groups are the Old Order Amish. They have the most home births and forgo prenatal care the most often, but do not have a markedly higher perinatal or neonatal death rate then among everyone in Ohio. Now what this means is that statistically birth usually turns out pretty well and that the Amish have no significant impact on any home birth neonatal death statistics. They also live a very healthy life, free of the stresses and environmental toxins the rest of us are exposed to.

      What this doesn't mean is birth always turns out well and that it's okay for undertrained and under-qualified midwives to charge people money to attend their births. I would wager even the Old World Order Amish communities have women attending births who have attended hundreds if not thousands of births. Not a CPM who has been to a handful and apprenticed with a women who has only been practicing for 3 years and only attended 50 births herself.

      I'm not here in this fight to admonish all home birth or all midwives. I'm here for the women who aren't the lucky ones. The ones whose birth is in that statistical area where baby doesn't get to make it and mom doesn't get to make it without some excellent medical care and interventions. Those women and babies deserve the best, most qualified, medical professional by their side when those unpredictable complications happen at home. I don't really need statistics from the CDC and MANA to know that person isn't the majority of CPMs and DEMs in the US. This isn't about taking away home birth or denouncing home birth this is about pushing for the same save midwifery practices afforded to the rest of the developed countries. Yes we have problems in our hospital birth system. I mean looked at Japan! 80% of women have drug, free natural deliveries in hospitals with OBs. They stay in the hospital for 5-7 days and they have the lowest perinatal and neonatal death rate in the world! CPMs and DEMs are not the answer to this problem they are part of the problem. Requiring them to have more training, be regulated, carry insurance and answer for their actions and bar them from taking on high risk clients is a good thing! It can only help!

    • profile image

      Misha 6 years ago

      Hi Rain- I find it interesting what topics you chose to bring up in your post. All the very valid points I made, all the legitimate questions I asked were completely ignored. It is obviously much easier to focus on the parts that are my personal opinions ( although I would argue that many people would agree with me on the A.Tutuer thing) and the ones easier to argue with anecdotes. I would like to thank you for making my case about the Amish though. The links you provided did an excellent job of showing that most Amish give birth at home and that they have many high risk mothers and genetic defects. Even that one doctor who was trying to help the Amish, ended up teaching midwives how to deliver their babies, where? You guessed it, at home. I like your anecdote about Christian Scientists, I have my own. My mother's best friend is one and a teacher from my high school- they both had homebirths and never take medicine or step in the hospital. Maybe there are no RESTRICTIONS on giving birth at the hospital but a huge part of the Christian Scientist religion, is the belief that God will take you when it is your time and we shouldn't mess with God's decisions. I'm trying to respond to each of your points so sorry if I am jumping around. "Women's experiences mean nothing?" Well, Rain, let me ask YOU that question. I had a fabulous homebirth, everything was amazing, my baby was healthy, I was healthy- therefore homebirth is safe! My midwives were fantastic, therefore all CPMs are the best!! Yes, our experiences mean nothing when we are talking about facts. I cannot say homebirth is safe or unsafe from my own personal experience. You following me?

      Do you have any remarks on the other points I made? Do you really feel ONE year of raw data based on death certificates- including planned and unplanned pregnancies and high risk pregnancies and (possibly-gotta check this one) no removal of congenital anomalies in the homebirth group, make it conclusive that homebirth is dangerous? So, that is it. Homebirth is dangerous from the CDC statistics of 2004? The truth is, nobody can answer that question and I would really be wary of anyone that tries to tell you they can, wether they say it is safe or unsafe without question. Dr. Amy hates homebirth and Natural Childbirth because it somehow is a threat to her. She doesn't want to think that her profession, a profession that has given her identity, is getting trashed. And she sure as heck is not going to let anyone get away with it. If you can't see it's all about her ego than I just don't know what to tell you. I am sure there could plenty of room for improvement for midwives and their standards but no one can claim they know if homebirth is safe or not. Sorry we don't have the information to answer that question.

    • profile image

      Rain  6 years ago

      @Misha Did you really say that these women's personal experiences mean "nothing". Also, how can you compare highly trained midwives in Canada with the ridiculous midwifery system we have in the United States? Also, the reason there is no data to provide is because MANA refuses to release it. You and I both know if the data they have collected helped their cause and showed how low risk home births with CPMs and DEMs were, we would have already seen it. I am not against home birth and plan on having one myself. What I am against is the inconsistent regulations of CPMs and DEMS in the United States. Canada does not have a second class group of midwives delivering babies at home! We do! Finally, you insistance that Amish people squew home birth statistics is some of the most ignorant drivel I have ever heard. There is no mandante in their religious practices that requires them to delivery at home or receive no prenatal care. In fact, the majority of Amish women who are found to be high risk delivery in a hospital or at home with a medical doctor in attendance. I grew up with Amish and Mennonite families as close family friends as I was home schooled on a small dairy goat farm. I was also born at home along with the other children in the small commune community I lived in. The Amish, Mennonite and my family all has excellent prenatal care. In fact, according to research done for the book "An Amish Paradox" it was discovered 3/5ths of the women in the largest Amish communities deliver in the hospital Only the extremely old school, ultra conservative groups still delivery at home with no prenatal care. This group makes up such a tiny portion of the Amish community it could have no to little affect on home birth statistics

      In addition, I am very close friends with a girl who is a second generation Christian Scientist and am also friends with her mother. My friend was born in hospital and she had her own daughter in a hospital 3 years ago here in Los Angeles. We have a large population of Christian Scientist here and I have yet to meet one who had no prenatal care. The hospitals respected their religious doctrine much as they do Orthodox Jews who also delivery in the hospital. The First Church of Christ, Scientist has taken no official stand regarding prenatal care and where birth should occur. Members are not chastised for having prenatal care or birth with an OB. There is a protocol to follow during and after labor, but freedom of religion binds doctors to respect this.

      Your claim that all people calling for regulations and standards for home birth midwives have simply been brainwashed by Dr. Amy because she went to Harvard is insulting! I don't agree with everything Dr. Amy says. I could give a hoot where she went to school. I'm an intelligent, educated woman capable of making decisions for myself. I have no vendetta against home birth. In fact, all of my experiences with home birth have been very positive. It is possible for me to support a woman's choice to home birth while at the same time denouncing the mockery of a midwifery system we have in the United States. Also, I know you think we're all idiots here who can't possibly be enlightened as you are, but please don't patronize me by expecting me to believe you have no agenda. Your statement "The woman who wrote this and the majority who supported her, are all just regurgitating what they have heard Amy Tuteur spew, over and over and over again. The problem is Amy T. twists the truths and fools her readers. They believe her because she is Harvard educated." speaks volumes to your your own personal preconceptions and biases you have drawn about those who are behind this cause. Where may I ask did you find the statistical data, reports and scientific information to make this claim? I'm assuming in the same place you found the information that made you confident enough to claim that Amish and Christian Scientist all have home births with out prenatal care by the thousands.

      @rebekahELLE The midwifery laws and regulations for Florida do not apply to the rest of the country. Here is SoCal we have a pretty good thing going with home birth midwives regulations too (for the midwives who follow them since there's no recourse if they don't). That's not good enough for me I want to see home birth made safe for all women across the USA. In addition, you claim that "Pregnancy and birth are a natural process, which sometimes may need assistance, but it is NOT a disease or condition to fear." that's all fine and dandy, but midwives ARE providing a medical service just like an OB and conveniently admit that when they practice in state that allows them to accept medicare from the government. Midwives are medical practitioners and should be regulated as such.

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      Misha 6 years ago

      SkeptiMommy- relax. There is no need to resort to ad hominem attacks. I know it can be frustrating when you have nothing to support your "beliefs" but that is when you stop for a moment and think. Ask yourself why you are so anti-homebirth and so anti- midwife. More often than not it is due to some personal experience which you have not let go of yet. You are letting all your anger cloud your better judgement. Let's not resort to childish behavior, it doesn't help anyone. I am providing you information based on fact. Fact: the Wax Study concludes homebirth and hospital birth have the same perinatal death rate. Fact: the WHO concludes the perinatal death rate is the best measure of obstetric care. Fact: we have no other US studies on homebirth that prove that homebirth with CPMs is dangerous. Fact:The CDC statistics are taken from only ONE year, are based on raw data and include high risk women, the amish( extremely high risk) and christian scientists( even more high risk). Therefore the CDC statistics prove nothing. You have cited no studies SkeptiMommy that prove anything,really. That is why I am asking that, if you are going to have such strong convictions about homebirth, you have something to back up your claims. You can't just say something bad happened to you and your friend. That, my dear, is called an anecdote. I am being honest and showing no agenda when I write that we don't have enough information to make a conclusive decision, you are showing your bias and your ignorance when you claim, you KNOW homebirth is dangerous. I can see you are getting a bit riled up but all you have to do is provide the data that I am asking for or admit that you are wrong. There is no gray area here. As a "skeptic" you should appreciate that. ~Mish

    • SkeptiMommy profile image

      SkeptiMommy 6 years ago

      You show dangerous bias and an even bigger agenda by pretending homebirth is safe as hospital birth when you admit that you "just do not know." Period. I do HAVE real data- it's from the CDC. MANA has the same data but refuse to release it to anyone. Fishy? I think so. Also, I never said that it's unethical to treat Amish women, Read what I wrote. But thanks for inventing an opinion I don't have- it chisels away at your own credibility and makes less work for me! It's hilarious- if I cite a study or metanalysis, you claim it's bias, it's funded by ACOG (the only ppl who really think there is a war bw midwives and doctors are...midwives!) and if I cite nonbias stats from a government agency, you claim they are of no worth because they're "raw." Which means you can't cry that someone has interpreted them wrongly. Poor Misha- continue to write pages and pages of how you prefer to ignore the truth- it's really entertaining. I mean effective.

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      Misha 6 years ago

      You have no evidence- ZERO- a big fat ZERO- that proves that homebirth, in the UNITED STATES, is dangerous. We just do not know. You show your extreme bias and agenda when you try to portray homebirth as dangerous. Period. You have no real data to support that conclusion!! The CDC statistics you are basing this all on? That is RAW data based on death certificates of only ONE year! Any real skeptic would never make a conclusive decision based on that alone. You are not skeptics, you have some vendetta against homebirths because off your PERSONAL experience, which means nothing. And who do think delivers the babies of Amish women? Lay Midwives and CPMs. You may not think it is ethical but if they won't do it, who will? And yes Amish women and religious women( Christian Scientists for example) skew those results! These women do not have ultrasounds or prenatal testing. They have 10, 12, 15 babies into their 40's. They give birth to twins and breech. They go postdates. They are more susceptable to having babies with congenital anomalies. AND our Country has over 150,000 of them and when only a 20,000 women are having homebirths, I promise you the Amish DO effect that number. What about Christian Scientists? They won't even take an aspirin and would not go to the hospital under any circumstances. And you are not being honest when you say CPMs do not take on high risk patients. You know perfectly well that they do. Maybe they shouldn't but they do. And if a woman is going to give birth unassisted at home over going to the hospital, sometimes the best that can happen for those high risk women is a Midwife at least attempting to help. Unplanned pregnancies most certainly skew the results. Do you think a woman giving birth her car or the bathroom floor, who has had no prenatal care is going to have positive results? The numbers also include ALL midwives. Midwives that have no training and have never delivered a baby. So you are comparing high risk women with lay midwives and saying they will have the same outcome as a low risk woman with an experienced CPM? That is preposterous. And I don't think YOU understand math. Did you see the numbers above? The MDs numbers are .6/1000 where the CNMs are .37/1000. Do we say that doctors DOUBLE the death rate over CNMs? No, Of course not! because those numbers are insignificant. I suggest you ask someone who really understands statistics what their take on the CDC numbers are. You people against homebirth claim to be skeptics, claim you only go by evidence and facts but that is simply false. There is NO real data that supports your homebirth is dangerous theory. Low risk can turn to high risk quickly, we are all aware of that. But if the evidence is not supporting that that really makes a difference, it means nothing. It means that most of the time, women are able to transfer in time when there is an emergency. Some don't but the numbers we are seeing show the numbers are low and consistent with death rates in the hospital. Please, explain to me why the Wax Study concludes the perinatal death rate for homebirth and hospital birth are exactly the same if homebirth is so dangerous. ACOG supports those findings. There are flaws within the study but not with the perinatal death rate. That is our most recent study. NOT funded by MANA or midwives. AND they concluded women at home suffer less PPH, less lacerations and infection! That is very significant. I am sorry that some of you had bad experiences with some CPMs. But you are naïve if you believe you will never encounter unprofessional and unethical people in your life. You think every CPM is going to be experienced, ethical and never lose a baby? You think every OB is ethical and never will never lose a baby? It is unrealistic to believe that because something bad happened to you, it will happen to everyone. If you are going to go on a rampage against homebirths, please provide us with something real. No Netherland studies- they are meaningless here, No Australian studies- they are meaningless here. If you are writing about the States, provide us with American Studies. The most legitimate one I have seen is the Wax Study and I gave the conclusion of that- Perinatal death rate is exactly the same.

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      MsFortune 6 years ago

      I've been considering a career change. I love babies but hate school and formal education. I also don't like anyone making professional judgments on my behavior.

      Maybe I should consider becoming a midwife! I never realized that the barriers to entry are so low and the oversight so lax or nonexistent.

      I just read "The Red Tent" so I'm totally trained!

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      ucuz şişme bebek 6 years ago

      So delicious chicken recipe ever!THanks

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      rebekahELLE 6 years ago from Tampa Bay

      If you don't object, I would like to add a link which explains requirements for midwifery in the state of Florida. One other distinction I would like to add about midwifery and OB gyns. OB's are trained surgeons who are taught to actively manage labor while midwives are trained to allow for the natural process of labor with less intervention. Pregnancy and birth are a natural process, which sometimes may need assistance, but it is NOT a disease or condition to fear. Licensed midwives help assist the couple through the entire pregnancy/birthing process.

    • rebekahELLE profile image

      rebekahELLE 6 years ago from Tampa Bay

      I have to agree with those who are questioning your sources. Have you toured birthing centers and interviewed midwives, etc. Do you have statistics and facts? I find this hub very disturbing and am wondering also why it was chosen as hub of the day. To be a skeptic is one thing, but to try to instill fear over an entire industry is worrisome to those who may be planning on going the midwifery/birthing center route. Many who decide on this manner of birth is because of the high rate of infant mortality in hospital assisted births. A more fair and balanced look at midwifery could be much more useful for expectant couples.

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      Mama Tao 6 years ago

      Oh and your reason for dismissing the CDC studies? Because they had high risk women in there too? DEMs and CPMs are not supposed to see high risk women. Only OBs. DEMs and CPMs were either seeing high risk women unethically (by your idea that is) OR they have a worst rate them OBs...DEMs and CPMS only see low risk women and STILL have a worse rate than OBs who see high risk clients. It only shows how shitty DEMs and CPMs are! You totally missed the boat on that one.

    • SkeptiMommy profile image

      SkeptiMommy 6 years ago

      Doozer- what state are you in because the only state in America to require midwives to have insurance is Florida. Also, HIPAA is not a state to state piece of legislation, where some states require more care providers to comply with the Privacy Act than others. It's federal regulation that blankets this country, every state is the same, either you are a covered entity or you aren't. It's that simple. NARM doesn't require anything you are referring to, but thanks for playing.

      Misha, it's obvious you have no understanding of math. That is a HUGE increased risk of losing a baby that you are simply brushing of as "eh, worst case scenario." Especially considering midwives are only allowed to accept low risk patients- OBs don't have the luxury of cherry picking only healthy patients and they STILL have extremely lower numbers than midwives. That's terrifying. (Also, why the feck would Amish and unplanned pregnancies be high risk?) We definitely can't assume it's lower than 1/1000 because it's 1.15/1000. Clearly stated in the data and in the link I provided above in the comments. Stick your head in the sand and click your heels three times and see if it lowers. Oh, it didn't? Well, keep lying to yourself or jump on the bandwagon of reality. Where is my evidence? Are you kidding me? It's in the CDC numbers in the links I have provided above. Learn something. Also- our country's debt? That's a red herring if I ever saw one. "I have nothing more to add, because, well, because I know there's proof, I just want to ignore it, so let's comment about the country's debt and divert attention from the fact that I'm wrong!" Remember: Low risk pregnancies do not guarantee low risk birth. Ever. Things can change in an instance- where do you want to be if that happens?

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      MAma Tao 6 years ago

      The Canadian study was done using Midwives that had 4 year educations....not so much the state of US midwifery. It would be like compairing apples to oranges. How about a Study from the Netherlands showing that while they have the most homebirths and midwife care, they also have horrid results. 10.9 per 1000 Geez!

      By the way, everything she said about midwives is backed up by their own governing parties. NARM and MANA.

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      Misha 6 years ago

      The woman who wrote this and the majority who supported her, are all just regurgitating what they have heard Amy Tuteur spew, over and over and over again. The problem is Amy T. twists the truths and fools her readers. They believe her because she is Harvard educated. Yes, that may mean she is smart but she is also a narcissistic egomaniac and is COMPLETELY biased in her views.

      Let me give you some real FACTS. There are no American Studies- ZERO- that prove that homebirth is safe or unsafe. They are ALL flawed. When you look at the studies that have been done it is very obvious to see that the death rate for babies at home and hospital are marginally different. We are talking about tiny, tiny numbers here and yet homebirth bashers like to make it seem like homebirth is exceedingly dangerous and risky. One of the recent studies done in this country on homebirth safety is The Wax Study. A study that has been supported by ACOG. The results of the the Wax Study conclude that.. the perinatal death rate for hospital and homebirth babies is THE SAME. According to the WHO, the best measure of obstetric care is.... Perinatal death rate. So, as much as people who are against homebirth would like scare people into giving birth in the hospital, the ONE study, supported by ACOG states that midwives, delivering babies at home are saving as many babies as doctors are in the hospital. This study did show a a slightly higher neonatal death rate at home but it is much more significant to look at the perinatal death rate as the numbers were larger ( close to 400 deaths in perinatal rate) as opposed to only 37 deaths in the neonatal death rate. And of course, most importantly, perinatal death rate is how we measure obstetric care. But that's not all. The study also found, along with every study that has ever conducted the safety of homebirth, that women at home are less likely to have PPH, have a lesser chance of infection, a lesser chance of laceration and tearing. Their babies need less oxygen and suffer less instance of birth trauma. Then you take into account that immediate skin to skin contact at home, the delayed cord clamping, unobstructed nursing relationship and the simple fact that mother, father and baby can all be together and do not have to spend one minute being separated. Mother has more privacy,more comfort and more respect. ( Unfortunately, at the hospital you are dealing with all kinds of people, nurses residents, etc. who may be having bad days or are generally unpleasant to begin with.)

      Also, someone brought up the CDC statistics. Let's look at those more closely. These statistics are only from one year 2005-2005, so I don't think that tells us much but the numbers are- .37/1000 for CNMs, .61/1000 MDs and 1.15/1000 for midwives ( including CPMs and Lay Midwives). So just on those numbers alone, the worst case scenario is a 1/1000 chance of losing your baby at home. That is not the huge risk some make it out to be. BUT, these are numbers based on low risk AND high risk women. That means that included in the death rate for midwives at homebirths are amish women, breech babies, postdates, twins and unplanned pregnancies. I also believe-not sure- that congenital anomalies have not been removed from the homebirth numbers. So, that leaves us to ask- What is the true death rate for LOW risk mothers giving birth at home. At this time, we just don't know but we can definitely assume from the CDC that it is UNDER 1/1000.

      To the writer of the article, where is your evidence that giving birth in the US at home is unsafe? Please don't give us some obscure Australian study because I will just come back with the Canadian one that proves it is safe. Please don't tell me how your friends lost babies at home or your friends friends, or someone you met on the internet or a story you heard on the internet. Those are anecdotes and they prove absolutely nothing. So, where is all your evidence? Where is your proof? Until you have some concrete, indisputable evidence that homebirth is as dangerous as you make it out to be, you are only wasting your time. There are many other thing s that cause many babies and children to die every year, things that no one disputes like choking and drowning. Spread more awareness about those things and then you truly will help save lives. Trying to stop women from homebirthing by scaring them into thinking all midwives are evil, selfish women isn't going to do anything but make you look resentful and angry. In addition to that, do we really need to put our country into anymore debt?? Let low risk women give birth at home if they so choose!!

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      Snorkle 6 years ago

      I'm an Australian and it always intrigued me that the "Mother of Midwifery" Ina May Gaskin wasn't actually a real midwife. Lucky I took her crap with a grain of salt and gave birth in a really unfriendly hospital whose staff saved my baby's life when my low risk pregnancy became a difficult birth.

      How on Earth can you listen to people who aren't educated in the practise they are seeking to revolutionise?

      Yes, midwifery and obstetrics needs to become better for women! Yes, there need to be better facilities at hospitals and more birthing centres. But the way to improve the system isn't to stay home and risk your baby's life with an uneducated midwife who will pretend to be your best friend. Seriously, when the sh!t hits the fan, I want someone there to whom success matters. I want a caregiver who is too busy ROCKING AT SUCCESS to get to know me as a person. I want someone to whom knowledge matters.

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      WryLilt 6 years ago

      I'm amazed that the rules are so lax in the US - here in Australia midwives have to complete a course as an RN (registered nurse) THEN complete another course as a midwife.

      All midwives have insurance - a recent ruling that effected homebirth insurance saw many mothers up in arms because midwives generally WON'T homebirth without insurance.

      I don't know if the definition of midwife is different here or not - but over here a midwife can either be a homebirth midwife (same training but private practice) or work in the hospital delivering babies. I never saw a doctor for my entire first birth - I had a fully trained midwife till after my daughter was born.

      This time I'm in a public hospital again but 20 pregnant women each month are taken into a "caseload" at the hospital which means a drug free, breastfeeding preferred birth and guidance through the pregnancy by a select midwife and early discharge.

      I feel so sorry for women in the US - over here midwives are often seen as the "safer, more natural" version because doctors often don't turn up at births at all AND when they do are a lot more likely to have an "easy caesarian" than a midwife.

    • Les Trois Chenes profile image

      Les Trois Chenes 6 years ago from Videix, Limousin, South West France

      Great punchy hub and, yes, is scary.

    • jacqui2011 profile image

      jacqui2011 6 years ago from Norfolk, UK

      It's scary to think that this goes on and the authorities allow it. Very well written and voted up. Congratulations on being hub of the day.

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      Rain  6 years ago

      I wish everybody would stop trying to blame our infant mortality rate on OBs and hospital births! The infant mortality rate includes the whole first year of a baby's life! A lot can happen from the time a baby leaves the hospital until their 1st birthday. If you want to know where we actually rank in newborn deaths you need to view the perinatal period which is according to wikipedia:

      The perinatal period is immediately before to after birth. Depending on the definition, it starts between the 20th to 28th week of gestation and ends between 1 to 4 weeks after birth (the word "perinatal" is a hybrid of the Greek "peri-" meaning 'around or about' and "natal" from the Latin "natus" meaning "birth.").

      You can even use the neonatal death rate. The neonatal period being the first 28 days of a baby's life. However, this will also include preemies who didn't make it, but ours is still in line with most other developed countries.

      The perinatal and neonatal rate for the United States is at the same level as the UK and even the Netherlands where home birth is more common. Are perinatal and neonatal death rate is in line with most other developed countries.

      You can not blame the infant mortality rate on OBs and hospital births, but you can thank them for our very low perinatal and neonatal rate.

      Why are babies are dying so much in the first year is a very good question, but it's a separate issue. Our substandard infant mortality rate has nothing to do with OBs.

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      Rain  6 years ago

      @Nessa Oh my lord please tell me you reported her to what ever organization she got her training through! I am also a doula and had the same training and doulas are never allowed or qualified to give medical advice! Doulas are not medical professionals in any way shape or form. The word doula means "female slave" they are only there to support you and try to help you with comfort measures! It wouldn't matter if she had attended 1000 births before yours she has no right to suggest those things and the definition of what a doula does and does not do is pretty clear. They are not considered health care providers. I'm so sorry she acted that way! If you haven't already I really suggest you file a complaint against her. From what you're saying I'd guess she's DONA certified like me. I an assure you she didn't learn that behavior from the women I did my training with!

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      doozer 6 years ago

      Those "truths" aren't truths on a national level, for CPMs, and on a state level in many states, including the one where I reside.

      This state licenses and regulates midwives.

      This state tracks midwives' transfer rates.

      This state requires continuing education, as does NARM.

      This state requires HIPAA compliance, as does NARM.

      This state mandates OB backup.

      For midwives who have credentialed nationally with NARM, there are requirements and accountability in place. Please see the NARM website for facts.

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      tara dukaczewicz 6 years ago

      Here's some truth for you, a few weeks ago a homebirth went drastically wrong. Not because there was anything wrong with the baby, but because two women decided they could be midwives too because they trusted birth. Because a baby knows how to be born. Because Ricki freaking Lake made a movie about it. They allowed a woman to labor for EIGHT DAYS. She was pre-eclamptic, post dates, had ROM for 3 days, meconium stained fluids. They told her that her high BP's was because the cuff was too small, they took away her phone so she couldn't call for help, they barred the door so her friends couldn't get in, her husband was in india, they ignored her pleas for a transfer and went into another room so they couldn't hear it. They had no bulb syringe to clear out his mouth, didn't know CPR and argued about calling 911. Why? Because it was Darby Partner's first solo delivery. Now this mother has to buy a little tiny coffin to put her baby in and face all his clothes and furniture that he will never get to use. This baby did not have to die, the coroner reported what should have been a healthy full term baby. He died for someone's arrogance and desire to be midwife without going through the tediousness of actually learning how to do it. So no, midwives aren't all gentle earth mothers that spend so much time caring for their clients. Sometimes they just care for themselves. Midwifery is in a sorry state right now, not enough accountability and not enough punishment for those who willfully abuse it. We should be weeding out these poor examples instead of closing ranks around them. But I know what you people will say,because it's what you say every time. "Babies die in hospitals too."

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      Kate in Aus 6 years ago

      I'm with MJ - I am grateful that midwives here are tertiary qualified clinical care providers, whether they studied nursing then qualified or chose to study a direct entry Bachelor Degree in Mid.

      Traditional midwives should be clearly differentiated so families can make informed choice.

    • Denise Handlon profile image

      Denise Handlon 6 years ago from North Carolina

      Interesting hub.

    • SkeptiMommy profile image

      SkeptiMommy 6 years ago

      Silly, if your midwife was delivering in a hospital, in America, she is a CNM! I fully stand by CNMs- they are great care providers and incredibly educated! I am referring to the requirements of CPMs and DEMs.

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      silly me 6 years ago

      Interesting hub.

      My son was delivered in the hospital by a midwife. I actually switched from an ob/gyn to the midwives. My midwife did an amazing job! She kept checking on me, left it totally up to me whether I wanted the epidural, and made me feel at ease. I never felt rushed, pushed into one thing or another, and was always encouraged with words of affirmation. I will definitely choose the midwives again and can only recommend them. But I agree, we have to be informed and know who we are dealing with.

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      Staceyjw 6 years ago

      Just because your hospital birth sucked, doesn't mean it's OK for MWs to be so inexperienced and dangerous. Home birth isn't the logical response to a crappy hospital birth. Thats like saying "my kid hate shis car seat, and it burned him in an accident, so Im going to just put him in the back seat instead!".

      I don't care if you know a great CPM (news to you- 250 births is not very many!), all of these things are TRUE. The take home here is that everyone thinks they have hired the "good" COM, until something bad happens. and there is NO way to check.

      Sunshine Momma- Maybe people like you, that support these MWs and HB, should quit rallying around the MWs (Amy Medwin, anyone?) that are so obviously negligent and have KILLED because of it. How is this stuff Ok to you? if you want HB and MWs, why wouldn't you want them to be safe and educated? Its not bitter or mean to point out the TRUTH.

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      Monica 6 years ago

      Very well said. For those who keep saying I had a great homebirth and every midwife I've ever met disclosed all to me, well all I can say is good for you. But for all the women who had a midwife say they were fully trained and never lost a baby, but then lost YOUR baby I feel for you. And I really feel for their future patients who will never know what happened before them. Doctors and hospitals aren't perfect. And sure there are bad midwifes out there too. But shouldn't Americans expect to get the most trained and educated professionals possible. Whether you want a midwife or a doctor. A home birth or a hospital birth. Shouldn't we require these people we trust with our lives and the lives of our child to have the best education possible? Shouldn't our country be assuring that this is exactly what we are getting in our maternity care? Shouldn't they be requiring fully educated midwives attend all homebirths? Shouldn't they require that they carry malpractice insurance? Shouldn't there be consequences when there is clear negligence? That is what we should all be striving for. I had a perfectly nice hospital birth four times over including one c-section with great care each time, but that doesn't mean there wasn't room for improvement. That doesn't mean that there aren't bad doctors out there. The difference is that a doctor can't easily sweep negligence under the rug. Awesome hub here! Bringing light to what really is happening in the world of midwives and homebirths. Lets keep in mind infant mortality rate is not what we should be looking at to judge hospital births vs homebirths. Doctors and c-sections are not the devil people. They have their place and they do save lives.

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      MJ 6 years ago

      In Australia, a person with the equivalent standard of a DEM or CPM would not be able to call themselves a midwife or care for pregnant women in the hospital or home. Our midwives have minimum educational standards, national registration requirements (by the same board that registers nurses) and practice guidelines - you can check your midwife's registration status and any reports, reprimands or suspensions with the registration board.

      Why on earth would you allow anything less for women and babies in America? You can support midwifery and still say that this just isn't good enough.

    • SkeptiMommy profile image

      SkeptiMommy 6 years ago

      Thank you all for commenting and support! You'd be amazed at how difficult it can be to swim against the current of woo so I was amazed at the rational comments- together, through understanding, we can change the current legislation of midwifery in the US! It's going to be very difficult to address all the comments individually, so I'd just like to say in general to the dissenting views:

      1. I am not bitter. That's a passive aggressive ad hominem, but thanks for playing. I am very concerned at the lack of regulation in midwifery in the USA in regards to laypersons such as DEMs and CPMs. I want better policies, heavier regulation, and a lower neonatal mortality rate.

      2. I live in Colorado- a state that is triple the national neonatal mortality rate. The requirements I listed to become a CPM are Colorado requirements. You can find them online by searching Colorado Midwives.

      3. The anecdotes are great, but they are just that- anecdotes, not facts.

      4. There are NO studies whatsoever that show that American mothers who choose to homebirth are as safe as those who choose to birth in a hospital. None. The CDC wonder holds data that shows it actually triples the risk of neonatal mortality.

      5. Just because you yourself have not experienced or seen evidence of negligence of careproviders does not mean it does not happen.

      6. I can't believe anyone would compare someone who is helping you birth your baby to someone who is removing your pubes. It was a terrible analogy to compare them to midwives- same for massage therapists, although even massage therapists require more education!

      7.Saying "I'm not required so much as a GED" is not a broad statement. It's a very direct statement. And it's true. Look up MANA and NARM definitions and requirements yourself.

      8. Don't ever ever ever ever quote wikipedia and expect to get any reaction or respect from me. Ever. It's not a legitimate source- it's not accepted by medical journals, academia, and other respected media- it's not accepted by me. Don't be lazy. Use actual studies and scholarly journals.

      9. Simply throwing out the words "infant mortality" and "wikipedia" mean nothing. Here, I'll do your work for you: Please educate yourself in statistics and account for confounding variables like the increase in preterm birth and maternal health. I trust you'll read all of this as well (no skimming- you need to be informed, right?) Particularly pay close attention to the part where this non bias government agency says, "•The main cause of the United States’ high infant mortality rate when compared with Europe is the very high percentage of preterm births in the United States." Humble pie. It's tasty, isn't it?

      10.Personal responsibility is a big issue- but women who choose laypersons as careproviders are sold a picture that hasn't been painted with truth. They aren't UC'ing- they trust in their birth attendants to guide them safely through the journey of labor and into the harbor of motherhood. If they aren't told everything, how can they be truly informed?

      11. Women have been giving birth since the beginning of time- and dying from it as well. And c-sections haven't been only happening for a few decades- they have been happening since the beginning of time as well- the first recorded c/s was roughly 320 BC. Typically, they were done to only save the baby. The first woman to survive a csection was in the 1500s, in Switzerland, by a pig gelder.

      12. If you think I'm bias- Ricki Flake of Business of Being Born will give you a heart attack! 1 documentary. Too many lies. How this woman went from a step below Jerry Springer in daytime ratings to exhaulted as a hero for women is beyond me.

      13. Midwives are NOT constantly with their clients. Busy midwives are often overbooked with clients and since birth is unpredictable, often, mothers are in labor at the same time. They often leave laboring women with doulas to float between clients.

      14. Boiling, no matter how long, DOES NOT eradicate all blood borne pathogens that could be transferred mother to mother.

    • profile image

      Kate 6 years ago

      The people who are pointing out that the United States has a high infant mortality rate--your ignorance is showing. Infant mortality is a measure of PEDIATRIC care, not obstretic care. Perinatal mortality is the number you want to look at, and the rate for the U.S. is lower than the countries you worship. But hey, as long as you get your ~birth experience~

    • profile image

      Mama Tao 6 years ago

      Sunshine Mama...what did a midwife ever do to me. Well I for one had a great CNM who delivered my kids, so before I tell you all this and you accuse me of hating midwifery, I wanted full disclosure.

      Midwifes (CPMs) have killed my friends children. They have made mistakes that a child might have noticed. Midwives have left my riends broken, torn, damaged beyond repair both inside and out. Every day I talk and work with these women and you do not. THAT is what midwives have done to those I love. And this is why I am here to support my friends.

    • profile image

      Ivorwen 6 years ago

      Very well said heartwort!

      Every midwife I have ever met has given me a full accounting of her credentials, stance with insurance and all the other hoopla mentioned above.

      Considering I live in a state where "practicing midwifery" is illegal, I felt blessed to find those who would assist with a home birth. (NOTE: The definition of practice is to accept money for preforming a service... so, according to our local state representative, midwives are more than welcome to assist, but not to charge. Now you tell me how THAT works out with insurance!)

      ...not that I needed a midwife...

    • nikki_m profile image

      nikki_m 6 years ago from Kansas City, Missouri

      Congratulations on being Hub of the Day.

      I think this has raised many valid points that should be considered when choosing between a home birth or hospital birth. While they may not be true for every midwife out there, too many people assume that because someone has a few letters after their name, they are knowledgeable about what they are doing. This is false!

      It's so important to do research, to ask questions, to find out what the plan is, and the backup plan, and to MAKE SURE that everyone involved with the pregnancy, birth, and postpartum care is qualified and experienced.

      Especially now, with the job market the way it is, you will find so many people that just stumbled into a job because it paid the bills. They may have a trustworthy face and a nice personality, but that does not substitute for experience and wisdom.

    • J.S.Matthew profile image

      JS Matthew 6 years ago from Massachusetts, USA

      Congratulations on being selected for the Hub of the Day!

      This is some scary information! I didn't know much about this trade at all as I don't know anyone personally who is or has used a mid-wife. I hope people read this and maybe some laws can be put in place to insure that the people who do this are truly knowledgeable professionals. Thanks for sharing! Voting Up and will share.


    • CennyWenny profile image

      CennyWenny 6 years ago from Washington

      While these things may be true, and I don't disagree with them at all, I think the financial cost of hospital birthing is totally out of control. I did have to be induced unfortunately and after 15 hours caved and got an epidural, so I'm sure this contributed to the cost, but my NON-Cesaerean birth at a hospital with no significant complications cost over $25,000, of which I was responsible for $3,500. The cost of care is completely and utterly out of control. Also, for women who are on public assistance and have many children (3+) at $25,000 a pop per child plus prenatal care, no wonder taxpayers and the state are going broke! I personally did have a midwife for prenatal care but was transferred with the cooperation of my midwife and her contacts at the hospital because I went 42 weeks and just wouldn't pop. I personally had a great experience with both my midwife and the people at the hospital. However, my midwife's costs (she broke them down for me during prenatal care) totaled less than $5,000 for everything. I just am flabbergasted by the cost of care at hospitals for people like myself who have insurance and are not on public assistance.

    • profile image

      Just Life 6 years ago

      ROTHFMBO!!! You wrote this as if you are serious!!!

      I gave you a point for "funny"!

    • RunAbstract profile image

      RunAbstract 6 years ago from USA

      I have a neice and nephew that were both delivered at home by midwives, and each birth was successful, and uncomplicated.

      Also I have twin nephews who were going to be delivered athome with a midwife, but complications arose, and so mother went to the hospital where a c section was preformed.

      Mother had been seen by the midwife throughout the pregnancy, and rather than being born premature

      as most twins are they were each weighed in at over 7 pounds a piece! And that's very good birth weights for twins!

      As most midwifves are known to do, when the delivery was beyond her expertize, she sought help from a medical doctor able to perform the needed surgery.

      Rock on MIDWIVES!!!

    • SEXYLADYDEE profile image

      SEXYLADYDEE 6 years ago from Upstate NY

      I too delivered a baby, in the hospital with a certified nurse midwife. My daughter's cord was wrapped around her neck and she needed to be delivered quickly and given oxygen assistance (done by me). The doctor "on call" was not called until after the delivery to sew me up and the episiotomy was horrid, the birth was not.

      My good friend had 2 home births and her mother and I assisted in purchasing and sterilizing the clothing for the last newborn. The women was very clean, boiled things for more than 20 minutes and both boys were healthy and delivered without complications. The midwife called an ambulance to take her to the hospital after the first birth because she bleed longer than she felt was reasonable. She was discharged the following day. They spoke highly of the midwife and the babies condition.

      I on the other hand delivered early twice in the hospital, was told both babies had infections, no cultures ever grew to prove that assumption and the first baby did not live through the day. There are indeed misfits in a hospital setting as well.

      I am so sorry you had a horror story and that you encountered a bad midwife and had to vent in this manner. I do understand that you feel the need to warn other mothers to be careful and to do their research. It's very important that anyone with a medical issue thoroughly investigate their; midwife, surgeon, ob/gyn, oncologist, etc. Never just take anyone's word. Thank you for your insite. I pray that enlightening others helps you heal. Dee

    • heartwort profile image

      heartwort 6 years ago from Virginia

      If you are going to have a baby, educate yourself on what you can expect from your providers, whoever they are! These statements here are misleading and sensationalistic. They foster fear amongst ignorance.

      "I'm not required to obtain any education- not even a GED."

      -Very broad statement. Perhaps you should define education as there are many forms of learning and gaining experience. Apprenticeships can be very effective. Also, they do not just "observe" deliveries. They attend along w/an experienced midwife.

      -It is worth pointing out that regulation varies greatly from state to state. Lay midwifery may be unregulated, illegal or regulated. Contact your state regulating agencies to find out more.

      "I do not have to carry malpractice insurance, even though it is available."

      -For some this is a benefit. Lay midwives do not have to pass that cost on to their clients, nor do they operate on the basis that they have to do this or that for fear of suit. Remember, lay midwives often serve the population that does not want the interventions that are so often done because of AMA or ACOG standards and the provider's fear of blosing a suit if they are not followed.

      "I am an independent care provider- I have NO legal requirements for physician backup or oversight."

      -Yeah! See above.

      "I could be lying about my emergency transfer and cesearean rate and you would not know the difference."

      -Helloooo? Your physician or CNM can mislead you as well. Buyer beware, whereever you go. Ask questions, get referred by someone you trust and check for complaints.

      "I don't have to complete any form of continuing education in midwifery."

      -A competent lay midwife will be continuing her education on her own. They are not doctors, CNMs or nurses. They are LAY people. If you want to regulate them out of existence then you are depriving women of choice. You also create an environment where some women may elect to have an unattended home birth because there are no midwives available to attend to them.

      "I typically don't have access to sterilizing equipment such as an autoclave for my birth instruments, so don't think my instruments are clean."

      -High level disinfection can be done by boiling cleaned instruments in water for 20 minutes. This is appropriate for instruments like speculums, etc.

      Next time you're in stirrups and the doc touches you w/his gloved hands and then reaches into his drawer for a speculum, picks up another to judge the right size and then selects one, you might wonder about your flora implanted on the other speculums. As well as the patients' before you. I've seen it. Cleanliness does not require a degree and, btw, some of our nastiest antibiotic resistant organisms are born in hospitals.

      "I do not have to adhere to HIPAA guidelines or the Privacy Act."

      -Neither does your massage therapist or the girl that does Brazilians at the spa. The example here is absurd. Don't go to someone you don't trust.

      "I can still practice midwifery if someone has filed a complaint against my license- even while I'm being investigated by the state."

      -Not guilty until proven guilty? Also applies to doctors and nurses. Note that how complaints are handled is dependent on the state regulating board and may vary from state to state. Check there for any complaints under investigation.

      "The state will only investigate a homebirth loss or injury if a complaint is filed."

      -True of most situations where an investigation occurs unless there is specific monitoring such as in the prescribing of narcotics.

      "I can still practice midwifery with blood on my hands."

      -Quite the sensational statement. Ask your experienced OB/GYN how many of his (or her) babies and moms have ended up damaged or dead. Do you think he's going to tell you if any were the result of his mismanagement?

      Properly done studies have shown that home birth outcomes are about the same as hospital birth outcomes.

      I'm an RN who has worked many years as a neonatal ICU nurse. It's pretty rare to have a newborn admitted from a lay midwife attended home birth but it does happen and it's usually pretty appropriate that they came in. In urgent situations the mom and babe are brought in by EMS. Like I said, it's rare, so I don't have a lot of these cases to recount, but in the one's I do, I've never seen a case where the lay midwife was negligent. Things do happen in deliveries. That's why NICU's are full of kids that come from the O.R. and the delivery room. I also know of several cases where parents were referred to a doctor by the lay midwife because a home delivery was not appropriate for their circumstances.

      I've had occasion to contact several lay midwives about their practice and experience. Not one of them was ever misleading. Contrarily, they were very specific about what they would and would not be able to provide. They wanted no part in clients who did not understand and accept the services they provided. A couple were also willing to work w/women who also saw an OB/GYN during their pregnancy. This article suggests that they are all deceptionists and liars which is far from the truth.

      Home birth by a lay midwife is obviously not for everyone but does provide a viable option for some women. Certified nurse midwives are great. I wouldn't want to be misconstrued as knocking them. My 10-pounder was attended by them. But they are not available for everyone, especially country dwellers, and they are restricted by the oversight of a physician.

      I feel bad for the author here. There is obviously a lot of bitterness from somewhere and that is unfortunate. I hope she can shed that and let herself heal at some point.

    • stunnercold profile image

      stunnercold 6 years ago from Dubai

      I've known that midwifery was a registered profession in the US, but never knew it was this unregulated!

    • RoughOutline profile image

      RoughOutline 6 years ago from England, UK

      Sad state of affairs and a lot of scary truths there.

    • rafatalam73 profile image

      rafatalam73 6 years ago

      Quite interesting hub.

    • profile image

      Anna 6 years ago

      10 truths? Ha! Ha!

      2 weeks ago a young mother of a 5 year old and a 3 year old went to the emergancy room thinking she was in labor with her 3rd child. Her doctor came in, examined her, and sent her home. A few days later the same thing happened. Then a third time last week.

      When the doctor finally decided he would have to do a C-section, mother and baby both died!

      It was a tragic thing for our whole community.

      One thing about midwives, they listen to their mommies. A doctor says, "you're not diolated, go home and wait". A midwife says, "lets find out why you are feeling so oddly".

      Voted down!

    • profile image

      Guest 6 years ago

      I don't know where you're from, but the state I live in has MUCH stricter laws concerning practicing as a midwife! For starters, you have to be a licenced nurse, and apprentice MUCH longer than 20 prenatal visits, and 20 birthings. Good grief!!!

      From your article, (which never mentions the natural benefits of using a midwife) I would think you have never experienced a birth with an attending midwife. And your name "skepiMommy speaks volumes to me, by the way.

      Midwifes may come upon problems at birth, just like a doctor does. That's why they are notorious for calling 911 if they consider a problem is developing beyond their capabilities. I repeat... Good grief!

      You also failed to mention how a midwife is constantly with the mother while the birth progresses. While doctors call in orders, and get there in time to catch a baby at birth.

      Your article may be well written, but I consider it very misinforming, to say the very least!

      And I think people who are so obviously biased, and uninformed, should mention they are writing an OPINION, rather than FACTS. The "disclaimer" you have is more like a "lead in" to the disinformation you supply.

      To the moderators (?) who encourage this type of propaganda with little "seals of approval" or whatever that icon up top represents..... WOW! Really?

    • Kate Spenser profile image

      Kate Spenser 6 years ago from Austin, TX

      I agree with SunshineMama that this needs to be taken in the context of the fact that the U.S. has one of the highest infant mortality rates in the "developed" world. (See the chart on wikipedia here: - the U.S. is #34). Given that the majority of women in the U.S. give birth in hospitals, this should remind us that giving birth in a hospital isn't necessarily the "gold standard." I've known women who have lost babies during childbirth due to hospital or doctor error - does this mean all doctors are incompetent? That all medical education is deficient? No. Does it mean that there are probably improvements that can be made in all ways that we think about and practice childbirth to make it safer all-around? Most definitely.

      I think one of the things that is MOST important for anybody, whether they are giving birth at a hospital, at a birthing center, at home, or wherever, is to know that you absolutely can NOT plan how your birthing experience is going to go. You never know exactly what will happen - it's okay to have an ideal in your head (at home, in the water, drugs, no drugs, C-section, no C-section) but it's important to know that what you want to happen might not happen, and to be willing and able to let go of that vision if and when the time comes to change your plans. Making sure that your midwife, doctor, OB-GYN, whoever understands your wishes AND is adequately equipped (and willing!) to go with a different plan if necessary is super important.

      Also, no matter who you have deliver your baby, it's important to ask tons of questions - their qualifications, their philosophies, their practices, etc. Ask other women for recommendations. ask the person you are considering having do the delivery if they have anyone who has worked with them before that you can speak to about their experience. Generally speaking, the more transparent they are, the better. This hub is useful because it reminds us that just because a person says - or implies - that they are qualified doesn't necessarily mean they are. But remember that this is just one side of the story, so the best thing to do is do your research.

    • applecsmith profile image

      Carrie Smith 6 years ago from Dallas, Texas

      Congratulations on being the Hub of the day. This is a somewhat biased post, but still very informative and well written. Thanks for laying it out there for the rest of us.

    • NiaLee profile image

      NiaLee 6 years ago from BIG APPLE

      I thnak you for all the information you are giving to everybody out there. The thing is parents need to be responsible too. I had three children in hospital and it went well for all of wouldn't have survived if I was not in a hospital! The thing is I had friends who tried to push natural birth without any pain relief, in water and other things like that. I do love natural things, I did have two vaginal births after a C section but I would not let anybody decide what kind of birth or medication I take or not. Why? Because my health and safety and my child's are my responsibility. You can play I go camping without anything for days in the most dangerous place in the world...but when it comes to another precious life, you make the wisest decision, the one that will be the safest for the baby. If you prefer to follow your convictions even though it is dangerous, you have to assume the outcome.

      Giving birht is a natural but also dangerous, see life threatening process for two beings or more, so being careful and choosing the environment where the most help can be there if necessary is wise.

    • randomcreative profile image

      Rose Clearfield 6 years ago from Milwaukee, Wisconsin

      This is definitely true, and I'm glad that someone is saying it. It's too bad that there are midwives out there like this because it makes it that much harder for the good ones.

    • MonicaRobinson profile image

      MonicaRobinson 6 years ago

      It is easy to put a negative spin on either side. I have had three homebirths with midwives, in three different states, and one hospital birth with my last. The hospital birth went better than I thought it would, but would rather have had a homebirth. I think the key to any decision made is to be informed and take RESPONSIBILITY! Ask those questions that need to be asked, research and and know the consequences of your decisions as well as the doctor or midwife's decisions. Awful things can and do happen, in any many instances no one is at fault, that is why they are called accidents. But, on the other hand, negligence on either side is indeed negligence.

    • Mcham Law profile image

      Mcham Law 6 years ago from Round Rock, Texas

      I wish more people would look into birthing centers and midwives. My wife labored at birthing center for 24 hours before finally giving in and getting the c section she needed. We were dedicated to the idea of a natural birth, it just didn't happen for us. The reason I wish people would consider it more is that we live in a demand driven market of a world. If more people were interested the midwives would have to step up their game to get customers. As it is they don't have a lot of competition so the standards can be low.

    • ChristinS profile image

      Christin Sander 6 years ago from Midwest

      I have to agree with sunshinemama's comments here. I did the doctor route with my first son and although he was really good - he was not a woman and was trying to do a "text book" delivery - and my son was not that :). That labor took 23 hours and 46 minutes. The epidural was missed resulting in horrible pain on top of the labor and then spinal headaches for a year after. The episiotomy they swore to me was "standard" caused me pain and discomfort for nearly two weeks. No doctor ever told me about perineal massage as an alternative to "standard" episiotomy. I also got a staph infection on my legs from the hospital that lasted for 3 weeks upon my release before I realized what it was... While in the hospital I was told it was "probably an allergy"... so I let it go a very long time and that could have been life threatening!

      My second child was born with the assistance of a midwife, in the water. Total labor time 5 hours 35 minutes, no episiotomy, no doctors barking orders etc. no one pushing drugs/epidurals - and to my surprise and delight the natural birth was much less painful than my other sons was with the drugs (and missed epi - ouch!) I was totally relaxed (despite being scared of a repeat). It was comfortable and I was up and recovering within 2 hours with no stiffness/pain that episiotomy causes. This son was a much larger baby.

      Women have been giving birth forever - only in the last several decades have we had our power taken away by doctors who think they always know better. C Sections are performed way more often than necessary to protect against lawsuits etc. There are big problems in both systems - midwifery has its challenges, but so do hospital births. To demonize one so thoroughly and make the other sound nearly perfect is also a disservice.

      Midwife's are highly demonized in this hub and most midwives are NOT in it for the money - they are in it for the love and genuine concerns for moms and children. Hospital care here in the US also results in an alarmingly high infant mortality rate for an advanced nation such as ours.

      As with anything else in life we should do our own research (not listen to propaganda from any side) and decide what is best for our own children and bodies. I would take a natural delivery without the high pressure to do it "text book" style any day over the experience I had with my older son. My youngest sons birth was a beautiful experience that I felt I was encouraged to actively participate in. My first sons birth felt like it was something being "done to me" and was not pleasant at all...

      Granted - both pregnancies for me were low risk. I did not have diabetes, bp issues, was not overweight or anything else risky. In high risk situations I would absolutely agree with hospital treatment - and I think most midwives with a conscience would to. Are there bad midwives - Sure. Are there just as many bad doctors - probably...every profession has its quacks.

      In the end, regardless of what women choose, I would love to see womankind as a whole be more empowered during their birthing process - so that it can be the beautiful experience it should be. :)

    • homesteadbound profile image

      Cindy Murdoch 6 years ago from Texas

      Wow! What can I say? I never had the fortune of being able to get pregnant but I know if I had, that I would have definitely considered a midwife, and I would have thought that they would have more education than this. This is down right scary with two or more lives on the line with every delivery. voted up, interesting,and useful.


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