Lay Midwives?

KellNY, RN · Jun 10, 2006

Where did it say anything about the family suing?

Looks like the state is persuing this, not the family.

Helping a family deliver a baby is not practicing medicine without a license. *Unless* she cut an episiotomy, gave stadol, performed a c/s, etc. But telling a mother when to push, when to breath, suctioning mucus out of a baby's mouth...that's not medicine.

And "midwife2b" yes, I do know people who have went the UC (unassisted childbirth) route. My next child will be a homebirth, very likely UC. Though I may have a midwife on call in case something goes wrong.

Kelly

allthingsbright · Aug 14, 2006

What is your opinion on them? Are they qualified to be delivering babies (certified professional midwives)? Should they be able to recieve licensure? What are the pros/cons of a CPM as opposed to a CNM? What are the dangers of using a CPM?
I was talking to someone yesterday and this came up...I'm curious what your opinions are on this.

In Florida I seriously considered lay midwifery, applied to a program and started precepting w/ a local certified lay midwife. She was quite competent and had a thriving practice (despite being kind of "wierd" :uhoh3: ).

Um, she and other lay midwives in the area were really into "bending the rules" (one being that they would attempt to deliver/deliver breech babies, which is against the law in Florida). What I saw from a short term experience scared the crap out of me (every lay midwife I met was being sued for something) so I got back into my old nursing program (had to move back to my old state) and am shooting for CNM at some point.

Lay midwifery has its value, but the liability is just crazy! ARG! It is almost more of a lifestyle choice, IMHO--if that makes any sense? I dont know how else to explain that...

fergus51 · Aug 14, 2006

The evidence though states otherwise. Very few people are going to practice midwifery without being qualified. You know the old joke.. what do you call a doctor who got Ds in med school.... DR.
You will always have a crappy fringe of practicioners, they are the minority, especially in midwifery.
I think apprenticeship is an amazing way to learn and study. Many of the worlds best midwives were trained this way. Midwifery is still the primay mode of birth care throughout Europe. We have an awful birth record as a nation and I believe that all types of midwives should be embraced. Yes training is essential, so we could have the CPM as a national standard, allowing the general to see what their midwife had to do and test through to become a midwife.

I think apprenticeship WITH formal study is a great way to learn. Midwifery is the primary model of birthing care in Europe and their midwives take formal courses. My countless positive experiences with UK midwives is the main reason that I am extremely pro-midwife in general.

BTW, For the poster who posted just the number of deaths.... that's almost meaningless without looking at the type of patients and controlling for that. Midwives look after the lowest risk patients.

CNM-to-be · Sep 2, 2006

All 4 of my childrens births were attended by a CPM at home. I had wonderful experiences each time despite a tricky case of shoulder dystocia, a slow to start baby, and uterine atony d/t a 10# baby. In each case my mw was extremely professional and always held our safety in the highest regard. I think that CPM standards for non-nurse midwives are excellent...the certifying exam is not a cake walk by any means.

Elvish, BSN, DNP, RN, NP · Nov 14, 2006

Ina May Gaskin is a CPM and, if I'm not mistaken, teaches OB at a med school in the Ivy League. I personally feel better about having a CNM as opposed to a CPM but I live in NC where the laws about home birthing are very tricky for everybody.

tntrn, ASN, RN · Nov 14, 2006

BTW, For the poster who posted just the number of deaths.... that's almost meaningless without looking at the type of patients and controlling for that. Midwives look after the lowest risk patients.

Also because there's no way to know which of the botched home deliveries were transported and then successfully or unsuccessfully delivered at a hospital. When I lived Northern CA, we had a lot of lay midwives, who when everything was working perfectly, had successful deliveries and very happy clients. But I think their judgments were very bad. They didn't know when to call it and head for more help.

In one instance, the midwife and couple appear,after 6 hours of pushing, no descent and then proceed to tell me that "we don't want an IV or PIT." um, okay, then exactly why are you here? If you don't want me to anything that might help, then perhaps you should just go back home, where you can also not do anything to help AND it won't cost you or the taxpayers a dime.

In another instance, we had a very compromised (color grey) baby finally and the midwife kept insisting that the mom "needed" breast feed and bond. This is while two NICU nurses and a neonatologist were furiously working just to keep the kid alive. After ignoring her first several comments, I finally told her that if she wanted to bond with a dead baby to keep it up, otherwise, she had to shut up and let the staff do their jobs. That seemed to get her attention. I seriously don't think she had a CLUE of the gravity of the situation.

So competent, maybe in the ideal world. But the judgments when the stuff started to hit the fan, was very questionable in my mind. I worked there in the 70's and 80's so maybe it's all better now.

andreabetty · Feb 14, 2007

Also because there's no way to know which of the botched home deliveries were transported and then successfully or unsuccessfully delivered at a hospital.

actually these statistics must be(are) well documented in Texas. How do you think they knew how many c-sections midwives had? Midwives are not in the habit of performing c-sections at home;)

As for the OP I think CPM's are a great alternative for mothers who are seeking a true natural birth. I had 2 of my children at home using a team of CPMs and had two wonderful births, the last being 10lbs with no tears. I did deliver my first child at a hospital and was very specific with my nurse that I wanted a natural birth. I ended up with a vacuum birth and a 6lb baby. Furthest thing from natural aside from a c-section. CPM's are an excellent alternative.

Elvish, BSN, DNP, RN, NP · Feb 14, 2007

It's my opinion -- my humble opinion -- that there is some risk involved in birth period. Low risk, usually, but it's there. Whether you deliver with the world's best OB, a CNM, a CPM, or by yourself at the beach.

There is a chance that something could go horribly wrong. I'm sure there are L&D nurses that could tell horrific stories about homebirths gone bad. But I'm sure there are EMTs who could tell horrific car accident stories too, but that doesn't stop us from getting in the car with our kids and going anywhere we want.

andreabetty · Feb 26, 2007

I wish I had posted this earlier...

http://www.bmj.com/cgi/content/full/bmj%3b330/7505/1416

ayla2004, ASN, RN · Mar 15, 2007

Why dou consider a trained midwife CPM as lay do you they not hold a professional license.

I'm asking as im in the UK where RM(registered midwifes) can either be direct entry doing a 3 year course getting either diploma or degree or if they ahve done a RGN(registered genarl nurse or its sucessor RN adult branch do a 18month course to become an RM

they have independe practiconers wrking both in the community and hospitals often closly with ob and peadartican for mother and baby health.

Would u consider out direct entry RM lay , they are education and regulation is done by the same counil as nurses and when they qualifty they are a higher grade(pay and senoirty) than new RN.