Grunting

Elvish, BSN, DNP, RN, NP · Mar 24, 2014

Yes, that is a sad story. It really upsets me, though, that they're blaming this on homebirth. It was the OBs they saw concurrently who didn't follow through with the results of the testing, nor did they explain to the couple that if she had GBS bacteriuria, she should get antibiotics in labor regardless (in fact, if there is GBS bacteriuria, we don't even do a 35-36 week GBS swab).

Agreed. There was a lot that went wrong in this scenario, but homebirth was not to blame. And it ended in a totally avoidable tragedy. Abx can be given at a homebirth, although my personal comfort level with a homebirth in general does not extend to below 37-38 weeks. (but that's another thread!)

Grunting can be tricky. Sometimes kids will do it as they transition, esp the late pretermers, and go on to do well. Regardless, if you have a grunter, it warrants close obs. It does sound a lot like 'singing'.

Esme12, ASN, BSN, RN · Apr 1, 2014

I have a question....and I am serious....do certified midwives advise garlic in the lady parts? Can a midwife cal them selves a midwife without being a certified midwife and RN?

klone, MSN, RN · Apr 1, 2014

The midwives I work with have suggested garlic once in a while. Not for treating GBS, though.

Yes, "midwife" is not a protected title in many/most states, and someone can call herself a midwife without being licensed or certified.

lmac0202 · Apr 7, 2014

Even the lay midwifes (who havent been to nursing school) have a certification board and training to complete. NARM | The North American Registry of Midwives is an organization that oversees lay midwifes. Not all lay midwifes are bad at what they do. I know a few in the Amish community that could out birth many OB's!

Elvish, BSN, DNP, RN, NP · Apr 7, 2014

Even the lay midwifes (who havent been to nursing school) have a certification board and training to complete. NARM | The North American Registry of Midwives is an organization that oversees lay midwifes. Not all lay midwifes are bad at what they do. I know a few in the Amish community that could out birth many OB's!

Part of the issue is that people use the term 'lay midwife' to mean different things. To me, a lay midwife is someone who catches babies without any sort of certification, license, or anything. To me, a CPM (which is what NARM keeps track of) is not a lay midwife, as they have a credentialing board, a licensure/examination process, and continuing education requirements in order to practice. In states where CPMs practice legally (i.e., not my state), some CPMs are also nurses.

But there are others who see CPMs as 'lay' midwives because they aren't CNMs. If anything, home birth bad outcomes makes a stronger case for legalizing and regulating the practice of CPMs across the board. I know for a fact that some CPMs practice in my state, but they do so illegally, which makes the whole home birth movement in my state a very secretive, underground sort of operation. Which makes people afraid to transfer care to an OB should they become high-risk during the pregnancy, and afraid to transfer to a hospital should something come up during the labor/delivery. A good midwife knows when to risk out and should not have to be afraid to be prosecuted if she does.

This is not exactly on the OP's original topic, but I don't like homebirth or midwives in general being blamed for a bad outcome that was clearly avoidable had a particular practitioner done their job correctly.

klone, MSN, RN · Apr 7, 2014

I don't consider CPMs to be lay midwives either.

In fact, the definition of "lay midwife" that I'm familiar with is a midwife who is not certified in any way.