What's a "midwife?" Please let the ACNM know.

This week, the birth blogosphere was abuzz with news that the American College of Nurse-Midwives has changed its position statement on midwife certification and its definition of what a midwife is.

Essentially, what it boils down to is that the ACNM will not recognize a midwife unless she has received her academic and clinical training in a formal education program. The North American Registry of Midwives is the national agency which certifies professional midwives. After a midwife has met conceptual learning objectives and gained significant clinical experience with out-of-hospital births and prenatal care, she can become a Certified Professional Midwife. There are a number of formal education programs in which an aspiring midwife can enroll; however, an aspiring midwife can obtain her theoretical and conceptual learning through apprenticeship, under the guidance of wise, experienced and mentoring midwives. It's probably the oldest, most traditional form of learning there is.

There are many paths to learning, and it makes sense that the art of traditional midwifery honors learning through apprenticeship. NARM certification is rigorous; it recognizes different paths to learning, and ensures quality practice and standards of care through its certification process. Additionally, its standards for certification are used by the 26 states that regulate midwifery, states in which CNM's, OB's and CPM's practice collaboratively in a variety of birth locations.

It is curious that in its definition of a midwife, the ACNM wishes to split the midwives certified by NARM into separate camps, legitimizing one and squeezing out the other. It is particularly disheartening in the 24 unregulated states like Massachusetts, where the only opportunity to learn midwifery is through apprenticeship. What gain does the ACNM have in only recognizing some CPM's?

NARM has created a petition asking the ACNM to reconsider its statement and respect the knowledge and diverse training that those who hold the CPM carry. At this writing, the petition has over 1160 signatures. Please take a few moments to sign the petition, taking action to protect birthing choices, which includes access to qualified, trained, experienced Certifed Professional Midwives.

(this has been cross-posted on the Massachusetts Friends of Midwives blog)

MRSA infections at Beth Israel Hospital in Boston

Click the title above, and you'll be linked to an article about infection control at one of Boston's largest hospitals. The hospital was found in serious non-compliance with infection control protocols, resulting in staph and MRSA infections -- in mothers and their newborn babies in the labor, delivery, and maternity units.

I don't wish to bash the BI. Two of my three daughters were born there. I had good experiences there. I hadn't developed an interest yet in midwifery, doulas, and non-medicalized, normal birth; my care there was a good match for what I valued then. As I learned more about birth as a non-medical event, I chose not to return to BI for my 3rd daughter's birth, but I have no regrets about decisions I made in the past.

But the situation, which could probably happen in any hospital in the country, can prompt more discussion about out-of-hospital birth. A healthy woman with a healthy pregnancy who goes into labor spontaneously at term should have the right to a homebirth or non-hospital birth center with a qualified and trained midwife. In the comfort of her own home or in a home-like setting, with the intimacy of loved ones around her, she can move freely through labor, feed herself and drink to thirst as she needs to in order to maintain her strength, and allow her body to engage in the uninterrupted physiological process of childbirth. That kind of normal birth is not medical, so therefore doesn't need a hospital and the whole hospital package -- like infections due to non-compliance of infection control protocol, or medical interventions that are either unwanted or not truly medically necessary, which leads to further interventions, which can then create an emergency. At the risk of sounding prosaic, hospitals are for sick people.

OK, Massachusetts Mommies! Get ready, get set...NURSE YOUR BABIES IN PUBLIC!!!!

Look what Massachusetts law now allows us to do. Although most of us have been doing it for years, now we nurse our babies in public -- at a restaurant, mall, you name it -- under full protection of the law!! (But I must say, I think the lead line of the article has a typo; "shouldn't" not "should.")

I fully intend to continue breastfeeding my baby in public -- now if only the weather would be as mommy-friendly as the law!