Arkansas Midwife Loses License - Mother Speaks Out Merged

[SweetFellowshipper]

It's not true that CNMs never do home births, but it depends on the state. My sister in law is a nurse midwife educated at Yale and both her births were at home with other nurse midwives helping. 

I'd personally never give birth at a hospital unless it was required by a dire emergency-- after some ovarian cysts this past summer that required vaginal ultrasounds, I completely understand what people mean when they say that the hospital can be a patriarchal, demeaning place, especially in reproductive situations and especially for women. I was penetrated twice by two different people with the ultrasound wand without my consent, and once when I explicitly, repeatedly said I was not ready due to my pain (she pushed it in anyway and *rolled her eyes* while shoving my knees apart). It was not an emergency situation so there was no way to justify this except that it was about *their* convenience and time, not mine. I won't put up with that while giving birth, be pushed into a C-section, or have to ask permission to move into different positions or have basic control over my birth as has happened to several people I know. I know it's different for everyone, and that's not everyone's experience, but I won't risk it. I prefer to have more control and choice.

That said, people like Venessa and Jill are a disgrace to midwifery practice. I'll only work with a certified nurse midwife in a birthing center near a hospital. There are plenty of reasons to choose a midwife and not a hospital birth, but to be irresponsible about it is to make other midwives look like charlatans. 

[ClaraOswin]

31 minutes ago, SweetFellowshipper said:

It's not true that CNMs never do home births, but it depends on the state. My sister in law is a nurse midwife educated at Yale and both her births were at home with other nurse midwives helping. 

I'd personally never give birth at a hospital unless it was required by a dire emergency-- after some ovarian cysts this past summer that required vaginal ultrasounds, I completely understand what people mean when they say that the hospital can be a patriarchal, demeaning place, especially in reproductive situations and especially for women. I was penetrated twice by two different people with the ultrasound wand without my consent, and once when I explicitly, repeatedly said I was not ready due to my pain (she pushed it in anyway and *rolled her eyes* while shoving my knees apart). It was not an emergency situation so there was no way to justify this except that it was about *their* convenience and time, not mine. I won't put up with that while giving birth, be pushed into a C-section, or have to ask permission to move into different positions or have basic control over my birth as has happened to several people I know. I know it's different for everyone, and that's not everyone's experience, but I won't risk it. I prefer to have more control and choice.

That said, people like Venessa and Jill are a disgrace to midwifery practice. I'll only work with a certified nurse midwife in a birthing center near a hospital. There are plenty of reasons to choose a midwife and not a hospital birth, but to be irresponsible about it is to make other midwives look like charlatans. 

Jill and Venessa are not REAL midwives, in my opinion. They just have some sort of weird, bogus certification, I think. Something someone made up because they were too lazy to become a real midwife.

[SweetFellowshipper]

12 minutes ago, ClaraOswin said:

Jill and Venessa are not REAL midwives, in my opinion. They just have some sort of weird, bogus certification, I think. Something someone made up because they were too lazy to become a real midwife.

I very much agree. They should not be using the word midwife. Actual midwives worth their salt are often nurse practitioners who get many more years of highly specialized training than even an ob/gyn. You go to them because they're an expert and often because they have a specific mother-centered, rather than doctor-centered, FEMINIST philosophy on birth and choice. Not because they love babies and are Christian and pro life so they want to help. That's all Jill and Venessa seemed to offer. 

Births, including home births, attended by certified midwives have actually been found to be safer than doctor attended hospital births overall for both mom and baby. But the important part is *certified*....Something the Duggars do not care about. 

[FakePigtails]

55 minutes ago, SweetFellowshipper said:

I very much agree. They should not be using the word midwife. Actual midwives worth their salt are often nurse practitioners who get many more years of highly specialized training than even an ob/gyn. You go to them because they're an expert and often because they have a specific mother-centered, rather than doctor-centered, FEMINIST philosophy on birth and choice. Not because they love babies and are Christian and pro life so they want to help. That's all Jill and Venessa seemed to offer. 

Births, including home births, attended by certified midwives have actually been found to be safer than doctor attended hospital births overall for both mom and baby. But the important part is *certified*....Something the Duggars do not care about. 

Which "certified" midwife type do you mean? Jill became a certified professional midwife, but IMO the only types that should generally be relied on are certified nurse midwives and certified midwives (http://www.midwife.org/acnm/files/ccLibraryFiles/Filename/000000005543/CNM-CM-CPM-Comparison-Chart-2-25-14.pdf). I have known of a few CPMs I would probably trust (though not for a home birth, between immediate access to emergency care and that sweet sweet epidural) but yes, many if not most are absolute crap. 

As to the bolded, I believe that's only been shown in countries with strict standards for midwifery education that mean any midwife is equivalent to a CNM in the US, strict standards for who can have a home birth, and excellent integration of midwives in the health system so transfers to hospitals are pretty much seamless. In the US, most home births won't have all 3 of those things except in certain places and even then a woman has to research carefully since there's little publicity about how so many who claim the title "midwife" are nothing like a health professional people usually expect.

BTW, I really want to smack those awful providers you saw and hope you reported them. That behavior is completely wrong.

[SweetFellowshipper]

8 minutes ago, FakePigtails said:

Which "certified" midwife type do you mean? Jill became a certified professional midwife, but IMO the only types that should generally be relied on are certified nurse midwives and certified midwives (http://www.midwife.org/acnm/files/ccLibraryFiles/Filename/000000005543/CNM-CM-CPM-Comparison-Chart-2-25-14.pdf). I have known of a few CPMs I would probably trust (though not for a home birth, between immediate access to emergency care and that sweet sweet epidural) but yes, many if not most are absolute crap. 

As to the bolded, I believe that's only been shown in countries with strict standards for midwifery education that mean any midwife is equivalent to a CNM in the US, strict standards for who can have a home birth, and excellent integration of midwives in the health system so transfers to hospitals are pretty much seamless. In the US, most home births won't have all 3 of those things except in certain places and even then a woman has to research carefully since there's little publicity about how so many who claim the title "midwife" are nothing like a health professional people usually expect.

BTW, I really want to smack those awful providers you saw and hope you reported them. That behavior is completely wrong.

I'm not sure how the studies defined certified (would have to look) but I agree that personally I'd only use a certified nurse midwife. Mine is also a nurse practitioner. And yes, the studies I'm referencing are in the U.S.

But what I mean about the Duggars is that they seem to have a slippery definition even of CPM. They were calling Jill a midwife before she qualified for ANY definition of the word. 

Re: the providers, what's weird is that I teach at a top 20 university so this was a high end university hospital (and these were not students). A friend who gave birth at the same hospital had a similarly demeaning experience. Luckily, they have a well known certified nurse midwife program and birthing center as well. 

[FakePigtails]

11 minutes ago, SweetFellowshipper said:

I'm not sure how the studies defined certified (would have to look) but I agree that personally I'd only use a certified nurse midwife. Mine is also a nurse practitioner. 

But what I mean about the Duggars is that they seem to have a slippery definition even of CPM. They were calling Jill a midwife before she qualified for ANY definition of the word. 

Re: the providers, what's weird is that I teach at a top 20 university so this was a high end university hospital (and these were not students). A friend who gave birth at the same hospital had a similarly demeaning experience. Luckily, they have a well known certified nurse midwife program and birthing center as well. 

I'd be interested in those studies as well. If they were from other countries though, you're most likely looking at situations where midwife can only mean equivalent to our CNM except in cases of blatantly practicing without a license (and I would bet a lot that those countries actually smack down on the "midwives" in those cases).

I definitely agree on the family using the term way too early! In the end though, she did become a CPM the same as other CPMs. I think that shows just how little that title requires.

I can't believe that hospital had such horrible people! I hope the bad ones are kept away from their CNM group. I used CNMs in an OBGYN-CNM hospital practice for my prenatal care and birth (with an OB at the birth too because of decels) and it was wonderful. I hope you can get care like I had. I was treated with so much respect and everyone was great. In those settings it's still possible to end up needing an OB who could end up being a jerk if there are any in the practice but IMO it's worth the chance, especially for those in areas where there aren't highly-qualified home birth providers or for those like me who want the blessed epidural  .

[SilverBeach]

5 hours ago, SweetFellowshipper said:

 

Births, including home births, attended by certified midwives have actually been found to be safer than doctor attended hospital births overall for both mom and baby. 

I don't know that I believe this, not for all populations. I get your lack of enthusiasm for doctor assisted birth, but I don't think it is useful to imply that women preferring a medical doctor are somehow selecting a less safe option. 

FWIW my long-time gyne delivered mine, in a hospital. He was kind, compassionate, and I would not have had it any other way. There was no rush to C section either, I gave birth vaginally after a very slow progressing labor. As long as the baby was not in distress, they waited!

I hope this does not become a topic of doom.

[SweetFellowshipper]

41 minutes ago, SilverBeach said:

I don't know that I believe this, not for all populations. I get your lack of enthusiasm for doctor assisted birth, but I don't think it is useful to imply that women preferring a medical doctor are somehow selecting a less safe option. 

FWIW my long-time gyne delivered mine, in a hospital. He was kind, compassionate, and I would not have had it any other way. There was no rush to C section either, I gave birth vaginally after a very slow progressing labor. As long as the baby was not in distress, they waited!

I hope this does not become a topic of doom.

It's not my personal opinion nor my implication. It is the result of a variety of studies done on the issue. Of course it depends on a HUGE variety of factors, so there's no one conclusive answer and everyone should have their own choice. Also, even if it were my personal opinion, the opposite has been implied many times here and elsewhere due to personal opinion, so it's unfair to suggest that that is somehow more offensive than the opposite implication. I was actually *responding* to the opposite opinion (that it's less safe to choose any other birth option) being stated many times-- so unless that's offensive, neither is what I said.   

It's great that you had a good experience with your birth option!  Many do. Many don't. Never said anything different. 

I don't want this to become a topic of doom either. What I am pointing out, and stand behind, is that there are legitimate reasons to choose a trained midwife (not just ignorance) and that especially among certain populations there is sometimes a problem with how we treat women when approaching prenatal care and reproduction, and control over one's body and care (this is especially important to me from a feminist perspective).  To me, choice is the key. I am 100% in support of what anyone chooses and never said anything different. The good news is that 72 percent of women with midwives reported satisfaction with their care in the recent Birth in America survey, and either 60% or 62% (sorry, having trouble with my phone and can't re-look up the link ATM) of women with obstetricians reported satisfaction. So luckily the majority are satisfied. But improvements can be made everywhere and I'm happy the array of options is widening.  

[FakePigtails]

This covers a few of the issues discussed here and in the Jill thread: http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth

Quote

 

Some recent observational studies overcome many of these limitations, describing planned home births within tightly regulated and integrated health care systems, attended by highly trained licensed midwives with ready access to consultation and safe, timely transport to nearby hospitals (7, 8, 10, 11, 16, 19, 23–28). However, these data may not be generalizable to many birth settings in the United States where such integrated services are lacking. For the same reasons, clinical guidelines for the intrapartum care of women in the United States that are based on these results and are supportive of planned home birth for low-risk term pregnancies also may not currently be generalizable (29). Furthermore, no studies are of sufficient size to compare maternal mortality between planned home and hospital birth and few, when considered alone, are large enough to compare perinatal and neonatal mortality rates. Despite these limitations, when viewed collectively, recent reports clarify a number of important issues regarding the maternal and newborn outcomes of planned home birth when compared with planned hospital births.

 

Quote

 

Although patients with one prior cesarean delivery were considered candidates for home birth in two Canadian studies, details of the outcomes specific to patients attempting home vaginal birth after cesarean delivery were not provided (24, 25). In England, women planning a home trial of labor after cesarean delivery (TOLAC) exhibited fewer obstetric risk factors, were more likely to deliver vaginally, and experienced similar maternal and perinatal outcomes compared with those planning an in-hospital TOLAC (35). In contrast, a recent U.S. study showed that planned home TOLAC was associated with an intrapartum fetal death rate of 2.9 in 1,000, which is higher than the reported rate of 0.13 in 1,000 for planned hospital TOLAC (36, 37). This observation is of particular concern in light of the increasing number of home vaginal births after cesarean delivery (38). Because of the risks associated with TOLAC, and specifically considering that uterine rupture and other complications may be unpredictable, the College recommends that TOLAC be undertaken in facilities with trained staff and the ability to begin an emergency cesarean delivery within a time interval that best incorporates maternal and fetal risks and benefits with the provision of emergency care.

 

Quote

 

Another factor influencing the safety of planned home birth is the availability of safe and timely intrapartum transfer of the laboring patient. The reported risk of needing an intrapartum transport to a hospital is 23–37% for nulliparous women and 4–9% for multiparous women. Most of these intrapartum transports are for lack of progress in labor, nonreassuring fetal status, need for pain relief, hypertension, bleeding, and fetal malposition (27, 41, 42). The relatively low perinatal and newborn mortality rates reported for planned home births from Ontario, British Columbia, and the Netherlands were from highly integrated health care systems with established criteria and provisions for emergency intrapartum transport (23–25). Cohort studies conducted in areas without such integrated systems and those where the receiving hospital may be remote, with the potential for delayed or prolonged intrapartum transport, generally report higher rates of intrapartum and neonatal death (6, 9, 11, 15, 22). Even in regions with integrated care systems, increasing distance from the hospital is associated with longer transfer times and the potential for increased adverse outcomes. However, no specific thresholds for time or distance have been identified (43, 44).

 

Quote

 

A characteristic common to those cohort studies reporting comparable rates of perinatal mortality is the provision of care by uniformly highly educated and trained certified midwives who are well integrated into the health care system (23–25, 27). In the United States, certified nurse–midwives and certified midwives are certified by the American Midwifery Certification Board. This certification depends on the completion of an accredited educational program and meeting standards set by the American Midwifery Certification Board. In comparison with planned out-of-hospital births attended by American Midwifery Certification Board-certified midwives, planned out-of-hospital births by midwives who do not hold this certification have higher perinatal morbidity and mortality rates (18). At this time, for quality and safety reasons, the College specifically supports the provision of care by midwives who are certified by the American Midwifery Certification Board (or its predecessor organizations) or whose education and licensure meet the International Confederation of Midwives Global Standards for Midwifery Education. The College does not support provision of care by midwives who do not meet these standards.

Although the College believes that hospitals and accredited birth centers are the safest settings for birth, each woman has the right to make a medically informed decision about delivery (45). Importantly, women should be informed that several factors are critical to reducing perinatal mortality rates and achieving favorable home birth outcomes. These factors include the appropriate selection of candidates for home birth; the availability of a certified nurse–midwife, certified midwife or midwife whose education and licensure meet International Confederation of Midwives’ Global Standards for Midwifery Education, or physician practicing obstetrics within an integrated and regulated health system; ready access to consultation; and access to safe and timely transport to nearby hospitals.

 

 

[SweetFellowshipper]

18 minutes ago, FakePigtails said:

This covers a few of the issues discussed here and in the Jill thread: http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth

 

Yes, it definitely matters what state or country you're in. In Britain they actually urge women with low risk pregnancies to have a home birth with a midwife because it's been found to be safer, but the educational requirements there are universally high from my understanding. Not exactly Jillymuffin in Arkansas.

http://mobile.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html?_r=0&referer=http://mobile.nytimes.com/2014/12/15/opinion/are-midwives-safer-than-doctors.html

[SilverBeach]

39 minutes ago, SweetFellowshipper said:

It's not my personal opinion nor my implication. It is the result of a variety of studies done on the issue. Of course it depends on a HUGE variety of factors, so there's no one conclusive answer and everyone should have their own choice. Also, even if it were my personal opinion, the opposite has been implied many times here and elsewhere due to personal opinion, so it's unfair to suggest that that is somehow more offensive than the opposite implication. I was actually *responding* to the opposite opinion (that it's less safe to choose any other birth option) being stated many times-- so unless that's offensive, neither is what I said.   

It's great that you had a good experience with your birth option!  Many do. Many don't. Never said anything different. 

I don't want this to become a topic of doom either. What I am pointing out, and stand behind, is that there are legitimate reasons to choose a trained midwife (not just ignorance) and that especially among certain populations there is sometimes a problem with how we treat women when approaching prenatal care and reproduction, and control over one's body and care (this is especially important to me from a feminist perspective).  To me, choice is the key. I am 100% in support of what anyone chooses and never said anything different. The good news is that 72 percent of women with midwives reported satisfaction with their care in the recent Birth in America survey, and either 60% or 62% (sorry, having trouble with my phone and can't re-look up the link ATM) of women with obstetricians reported satisfaction. So luckily the majority are satisfied. But improvements can be made everywhere and I'm happy the array of options is widening.  

Women today have more options than ever. I haven't seen FJ members bashing non-doctor births, but some are reluctant to take any risk at all since things can go south very quickly, even when the pregnancy has been non-eventful. So, a doctor and medical facility is considered by many to be the gold standard.

When you see posts implying that doctors are safer, as you put it, you can certainly challenge that without saying the opposite, which in my opinion is no better. 

BTW I used the term imply because you did not link to any studies supporting your assertion. Also, saying that it depends on a huge number of factors, and there is no conclusive right answer for everyone, contradicts a blanket statement that doctor assisted births are less safe.

I never said what you posted was offensive. I said it was not useful. I stand by that, because an us vs. them approach is not beneficial to anybody. A robust discussion of advantages and disadvantages to all birthing approaches is good, realizing that a woman's personal choice is hers and hers alone. Unless she is blatantly careless and unnecessarily risking her and the baby's health, it's all good.

[19Kittens]

Not all CPM's are incompetent. A lot of the responsibility falls on the state to regulate the level of education these women have before gaining their certification (personally, as a midwifery student & current pregnant woman,  I'd love to see the standard nationalized)

Where I am studying (California) you have 3 years minimum of training, with the first year being strictly textbook, and the final two being textbook & clinicals/assisting births. You then sit for the NARM to gain your midwifery certification. Arkansas allows "Direct Entry" or Lay midwives who literally just start assisting births with little to no prior training or experience which is fucking terrifying. Also, I was looking at their state roster for licenced and certified midwives & Jill wasn't on there.... has her license been revoked too? 

[grandmadugger]

14 minutes ago, 19Kittens said:

Not all CPM's are incompetent. A lot of the responsibility falls on the state to regulate the level of education these women have before gaining their certification (personally, as a midwifery student & current pregnant woman,  I'd love to see the standard nationalized)

Where I am studying (California) you have 3 years minimum of training, with the first year being strictly textbook, and the final two being textbook & clinicals/assisting births. You then sit for the NARM to gain your midwifery certification. Arkansas allows "Direct Entry" or Lay midwives who literally just start assisting births with little to no prior training or experience which is fucking terrifying. Also, I was looking at their state roster for licenced and certified midwives & Jill wasn't on there.... has her license been revoked too? 

I think she tested in Texas so she may not be on the roster in Arkansas. 

[19Kittens]

Just now, grandmadugger said:

I think she tested in Texas so she may not be on the roster in Arkansas. 

If she didn't transfer her licence legally and is practicing in another state she can get into SO much trouble including losing her license. Jill wtf are you doing. 

[Shadoewolf]

It was also put out there in the Jill thread (I think) that AR is 1 of 4 states that does not legally allow VBAC at home, so unless she goes to Texas, Oklahoma or Missouri anyone who helps her could face a lot of trouble. But then she helped Vanessa deliver a baby in Oklahoma since they've been back so I see it as possible. Sadly, I see her pulling a "we were gonna go to the hospital and didn't make it in time" type of scenario to get her birth her way and skirt the law.

[goldengrove]

14 hours ago, grandmadugger said:

<snip>

I think that's why we got cell phone video of the previous two births. 

I wondered about this...I remember Mr. Jim (the sound guy? he seems very nice) talking about how wonderful it was to be there to film the births, and that the crew got to hold the babies when they were just born (not quoting, hopefully not remembering wrong)

[grandmadugger]

12 hours ago, 19Kittens said:

If she didn't transfer her licence legally and is practicing in another state she can get into SO much trouble including losing her license. Jill wtf are you doing. 

I looked it up just to make sure I was on the right track. Jill posted October 2, 2015 that she passed her NARM exam. In the post she said she was enrolled in a class in Texas and had to go every few months for tests. Anyone know how to look up Texas or a national NARM list?

[Bethella]

14 hours ago, 19Kittens said:

Also, I was looking at their state roster for licenced and certified midwives & Jill wasn't on there.... has her license been revoked too? 

Jill never had a license in Arkansas, she only had a student permit. I don't remember the exact circumstances, it either expired on its own or was revoked after the Venessa fiasco.

14 hours ago, 19Kittens said:

If she didn't transfer her licence legally and is practicing in another state she can get into SO much trouble including losing her license. Jill wtf are you doing. 

Oklahoma currently has no state regulations prohibiting or regulating direct entry midwives, so she doesn't need a license to practice there.

1 hour ago, grandmadugger said:

I looked it up just to make sure I was on the right track. Jill posted October 2, 2015 that she passed her NARM exam. In the post she said she was enrolled in a class in Texas and had to go every few months for tests. Anyone know how to look up Texas or a national NARM list?

She's not on the list in Texas. (https://vo.licensing.tdlr.texas.gov/datamart/searchByNameTXRAS.do) I can't find an list for people who've passed the NARM exam.

[19Kittens]

I just messaged one of my instructors inquiring about how to see who's passed the NARM. If I can find her on the roster I'll let you guys know. 

[grandmadugger]

42 minutes ago, Bethella said:

Jill never had a license in Arkansas, she only had a student permit. I don't remember the exact circumstances, it either expired on its own or was revoked after the Venessa fiasco.

Oklahoma currently has no state regulations prohibiting or regulating direct entry midwives, so she doesn't need a license to practice there.

She's not on the list in Texas. (https://vo.licensing.tdlr.texas.gov/datamart/searchByNameTXRAS.do) I can't find an list for people who've passed the NARM exam.

Wouldn't she need to be licensed in a state?  I'm nationally certified EMT but I am not state certified so I can't practice anywhere until I sit for state boards. 

[Bethella]

28 minutes ago, grandmadugger said:

Wouldn't she need to be licensed in a state?  I'm nationally certified EMT but I am not state certified so I can't practice anywhere until I sit for state boards. 

It depends entirely on the state. In Oklahoma, no. In Arkansas, yes. She would need to have supervised practical experience, pass the NARM exam, and pass the Arkansas Midwife Regulations Exam to be licensed. Details can be found at http://www.healthy.arkansas.gov/aboutADH/RulesRegs/LayMidwifery.pdf. Here's a state-by-state listing of midwifery laws http://mana.org/about-midwives/state-by-state.

In looking this up I noticed that not only is Joy Coonfield (one of Jill's old preceptors) still licensed, Debora Query is also licensed now.

 

 

[eandre31]

I think more women are looking into midwifery because of the asinine c-section rates in the US. Section rates in the US are at a crazy high - meaning many are medically unnecessary.  WHO recommends c section rates being between 10-15% of births and the US is something over 30% last I checked. Many doctors in the US love the convenience of sections. Which is why I am glad there are more options- even many midwives that practice and deliver through hospitals.

My next birth will most likely be through a certified nurse midwife at the hospital- i know far too many people who have been pushed into c sections early on.

That's said, I would never trust Jill of her like to deliver my baby. God no.

[Denim Jumper]

1 hour ago, eandre31 said:

I think more women are looking into midwifery because of the asinine c-section rates in the US. Section rates in the US are at a crazy high - meaning many are medically unnecessary.  WHO recommends c section rates being between 10-15% of births and the US is something over 30% last I checked. Many doctors in the US love the convenience of sections. Which is why I am glad there are more options- even many midwives that practice and deliver through hospitals.

My next birth will most likely be through a certified nurse midwife at the hospital- i know far too many people who have been pushed into c sections early on.

That's said, I would never trust Jill of her like to deliver my baby. God no.

The problem is that the 10-15% recommendation isn't based on empirical evidence, but on observing the change in maternal and perinatal mortality rates. The WHO observed that mortality rates decrease when c-section rates rise to 10%, but don't decease further when the c-section rate goes higher than 15%. However, WHO also acknowledges that mortality rates should not be the only consideration, and the 10-15% recommendation is not applicable across the board. 

ETA: not to mention, that 10-15% figure is from 1985. A lot has changed since then, such as increased obesity, women having babies later in life, more high-order multiples. All risk factors for a c-section birth. 

[FakePigtails]

16 hours ago, 19Kittens said:

Not all CPM's are incompetent. A lot of the responsibility falls on the state to regulate the level of education these women have before gaining their certification (personally, as a midwifery student & current pregnant woman,  I'd love to see the standard nationalized)

Where I am studying (California) you have 3 years minimum of training, with the first year being strictly textbook, and the final two being textbook & clinicals/assisting births. You then sit for the NARM to gain your midwifery certification. Arkansas allows "Direct Entry" or Lay midwives who literally just start assisting births with little to no prior training or experience which is fucking terrifying. Also, I was looking at their state roster for licenced and certified midwives & Jill wasn't on there.... has her license been revoked too? 

It totally sucks that the certification rules allow CPM quality to vary so much. It's very unfair that good ones like you and the other good ones I've seen get put under the same umbrella as Jill and her crew. Unfortunately, because of that variation and just how bad those claiming the CPM title can be, if I were advising another woman on who to choose as a care provider I wouldn't be comfortable telling them to consider a CPM unless I knew of a specific safe one to point them to.

[grandmadugger]

1 hour ago, Bethella said:

It depends entirely on the state. In Oklahoma, no. In Arkansas, yes. She would need to have supervised practical experience, pass the NARM exam, and pass the Arkansas Midwife Regulations Exam to be licensed. Details can be found at http://www.healthy.arkansas.gov/aboutADH/RulesRegs/LayMidwifery.pdf. Here's a state-by-state listing of midwifery laws http://mana.org/about-midwives/state-by-state.

In looking this up I noticed that not only is Joy Coonfield (one of Jill's old preceptors) still licensed, Debora Query is also licensed now.

 

 

Yikes!  I am appalled by the number of states that don't regulate direct entry midwives.  I looked at my state that I knew had lax laws on birthing. We have 3 CNM listed but I know there are a few that work at a birth center.  The birthing center is an interesting case because it was shut down for awhile due to some Vanessa like stunts.