All Things Dillard - Part 6

[Themiscyran]

If anyone is curious, here are Arkansas state regs for CPMS (in AR they're called "lay midwives"...you'll also see the term "direct entry" midwife which sounds terrifying like they're entering the womb, but really just means they don't do nursing training first)

healthy.arkansas.gov/aboutADH/RulesRegs/LayMidwifery.pdf

It includes a description of what exams the midwife has to perform pre-birth and post-birth, what conditions preclude midwife care and require a physician or CNM, etc. As you can see, Jill would not really need to master as much in the way of medical knowledge, as compared to a nurse-midwife.

In AR, she'd also have to pass the North American Registry of Midwives exam:

narm.org/entry-level-applicants/

The model is highly predicated on practical experience (apprenticeship) and although there's some study required, apprentices need not attend a formal school to do so (though again that depends on the state--the MIdwives Alliance of North America maintains a list of state-by-state licensing situations: mana.org/about-midwives/state-by-state

[EmmieJ]

The best nurses you THINK you've had were the gentle, nurturing types. You have no idea if Nurse Ratched actually caught a med error from an order before it got to you, or advocated for you to the MD when her spidey senses were tingling. Nurturing is all well and fine, but that's hardly an RN's main function. I understand that as patients, we all want someone who's caring for us to be soothing and have a sweet demeanor and that they're the ones that are most remembered. However, that doesn't mean that people's lives aren't saved every day, outside of that patient's knowledge, by RNs who aren't as touchy feely. Just sayin'.

Jill being a certified practical midwife seems off to me too but surely those exams (or whatever they do to get certified) weed out the idiots, correct?

Good point. My mom was the best when I was sick as a child, or just sad or upset, at providing loving comfort. But the best nurses I've had in my life were not what you would call sweet and nurturing. One was the nurse who helped me through childbirth when the physician's assistant left as my baby was crowning because she had to catch a flight. It was that nurse who really was there for me, barking out orders. I needed that drill sergeant :) I still laugh when I think of how she tucked my newborn under her arm like a football to clean him up after birth, then expertly wrapped him in a swaddling blanket before presenting him to me. Tough, no nonsense, and amazing.

I think Jill could be a decent midwife if she actually trained under someone who was qualified, and did the necessary study. But the way she handled her own childbirth raises serious concerns for me. I hope she has greater insight into the reality that in childbirth, things can sometimes go from "going smoothly" to "uh oh, we need to get to a hospital" in the blink of an eye. I worry that she doesn't have the critical thinking skills necessary to analyze an ever changing situation and make good decisions.

[Trynn]

Well, when you're the one giving birth, it can be hard to tell what to do, because you have the added stress of being the one in labor. Whereas one might be a lot more clearheaded when one is the midwife. So I'm not sure I can judge Jill much.

[halcionne]

Was it truly a Minute Rice box she struggled with? If so, they do have chart that can be confusing if you're rushing only because most on-the-box instruction are less complicated. Yes, it i something a child would learn in early elementary school, but she probably only ever saw something like that one time considering the minimal education. Once I mixed up the amount measurements. What episode was this in? I'd like to see what she did. I've seen mastered degreed professionals not able to make Kraft mac & cheese.

"Race to the Altar"

Unrelated to MatthewDuggar's post, but since I'm commenting, I need to rant about James and those flashcards. I've always suspected that production or somebody felt they needed show filler or some manufactured excuse for why Jill's buddies were at her house, so they grabbed the first thing they saw and built a segment around it (disclaimer: I have not seen the episode). Jennifer is Jill's other buddy and those flashcards could very well be hers. It bothers me that people assume that something is true just because it got aired on the show.

[Themiscyran]

Well, when you're the one giving birth, it can be hard to tell what to do, because you have the added stress of being the one in labor. Whereas one might be a lot more clearheaded when one is the midwife. So I'm not sure I can judge Jill much.

I agree--there's a lot of pain and hormones and emotions for the person giving birth. The midwife is in a much better position to observe and make a call. If anything, it might give her some insight as to what a person is feeling, and why they might resist a transport when it becomes necessary.

[Trynn]

Also, it is said the doctor is his own worst patient. It's often easier to make judgement calls when it's someone else's welfare on the line. Sometimes people will take chances with their health but not the health of a loved one.

I'm the idiot who waited 24 hours to go in with abdominal pain in the lower right quadrant. Everyone else was telling me what an idiot I was.

[EmCatlyn]

Well, when you're the one giving birth, it can be hard to tell what to do, because you have the added stress of being the one in labor. Whereas one might be a lot more clearheaded when one is the midwife. So I'm not sure I can judge Jill much.

YES.

If anyone judged my thinking, decision-making and coping abilities based on my behavior during pregnancy and delivery, they would have a very poor opinion of me. ;) But under other circumstances I tend to be a problem-solver and I have coped well with most crises that have come my way.

Pregnancy can really impair some people. :(

[Arete]

Also, it is said the doctor is his own worst patient. It's often easier to make judgement calls when it's someone else's welfare on the line. Sometimes people will take chances with their health but not the health of a loved one.

A

I'm the idiot who waited 24 hours to go in with abdominal pain in the lower right quadrant. Everyone else was telling me what an idiot I was.

Another idiot over here waving "Hi!" to you, Trynn. I waited so long with my abdominal pain I wound up with a ruptured appendix and emergency surgery. My family has not stopped calling me an idiot to this day on that one. I nearly died.

[halcionne]

If anyone is curious, here are Arkansas state regs for CPMS (in AR they're called "lay midwives"...you'll also see the term "direct entry" midwife which sounds terrifying like they're entering the womb, but really just means they don't do nursing training first)

healthy.arkansas.gov/aboutADH/RulesRegs/LayMidwifery.pdf

It includes a description of what exams the midwife has to perform pre-birth and post-birth, what conditions preclude midwife care and require a physician or CNM, etc. As you can see, Jill would not really need to master as much in the way of medical knowledge, as compared to a nurse-midwife.

In AR, she'd also have to pass the North American Registry of Midwives exam:

narm.org/entry-level-applicants/

The model is highly predicated on practical experience (apprenticeship) and although there's some study required, apprentices need not attend a formal school to do so (though again that depends on the state--the MIdwives Alliance of North America maintains a list of state-by-state licensing situations: mana.org/about-midwives/state-by-state

Jill was in the AR lay midwifery program. Her instructor was a lay midwife who lost her license, which voided Jill's instruction permit. I looked up current lay midwives and apprentices yesterday--neither Jill (or Jana) or her former instructor are registered at this time. Deborah Query has succeeded in becoming a licensed lay midwife. Congratulations to her. I wish I had more faith in AR's lay midwifery program. :?

[Gimme a Free RV]

Has anyone commented on the picture that Jill posted on Instagram just a while ago, wishing her mom a happy birthday? It's a picture of Michelle holding Izzy and they appear to be in a hospital. Izzy is big, so it's not an old picture. Are Jill and Derrick still in the States? If so, could it possibly be that Jessa is in the hospital? Of course, I realize they also might be visiting someone there that they know.

[calimojo]

I think it is from when Izzy was born. I think the angle makes him appear a bit bigger.

Or maybe it is from when Derick had his oral Surgery. He was possibly at a hospital outpatient surgery area, and Michelle may have come along to help tend to Izzy as Jill was still pretty weak from her surgery back then.

Izzy would have been about 2 weeks old by then I think, if I am remembering correctly.

[Themiscyran]

Jill was in the AR lay midwifery program. Her instructor was a lay midwife who lost her license, which voided Jill's instruction permit. I looked up current lay midwives and apprentices yesterday--neither Jill (or Jana) or her former instructor are registered at this time. Deborah Query has succeeded in becoming a licensed lay midwife. Congratulations to her. I wish I had more faith in AR's lay midwifery program. :?

I totally forgot about her instructor losing the license! I wonder if that means Jill also "loses" credit for the hours and births she attended? Maybe she doesn't plan on AR licensure anymore, if she's planning to stay on with the missionary work? Although is ee that AR can grant credit for work done outside AR as well...

As for the overall AR program, I have no idea how good it is. It's probably a good sign that people can and do lose licensure, though--someone is paying attention. Overall I think it's much better to have licensing than not, because plenty of direct entry/lay/CPMs still operate in places where there's no licensing and/or legal grey areas. Better regulated than not, IMO.

[What the fux say]

Who was her instructor and why did she lose her license?

(Should I post my own Let Me Google That For You link now or give someone else a chance first?)

ETA: Ha! The first link regarding specifically her midwifery instructor lead me back to FJ. viewtopic.php?f=8&t=25826

[MatthewDuggar]

The link to go to Jill & Derrick's website from the Duggar Family website takes you straight to the their donation page.... :roll:

[luv2laugh]

Jill would make a good Christian preschool teacher. She loves children and she would be in her element. That way, she wouldn't be putting women's lives at risk by attempting to deliver babies in other countries while doing mission work... There IS a reason why it is ONLY legal to be a LAY midwife in some states.... NOT safe! She will tell poor disadvantaged women or women who don't speak English that she is a "medical professional and midwife" and they will trust her and believe it when it's simply not the case... Remember when Michelle said Jill's training is similar to a doctor's? Scary.... Speaking of delivering babies, OBGYNs have to pay for very high malpractice insurance because they constantly get sued. What would Jill do if she was sued?

[MatthewDuggar]

In the "About Jill" section of her website she claims she has no plans of using her midwifery skills while she has her own little ones at home.... Well, that's going to be a long, long time. I wonder why she's now trying to keep up with it? Perhap$ $he'$ a bit worried.

[halcionne]

I totally forgot about her instructor losing the license! I wonder if that means Jill also "loses" credit for the hours and births she attended? Maybe she doesn't plan on AR licensure anymore, if she's planning to stay on with the missionary work? Although is ee that AR can grant credit for work done outside AR as well...

As for the overall AR program, I have no idea how good it is. It's probably a good sign that people can and do lose licensure, though--someone is paying attention. Overall I think it's much better to have licensing than not, because plenty of direct entry/lay/CPMs still operate in places where there's no licensing and/or legal grey areas. Better regulated than not, IMO.

Absolutely, and I suppose the AR rules and regs are fairly well-done, though I'm not in this field and don't know how to measure or compare it to other states. I hope she goes through the proper channels, whatever they are, to practice in El Salvador/Honduras/Guatemala. Good luck delivering babies in Spanish, Jill. :roll:

For about ten minutes (only a slight exaggeration ;) ) last year I considered doula training for myself--my community has lots of alternative lifestyle people in it and I thought I might enjoy it and be able to be a productive member of society while setting my own hours/workload and even doing pro bono work because I feel that all women should have access to quality birth attendants, not just the upper middle class folks who go in for it in my zip code. To that end, I thought I might eventually hang a shingle advertising bilingual doula services with sliding scale fees or something. I have spoken my second language for thirty years but I don't use it every day anymore and I decided I wouldn't be comfortable using it under the kind of high stakes circumstances where a high level of communication is paramount, like, you know, childbirth. Jill delivering babies in Central America makes me even more uncomfortable than Jill delivering babies in Arkansas does.

[Marissap]

I think it is from when Izzy was born. I think the angle makes him appear a bit bigger.

Or maybe it is from when Derick had his oral Surgery. He was possibly at a hospital outpatient surgery area, and Michelle may have come along to help tend to Izzy as Jill was still pretty weak from her surgery back then.

Izzy would have been about 2 weeks old by then I think, if I am remembering correctly.

I really don't think that's when he was born. His face has a much older infant look to it. He looks at least two months old to me. My kids and all the babies I know all started to fill out a bit around that age and not look so creepy. His face looks much fuller here, not like he did when he was born. Wonder when it is from.....

And if by chance it is from when he was born weird that they never posted a pic with him then but waited until now??

[What the fux say]

So in reading through that thread about Jill's midwife instructor, I stumbled across a link to two sites re: dangers of homebirth. Which reminded me of when I was pregnant, how I considered going to a birth center (associated with a hospital) and did end up under the care of a group of CNMs but had my kiddo at the hospital. After he was born and the cord was cut and all the "drama" was done, the rest of the cord and the placenta came out and there was a true knot in the umbilical cord. The CNM and L&D RN both sort of gave little gasps when they saw it, otherwise I would have never noticed it. I think about what could have happened if I hadn't had all the annoying, frustrating hospital interventions to constantly monitor the baby's heart rate and such and it scares the shit out of me. That right there was the makings of a disaster if I was at home with a CPM, without constant fetal monitoring. I just can't see Jill responding appropriately to the type of emergency that could come about from a true knot tightening during labor.

[ClaraOswin]

I wondered about that picture today too. Not only does that kid look huge but he doesn't have that pinkish newborn look to him at all. But you can clearly see a hospital bed behind her. Wonder who is in it. Hmm...

Did that mentor or whatever of Jill's get her license back or what? I believe she still posts pictures online with babies she delivered. Is she doing it illegally?

[bingbangboom]

This isn't meant to be body shaming, she has a perfectly acceptable body, but Jill is looking pregnant in Amy's wedding shots...

Or perhaps she just gained the Jesus equivalency of the freshman 15.

[What the fux say]

*snip*

Did that mentor or whatever of Jill's get her license back or what? I believe she still posts pictures online with babies she delivered. Is she doing it illegally?

I don't know. The laws and regulations for lay midwives are so crazy different state from state that I find it all very confusing. One would think that if she lost her certification or whatever the heck it is that she wouldn't be allowed to act as a CPM but maybe she just attended births with other CPMs, not by herself? I don't know, the whole lay midwife thing is just so sketch.

[NotALoserLikeYou]

I wondered about that picture today too. Not only does that kid look huge but he doesn't have that pinkish newborn look to him at all. But you can clearly see a hospital bed behind her. Wonder who is in it. Hmm...

Did that mentor or whatever of Jill's get her license back or what? I believe she still posts pictures online with babies she delivered. Is she doing it illegally?

The other day she delivered a baby in Missouri, according to instagram. Not sure what her deal is. The pic before she was at a hospital in AR but she could just be visiting someone who had a baby, instead of it being a home to hospital transfer she was a part of. She doesn't post the location usually. 22 weeks ago she had an AR homebirth, I think her license was revoked around then. According to facebook her home and practice are in AR so I find it very confusing.

[NotALoserLikeYou]

Facebook says she is licensed in AR in her bio. This is no longer true. the practice offers homebirths in AR and OK and there are other midwives so maybe they do AR she does OK?

[What the fux say]

All I know (well, *think* I know) is that lay midwives seem to cater to the "off the grid" type people... so it seems like I'm always reading stories about them assisting a birth in a shady situation, like, for example, in a fucking hotel room over a state border where they are sorta kinda legal to practice. So yeah, I find it totally unsurprising that they are leaving all that super ambiguous.

And also, giving birth in a motel/hotel room? What the fuck is wrong with people?