The Man Behind the Curtain

This has been the most difficult post I have ever had to write.  For several days now, I have had a heavy heart and upset stomach because of what’s happening in our little state.  For those of you in other parts of the country – places where you have access to licensed, autonomous midwives and birth centers and home birth and everyone is working together nicely – count your blessings.  North Carolina is one of the worst states for birthing options due in large part to the leaders in our Medical Society.  For years now, they have fought any perceived encroachment on their scope of practice.  Visit their website and you will find legislative warnings about the danger of naturopaths and advanced practice nurses and, of course, those pesky “lay” midwives (check out the letter at the beginning of their 2012 Legislative Summary).  Their insistence that North Carolina should not license CPMs because home birth is unsafe is ironic considering it is their refusal to license and regulate midwives that is currently making home birth unsafe.  If we don’t offer a path to licensure for midwives practicing at home, how can the families, who are legally able to choose to give birth at home, know if the women practicing are safe?  When I asked this question at our meeting with the Medical Society, Haywood Brown looked me in the eye and said, “Go to the hospital.”  These are the same folks who also put pressure on Dr. Henry Dorn to stop backing CNMs practicing home birth in our state, resulting in hundreds of families loosing their care provider mid-pregnancy.

But all this talk about the ‘safety’ of home birth is smoke and mirrors, y’all.  The physicians want the conversation to be about home birth because then we don’t have to talk about what’s going on inside of hospitals right now.  Let’s talk about the fact that the United States currently ranks 50th in the world in maternal mortality, and we rank 35th in the world in infant mortality.  Is it really all that safe to give birth in hospitals?  If one in three women are being subjected to a surgical birth, I like my odds better elsewhere.  Why do you think the number of women who are choosing to give birth at home is on the rise in our state?  Women are suffering from Post Traumatic Stress Disorder because of what is happening to them in hospitals.  Women are using words like, “coerced” and “bullied” to describe how they feel they were treated in labor.  But as long as they can keep the focus in the media on what’s happening at home, they don’t have to answer for their own bad outcomes.  Not to mention the fact that if a baby or mother dies in a hospital, the physicians and hospitals have very expensive lawyers to settle lawsuits and millions of dollars to pay the families.  And then the families are told they are not allowed to discuss their bad treatment with anyone.  Ever.  So the bad behavior continues and the public remains ignorant of the truth.

The-Bully-the-Bullied-and-the-BystanderLet’s go back to the word “bully” for a moment.  Last year, my daughter was experiencing some bullying at school so I bought The Bully, the Bullied and the Bystander by Barbara Coloroso.  If you work in the birthing world, I highly recommend this book.  As I read the book, I realized that if you replace the word ‘bully’ with ‘provider,’ the word ‘bullied’ with ‘patient’ and the word ‘bystander’ with ‘support staff’ she could have easily been describing what’s playing out in maternity wards all over our country.  Her solution is not simply to deal with teaching the bully how to be nice or teaching the bullied how to stand up for themselves.  This dynamic will only change when we teach the bystanders not to tolerate bullying and to speak up for the bullied.  When I google searched the word ‘bully,’ I followed the link to the Wikipedia website and found that there were links to separate pages titled “Bullying in Medicine” and Bullying in Nursing.”  Hospitals are a culture of bullying, so much so there have been studies to try to understand why.

Maternity care in this country is such a mess, we have entire websites and organizations dedicated to try to make it better (ImprovingBirth.org, The Unnecesarean, CesareanRates.com, Childbirth Connection, Coalition for Improving Maternity Services, Karen Brody’s “Birth” on Labor Day movement, Choices in Childbirth, My Best Birth, BirthNetwork National).  The only folks who seem to be uninterested in working on making things better are the physicians.  Rather than asking what women want, and striving to provide that, they are out there fighting to take away the very services women want.  Look at what’s happening in Texas and South Carolina right now.  They are actively trying to take away access to licensed midwives, and they are trying to take over control of birth centers.  It’s time to stand up to the bullies.

Next week, join us in Raleigh outside the General Assembly as we demonstrate our frustration at the lack of leadership in the Senate.  We demand due process.  The citizens of our state have made it obvious to their elected officials what they want.  The physicians in our state do not get to decide what happens in our legislature.  We will be protesting on Jones Street from 10 to 11am Tuesday, Wednesday and Thursday.  Now is the time to take a stand.  Now is the time to send a clear message to the Med Society and the legislators who value campaign contributions more than the wants and needs of the people they govern.

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8 thoughts on “The Man Behind the Curtain

  1. I appreciate very much the efforts you are encouraging to create change! I love your statement about distracting citizens from what is going on in the hospitals by focusing on homebirth!

    I just want to share one thing in hopes another perspective might be visible- Licensure does not make skilled midwives. Yes, I do believe every woman everywhere should have access to midwifery care and homebirth if she chooses, but if we push too hard to mandate all midwives be licensed we will lose many great “lay” midwives who are far more skilled than some of their licensed counterparts, as well as remove options for women to choose from. Licensure creates restrictions on what type of birth is legally allowed to be attended. Currently, for example, in some states CPM’s can attend breach births and in other states it is illegal for a CPM to deliver a breach. So, some midwives choose not to become CPM’s because they are skilled at breach and want to be able to attend them. This of course makes their entire practice illegal but it is the only way to provide women the access to the care they want.

    It is really two battles we are a part of- 1 to get legal access to homebirth everywhere, and 1 to prevent the monopoly of licensure as the only path. Legalizing only licensed midwives narrows the choices for women and will create a system no different than that of a hospital- heavily regulated births in both locations.

    • I agree, which is why there are currently 2 bills in NC. One is Decriminalization, the other is a pathway to licensure. We live in a state that is arresting midwives and charging them with murder. Asking the legislators to vote on these bills is imperative to making our state safe for families who choose out of hospital birth. If we do not pass one or both of these bills, midwives will continue to have to practice in a very hostile environment and that is unacceptable.

      • even more unacceptable – MOTHERS will continue to have to birth in a very hostile environment. MOTHERS will continue to have little to no choice of midwife, simply because there is only one in her area. MOTHERS will have no way to verify the skills and reputation of the midwife available to her. Yes, a small number will choose an uncredentialed or unlicensed midwife (just as they do now). With the licensing board for CPMs, the aim is to provide oversight – not restriction of practice. The licensing board will NOT be under the NCMS or the BON…they missed that boat a couple years ago – so, we walk forward in power and get the job done, so the homebirth families of this state can make a real choice for themselves!

  2. Pingback: The Man Behind the Curtain | Birth Activist Collective

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