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#11
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Midwife versus OBGYN
"ChocolateChip_Wookie" "wookie[at]bluelotusblossom[dot]com" wrote in message ... Hi All, One of the defining features I have noticed when watching 'birth' programs from both here and across the pond is the completely different aproaches to medical care in pregnancy. Here, almost all children are delivered exclusively by midwives, so much so that I did not even see a doctor during the course of my last pregnancy and labour. However, watching a program from America, I was struck by the fact that midwives are generally considered to be little better than quacks/witches and charlatans and there rarely appears to be a midwife in attendance. Any comments? How did this disparity come to pass? Where are all the midwives in America? Wookie Here (Long Island, New York) there are barely any midwives available for prenatal care and labor and delivery. The ONLY one I was able to find that would assist in a home birth is a few miles from here and is literally the only one for about a hundred miles. What's even scarier is the C-section rate over here. There was actually an article in Elle magazine not too long ago about all of the elective C-sections and *all* of the hospitals and doctors they mentioned are within 25 miles of my house. I consider myself lucky to have managed thus far without a C-section and to have had 2 relatively normal vaginal births. I birth in a hospital, and I will again this time (because we decided as a family that a home birth was not for us - mostly due to our other 2 kids). Many offices here have midwives on staff, but they are not permitted to deliver babies. My OB's office has one and it's the same situation. It also has to do with malpractice insurance, which is sky high in New York. HTH, Jen |
#12
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Midwife versus OBGYN
Many offices here have midwives on staff, but they are not permitted to
deliver babies. My OB's office has one and it's the same situation. It also has to do with malpractice insurance, which is sky high in New York. what exactly is a midwife who doesn't deliver babies, presumably they don't have the same level of training as a midwife practising independently, so what training do they have, are they really a specialist anti/post parturm nurse? I'm sure they do a helpful job, just that calling them midwives is rather confusing, though of course if they really are midwives and just not able to practise as such, that makes it even sadder, for them as well as the women missing out on their care. Cheers Anne |
#13
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Midwife versus OBGYN
"Anne Rogers" wrote in message ... Many offices here have midwives on staff, but they are not permitted to deliver babies. My OB's office has one and it's the same situation. It also has to do with malpractice insurance, which is sky high in New York. what exactly is a midwife who doesn't deliver babies, presumably they don't have the same level of training as a midwife practising independently, so what training do they have, are they really a specialist anti/post parturm nurse? I'm sure they do a helpful job, just that calling them midwives is rather confusing, though of course if they really are midwives and just not able to practise as such, that makes it even sadder, for them as well as the women missing out on their care. Cheers Anne In most cases, they *used to* deliver babies, but now just perform office exams. Again, the insurance was making it impossible for them to practice. They are CNMs (certified nurse midwives - same as any others here in the US). |
#14
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Midwife versus OBGYN
In most cases, they *used to* deliver babies, but now just perform office exams. Again, the insurance was making it impossible for them to practice. They are CNMs (certified nurse midwives - same as any others here in the US). aww, that's a shame, I guess most of them don't want to be practicing like that, but are forced to as moving elsewhere for employment is not an option. remember that there are both CNMs and direct entry midwives in the US. I don't know how long the extra training is to jump from nurse to CNM, we have similar in the UK, though the end title is the same, direct entry midwifery is a full 3 year training course, for those already nurses it's around 18 months, but is gradually being extended to 2 yrs, which just shows how much more there is to learn beyond nursing to become a midwife. It may even become the case that even those already qualified as a nurse have to do the full direct entry program. Cheers Anne |
#15
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Midwife versus OBGYN
Anne Rogers wrote:
remember that there are both CNMs and direct entry midwives in the US. I don't know how long the extra training is to jump from nurse to CNM, we have similar in the UK, though the end title is the same, direct entry midwifery is a full 3 year training course, for those already nurses it's around 18 months, but is gradually being extended to 2 yrs, which just shows how much more there is to learn beyond nursing to become a midwife. It may even become the case that even those already qualified as a nurse have to do the full direct entry program. I believe that it's typically two years from RN to CNM in the US. Also keep in mind that DEMs do not all have the same background or education in the US. A DEM can have anything from no formal training to a great deal of formal training. A DEM may be registered or certified or not. Of the states that allow direct entry midwifery, most require the CPM (Certified Professional Midwife) credential, which requires some combination of in class education, an apprenticeship, and passing an exam. There is no formal curriculum that applies to all DEMs in the US. Best wishes, Ericka |
#16
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Midwife versus OBGYN
I believe that it's typically two years from RN to CNM in the US. Also keep in mind that DEMs do not all have the same background or education in the US. A DEM can have anything from no formal training to a great deal of formal training. A DEM may be registered or certified or not. Of the states that allow direct entry midwifery, most require the CPM (Certified Professional Midwife) credential, which requires some combination of in class education, an apprenticeship, and passing an exam. There is no formal curriculum that applies to all DEMs in the US. it's actually fairly similar in the UK, that there is no formal curriculum, but to use the word use the word midwife you have to be a member of the royal college of midwifes and though there is still no set curriculum, that does at least give a professional body and you know what you are getting, obviously there is going to still be a range of knowledge and experience, but the minimum is still pretty high and within the NHS they must undertake ongoing training, only a tiny amount, but some nonetheless. There would be room within the system for some midwifes who don't practice within the NHS to be not undertaking/keeping uptodate, but the number of them is very small and when you are paying to use their services rather than getting it free on the NHS, they have to be practicing at a higher standard and actually be much more competant as they almost always attend births at home, but will attend things other than straight forward births, so are likely to more experienced in breech, twins etc. In the end it means I can't really get what I want in either the US, or the UK, because I don't think I'd want to go for a homebirth anymore, because I feel I need the option of a c-section right there and having had 2 precipitate labours, I don't have time to let labour start, see how it goes then transport, but if I'm going for a vaginal birth, I want an expert midwife there! Cheers Anne |
#17
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Midwife versus OBGYN
Lady Penelope Creighton-Ward wrote:
I am one of those rare 1% to give birth at home here in the Boston area, attended by two direct-entry midwives. I faced a lot of incredulous looks and comments about my irresponsibility when I would tell people about my homebirth plans. Eventually I learned to just not talk about it. Yes...that's what I gathered from the programs. Whilst homebirths here are rareish, its generally accepted that if that's what you want to do, then it's up to the medical staff attending to support this. The Royal College of Midwifry states that a community midwife cannot 'refuse' to attend a labouring woman at home since this constitues dereliction of duty. Many women are strongly advised against home births for a variety of reasons, not least of which is lack of resources, but most ordinary people would not particularly look askance at a woman if she said she would have a home birth and the midwives would certainly attend. Anyway, I just spoke with a colleague who tells me a friend of hers is planning to have a natural hospital birth, also attended by a midwife, and her father who is an OBGYN is very distrustful, partially because in his entire career he has never witnessed a natural birth. Huh? I'm sure I must have misunderstood... Are you saying that the obstetrics consultant has NEVER seen a birth? How can this possibly be and where the hell did he get his license, out of a cornflake packet! I'm surprised he's allowed in the delivery room. What are they teaching consultants! Frankly, I'd rather be delivered by my best friend then someone who has never seen a live human birth, at least she's had a couple of children and has a vague understanding of what is going to happen. I'm astounded that this man has the temerity to call himself a medical professional. Imagine entrusting the birth of your child to a doctor who has never actually seen a real birth! Heaven Forbid! |
#18
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Midwife versus OBGYN
ChocolateChip_Wookie wrote:
Lady Penelope Creighton-Ward wrote: Anyway, I just spoke with a colleague who tells me a friend of hers is planning to have a natural hospital birth, also attended by a midwife, and her father who is an OBGYN is very distrustful, partially because in his entire career he has never witnessed a natural birth. Huh? I'm sure I must have misunderstood... Are you saying that the obstetrics consultant has NEVER seen a birth? She said a *natural* birth--i.e., one without interventions. Best wishes, Ericka |
#19
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Midwife versus OBGYN
She said a *natural* birth--i.e., one without interventions. Best wishes, Ericka That's just appalling! That there are so few natural births that he has never seen one. I guess that's the American medical professional all over then. If no woman is allowed to have a *natural* birth because of the risks then of course, none of the medical staff have ever seen a natural birth and this just re-enforces their prejudice that you cannot have a *natural* birth! That's just insane! Urgh! Wookie |
#20
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Midwife versus OBGYN
Lady Penelope Creighton-Ward wrote: I am one of those rare 1% to give birth at home here in the Boston area, attended by two direct-entry midwives. I faced a lot of incredulous looks and comments about my irresponsibility when I would tell people about my homebirth plans. Eventually I learned to just not talk about it. I also had a homebirth, but I was attended by two certified nurse midwives. I got LOTS of comments, also but both my husband and I used it as an opportunity to tell people that statistically it's safer for an uncomplicated labor and birth to happen at home, and that if complications occured, we'd simply go to the hospital, that in over 3000 births, my midwives had never lost a mother or baby. I would NOT take the irresponsibility comments lying down, especially without knowing all the details, they are making assumptions based on inadequate information. I was aggressive enough that I didn't wait for people to make those comments - I informed them of the stats BEFORE they could get around to insulting me. Surprise, or incredulous looks or "you must be really brave!" comments, I could take (after all, it is a fairly rare choice), but insulting me for my choices wasn't something I would tolerate. I also take most opportunities to talk about it - that it was a safe and wonderful experience. Not so much because I am pushing my beliefs on others, but because I want people to realize that it's a legitimate choice, and to be accepting of it, not just for me, but for other people as well. A woman should be able to birth whereever she is most comfortable (home, hospital, birthing center) without people getting all judgemental on her, especially in ignorance. rant off Cathy Weeks |
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