No frogs were boiled in the writing of this note…but the metaphorical reference is intentional…


So all this uproar about licensure doesn’t affect you….right? WRONG….if you are a mother or a midwife, it definitely has the potential to change your life in a major way. If you are a mother, you will find that licensed midwives are NOT allowed in some instances to serve you because of history or your size or age…..or you won’t be able to choose a veteran 35 year midwife with stellar stats because she chooses not to align politically with the ONLY licensing group…..or you may find that the cost of hiring a midwife has much for that inceased access theory if you don’t qualify for medicaid and have no insurance coverage..and what happens when the insurance companies start limiting coverage, which is their right? It will cost a midwife a LOT more to get the credentials since MEAC and NARM will be the ONLY grantors and they can and will charge whatever they want…and keeping a license will prove to be costly…again just because the exclusivity makes that possible….

If you are a papered up midwife, with a CPM and a license, you may not have thought of this…but the reality is that you will be forced to practice medicine without a license under the guise of practicing midwifery. The administration of drugs and oxygen are indeed medical…(which, if you really knew your stuff, you would know that these are REALLY dangerous ideas.) And year after next you might have to start on your master’s degree in order to maintain your status….Often, you will find yourself practicing CYA style rather than just serving the way you want to. You will be pushed into many corners where you have to choose between serving women and serving those who gave you the paper….remember that they can take them away for any reason they choose with no real recourse on your end.

Here are some facts….licensure does not mean you are a better midwife, the CPM doesn’t mean you are a better midwife than one who chooses not to attain that title….In fact the most incredible midwives I know have put their investment into education rather than credentials. An in-depth education that is sought voluntarily has far more integrity than a short easy one to prepare for a test. And that is all that many CPMs and licensed midwives have to offer. Very few have gone beyond the “entry level” education and testing required for the CPM. At the onset of the CPM credential, I asked NARM to reconsider the long term ramifications of creating a credential, and specifically of creating one that is so easily obtained. At that time, two thirds of my enrollment was experienced midwives, many with 300 or more births and some with 1000 or more. As I predicted, once the credential became the goal, the really thorough education we offer would not be so highly sought after. I was right. Almost no experienced midwives enroll in AAMI’s Advanced Midwifery Studies anymore. We have many dedicated and brilliant students, but most of them are inexperienced and only starting their journey.

AND papering up says a lot of things about you that you may not want said next year or the next….Do you really not mind if mothers’ rights to choose anyone they want are taken away? Do you really want to sign a paper that affirms that you will rat out other people who attend a birth? Will you really agree to carry drugs and oxygen, induce, use a doppler or routine vaginal exams after you have done the research like we do at AAMI about the dangers of those? Will you agree to be liable for NOT practicing the way that NARM, MEAC, MANA and your state entities want you to practice…..practices that are based on medical myth and NOT on science or respect for mothers’ ownership of their own births? It is important for you to stop thinking this is about OTHER people. If you are a birthing woman, or someone who serves birthing women, everything is at stake here. Everything.

A last word about qualifications and education. I honor the fact that mothers own their births. Each mother has the right to choose where and with whom to birth, even if that is no one. However, I think that any woman who calls herself a midwife should know a lot more than what it takes to pass the NARM exam. My conviction, as a midwifery educator of more than three decades is that it takes a lot more education to not interfere with birth. Midwives need to know everything in order to be competent and confident doing as little as possible. That is what KEEPS birth safe. It starts at safe….it is usually what WE do that adds risk. And that is the difference in the principles I stand for and those who are pushing for licensure. I do not believe birth is a medical event except for a small percentage of women some of the time. I believe that birth belongs to mothers and not to medicine or midwives. I do not think midwives should be trying to be part of the medical system that has proven it has little regard for mothers and babies and no faith in the process. I think midwives should be putting their desires for “recognition” or third party reimbursement aside, in light of the far more pressing issues of protecting a mothers right to choose her, or anyone, or no one. Once parents’ rights are gone, midwifery rights will be a moot point……and it will be too late to jump.

~Carla Hartley

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