Sunday, January 16, 2011

Where are the mothers?

I live in a city with a hospital that has roughly 3,500 births every year.

Their cesarean rate is very hard to find (as are most hospitals'), but based upon information from some of the doctors and nurses that work there, it is estimated to be around 50% (some say closer to 60%). The rate is, in part, this high because the hospital doesn't "allow" VBACs. So, the many first-time mothers whose labor inductions fail (induction rate is very high in my area) or whose labor is taking too long that end up having a cesarean...with future babies, they are told that they must have a repeat cesarean. I have met many mothers in my city that have had 4 and 5 cesareans. It is criminal.

There is a hospital about 20 minutes away that allows providers to attend VBAC, though not every provider does.

Where are the mothers? I am a little surprised to see how very, very few women seek out the services of a midwife for an out of hospital VBAC. I would expect there would be such a demand that we would be needing more and more midwives to accommodate the demand. But, there isn't.

Of course, not every mother will decide that an HBAC is the right choice for her. But, it makes me wonder...where are the mothers? Ar they signing up for repeat cesareans? Are their doctors telling them that, although their hospital doesn't 'allow' VBACs, even the National Institute of Health came to the conclusion that a VBAC is a perfectly safe option and that perhaps they should look into different birth options? I seriously doubt that.

There are approximately 50-60 homebirths each year in my county. It would make me so happy to see that number sky-rocket in the coming years.

Pet peeve

I need to clear something up.

I notice all of the time on message boards, news articles, or among conversations in person, that many people are under the assumption that DEM (direct entry midwife, a midwife who has not entered midwifery through a nursing degree first) and CPM (certified professional midwife, a term created by NARM) are synonymous. When asking about midwives or referring to midwives, it sounds like you now have two choices in the US: Certified Nurse-Midwife and Certified Professional Midwife. This is not true. CNM and CPM are not the only options, and DEM is not the same as CPM. (Though most CPMs are indeed DEMs, the reverse is not true).

All of these letters make things confusing.

A midwife can be a midwife without being a CPM. There are many, many fabulous and highly expereinced midwives in our country whose title is 'Midwife', not CPM or CNM or CM. And there are currently wonderful student midwives in this country who are apprenticing with a homebirth midwife who have no plans whatsoever to become certified. We need to stop expecting some certifying body to determine who is a midwife.

Please, please, please, people...stop referring to ALL non-CNM midwives as "CPMs". This is simply not true and it does a huge disservice to midwifery.