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.

Clarification

Because I think there may be some confusion from my last blog entry, I wanted to clarify something.

The rule changes that are being proposed will not make breech, twins, VBACs and postdates 'illegal' or absolute risk factors for licensed midwives. They will still be 'allowed' to attend them out of hospital.

But, they are creating stringent criteria in each of those categories, proposing to dictate under what terms a VBAC, breech, twin, postdate birth would be considered safe enough to stay home (with a licensed midwife).

For example, if the baby is breech, is must be frank breech with an estimated fetal weight less than __gms. Or....once you hit 41 weeks, you must have a weekly biophysical profile and get a score of __ or better to continue with a homebirth. (AGAIN, THIS IS JUST AN EXAMPLE OF SOME OF WHAT I HAVE HEARD BEING PROPOSED. ITS STILL ALL IN PROCESS).

Oregon's current rules dictating what is an absolute risk factor for out of hospital birth with a licensed midwife are very BROAD with lots of grey area. They were originally written this way on purpose.

It should be up to each mother and each midwife individually to decide if they are comfortable proceeding with an out of hospital birth, not up to the licensing board. I think that the informed choice process is critical in this issue.

So, when writing those letters, please remember they are not (at this point) discussing making VBACs, twins, breeches, and postdates illegal...but are trying to put restrictions and set in stone guidelines around them. (Not good for birthing women!)

Come to the meetings if you can!!!