Bravo I agree too. There is a place where we meet in the middle. In my opinion, in the best of all possible worlds, we homebirth midwives ( and that is my training, DEM, Seattle Midwifery School) can safely assist moms to birth at home, which is most of the time, and make appropriate transfers of care to the hospital when necessary, hopefully to be greeted by hospitable nursing staff. At the moment, in Seattle that is mostly the case, although some hospitals and obstetricians remain hostile to out of hospital birth. But I do bristle at those who seem to imply that if a mom is committed enough, and trusts her body enough, then if she also has attendants who do the same, she will birth normally and gently. I have to say, not necessarily so. Perhaps we come from different spiritual paths and that is the source of differences of opinion on this. I just know that neither my body nor my mind are perfect, and sometimes as Kirsten (I think, or was it "thrupps") said, our bodies go off the rails. As midwives, whether at home or in the hospital, we need the skills to assess these situations. From what I have read on the list, I don't think anyone disagrees with that. And there are many ways to get these skills.
Ina May and her fellow midwives at the Farm where fortunate enough to run into amiable docs along the way who provided training and education. The commune was also large and included women already trained as nurses. Aspiring midwives were also required to train as emergency medical techicians, the Farm at one time had their own ambulance service. Through all this, Ina May became President of MANA (midwives association of north america) and a strong advocate of lay/dem midwives credentialing themselves with through the NARM process to become CPM's. This has met with some dissention from within the MANA community as some people are philosophically opposed to any form of credentialing or regulation or professionalisation of any profession or calling including midwifery. Apparently there is no means for lay midwives in Australia to become certified or registered as their training (for whatever reason) is not being recognized by the ACMI, Nurses boards, or Universities. Maybe it is time for them to start their own organization similar to MANA and develop their own certifying process. Maybe you do this already. Even if you do this, their will be people who place themselves outside the system. This is their choice. The B. Mid programs will not necessarily solve these problems, especially if they do not recognize prior, documented experience in some appropriate way. In my training as a direct entry midwifery student (in the US) I have come across a wide range of tolerance of deviations from the "normal" amongst my various preceptors. They have been from conservative to radical and you wouldn't have been able to pick their style of midwifery from either their credentials (lay, dem, cnm), their deamenour, or their appearance. Usually their philosophy was disclosed to potential clients in their initial interview. Amazingly, in looking at my stats, their transfer rates have been about the same, the more conservative midwives transfering clients earlier, being the main difference. Interestingly, none of my preceptors have been willing to work with free birthers. All were occassionally fooled by people who came for prenatal care and then either called too late in labor for the midwife to arrive in time, or didn't call at all. None were happy when they weren't called. Of course we get called to births where you arrive as the baby is coming out. Obviously, some of us could birth successfully in the back of a truck or up in a tree, and some of us could not. Some of us and our babies would have died on the prairie, in the wagon train, on the convict transport ship, and some of us survived and thrived. At this point in time our society has a low tolerance for maternal and infant mortality and morbidity. How we react to this is critical and I believe, requires radical, open, and honest debate. Sorry if I have raised too many issues in one email. I could go on and on but need to continue packing my bags. regards marilyn -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
