Tuesday, November 15, 2011

just 5 things I believe about midwifery .....

#1 Midwives have no rights apart from serving parents. Nobody wants to hear it, but it is true.
#2 Authentic midwifery is about serving mothers, not saving mothers or babies, from birth.
#3 Midwifery that incorporates, or is based on THE lie, is not authentic midwifery.  I am interested in honoring and saving authentic midwifery because it serves parents WITHOUT adding risk or diminishing safety. (THE lie is that birth is a medical event.  It rarely is.  When it is, thank God we have medical facilities and medical personnel.)
#4 Midwives who believe that their presence, or drugs or gadgets make birth safe don't believe the same things that I do about birth.  My beliefs are grounded in science and wholesale trust in the physiology of birth.  So, when we talk about midwifery, we are often talking about something different.
#5 I believe that if you are going to call yourself a midwife, that you need to invest in a comprehensive education that includes the history of midwifery, nutrition, anatomy, physiology, terminology, normal labor and birth, the newborn, counseling and communication skills, some basic biology and microbiology, complementary studies, possible complications and how to prevent them, possible emergencies and how to recognize and respond appropriately.  Of course there are many other things included in my curriculum.  However, I do not believe that midwifery students need algebra, composition, chemistry, pharmacology.

Saturday, October 1, 2011

Parents rights

and people write about me  ...  actual quotes....

• Carla's ideas will never work. She is just dreaming.
• It will never happen.   It is too late.  The Big Push has won.
• Parents' rights can never be secured. We need to accept that and move on.
• Carla needs to give up and shut up.  Licensure is here to stay and there is nothing that can be done about it.

R E A L L Y ? ? ? ? ? ? ? ? ? ? ? ?

Some amazing women were told to give up and shut up. 


Friday, September 16, 2011

Carla Hartley is AGAINST Licensure of Midwives!

Yes, of all the things that are said about me on a regular basis, that one is absolutely 100% correct.  I am against regulation of midwifery of any kind, and that is what licensure is.  Licensure is for the purpose of identification, regulation and elimination.... AND.... for the richification of those who get to decide who does and doesn't get that golden ticket.  They print it and they can decide what it costs.  It is NOT about qualification or education.  In fact, it is not at all about education except to decide which education provider can also get one of them thar golden tickets.

Although most midwives do not think education is as important as I do, it is not my job to say who is or is not qualified to call herself a midwife. Mammas are smart enough to choose from the wide variety of people who want to offer their services as a birth attendant.

My proposition is that we help educate mothers as to what constitutes good midwifery vs. medical midwifery and/or inadequately educated midwifery.  It is not my job to designate who those are, nor to police them.  It is the parents' job to either keep them in business or go elsewhere.  That is called free enterprise.

And remember that it is not so much that I am against licensure, but that I am FOR something else.  That something else is for parents to have the right to choose to birth anywhere and with anyone they want, even if that is no one.  Licensure will ultimately eliminate what I am FOR.

Licensure is a really hot topic and my stance keeps me in hot water, so to speak, but I have yet to be convinced that parents or midwives, for that matter, will benefit from licensure.  NARM, MEAC, MANA will....but that is a different note....the upcoming note on the richification aspect.

I am going to share here some of the questions that come my way frequently.

So what about the dangerous midwives?
I will not deny that there are many dangerous midwives out there.  Most of them have a credential.  Still, I think educating parents about what is dangerous and what is not, is the best way to address this issue.
There are already laws against hurting people. 

Don't parents want licensed midwives?  Licensed midwives tell me that all the time; parents never do. They want something else entirely. Once in a while I will get a letter to the contrary but I can pinpoint it to one particular area where the midwives are writing the proverbial letters and having the mammas sign them. I can quote the letters verbatim.  They are all the same.

Does this mean that you think that midwifery should be illegal and unregulated?  Illegal, no, unregulated, yes.  Midwifery could be, should be, maybe already technically already is legal by virtue of it being legal for parents to exercise their right to life, liberty and the pursuit of happiness in their ownership of the biological function called birth, which is a private family event.  Midwives don't need regulation; they need freedom to practice midwifery (not medicine) and the "regulations" should come from the parents, not the government or any midwifery organization.

Do you think that midwives should be allowed to carry life-saving drugs, which licensure would allow? No, I do not.  I think that drugs = medical training, expertise and risk-taking that midwives have not attained, do not need and they should not take the inherent risks of the administration of chemicals.  Rather than licensing midwives, maybe there could be a license for anyone who wants to carry and administer drugs that involves the appropriate training, education and liability insurance?  Something to think about.  As for "life-saving", education is far more likely to save a life, than the administration of a drug that has the potential to do all kinds of things that a midwife is not prepared to handle in a home situation.  Learn how to prevent and respond to those situations without drugs.  We have the knowledge, but it is often easier to just reach for a syringe, suppository or pill.  Not good science to do that without a very specific education and contengencies.

What about oxygen?  Oxygen is a drug.  Room air is more beneficial and far less dangerous.  I recommend taking every class you can from Karen Strange on the issue of neonatal resuscitation.

But won't licensing bring midwifery into the mainstream and make midwives more likely to be respected?  I have never understood how anyone over the age of 12 could even imagine that licensing midwives could force doctors and hospital personnel to regard someone outside of medicine as equals.  Secondly, can you explain why would we WANT to be mainstream?  What has mainstream done for birth?  I will give you a hint, the numbers are over 34%.  Get back to me on this one.

Won't licensing keep midwives from prosecution and persecution?  Hasn't so far. If someone in the more powerful clan (medicine, government, midwifery organizations) want you, they can get you, no matter what credentials you have.  In medicine, and that is what we are talking about here, let's be honest.... the only initials that really matter are M and D.

Won't licensing which mandates that insurance companies pay midwives mean that more women can have home births with midwives?  Mandating MEDICAL insurance coverage for a NON medical event is not a good idea for a number of reasons.  Birth is medical or not.  Choose.  If birth becomes medical, medical insurance should pay, but as long as it is normal....why?  I am not convinced that money is the real obstacle for women who are wanting homebirths.  I would have sold all my furniture to have a home birth with a midwife after my first birth in the hospital. For what we knew at the time, my husband and I worked a second job each to pay for so we could get the "best" aka most expensive for our baby. The insurance and medicaid aspect is tricky in many ways.  For one, it can and will have a cap and midwives will NOT want those clients once the cap is in place and then, the "poor" women are back where they were.   And the other issue that no one seems to address is how many women will choose home birth, if their insurance pays,  just for that reason....not because they trust it...but because their insurance will cover it or their friends are doing it.  I would rather work with parents who are willing to work to pay for a home birth midwife because it is THAT important to them.  As for the ridiculous "equal access" blarney, women have a lot more equal access in a free enterprise system than in any government run program, which is what home birth midwifery will be.

I live in an alegal state and all the midwives here are pushing for licensure.  Shouldn't I be a part of that effort to make midwifery legal?  If your friends all jumped off a bridge, would you? Just because others are doing it, it doesn't mean you have to.  I am going to let you in on a little secret here.  The emperor has no clothes.  I do not care who they are or how famous they are, if they are working for licensure of midwives they are NOT working for parents' rights.  Parents' rights are always in danger when midwives are pushing for theirs.

Why are so many pushing for licensure if it is such a bad idea?  I cannot tell you that. I just know it is a bad idea.  I can tell you why some are pushing for it and it has to do with the concept of monopolization. If the only people who can legally drive are those who drive Volvos, the Volvo folks are going to make out like bandits.  I will let you do the math....and watch for the upcoming note on how licensure is motivated by a desire for monopoly and money.

But why should midwifery be exempt from regulation when even people who give pedicures have to be licensed?  Licensing is never about protecting the public. Interior designers are being licensed now as are florists, and there is talk of licensing dance teachers.  Think about the need for those professions to be licensed for a minute.  Licensing is a golden ticket printed by someone else, that allows you to do what you do. It always takes money out of the individual pocket and puts it into an organization or government entity's pocket.  Two wrongs, or in this example, multiple wrongs, don't make a right. I am not persuaded that midwives need to be licensed on the faulty premise that we have to because everyone else is.  Look at why everyone else is. And you don't want to get me started on the travesty of constraint of trade and the right to earn a living. I will put that in the richification note.....Otherwise, we would be here all day.

All the midwives in my state say you are crazy.  They are correct, but that does not tarnish the brilliance of the principle for which I work night and day. Mothers own their births.
Here are a few of my previously published notes on the topic of licensure and The Big Push.  Feel free to look through my notes for more.
 And visit www.ancientartmidwifery.com   www.trustbirth.com  carlahartley.blogspot.com




Background note:  I am completely FOR education and competition....I think if midwives are preparing to serve parents who have a lot of different midwives to choose from the will pay more attention to their education.  I think midwives should put years and years of concentrated effort into  becoming a midwife. I created the most comprehensive midwifery course on the planet.  My stance is that midwives need to know EVERYTHING, so that they are comfortable doing as little as possible.  DOING is what adds risk to the inherently safe biological function of birth.  I think midwives need a great deal more education than it takes to become credentialed o  licensed in this country, but I will have no part in any effort to determine who may or may not call herself a midwife and will not support any group that does.  That takes the power from the mother to choose her own midwife.

Tuesday, August 23, 2011

Corporate Takeover

Here is the blueprint:
MEAC to monopolize all midwifery education and makes great effort to lobby every state to become MEAC only, regardless of the quality of the course. Nothing compares to AAMI and many MEAC courses that I know of ONLY teach to test.  If you are strictly looking at quality, AAMI is incomparable.  But quality is not the issue; politics and power are.
Then thanks to TBP, every state will require the CPM, so now NARM monopolizes the term midwife. Then MEAC and NARM own everything.
Midwives cheated out of choice in education; parents cheated out of choice of midwife.

Thursday, August 11, 2011

Only One Possible Solution

Trying to integrate into the system won't work. Approval from the system is fleeting or false. The ONLY thing that will protect parents, home birth and authentic midwifery is to be sure that parents' rights are acknowledged and respected.
They own the right to the natural biological function we call birth.
If we don't protect their right to do that where, how and with whom they want., NO OTHER RIGHTS WILL BE SAFE. Midwives' rights will be moot and parents' rights will be subject to interpretation based on what has been lost....not what has been saved.

Monday, August 1, 2011

The System is not Broken; It Was Flawed from The Beginning

Someone thought my admonition for women to stay home to avoid a cesarean was somehow placing the blame on mothers.....and that it is the maternity system that is broken.  Here was my response:
Birth is Safe; Interference is Risky!

I think the problem is that we have believed a lie: birth is medical and dangerous and requires a medical setting and a medical manager. The out of control maternity system CANNOT BE CHANGED as long as that lie permeates our culture. Women who walk into a hospital should not ignore the fact that their choices are diminished and the probability of a surgical extraction is FAR greater than if they made the decision to birth AWAY from the place that has proven it is NOT about mothers and babies but fear - power- and profit.I wish it were not so. I wish the 90+% of women who choose hospital birth did not face the 1 in 3 chance of having a cesarean or repeated cesarean. But the FACT is that they do.*
If I thought that getting on one highway increased the risk of death...I would take another road. Fortunately, home birth is extremely safe if mother and baby are left alone to do their thing, with minimal interference. So for MOST women it is a far safer road.*I have dedicated my life to HELPING women; I am not blaming women; would be the last person to do that-------, but I am also not blind to the fact that in my 30 plus years in this field, that I have not been able to change one thing about the system and I have really worked hard...but to no avail. We have not and will not change the system because we have let it change us. Mothers and babies are harmed because we have not told them the truth....so I no longer will be complicit with the lie. I am going to continue to tell mothers of the dangers of hospital birth in the hope that they will avoid them for birth. You would have to work really really hard to make the average home as hazardous for birth as any hospital.

Monday, July 25, 2011

Midwifery is NOT Medicine.

Midwifery is not Medicine

• does not belong under medicine's rule
should not be patterned after anything resembling the practice of medicine
LAST WORDS FOR A WHILE: I meant what I said and I said what I meant.....Birth belongs to mammas, 100%!
Why would we want to emulate anything we don’t want to be?  Instead of wanting to ride into the future on the medical model’s coattails  or asking to be part of their “club”,  why aren’t we pointing out to the most salient point in this debate of who should and should not be allowed to call herself a midwife?  Parents own their births.  Instead we are in a tug of war with the medical community over something that does not belong to us.  I think it is not only more noble, but has more long term potential for success for midwives to be striving to protect parents’ rights to birth at home with anyone or no one. The credentials and the titles are all minor pieces of the big picture.  I have been asking midwives for years to concentrate on the WHO they do this for rather than WHO is allowed to  call herself a midwife.

I am tired of midwives acting like they are medical mavericks, disobedient children who need new rules and regulations, sheep that have strayed. 

We have our own history  and our own identity that is not related to the group we seem to be seeking approval from. Midwifery's roots are not in medicine.  Midwifery's past is not a product of medicine......but if we don't do everything we can to disassociate ourselves from medicine, we will be swallowed up by it. 

I know it is NOT politically correct to say this......but if I were the medical community and I wanted to stomp out midwifery........well......I couldn't have thought of a better plan than what midwives have done to themselves in their effort to get legal recognition*, credentials and third party reimbursement.

Midwives are starting to see the light...... and I don't feel so alone
anymore.   In fact, I believe with all my heart that we are looking at a resurgence of the heartbeat of midwifery.....the desire to serve families who want to have their babies at home......midwifery as a service is very different that midwifery as a career option......and not many people are
saying that , but I am not afraid to.

We are the originals....not the copies.....don't forget that.

*note that legal recognition is not the same as being legal. It does NOT mean I think midwives should be illegal.  It means that midwives should be legal by virtue of parents owning the right to give birth anywhere they want with anyone they want.