I remember being totally sold on using a midwife for my birth. A direct entry midwive, specifically. They are very eager to tell you about how they are different from the hospital and other health care providers (in terms of philosophy, not safety- they claim they are just as safe). There are some differences that they never alerted me to that I believe all pregnant women should be made aware of.
What midwives won’t tell you is that they do not want to be accountable for mistakes, and that they regard any attempt at making midwives accountable as ‘persecution‘. They only want their own midwife-run organizations to be in charge of accountability, mainly so that there will be no harsh consequences. Midwives with clearly dangerous practices can simply move from place to place, preying on vulnerable women who would otherwise never be candidates for a home birth. MANA (midwives association of north america) isn’t even willing to define what “low risk” means, they prefer to let individual midwives decide what that means. Why would individual midwives be better at deciding ‘low risk’ than a panel of experts (even other midwives), based on proper research?
This maverick do-whatever-you-want type of practicing was the norm in medicine for a long time. This documentary is about that era in medicine, specifically about a doctor who was performing hundreds of ethically questionable lobotomies in the 1940s. One patient died because he wasn’t paying attention to what he was doing, he was trying to pose for a picture during the lobotomy. He invented an ice pick technique to simplify the surgery (you can guess that there were no controlled trials in the development of the technique, and that results were mixed). In those days doctors did not publicly discuss negligence with non-doctors and there were not any real consequences for malpractice. Luckily, outside organizations and legislators got involved to hold physicians accountable for the outcome of their practices. Midwifery today is in the era of 1940’s physician accountability: the public has to fight for it, because midwives are unwilling to regulate themselves.
When professional colleagues work together there is a natural tendency to feel loyalty and assume good faith. I understand that, completely. No situation illustrates the tendency of professional colleagues to excuse the inexcusable more than sexual abuse scandals. The catholic church (and countless other religious groups). Jerry Sandusky (and other educational facilities). Teachers and doctors are often defended by colleagues when accused of abuse. And yes, midwives, too. The dynamic can happen in groups as small as individual families, with one parent ignoring the sexual abuse of their child by another family member. This is why outside accountability needs to exist in professional organizations.
If you need more evidence of midwives banding together when they should be condemning negligence, just look for what midwives have to say about it:
The reality is that if Rowan Bailey is found guilty of murder in North Carolina, then a precedent will be set that a death in a midwife attended birth was found to be WILLFUL murder of a baby.
Don’t talk to me about “But she wasn’t legal” because we all know that midwives hedge their bets on legal. They all do some small thing that is maybe crossing a line or helping someone they shouldn’t “legally” because frankly, the legal system is full of discrimination against healthy women and we all know it.
She is saying that all midwives break the law. They all determine their own guidelines and if they kill a baby or a mother because of the line they decided to cross- oh well. The midwifery community will be there to support the midwife instead of the patient with a dead infant.
For the record, the midwife in question let a woman labor for four days without obtaining any help. Gloria Lemay had this to say:
Shannon, thanks for this important post. I’m always reminded of the words by Angela Davis, “If they come for you in the morning, they’ll be back for me in the afternoon.” We’re all in this together. If one midwife is being bullied, all midwives are being bullied. The bright light of overblown charges is that, of course, they will be reduced. The tragic thing is that it’s akin to taking a baseball bat to a butterfly.
Please everyone, no matter how small, donate as a show of solidarity.
Everyone seems to be ignoring that a baby is dead, and their parents are very much alive and still dealing with the loss caused by negligence. They forget pregnant women completely when their colleagues are threatened with legal action. When the state is (understandably) angry about a needless death it is “bullying” to use the harshest possible charge against the midwife. What will a midwife call it if you have to pick up a phone and report her?
In defense of midwifery compels people to give money to the legal defense of the clearly negligent midwife. Midwives talk very differently on websites intended only for other midwives. The author has a warning that when YOU (a midwife) attend a perinatal death you don’t want a DA breathing down your neck, right? I mean, unless you have a sense of ethical responsibility and believe perinatal deaths should be investigated! This is what midwives do when there is negligence- they help each other pay their legal fees, and prioritize each other over patients.
Valerie ElHalta is one of the worst cases I’ve ever seen. When she caused death or injury and the state found out, she simply moved to a state with fewer regulations. She went to oregon, and then to Utah, where she used cytotec and a vaccuum extractor without adequate training. A preventable infant death occurred as a result. The midwifery community did nothing to stop her or warn other people that she had a history of poor judgment. When she was arrested in Utah the community here decided it was persecution, and that a political watchdog committee needed to be formed.
Midwives will talk your ear off about woman centered care, about respecting choice, and whatever you want to hear… but they won’t tell you that if someone hurts you or your child they will be donating money and time to help the person who wronged you. Its perverse. I am lucky to have ended up on the wrong side of Direct Entry Midwives with my baby alive, but it doesn’t make seeing the defense of needless suffering and death any less infuriating to me.