Because I Love Her | The Need for Change in Homebirth Care

27 Apr

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Lately, I’ve been spending a lot of time researching  homebirth and the midwifery model of care in the United States. I’ve discovered we’ve got some maturing to do. I feel that the natural childbirth movement is having some major growing pains.  We have been failing our mothers, and the excellent midwives who give homebirth a good name, because we’re allowing negligent midwives to practice (and teach us)!

Did you know that we don’t have a national and or reliable way of weeding out bad midwives?  Did you know that there are midwives who have lost babies at birth due to their own negligence and these midwives are still practicing? Did you know that there are loss mothers who have raised their voice at the injustice of their newborns’ death, and the mothers are the ones being shunned, not the midwives – whose negligent care caused the death of their babies?

I could cry, in fact I have cried.  I feel so deeply grieved by this. I love homebirth. I love the midwifery model of care, but I’m beginning to feel that we’re valuing the message and the look of homebirth more than the desire and effort it will take to see it blossom and grow into something strong, healthy, and stable.

We cannot ignore our need to change. As any healthy relationship moves forward in growth, there are times when we have to acknowledge our failings to each other – with love and care, so that the fruit of the relationship stays sweet. It’s time, birth lovers, it is imperatively… time.

20 Responses to “Because I Love Her | The Need for Change in Homebirth Care”

  1. sarahdipitousmotherhood April 27, 2012 at 11:25 pm #

    As usual, you have an intimate insight and a compassionate touch that stir something deep within me. The birthing world is lucky to have a woman like you.

    • Joy April 29, 2012 at 10:15 pm #

      Thank you, Sarah.

  2. Lisa April 28, 2012 at 6:57 pm #


  3. Sara Snyder April 28, 2012 at 7:09 pm #

    As a loss mom who has received a great deal of backlash for speaking out about the truth, and the very negligent circumstances that led to our son’s death last year, I thank you for recognizing the need for change. I’m so grateful that slowly, NCB supporters are starting to see that we aren’t out to end midwifery or take away anyone’s choice…the point is making those choices safer and ethical. The first step is recognition and then we move forward together. Sending sincere gratitude to you for writing and sharing this.

    • Adrienne Mullinax April 28, 2012 at 7:40 pm #

      i concur with sara. i, too, lost my first born child through the negligence of midwives. i have ncb friends who say that my experience does not represent midwifery care on the whole, and my speaking out will only stifle women’s choices in the future. however, with midwifery and homebirth on the rise, something must be done to prevent further damage to babies and families. no family should have to go through what ours did. this is a public safety issue, not a right to choose issue. i would love to see safe midwifery thrive. that means more education, accountability, transparency, etc. safer midwifery hurts no one.

      thank you, joy, for your understanding in this matter. loss families truly appreciate a voice advocating for them from inside the midwifery/homebirth realm.

      • Joy April 29, 2012 at 10:14 pm #

        Sending you care, Adrienne. Thank you for sharing and commenting. I hope that we can all begin to embrace our loss moms and their stories with sensitivity and compassion. Shutting out your perspective and voice on homebirth really only furthers us from making midwifery care stronger and better.

    • Joy April 28, 2012 at 7:45 pm #

      I’m very sorry for the loss of your child, Sara. I’m sending you all the care and love I can. Thank you for speaking up and sharing your story. I hate to hear that you’ve experienced backlash – especially in such a tender and raw time in your life. Please know that I stand beside you and other loss moms. I will do what I can to share your stories and to work for change. I love homebirth, I love midwifery care, but we must acknowledge our need for greater accountability and excellence in this community of care.

  4. Tara Dukaczewicz April 28, 2012 at 8:39 pm #

    Thank you so much for this post, we don’t ask for midwifery to change for the better because we hate midwives, but because we want to see them shine. And we want our mamas and babies to be safe. The death of a baby or mother hurts all our hearts.

    • Joy April 29, 2012 at 10:03 pm #

      Well said, Tara!

  5. Gray April 28, 2012 at 9:15 pm #

    I think you might get some good ideas about models for a more integrated and accountable midwifery model from “Mainstreaming Midwifery” or some of the other writings by Robbie Davis-Floyd. Part of the issue is the lack of a national body with review procedures for all midwives–which won’t happen until at least 1) all cpms are legal in all states and 2) until the considerable differences between cnm and cpm model of care is addressed.

    • Joy April 29, 2012 at 9:50 pm #

      Thanks for your thoughts, Gray. I always like hearing from you!

  6. Lisa W. April 30, 2012 at 12:34 pm #

    Thank you so much for giving a voice to those of us have seen the ugly side of a beautiful thing.

  7. JS April 30, 2012 at 1:08 pm #

    Wow, it is sad to hear that families have said good bye to such little ones. But I must beg to bring up that statistically during birth more children depart in hospitals than in the bedroom.(And I birthed all of my children in a hospital at the final stage – I am not biased to home birth) Also, public health is everyone’s concern and it isn’t something that is majorly neglected. Public health is in relation to everything that we do, and we would all be dead if our minds were not on it. At, least here in the US that is the case. I know when something tragic happens blame, saddness and other negative things do occur. But… lets not become stubborn because we are grieving (even though grieving is long and painful something I have experienced!). I hope you all will have a blessed time here on earth. But narrowed mindness and rash exageration do not help the human race to evolve it stifles us all, and keeps us back. Lets remember that we all do our best and we are not in control of fate.

    • Joy April 30, 2012 at 1:35 pm #

      I’m certainly not becoming stubborn, and if you’re speaking to loss mothers about their grief, I beg of you to step away from critiquing what is an appropriate way to grieve the loss of your fresh, tiny, fragile newborn life. I will not put rules on the way a woman grieves the loss of her child.

      All too often the rebuttal of “death occurs in hospitals, too” is spoken. But we must evaluate the reality that the average city hospital takes in thousands of patients a year. Many of them high risk. City hospitals will especially have moms that haven’t received prenatal care at all. On the contrary, when a midwife oversee a homebirth – it should be a normal, low-risk pregnancy. Also, if a homebirth midwives takes around 4 births a month, we must consider those stats when we look at the loss of a child’s life in homebirth care in comparison to a hospital. That is why, for instance, if a midwife or birth center has lost three babies in less than five years (due to preventable causes) it is TRULY ALARMING! And should make all of us seek out answers beyond the response of “hospitals lose babies, too.” I feel that response is disrespectful to the mothers who have lost their very own flesh and blood (and the hope and promise that new life brings) at the hands of negligent care.

      Enough is enough! We must stop being defensive. Let’s allow repentant sorrow to wash over our hearts and begin to seek a deeper answer other than “death happens.”

      I want homebirth to be better. I believe in order to live in the light, one must walk in the light. By embracing our failings, we can acknowledge our need for growth and change. These incidences of negligence should not make us defensive over homebirth, but rather should PROVOKE us to seek better standards of excellence in midwifery care.

  8. Sara April 30, 2012 at 4:19 pm #

    Hmm…but I believe the concern is who is doing the overseeing? If it is insurance companies, hospital admin or docs, or cnms then that is a huge problem for the great model of care used by competent, professional, lay midwives. My concern would be seeing the good birth centers and homebirth midwives being put out of business.

    • Lila April 30, 2012 at 7:00 pm #

      This. I know that there are midwives who are practicing on the fringe and doing things that are not very safe. We need to find a way to teach, and to find a way to communicate acceptable standards among midwives. The problem is no one else is doing what midwives do. Doctors are only so helpful because their training is *so* different. There are things they need to move quicker on because they don’t have the time to sit with one patient to see if things improve (slow labors for example). And insurance companies… well they never have health as their highest priority…

    • Joy April 30, 2012 at 7:44 pm #

      I think we have to weigh the risk/benefit of this. Insurance offers protection for the midwife as well, something we tend to forget. If something dire were to happen – legal fees are covered, etc. Also it’s protection (and respect) for the patients you care for.

      I don’t believe that insurance will put midwives out of business. I know plenty of birth centers and midwives that have insurance – and they are BOOMING.

      Personally, I feel the arguments against a midwife not having insurance are weak. Especially regarding the idea that insurance companies will take away a midwife’s right to practice as she sees fit. You see, based on what I’ve discovered, I’m beginning to think midwives need accountability in this area – we are stretching the “variation of normal” too far. I also think regulations are good especially for those midwives that work alone – without any peer accountability. Frankly, it’s is nothing new to work under the umbrella of regulations – that’s just life. Good rules keep all of us safe.

      I feel it is reckless and fool hardy to provide medical care to women without this safety net. I would never see an OB that didn’t offer this coverage. And while midwives are set as an example of better care than OBs – this is one area that is truly lacking. To assume that you’ll never encounter a need for insurance is to assume you’re infallible in your practice.

      If a midwife doesn’t want insurance because she feels it won’t allow her to attend certain types of deliveries then I would hazard to guess that midwife is already working outside the scope of what is considered low-risk birth.

      (just my two cents)

      • Mindy Wolfe April 30, 2012 at 11:00 pm #

        I just found your blog and have to say I couldn’t possibly agree more. And you have a uniquely elegant way of expressing your thoughts that I appreciate.
        Thank you,

      • Joy May 1, 2012 at 7:12 pm #

        Thank you, Mindy. I’ve just recently discovered your blog too!


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