Friday, September 9, 2011

Tempering Extremism in the Natural Birth Community

The online world of natural childbirth is often heavily influenced by extremism. People claiming things like "Birth is safe. Interventions are risky" sometimes leads women to believe that as long as there is minimal intervention in their birth and they listen to their intuition, there will be a good outcome. Worse yet is the belief that a bad outcome occured because the woman didn't "trust birth" enough or the ridiculous logic that anything makes a baby's preventable death okay.

Most people who promote natural childbirth also promote that women educate themselves, but as I have said before, the problem with not knowing is we don't know what we don't know. Many women may think that they are educated about birth when they really aren't. And if you really believe that "birth is safe," then what do you really need to know? The same is true of under-trained women who act as "midwives"--many of them follow this same mentality and are unaware of the information out there that they don't have. To be clear, I do not mean all direct-entry midwives. Some are well educated. Some are not. And having the CPM credential doesn't mean anything. Having a state license may mean something, depending on the individual state's requirements--they range from having a CPM (which, as I understand, at minimum, can be achieved by doing an apprenticeship involving at least 40 births, getting CPR and NRC certified, and passing the NARM exam) and being required to graduate from a three-year program at an accredited midwifery school, attend at least 100 births, and pass the NARM exam (Washington State).

I mentioned the homebirth midwifery laws in Oregon in a previous post. A recent tragedy in Oregon has opened debate about these laws, and many are calling for mandatory licensing. I think that this unfortunate event may be a consequence of extremism--untrained midwives thinking they were qualified enough to attend births and a poor mom who didn't know or believe that looking into their training was important.

There will always be extremists in every movement. The internet, with its power to bring people together, sometimes gives the illusion of normalcy to the extreme. Sometimes it is necessary to push back against the influence of extreme ideas--to nudge the proverbial pendulum back the other way a little. Those who do so will often be accused of being "from the other side" or "causing division." I think voices of reason are essential. I have recently come across a circle of bloggers who fight to temper extremism in natural childbirth and homebirth, and to raise standards for midwifery in the U.S. They promote Certified Nurse Midwives as the optimal caregiver for a homebirth and believe that the Certified Professional Midwife credential should be changed to match the CNM standard of education or be done away with. Amber and Jessie are both former CPM students who have now chosen to pursue CNM education. Deb ("The Sensible Midwife") is a CNM with a homebirth practice. While I may not agree with everything these women have to say, I do believe the natural birth movement needs voices like theirs to help keep it in check.
Temper (verb): to dilute, qualify, or soften by the addition or influence of something else: moderate (


  1. This is SO important. Unfortunately because of the extremes the movement doesn't get taken seriously as a whole. Plus, as you mentioned, it increases the danger for everyone.

  2. Thank you Brittany! It begged to be said.

  3. Wonderful post. Absolutely wonderful and so true on so many levels!

    Excellent job.

    Amber P.

  4. What an excellent post. I have a similar one brewing in my head and want to put my thoughts down as well at some point.

  5. Great info. So sad about the Oregon baby. Makes me extra grateful that I selected my home birth midwives so meticulously.

  6. i love your blog. love. i feel like in a birth world dripping with extremism, ignorance, and women donning rose-colored glasses, you are a sensible, wise voice. thank you.

  7. Great post. I agree wholeheartedly!

  8. Very very well written, thank you. I do think one should consider though...that no amount of education can still make up for the lack of proximity to emergency services when something unexpected happens in birth. Aside from poorly trained midwives, and lack of EFM, thats my biggest problem with homebirth...There often just isn't enough time to get to the hospital. I know my daughter would have died with the totally unexpected cord prolapse, that I had...had we not been right in the hospital. Even then they were literally counting the minutes, seconds, until they had her out. We spent three weeks wondering if she would then be brain damaged (she isn't). I wish more women would choose to have their natural birth in a birthing centre attached to the hospital (as long as it has EFM) rather than at home. Poor training and extremist behaviour are not the only things that can go wrong. Sometimes mother nature is just not on your side, and you need to be in a hospital when that occurs.