TROJAN HORSE
by Carla Hartley
Originally published in her Facebook Notes in Dec 2010

I have never for one second understood the rationale of licensing midwives.

What those who are pushing for licensure want, and what they get, will eventually be two very different things.

• They may start out with part of what they want: power and third party reimbursement. But professional equality and respect cannot be legislated and will never happen. So mark that one off the list. The only place midwives will ever work with doctors is under them; CNMs are not considered equals. Why do pushers keep telling me that they will gain respect and work side by side with docs as equals? On what planet? And it will be an easy thing to reduce any power with the creation of licensing boards. And that alluring carrot of third party reimbursement can, in no way, be guaranteed for too long. Many insurance companies are refusing to cover home births attended by any kind of midwife, papered or not. Medicaid won’t be far behind. Why would they pay for something that private sector insurance won’t cover?

• You can try to sell it to congress as something good for women, but it has to be repackaged and that is a whole “nother” rant.

• It is also a fallacy that licensing of midwives will create greater access for women to midwifery care. It will NOT create greater access to authentic midwifery care. It will create a new profession, because authentic midwifery is antithesis to government control. Authentic midwifery serves only the mother, with no one in between. In the long run it will not benefit poor women, many of whom WOULD NOT HAVE CHOSEN HOME BIRTH. It actually holds potential to force poor women into home birth who would rather birth in the hospital. That is not the way to promote midwifery.

• And along those lines, do you really trust the government to make the best decisions for your family about anything? Do you want them controlling the most intimate and feminine of all biological functions from a desk somewhere? It will create a lot of red tape. Don’t we have enough of that? Eventually this licensing idea will go the way of all other things controlled by any government. How long until woman may not choose their own licensed midwives but rather they will be assigned by zip code. The number of women who “qualify” for a home birth with a midwife will decrease, even faster than it already is.

How much more obvious could it be that licensure is a disaster in the making?

• Most CPMs aren’t too concerned about their future in all this pushing because they are “in”, right? Well, read a little history of the licensing of midwives in the south. That will give you a little less confidence in your safety. And the plan is already afoot to make it far more difficult to attain or maintain a CPM. How many of you who are CPMs today, will welcome a new requirement to maintain your CPM and/or licensure that involves years and years of college? Think you need a Masters Degree to be a good midwife? Well you might have to have one to be an “official” midwife within just a few years.

• The argument often railed at me is that midwifery needs to be like everything else. Really? Is birth like anything else? Should we lump it in with healthcare? (______________ leaving space here for you to think about the success of healthcare in general and what midwifery would look like as a part of that______________) Look at education and social work and related fields where the educational requirements for employment are escalating at a rapid rate. Do you really think that if you ply your way into the government controlled system that CPMs will escape that same kind of structured increase in educational requirements?

ARRRGGGHHHH! All that makes me crazy….

But here is what gives me even more concern:

• If we buy into the idea that midwives need to be regulated or licensed we are saying that midwives are likely to be dangerous and SOMEBODY needs to watch them.

• And then that those without paper need to be eliminated, which is whose objective? Not just the medical community, and the government, BUT The Big Push and others who seek to monopolize midwifery. Those opposed to woman centered birth is not just “them” anymore…..it is a lot of “us.”

• And where, oh where, did we get the idea that licensing and regulation produces better midwives? In fact, from where I sit, it has just the opposite effect. When a credential is the goal, rather than the acquisition of knowledge and wisdom, the credential will replace knowledge and wisdom in significance. I can tell you that this has already happened, just as I knew it would.

• When the issuing organization has the power, rather than the mother, what happens to the mother’s ability to make ANY decisions for her birth or her baby? Mothers own birth. Not NARM nor The Big Push nor any of the organizations who are at this moment speaking on the behalf of all midwives. Their presumption is that they are speaking for all midwives but actually they are only speaking FOR the midwives they have approved. I am guessing that half of them don’t realize what is being pushed on “their behalf.”

• And where are the mothers in this? They are completely left out, though they are held up as the beneficiaries of this fiasco. Yes, I know some are pushing, but they have not likely read the fine print. They think that it is all about legitimizing and freeing midwives. I understand that. But what will happen is that mothers will lose rights and freedoms while midwives gain some and when they lose some. As long as this is about midwives, the power will rest in the hands of the state and not in the hands of the owners: the mothers.

AND THE PUSH FOR LICENSING IS WHOLESALE PROMOTION OF THE LIE THAT BIRTH IS DANGEROUS AND ITS COROLLARY: SOMEBODY OTHER THAN THE MOTHER NEEDS TO BE IN CHARGE!

That is the most lethal aspect of this whole push. Once we hand midwifery over to anyone to regulate and control, we are turning mothers over to someone to regulate and control.

Regulating midwives is, in effect, regulating home birth and regulating mothers.

I may not be able to stop what is happening but I will never have to apologize to my daughters and granddaughters for having been complicit with stripping their birthing rights away.

I see the Trojan Horse for what it is and I am not going anywhere near it.