Licensure
On a list I'm on we're discussing the pros and cons of licensing midwives. In my state there is currently legislation in the house to require all midwives to be CPM's. The "rules" that it has laid out currently aren't too bad, but it gives power to the health department. Anyway I don't want to pick apart my current states legislation... I want to talk about legislation in general.
I don't honestly see too many pros. In fact that one that keeps getting brought up is that parents then know that their care provider is practicing within certain parameters and she's achieved certain standards in her education. My thoughts is "why is it the states responsibility to do this research for parents?" As a parent isn't it my job to research care providers? Find out their credentials, seek out references, and if there is a local group (not a governing body but a peer review group) be sure they are in good standing with that group. Isn't it my job to make sure that I am getting the care I need. Why does so many people think it's the states responsibility? Whatever happened to personal responsibility? Okay this rant is going in a different direction so let's try to get back on topic.
Cons to licensure... there are many! One midwife posted that she believed in the state of Florida a midwife can not assist a woman with a hemoglobin below 9. Now I understand the thinking behind this, there is some thought that a low hemoglobin increases your chance of hemorrhage. BUT! what about women like me who barely are 9 when they're not pregnant! I generally deliver around 7 and where as I've had slightly heavier bleeds certainly not anything that should prevent me from a homebirth because this is MY range of normal. Now some midwives wouldn't be comfortable assisting me and that's okay, but many wouldn't mind especially when looking at my history. Licensure takes away the right of the woman to choose to take that risk and the right of the midwife to choose to take that risk. Now the state has determined that neither the midwife nor the woman are capable of determining what is an acceptable risk. And that my friends is my biggest issue with licensure, that the state takes away a mother's right to self determine care and a midwife's abilitly to practice in a way she is comfortable with.
I don't honestly see too many pros. In fact that one that keeps getting brought up is that parents then know that their care provider is practicing within certain parameters and she's achieved certain standards in her education. My thoughts is "why is it the states responsibility to do this research for parents?" As a parent isn't it my job to research care providers? Find out their credentials, seek out references, and if there is a local group (not a governing body but a peer review group) be sure they are in good standing with that group. Isn't it my job to make sure that I am getting the care I need. Why does so many people think it's the states responsibility? Whatever happened to personal responsibility? Okay this rant is going in a different direction so let's try to get back on topic.
Cons to licensure... there are many! One midwife posted that she believed in the state of Florida a midwife can not assist a woman with a hemoglobin below 9. Now I understand the thinking behind this, there is some thought that a low hemoglobin increases your chance of hemorrhage. BUT! what about women like me who barely are 9 when they're not pregnant! I generally deliver around 7 and where as I've had slightly heavier bleeds certainly not anything that should prevent me from a homebirth because this is MY range of normal. Now some midwives wouldn't be comfortable assisting me and that's okay, but many wouldn't mind especially when looking at my history. Licensure takes away the right of the woman to choose to take that risk and the right of the midwife to choose to take that risk. Now the state has determined that neither the midwife nor the woman are capable of determining what is an acceptable risk. And that my friends is my biggest issue with licensure, that the state takes away a mother's right to self determine care and a midwife's abilitly to practice in a way she is comfortable with.
Labels: midwifery
posted by Babylady at 12:16 PM
1 Comments:
i live in a state where licensure is voluntary. this, in my opinion, is the only way licensure works not only for midwives but for families.
i chose to become licensed in order to receive state medicaid insurance to cover my services and other third party reimbursement.
it's hard to consider going from no licensure to mandatory. i can't imagine.
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