Earlier this year, a former CPM midwife spoke out. She started a new blog called
"Honest Midwife" to pull back the curtain and expose some of the unethical and illegal practices of the CPM world.
Her
name is Leigh Fransen, and she attended a midwifery school accredited
by the state of Florida. After graduating she moved to South Carolina
and started a successful freestanding birth center in partnership with
three other midwives. She left the practice in 2013. After she left, the
birth center had three deaths
within two years. She
wrote of the experience:
"As
I drove home, I gripped the steering wheel tightly, my heart racing in
my chest. I GOT OUT. It was messy and confusing and ugly, but I was out
of there for good. I was relieved, but I wasn’t ready to be honest with
the world about why."
"That was January 2013. In April
2013, I heard the first rumors of a baby’s death soon after her birth at
the center. In September 2013, news of a second death was splashed
across local newspapers. And in January 2015, a third death was
reported. My thoughts and emotions ran rampant. One moment, I would
arrogantly congratulate myself: No deaths on my watch, and three on
theirs, who’s the best midwife now? Another moment, I would wonder at my
favored status in the universe, that God had spared me from all the
horror, and just in time. And in my most honest moments, I knew the
truth of it: I had gotten incredibly, ridiculously lucky. And those
three mothers who sat at home with empty arms, they simply had not."
Her full account is breathtaking, and I encourage you to read it in its entirety.
In her account,
she describes finally "doing her research" after years of telling parents that home birth was safe.
"I began in familiar territory, the website of the Midwives Alliance
of North America (MANA.org). On this site there is a button titled
“Research,” and it leads to an extensive collection of the studies that
MANA has determined builds the case that nonhospital birth with a
midwife is safe...I spent the next several hours using my
university library (and helpful librarians) to track down every one of
these 24 studies and print them out, filling a large 3-ring binder with
my efforts."
"Shades of guilt danced in the back of my head: shouldn’t I have done
this years ago? Perhaps before I decided to actually give birth to my
own child in a bathtub in a residential neighborhood in Miami? Possibly
during my years as a student of midwifery? Maybe before I had assured
scores of women that “research showed” giving birth at my birth center
was as safe as any hospital? I cleared my head to focus on the task at
hand. The research was all here in front of me now. I sat down with my
giant binder of studies, a cup of coffee, and a handful of pens and
highlighters. I had a long day ahead of me. I began at the beginning of
MANA’s list."
She writes about reading each study, one by one, and again, I highly encourage you to read her analysis. What did she find?
"The
hours I had spent combing over all of MANA’s best evidence led me to
this conclusion: nonhospital birth might be as safe as hospital birth,
but likely only in health systems in which midwives are hospital-trained
and well-integrated, and where exclusion criteria are strictly observed
to permit only the lowest risk women to proceed. Nonhospital birth in
the United States as currently practiced is responsible for lower
numbers of interventions (such as cesarean section and medical pain
relief) but a substantially higher risk of death or injury to the baby."
"
Unbelievably, our 'own' evidence, upon close inspection, was almost unanimously against us."
As
damning as this is, it is not the worst thing that Leigh Fransen
reveals in her account of CPM midwives. The most stunning indictment of
CPMs comes as Leigh describes her first-hand experiences at her
midwifery school and in the field as a fully-practicing CPM:
"When,
as a student midwife, I first participated in nonhospital births, I
witnessed some things that made me uncomfortable. At my school, the head
midwife would sometimes do illegal vacuum-assisted deliveries. The
first time I saw one done I didn’t realize it was illegal, but when I
started talking about it freely, I was quickly quieted by the more
senior students. “We call it ‘the fruit,’” they said, a reference to the
vacuum’s brand name, Kiwi.
I rationalized that these other students
and midwives would not be using “the fruit” if it was really harmful, so
the law must be an unnecessary one. Soon, I was recruited to help
usher family members out of the room “so the mother can rest,” as a
cover for the vacuum use; I would then lock the door and stand guard. If
I was instructed to cover the mother’s face with a cold washcloth “to
help her relax,” I made sure her eyes were covered so not even she could
see the vacuum being applied. I rationalized that surely she would have
given us permission to do this to help her get her baby out without
transporting, but that it wasn’t smart to ask permission to perform an
illegal procedure. Toward the end of my apprenticeship, I was the one
holding the vacuum, applying it to the baby’s head, exerting the
carefully angled pressure to help pull the baby down. I rationalized
that now I would know how to get a baby out, if I were ever in a
situation where there were no available hospitals."
"I
did not originally plan to attend a school where I would learn to
perform dangerous, illegal procedures; I became complicit through a
chain reaction of participation and justification.
"The fruit" was
only one of many "exceptions" I learned to make; many of these
exceptions I carried with me to my later practice. Illicit use of
medications, cavalier usage of toxic herbs, induction techniques,
pretending not to see a cesarean scar, fudging dates, doctoring charts,
“accidental” breech deliveries, cheating blood pressure readings, lying
to doctors, ignoring borderline test results, pretending to know answers
while furtively Googling, waiting just a little bit longer for baby’s
heart tones to improve, purposely underestimating the staining of
amniotic fluid, misrepresenting our personal statistics and the
statistical realities of our “profession”… all of these practices are
endemic to direct-entry midwifery in the United States. I know
because I did most of them. I was present (and silent) as others did
them. I heard the stories in “peer review.” Not every midwife does all
of them; very, very few, if any, do none. It all starts with one small
step, and we justify along the way, until we are lost in the woods with
no moral compass left to guide us."
To read Leigh Fransen's full account, click here:
High Risk: Truth, Lies, and Birth
To read Leigh's account in blog form, click here:
Honest Midwife
.
