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Readers have asked why I stayed in midwifery as long as I did. Now I’ll tell you what happened after I moved from Florida to South Carolina to open a birth center. This is the final section of a three-part series about How I Got In, Why I Stayed, and now: 

How I Got Out

bridgepathWhen I moved to South Carolina, I was very excited to begin my career as a midwife. The midwives I met in SC seemed to be much more like how midwives were supposed to be compared to the bossy, brassy woman who had trained me. They were soft and gentle. They smiled and laughed a lot. They really loved facilitating births in the most natural and beautiful way possible, and I wanted to be just like them.

The elder midwives took me under their wing, teaching me and counseling me. My first year of practice I had several births that did not go very smoothly, but there was no blame. I was a new midwife, but I was doing everything right. They were understanding and supportive. I was doing everything I was supposed to do and following all the laws. Everything was above-board, and nothing at all like the birth center in Miami.

I had moved to the Carolinas with the particular goal of opening a birth center close to Charlotte. I didn’t have any money, but I was determined to find a way to start a birth center anyway. I enlisted three other midwives to partner with me, and together we rallied the natural childbirth community of Greater Charlotte and made it happen. The birth center was beautiful. Women told me that coming to a prenatal visit felt more like coming to a spa than a medical appointment. And women were extremely happy with their birth experiences.

Once in a while, a situation would come up in birth and other midwives would ask me, “Do you have any tricks you learned in school for this?” I would tentatively tell them about what might have been done in my school in such a situation. More often than not, the reaction was, “Well, let’s try it!” They would look to me for instruction on how to do it. At first I was uncomfortable spreading these questionable practices. Some of them were illegal; others fell into a grey area, but I knew the health department would frown if we were to ask, so we never asked. But I figured if these practices were really dangerous, these earthy-birthy midwives would not be willing to try them. I had seen them work, I had seen everyone turn out ok, and I just didn’t think that they would ever hurt anyone. I thought I was helping. I really thought everything I did was OK.

When I started becoming aware of some of the statistics regarding babies dying at nonhospital births, little seeds of doubt were planted. I carefully read stories of babies who died or almost died at home births or in other birth centers, and I made sure that I didn’t make the same mistakes that the midwives in those stories made. I still believed that what we were doing was safe enough to continue doing it, but I doubted that it was as safe as most of my fellow midwives believed. As time went on, I became less and less comfortable. My doubt started looming over me. Haunting me. I kept going, but I was not happy. I started to want out. But how could I just walk out on my clients, my partners, my business? Who was I, if I wasn’t a midwife?

I wrote very briefly in my paper about how my leaving the birth center came about. For legal reasons and reasons of others’ privacy, I won’t be able to go into more detail at this time. Suffice it to say, by the time I managed to get myself kicked out of the birth center, I was a very conflicted person. I wasn’t convinced that my birth center was practicing dangerously. I thought we pretty much had it right. But I couldn’t shake the fear that maybe I was wrong about that, and maybe our luck would run out.

When I found out about the first baby’s death in April 2013, it was only through rumors. I never heard many details. I thought about it a lot and imagined how it might have happened. I hoped that maybe it was unavoidable regardless of where the baby had been born. When the second death occurred in fall of 2013, it made big news. The birth center was shut down temporarily. I read some details in the news and heard other details via rumor. Many months later, lawsuit paperwork arrived in my mailbox, an error because my name was still left on some paperwork. I read every word. It was then that I knew. I knew that what I had been doing all along was not OK. I knew that my birth center was part of a beautiful lie.

It took me a little longer to completely give up wanting to stay in midwifery. I thought, maybe if I practice really, really carefully, and transport to the hospital the moment I see a problem, maybe I can pull this off safely. But eventually it all became clear: the only true way out of this was to throw gasoline all over the lies and light them ablaze for all the world to see.

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How I Got Out

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7 thoughts on “How I Got Out

  1. Thank you for sharing your experiences. It’s hard to be truly honest with ourselves most of the time. To look past the surface feelings and dig into the true motive behind our decisions is difficult. I’m glad you followed your intuition and was honest with your confliction.

  2. Thank you for your blog. A lot of what you write resonates with me. I am trying to figure a way out. I struggle with not knowing what else I would do. I am angry that I spent 6 years becoming a CPM and only now realize what a sham it is – both for parents and practitioners. There is nothing to fall back on, nothing else to show for my 20s, basically. I do feel like my partner and I are the sanest and safest homebirth midwives in my city, I don’t want my clients to go to other homebirth providers! I will keep reading and re-reading your blog. Thank you.

    1. So much of what you are saying sounds so familiar. You are where I was for a long while. I thought I ought to stay in to try to keep an eye on things, make things better, give people an alternative to the “truly dangerous” midwives that I didn’t want them to resort to. I had to learn the hard way that as careful as I was trying to be, I was still putting people in danger. I was still empowering them to make dangerous decisions. I was still participating in the deception even as I strived to be honest.

      I understand the frustration of feeling like you wasted years of your life and that holding you back. I think a lot of women stay in bad relationships for the same reason. Reading Mistakes Were Made (But Not By Me) by Carol Tavris and Elliot Aronson helped me with a lot of my errant thinking. Finding an alternate passion (for me, it was going back to school for psychology) is probably going to be an important step for you. I was very privileged to be able to survive financially without my midwifery income; I don’t know how to advise others to navigate that. You have all the skills necessary to be a really awesome hospital-birth doula; perhaps that could help bridge the gap while you find a new path.

      Thank you for writing. The truth is going to set you free. I hope that you are lucky, like I was, and get out before statistics catch up with you.

  3. I guess in a nutshell it all boils down to this, quoting your article:

    “At first I was uncomfortable spreading these questionable practices. Some of them were illegal; others fell into a grey area, but I knew the health department would frown if we were to ask, so we never asked.”

    Above all else, it is imperative that midwives function within the law they are working under. And in states where midwifery care is still considered ‘alegal’, midwives should voluntarily follow a comprehensive midwifery law from a state near them.

    Midwives overall are hired to guide and guard the normal process of pregnancy, labor and delivery. Having a warm, fuzzy birth is secondary to that.

    We live in a time where women’s pelvises are becoming less able to birth naturally for reasons still not illuminated. We have to expect not only a higher transport rate than yesteryear, but a higher cesarean section rate as well. Midwives who cling to past ideals of <5% c section rates at all costs are living in lala land, and are at higher risk for being sued, if they do not follow the midwifery laws impeccably.

    Even though birth is becoming higher risk, women should still have the choice to birth where they want to (if they present as low-risk, and stay low-risk during pregnancy and labor), and have the midwifery model of care given to them.

    The days of the vigilante midwife are over.

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