The community college in Lafayette, Louisiana has been trying to get a direct entry midwifery program off the ground for years. It finally looks like it will take flight this January. How do I feel about this? Well, it is unfortunate that I had to relocate my family 1,000 miles away from our home and separate my husband from me and the girls, but I do not regret it for a minute.
I feel this way because I know some of the potential problems that the school is going to have—one of which is that there is not the volume of births for the students to attend because there aren’t enough midwives or clients. Louisiana has a very small midwives association and no consumer support group. Therefore, few consumers even know that midwives are still around. But this new program will definitely get eyes open, which is good for everyone!
My issue stems from the clinic component of the college—half of all births (assists or observations) need to be in a hospital setting and half of out of hospital births need to be in a clinical, birth center, or public health setting (I have no idea what that might be). Finally, the remaining ¼ births will be in a home setting. Now, don’t get me wrong, I am happy that more midwives will be made, but is this really the most effective mechanism—to require the majority of births be in a hospital setting? Seriously? I must be missing something.
Plus, to make it all the worse, MANA and NARM apparently are supporting this curriculum. HMMMMM. The last time I checked, MANA’s core competencies did not include hospital births. And it isn’t like I think it would be invaluable AT ALL to be in the hospital. I was a doula for 5 years and gained incredible perspective and knowledge from attending births in hospitals; however, hospital births will not be the basis for my education and experience –besides—how will NARM even count these births on the NARM paperwork, unless they are making special concessions for this school? Currently, I believe NARM only allows for 2 hospital births to be part of its requirements. So what are these students going to do with the other 18? And what about the transport rate? It isn’t like Louisiana doesn’t have a high surgical birth rate—oh yes, it is high, one of the highest in the country. Can these student midwives gain valuable experience from a c-section? Well, maybe the first one or two, but again, we are not training surgeons here! We are training home birth midwives! So, why aren’t they training in that setting?
And another bone of contention—a student cannot count more than 10% of total births from out-of-state experience. So, even if that student was to get a rockin’ apprenticeship in Washington, she couldn’t take that experience and apply it to her educational component because that would be too practical, no wouldn’t it? My understanding is that the NARM functions to provide a minimal standard in midwifery skills and competencies — towards creating a national standard. How can a national standard have different qualifications? I feel that if the minimal standards are not being met that it will cheaper my degree and/or my CPM making this whole quest for standardization and respect for it null and void.
My Journey as a Licensed Midwife in Louisiana 