Wednesday, August 17, 2011

Amber Plyler- Paying For Perfection

Guest post from Amber P, or Midwife{ology}. << You know you wanna click the link!!

Paying for Perfection

As I began the transition from pursing midwifery as a Certified Professional Midwife to a Certified Nurse Midwife, I anticipated many of my friends would not agree with me regarding my new stance and would perhaps not quite understand why I was choosing a different path.  However, there is no way I could have anticipated the fury that would be unleashed when the announcement of my new path was given.

Instead of my friends finding out through hear-say, or through things they see on Facebook or on my blog, I decided to make a blog post devoted to announcing my new path.  I felt this would be best so that I would not have to explain my decision to everyone individually, and instead, I could direct them to my blog and they could read my innermost thoughts and feelings on this change.  Slowly, one by one, my friends read my blog and commented both there and on Facebook. Some were supportive and encouraged me in my new journey, and many were very excited to see that I had changed my path and realized some of the things I had once thought were true and good, really were not.  Unfortunately, many were not in agreement with me and there were several who were outraged. 

Another massive uproar happened when I joined a Facebook group entitled “Fed Up With Natural Childbirth”.  The group was actually created by Dr Amy of “The Skeptical OB” blog, and is basically devoted to dispelling the myths of what I refer to as the Natural Childbirth Movement (NCB Movement).  Many are turned off by Dr. Amy because of her straightforward speech and curt, sometimes callous attitude.  I will admit, Dr. Amy seems overly harsh sometimes to mother’s who have lost their babies due to negligent CPMs/homebirth.  I feel like she tends to place much, if not most, of the blame on the parent’s for choosing that particular care provider and/or homebirth.  She also seems very anti-homebirth, even with a care provider who is competent such as a CNM.  Like most anything, you must weed the bad out while focusing on the good.  Dr. Amy makes very valid points and gives wonderful, science based information and facts.  While she does tend to be harsh sometimes, I firmly believe she has the best interest of mother’s, babies, and safe childbirth at heart.  The group “Fed Up With Natural Childbirth” is not at all about hating normal, natural childbirth!  It is simply a group of women that agree you don’t have to cloth diaper, homeschool, have a medication-free birth, have a vaginal delivery or even breastfeed to be a great mom!  We also believe you can have an epidural, birth at a hospital, or even have a cesarean section and still be a wonderful, loving mother! What we don’t like about the NCB movement/community is that so often women are put down and cast out simply because they gave birth somewhere other than their home, or had an epidural or IV pain medication, or even needed a cesarean section.  Many NCB advocates seem to think that any mother who had any of these interventions is somehow less of a mother or isn’t a “birth warrior”.  “Fed Up With Natural Childbirth” is a place where women who don’t fit the mold of the NCB movement can come and feel supported in their choices and in their experiences.  The main goal of the group, is to dispel the myths that so many NCB advocates, doulas, traditional midwives (CPMS and DEMs), and others spread.  So many lies are being told and it is ultimately killing mothers and babies.   Quite a few women in the group have lost babies to negligent homebirth midwives and now rally against them and for the cause of safer maternity care for all women.   The name is misleading unfortunately, as many of the members have had natural hospital births, and some homebirths!  Sadly however, several of my friends could not get past the fact that I had joined a group entitled “Fed Up With Natural Childbirth”, no matter how much I tried to explain to them that they needed to look past the name and look at what the group is really about.

Another issue that many of my friends disagreed with me over is my stance on traditional midwives (CPMs and DEMs).   I’m a firm believer that traditional midwives need much more education, mandatory licensing, a nationwide set of practice standards, must be required to carry malpractice insurance, and have strict penalties for not adhering to these regulations.  I also believe if a midwife practices without any of the above requirements there should be strict penalties including fines, loss of license, and prohibition of practice.  If these requirements are not satisfied, I do not think traditional midwives should be legal.  There simply must be a nation-wide standard each and every midwife must conform to.  Unfortunately, many of my friends did not agree.  They felt as if this would infringe upon the rights of a woman to choose where and with whom she gives birth.  I believe in a woman’s choice as well, however we must make the choices safe, and as it stands now, birth with a traditional midwife is not safe.   I typically do not like to make blanket judgments or statements, but in this case, it is something that must be done since there is no real way to judge the good apples from the bad apples when it comes to midwifery.  I have many friends who choose to birth with a traditional midwife at either home or a birth center, and they were deeply offended by my feelings on traditional midwives even though I try my hardest to not be offensive and strictly speak fact.  Even though I don’t agree with their choice in care provider, I respect their feelings and decisions, and I wish I could say they did the same for me.

Ultimately, my decision changed quite a few friendships.  After many arguments and disagreements, after being called many names and being accused of just trying to be better than everyone, being told I was just a midwife hater and homebirth hater, and after being told I simply go with whatever choice gets me the most attention - I lost 29 friends from my Facebook friend’s list.  Many of those were simply acquaintances, some were great friends, and a few of them were people very near and dear to my heart that I never expected to turn on me like they did.  I’ve been called names, told I was wishy-washy, told I was acting like a defensive child, and talked about openly on message boards and other Facebook pages.  I was even told by one that I was no longer welcome to our local playgroup because of the thoughts I had shared.  I did expect some backlash when all of my feelings came to light, but I could have never prepared myself for the hateful words I received.

The way I was treated by so many reminded me of the way many NCB advocates treat mothers who do not fit into their perfect mold or mesh with all of their ideologies.  I define the advocates in the NCB movement to be those who feel any woman who doesn’t birth at home, has pain medication or an epidural, is induced, has a cesarean section to be inferior, or somehow less of  a woman.  I personally have had an induction due to HELLP Syndrome, an epidural, and ultimately a cesarean, as well as an induction due to preeclampsia, no epidural but one dose of Nubain, and a VBAC.  I was ostracized by several because I called my VBAC a “natural birth”.  For me, I simply meant vaginal, but was called out numerous times and belittled for allowing them to induce me even though it was medically necessary, and attempts were made to make me feel like less of a woman for having a dose of pain medication to help me cope around 8cm.   I caught flak from others because I gave my son the “evil” Vitamin K injection because he had a severe cephalahematoma  due to birth trauma.   I have sat back and watched women hen-peck others on Facebook groups and message boards because they had cesarean sections, or decided to have pain medication, had continuous fetal monitoring during labor, had their membranes ruptured artificially, or decided to have their baby receive the Vitamin K injection or Hepatitis B injection at birth.  The NCB community seeks out women to prey upon and criticize in order to make themselves look and feel better and seem superior to another.  There is simply no need for all of the hateful words, looks of disgust, and shameful glances given to mothers just because of the way their precious baby came into this world, and there is absolutely no need for the hateful words I received simply because I chose a path where I can serve a large number of women and their precious babies safely and fight against a broken system that is continuously allowing traditional midwives to kill innocent babies.

Ultimately, I have learned so much during this transitional point in my life.   I have learned much more about myself over the past few months than I have in the past few years!  My goals and ideas are growing stronger day by day and my realization of how broken our maternity system is becoming clearer.   Just as the NCB advocates forsake those who do not fit their perfect birth or motherhood mold, many of my friends have forsaken me due to the fact that I am seeking to better myself and better our nation’s maternity system so that more women have access so safe, competent, and personal maternity care.   At first, it bothered me that so many seemed to truly hate me for my choices.  However, I stepped back and allowed myself to think with my heart instead of my head and realized that as long as I know I’m making the right choices and trying to better myself, that is all that matters.  Along the way, I have realized that I do have some amazing friends who have stuck by me through this change – even one’s who do not agree with me, but respect me just as I respect them!  I have also found a great circle of women who are all fighting for the same thing I am.   I intend to continue growing, learning, and discovering more about myself.  I hope to be a key component in either abolishing the title of CPM/DEM, or making it so that they are more on par with the CNM credential so that no more mothers and babies have to suffer at the hand of a negligent traditional midwife.

10 comments:

Anonymous said...

Stay strong, Amber! One day, the haters will have to thank you because your efforts will make the world safer for them and their children. Even if they never thank you directly, or even if they never apologize, you can rest easy in the knowledge that you're doing the right thing.

Areawoman said...

Amber, I'm so sorry you've had to go through this! I guess it just goes to show you who your real friends are -- a real friend isn't going to push you out of her life because you decided to get a different kind of schooling. I applaud your strength and tenacity in dealing with your detractors. Keep up the good work!

Elizabeth said...

I applaude that you did more research and are championing the facts regarding DEMs and CPMs so women can make more informed choices. You know I used CNMs and loved them. However, I don't think it is fair to lump all this negativity into the NBM. I consider myself a natural birth advocate and I, much like you are trying to inform people about CPMs and DEMs, try to inform other women that they may have other options besides the convential birthing on your back, OB, in the hospital route. Now I always told everyone I used CNMs and they would have to do their own research if they wanted to go a different path, but I did tell them to research. Then research some more, they have choices in birth more often than not and they should be informed whether bithing in a hospital, a birth center, or at home. That being said I also never judge another mother. If she has a VBAC, pain meds, whatever - birth is a very personal path and ultimately she did what she needed to do at the time. It makes me very uncomfortable that the rotten tomatoes of the NBM are making the rest of us look bad. Hell if a woman can't breastfeed I would never judge her either, we need to support each other being a Mom is hard enough! At the same time I love talking natural birth, breastfeeding, cloth diapering - oh yeah and I work full time in corporate America and am finishing my MBA. I understand we do what we have to to make it work. Please don't typecase everyone into this quagmire of uglyness a few people have painted. The NBM should be about informing mothers of fact based research and encouraging them to do their own and make the decision that is best for their families. I don't want to see you alienate those that are NBM supporters who also support you due to generalizations. I also can't support the "fed up with natural birth" group. I realize the point but the name is not tasteful to be taken seriously if research and education is truly the point of the group.

Lyndsay said...

Your writing is so inspiring and I commend your deep commitment to mothers and babies. You really show your depth of character to stand up for what you believe in- I can't think of any better qualities in a CNM.

Earthmomma3 said...

You are on a journey and a journey can lead us on many different paths. You are learning new things as you go. We all may get on that "soap box" sometimes and it's okay to jump down and come together as women and work for the common goal. Safe birth and the vision the mother has for her birth. We are not here to judge anyone for their choices. I think you are amazing and I admire your spunk! Keep strong and friends that drop you, were never really friends at all!

moto_librarian said...

This is a beautiful post, Amber. I have seen some of the vitriol directed at you by those who were supposed to be your "friends," and it made me sad for you, but more so for them. You are choosing the educational pathway that creates a superior midwife, and it is a shame that there are so many people who claim that you are turning your back on midwifery. CNMs are a wonderful option for many women, and I plan to use the hospital-based CNM practice that delivered our son when we have a second child.

I will also add that you did indeed have a VBAC (vaginal birth after ceserean). There is no reference to pain medication in that term, and it strikes me as incredibly petty for other women to claim that you didn't have a "real" birth. For what it's worth, I had a totally unmedicated birth, and I'm definitely having an epidural next time. I find no valor in suffering.

Jessie said...

Keep it up Amber, you are doing great and you know I'm with you 100%!

I'm getting kind of tired of people getting upset at you for "lumping" all the CPM's and NCB advocates together into the negativity. You have stated over and over again that there are good CPM's/DEM's out there. We all know there are. And of course not every NCB advocate is that way. But its kind of hard not to lump all the CPM's together when there is no way to tell the good apples from the bad apples. Their education standards, or lack there of, are the same whether they are good or bad! Across the board, even with good CPM's, the education and standards need to be raised. So that is why they are being lumped together. Not because Amber is narrow minded and hates all CPM's!!

As for lumping all the NCB advocates together, its kind of hard not to do that either. There are forums and facebook pages with THOUSANDS of members who act ugly towards mamas who don't have natural births. They tell mamas whose babies have died that they didn't trust birth enough. I had a natural birth and I loved it and will do it again, but I'm not going to look down on people for making different choices. The point is...its easy to lump NCB advocates together because the majority of internet forums and facebook pages promote that kind of behavior. (Mothering, Birth Without Fear, ring a bell?)Its hard to find an internet outlet where all the mamas are open minded about birth.

Rant over. Love ya Amber!

mom2natnkatncj said...

Amber, as a friend of mine always says when we know better we do better so good for you for doing better. I myself find it hard to believe that so many people would rather be right than admit they were wrong. How do they turn a blind eye to the truth about CPM training. And how somehow if you agree with something Dr. Amy says then you are a fool. I know Dr. Amy is extreme and she's harsh, but I'm not falling all over myself saying she's a God or something. When you weed through the harsh and blaming the rest of the stuff she is saying is important and true. Stay strong and keep on your path. Anyone who would dump you as a friend simply because you want to be more educated were never really a friend to begin with.

RSM said...

Amber,
I commend your honesty and willingness to do the hard work it takes to become a better maternity care provider. Anyone can go the CPM route- it takes a caring, committed person to become a real MW, a CMN. You don't get to take the easy road to be a CNM, and it says a lot of good things about you that you aren't trying to take that path.
I am so sorry you had to go through this, I know the remarks people make can reaqlly cut deep. They may think it's simply a comment of FB, but it does hurt, especially if you coqnsidered them friends. Especially if you respect them, but they can no longer give yup the same benefit. You are better than those people, but it still hurts. Stay strong. You are an inspiration.

As for those who say "all NCBers aren't like this", I say- there's a difference between a mom that chooses an unmedicated birth, Bf, etc, and an NCB advocate. What's the difference? Well, one is a reflection of individual choice, respectful of others, and the other is the promotion of an all encompassing ideology that is intolerant of even the slightest dissent. And I think you know which is which. If you aren't out there pushing unmedicated birth on all and saying mean things to moms that didn't NCB, than guess what? You aren't a NCB advocate! If you are, please stop and think before you tear into another woman for her choices. Women have enough to deal with, without all this nitpicking over the way our babies were born.

We all want the same thing- safe and healthy babies and moms. It is important to ensure women have access to quality care, and aren't being harmed or killed by ose who "play MW".

violinwidow said...

I absolutely loved this post, and have so much respect for you. Many people would take the easy way when it is offered to them, that you are willing to go to such lengths to learn your craft is amazing, beautiful and rare. You are going to be a fine midwife. (((hugs)))Tara

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