Archive for the ‘Licensing home birth midwives?’ Category

The two political/legal battles we need to be fighting are:

  1. The right of the people to choose their own health care (be it chiropractic, midwifery, craniosacral therapy, a naturopath, homeopathic, or an allopathic MD)
  2. The right of practitioners to offer and practice their skills without threat of arrest for “practicing medicine.”

I will weave a discussion of these two points in with further examination of licensure flaws.

Licensing works on the presumption that the state is trying to serve the public by protecting them from harmful practitioners through licensing.

But what really happens, and what has happened to the American public, is that the state suppresses their choices. The state suppresses your choices.

I will give you one example of this: We all know there is “no cure” for Hepatitis C.

But did you know that this is only true in the allopathic system of medicine? The statement should read: “Allopathic medicine has no cure for Hepatitis C.”

Did you know that there actually are cures for Hep C? It’s just that you are being stopped from knowing about them and having access to them. Why? Because the allopathic system (the American Medical Association) “owns,” by law, the right to “practice medicine,” and they don’t offer the cures. And they want you to have knowledge about and access to only their pitiful drug options.

So … Has the state protected you through the licensing system? … Or have they killed you?

Are the licensing laws working to protect you? Or are they harming you by suppressing other practitioners’ freedom to practice certain health arts and your right to freely choose them without fear of your practitioner being arrested and charged for helping you?

This is not just about midwifery. It encompasses midwifery, especially the true, non-allopathic-based practice of midwifery.

“If the midwifery movement is lured by the apparent short term benefits of licensing, it will, in the long run, sacrifice its independence, its identity, an creativity, and people’s freedom of choice” (Solares, Compulsory Hospitalization, vol. 2, p. 400)

In the late 1800s, [Dr. Benjamin] Rush’s fears came true when the exclusive licensing of one system of healing—allopathy—established State Medicine. … State control in either religion or medicine leads to intolerable abuses of our basic human rights. It is a fundamental human right to make decisions about what is right for your body and soul, and to be free from the interference of self-interested, competitive groups, especially in religion and its historical cousin, the healing arts. (Solares, p. 403)

So, our goals ought to be (Solares, 403-404):

  • “A constitutional amendment extending the Bill of Rights to include ‘freedom of choice in health care.’” “… the government has no business licensing any kind of healing art.”
  • Rewriting practice of medicine laws—i.e., narrowing down the legal definition of “practice of medicine”

Let’s talk about the legal definition of “practice of medicine.”

Solares cites an early medical practice act (MPA) definition of “medical practice” to be people who use drugs, performed surgery, or claimed to be doctors. … Great.

Today? Here’s a more current definition Solares cites; Medical practice is [emphases by this blog’s author]

Any person who practices … any system or mode of treating the sick or afflicted, or who diagnoses, treats, operates for, or prescribes for any ailment, blemish, deformity, disease, disfigurement, disorder, injury or other mental or physical condition [includes pregnancy in most/many states] of any person…

I thought of this definition of practicing medicine as I put olive oil drops in my daughter’s earaching ear. It’s truly a strangle-hold on your freedom and mine. And if I call an experienced mom, or even my sister, and ask about my daughter’s symptoms and possible treatments, she could be arrested for answering my questions? For diagnosing, treating … ??? Hello????

Solares points out: “Consequently almost any act relating to health or pathology could be interpreted as violating the medical practice act. More particularly, there is a substantial danger that any movement or method which challenges orthodox standards will be selectively suppressed” (p. 404) … Remember what I said about Hep C cures? … Selectively suppressed.

So stop and think. See what is happening already as midwifery becomes licensed. What have they given up? Compromised? “Selectively suppressed”? In order to practice legally?

It’s disgraceful. As a mom, if I used a licensed midwife, my health care options are limited to the midwife’s licensure laws. It has very little to do with my personal health and well-being. Her hopefully skillful hands are tied when she ought to be free to practice her art to my benefit.

Is this really the system we want midwifery crushed and deformed into? Over time, that’s what will happen. It’s what is already happening.

So to recap: One of our battles that Solares spells out is that we need to write laws that redefine “medical practice” as being limited to allopathic practice (i.e., using drugs and surgery to treat pathology, calling oneself a medical doctor).

So there’s one good, political battle for you to invest your time, energy, reputation into. A much better battle than mandatory licensure, for sure.

And second, don’t forget that Bill of Rights amendment—freedom of choice in health care.

You see? They go together. In order for us to have freedom of choice, practitioners must have freedom to practice without fear of arrest for breaking “practice of medicine” laws.

And yes, protect consumers through fraud and criminal assault laws, but don’t limit their choices by mandatory licensure.

🙂 More, more, more to come!

Midwifery will succeed only if we see that the attainment of freedom of choice is synonymous with our survival. ~Allen Star Solares

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Short answer, not inherently, and you can try to get the same protection without limiting 1) the right to choose a non-licensed but legal practitioner and 2) without limiting the practitioners’ right to practice his/her trade/skill.

Does licensing protect us from incompetence? Does it assure us of minimum competence?

Since there is a big campaign going on to get legalized mandated licensing for all 50 States, one of the campaign tactics is to highlight stories such as “an unlicensed midwife did THIS” or “an unlicensed midwife did THAT.” As if licensed midwives don’t do such questionable, even dangerous things.

They do.

It’s just that, during the campaign for mandatory licensure, we want the public to believe that it doesn’t happen, so we keep those stories quiet. And we also don’t tell the stories of things licensed midwives do because they are licensed and want/need to keep their clients within their practice bounds, for example (like pushing for inductions . . . strangely just like doctors!).

Licensing is not the optimal system for protecting consumers. In fact, it ends up working against consumers. Because the licensing organization is now heavily invested in maintaining the profession, regardless of compromises and the costs to consumers, and those licensed face frequent choices about, for example, dealing with a variation of normal in a client and the mandated protocols they must practice under.

(Well, when a profession starts on the road to licensure, sure they believe they will not compromise. But the more heavily invested (time, money, reputation) they become in licensure itself, the more compromises shrink in size in comparison.)

Solares says that a system should establish “freedom of choice in health care as a constitutional right, and implements it through a regulatory system that is educational rather than restrictive” (p. 401, emphasis mine)

So, yes, there should be a system, but not patterned after the medical model’s.

Also, mandatory licensing, in practice, doesn’t really assure us of competency. Licensing gives a minimum of experience and knowledge. It then issues a paper that tells the person that the standard has been achieved. Just assuming best case scenarios where applicants did not lie or cheat (which has been done), you now have minimally trained person out practicing. Will the parents be informed that one person with a license has caught 20 babies, another with a license has caught 300 (in a high-risk foreign setting), and another, who has no license, has caught 2000  in her 30 years of practice . . . ? As a consumer, I would like to know these things, not just if he/she has a license.

Now the question of giving consumers recourse to protest, be compensated for wrongs that a practitioner does, be able to remove a dangerous practitioner, etc.

Solares says that if consumers choose a non-certified practitioner, they have taken responsibility for outcomes unless fraud or criminal assault occurs.

This seems fair. Fraud would give me legal recourse if my caregiver lied or misrepresented him/herself to me. One definition is as follows:

A false representation of a matter of fact—whether by words or by conduct, by false or misleading allegations, or by concealment of what should have been disclosed—that deceives and is intended to deceive another so that the individual will act upon it to her or his legal injury.

So yes, there should be some type of legal recourse when not using a licensed or certified caregiver, and several recourse elements of the licensing method should be kept in place for those who choose to do that.

What I’m saying is, mandatory licensure isn’t the best answer for protecting consumers. In fact, it’s a terrible answer.

Coming up next: The 2 legal battles we really should be fighting.

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Midwifery will succeed only if we see that the attainment of freedom of choice is synonymous with our survival.

~Allen Star Solares

First, I want us all to back up a step and realize that this conversation is really not only about midwifery, nor is midwifery the first and only group facing these important issues (regulation of practice, practice of medicine laws, etc.)

Be aware: This issue concerns all non-allopathic forms of health care. Homeopathy, osteopathy, naturopathy, chiropractic, etc.

One system, that of allopathic medicine, has created almost a monopoly on the right to “practice medicine.”

The first response is to say, aha! so we also need to follow the same path allopathic medicine has taken in order for us to be free to practice, have validity, and professional acceptance.

But what we need to realize is that those who practice allopathic medicine are not free. For an infraction against protocols, rules, preferences, biases, peer strength, etc., the allopathic practitioners license can be revoked. (Like revocation for assisting or supporting home birth families and midwives.)

Those inside the system of mandatory licensing are not free to practice in a way other than what their oversight allows.

So, that is one fact about creating a monopoly of legalized-by-license midwifery (or any other alternative-care profession): if you do it the way the allopathic system has done it . . .  watch out. Those things we criticize about them will soon be true of us (. . . no matter your resolution or assurance right now).

The system of mandatory licensure is flawed. It should not be what we are striving and sacrificing to attain.

There is a much better goal for you to root for, sacrifice for and strive to attain for the good of all.

Midwifery will succeed only if we see that the attainment of freedom of choice is synonymous with our survival.

~Allen Star Solares

 But don’t we need licensing to protect women from harmful, unlicensed midwives? . . . stay tuned.

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OK, I’m sticking my hand into a hornets’ nest, I know.

I want to write a little series about licensing American midwives, which is a hotly debated topic right now. I also modestly hope this little series will change the world . . . 😀

I will say, up front, that most of these ideas come from a midwife named Allan Star Solares, chapter 34, “Midwifery Licensing: Pitfalls, Problems, and Alternatives to Licensing,” in the gem of a NAPSAC book Compulsory Hospitalization: Freedom of Choice in Childbirth?

I don’t know if Solares is still alive or if I can get the whole chapter reprinted for distribution, but I will look into it.

Just so I don’t automatically polarize people who are pro-licensing, I will say, after reading Solares, I think voluntary licensing is a great idea. That means that all midwives, licensed or not, are equally free under the law to practice and they can simply choose to be licensed or not.

The theme of my series is a sentence from Solares’ conclusion:

Midwifery will succeed only if we see that the attainment of freedom of choice is synonymous with our survival. ~Allen Star Solares

Stay tuned; there’s lots to come!

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