They did WHAT?!

midwivesOye.  I hate that I even have to write this today, but here it is – the Certified Nurse Midwives in our state have filed a bill in the house (H204) that will increase the penalty for non-nurse midwives practicing in our state.  So, if the CPM bills that are currently in the Senate do not become law this legislative session and the CNM bill does. . .all of the non-nurse midwives practicing in North Carolina could be charged with a class one misdemeanor.  Currently, the charge for practicing midwifery without a license is a class three misdemeanor.  The CNM bill, as it is written, adds the charge of practicing medicine without a license.

When NCFOM Legislative Chair, Lisa Fawcett, contacted the NC affiliate of ACNM regarding this language, she was told by their lobbyist, “Thanks for passing this along. The section Lisa cited would have the effect of increasing the penalty for practicing without a license from a Class 3 to a Class 1 misdemeanor. It was added to satisfy a request from the sponsors that the bill increase the penalty for those unlicensed providers who continue to practice midwifery in violation of the law.”  Uh, yeah.  There are midwives in our state practicing without a license, but not for a lack of trying.  The North Carolina Friends of Midwives have been trying to get legislation passed to license and regulate CPMs for the past 6 years.  I know because I have been helping them, and because my midwife closed her practice to focus on lobbying efforts.  She has spent the last three years driving two hours to Raleigh three days a week to educate legislators about why we need to license and regulate CPMs in North Carolina.  These women who are “practicing midwifery in violation of the law” are serving a growing population of families who want to give birth at home.  And they do so at great personal risk because they know it is a woman’s basic human right to decide where and with whom they give birth.

What makes this situation even more disappointing is the fact that the leadership of NCACNM know the history of the fight to get licensure for CPMs in our state (for a thorough recent history, watch from about 46 minutes):

In January of 2010, “Where’s My Midwife?” hosted a quarterly meeting for NCACNM and invited Wendy Dotson to speak.  Wendy is a midwife in Virginia who told the story of how the Friends of Midwives in Virginia were so close to passing legislation to license and regulate CPMs, that the CNMs decided it was time to lift the physician signature requirement from their licensing language.  Wendy told how the Friends of Midwives asked the CNMs to wait until they got the CPM bill passed, then they would turn their grassroots efforts to helping the CNMs get the job done the next year.  And that’s exactly what happened – in 2005, the CPM bill passed and in 2006 the CNMs got what they wanted as well.  Win/win.  NCFOM offered to do the same thing here for the CNMs – let us get the job done, then we will help you.  Instead, NCACNM decided to do what was best for themselves, not what was best for the families of our state.

So, why did the CNMs in North Carolina feel that NOW was the right time to file their bill at the General Assembly when NCFOM has been working so hard to educate the legislators and get the votes they need?  Why?  And why did they add language that would make it worse for their sister midwives if they get arrested?  I feel partly responsible for all of this because I suggested that the leadership from all of the organizations sit down and come up with a plan to work together and never followed through.  Could a meeting have prevented this terrible turn of events?  I’m not very good at confrontations.  The thought of getting all of those adults in one room and having to ask them to act like grown ups was unsettling at best, and downright depressing at worst.

But I think what is most disturbing to me is the trend with nurse midwives to side with physicians to rally against non-nurse midwives.  Why would you try to be more pleasing to the very people who are constantly putting you out of practice and creating restrictive policies to limit your ability to care for women?  Why do you continue to increase your educational requirements?  To be more pleasing to the physicians?  Does more education really make you a better care provider?  I would argue that it most certainly does not – 90% of our population are served by obstetricians and their statistics are horrifying.  The fact that NCACNM did not turn around and leave any legislator’s office that would require them to increase the penalty for unlicensed non-nurse midwives is downright disturbing.  It makes you the worst kind of practitioner – one who thinks of yourselves first.  How will that translate to the kind of care you provide your families?

“Where’s My Midwife?” seeks to increase access to ALL midwives in ALL settings.  We ask that the Certified Nurse Midwives in our state revise their bill to eliminate the language that is so divisive and dangerous to their sister midwives.  We need to be working with each other, not against each other.  If you agree, let them know (from the NCACNM website):



17 thoughts on “They did WHAT?!

  1. This is so sad, Kirsti,, and frustrating, too. Especially when one remembers that Where’s My Midwife? was born when certain physicians in NC fired their employee midwives, including one of the current officers of NCACNM, who were then personally helped by WMM? And by an officer of NCFOM. Seems like the leadership of NCACNM has not only forgotten the meaning of sisterhood, but also of gratitude.

  2. well said Kirsti; and thank you. It is so incredibly disheartening and distressing for the families of NC who support midwives to have this unwarranted attack from NCACNM. The Certified Professional Midwives have always been supportive of the nurse midwives. There is not one case of CPMs ever coming put against the nurse-midwives, in any state. Its time for a little quid pro quo ladies! We didnt start this, but we damn sure wont accept it lying down!

  3. I can’t help but feeling like this is a big slap in the face. A slap to those of us who have worked our selves to exhaustion trying to do what is right. In the end I feel we have been used. It seems the CNMs of NC have said “Thanks for supporting us ladies…but screw you, I’m doing what is best for me.” Good luck.

  4. I am sad at this new development. Sad, because historically brave CNMs put their names on the line to support us. After their licensing bill passed in the early 80s, making them legal for the first time in NC but specifically making all non-nurse midwives illegal, a promise was made. “Embrace this law, and through us being legal, we will bring you along.” Even though not all CNMs held this view, many worked tirelessly to keep their word in periods of great action, and in times where only a few would even listen. Relations were forged and many have served as quiet resources for consultation and referral when there were no other options. We have enjoyed conferences, meetings, partnerships, friendships and sisterhood. Through the 80s, the 90s, the 00s, until now, the CNMs were there. The Bridge was forged among the leadership, the Joint Committee, and public partnerships. And CPMs and direct-entry midwives have always supported the work of the CNM! Of course, we support a bill that would allow CNMs to join their national sisters in autonomous practice. But……..

    WE believe that waiting 30 years for legalization and licensure is LONG ENOUGH! We have jumped through every single hoop requested. From the early work of Carolina Association for the Advancement of Midwifery (CAAM), to the compromises forged within the North Carolina Midwifery Association (NCMA) and the tireless efforts of Magi King and Gigi Kovacs, through the emergence of the reliable, but steadfast work of Victoria Brown and Evelyn Walker who gave birth and walked and rocked the North Carolina Friends of Midwives through its infancy, to the tenacious and fierce Patti Barnes who would not ever accept “NO,” and found no challenge or directive too hard or unappealing to tackle, to the slow, but sweeping emerging swell of the North Carolina Friends of Midwives with Victoria, and Rebecca and the many others, and the quiet rumble and then roar that a growing grassroots effort brings-and to our steadfast, heroes, and optimists extraordinaire, Lisa and Russ Fawcett who have midwifed us through the longest labor over the last 5 years-to those who have fought on the front lines, Lisa Goldstein, Amy Medwin, Audrey Treppicione and to our alliances with “Where’s My Midwife,” Physicians for Homebirth, and to the thousands of homebirth families who have wrote letters, made phone calls, bussed to Raleigh, marched, fed legislators, passed out Hershey Kisses, and HELD HANDS—-WE HAVE WAITED LONG ENOUGH! 30 YEARS IS LONG ENOUGH!

    I appeal to those CNMs who have been compassionate sisters and REASONABLE people who are not preoccupied with political posturing to speak out against this provision within the bill.
    To all that agree, flood the phones of the CNM leadership with the mighty voices of all who want the freedom to birth where and with whom they choose.
    Nancy Koerber

    • Nancy, you brought me to tears. I’m reminded of the saying of standing on the shoulders of giants. ENOUGH ALREADY.

    • Thank you, Nancy. Having a longer history helps everyone to put this situation in perspective. It’s time to get the job done.

    • I spoke to my representative about this huge mistake (as well as others) in the bill the day the bill was filed. It was the first time I’d seen it. We, as members, did not see the bill prior to its being filed. I feel certain I did not make friends in my organization when I questioned the language and asked for redrafting or improvements/amendments but, it was the right thing to do. I will not stop speaking my truth and only hope other CNMs will pay attention to what’s going on. THANKs for the great history and please know not all CNMs in NC agree with the language as it is.

  5. As a CNM in this state- but, first and foremost, a mom… I can promise you that the attitude of CNMs in this state is not to say… Screw you, we are on our own. We have also fought tirelessly to take care of women and their families and have been fighting awhile to remove supervision from our language. I love the passion and support for all midwives.

  6. It’s appalling any CNMs would introduce a bill like this. It’s ridiculous enough that our state is surrounded by states where midwifery is practiced more freely, but here the patriarchal backwards thinking still seems to reign supreme.

  7. *headshake* It’s so painfully obvious that in NC there are 2 awesome medical schools within an easy drive of the capital. Even with the changed political environment, it’s going to be a huge uphill battle even to get the CNMs stand alone licensing.

    I deeply appreciate women having access to alternative medicine. I’ve had 3 wonderful homebirths myself. The realty is that right now there are practically NO choices for homebirth in NC. Millions of NC women have to go the hospital or drive to the few birth centers. The few legal midwives willing to practice at home were have been systematically put out of business in the last 2 years.

    You wail and cry about “your sisters” not standing next to you. What about YOU standing next to your sisters? Look at the calls to flood the CNMs with calls, etc Good grief – all of my midwives have been CNMs. They have all cared as deeply about the same issues as CPMs but have chosen a different training path.

    What is wrong exactly with at least getting the CNMs licenses and letting them lead the way? Maybe get the NC political world used to the idea of professional midwives at home, regardless of credentials? It seems in a credential crazy state, it’s going to take baby steps to get to where all choices are available. I repeat – right now there are *no* practical alternatives to going alone except institution based birth. Demanding the ideal right this second risks any progress that could be made.

    It seems like there are two paths in front this group. The first is to continue this political cat fight and ensure that the status quo remains of NO choice remains because CPMs won’t stand behind CNMs. The second is to see the full licensure of CNMs as a stepping stone to full practice rights for all midwives in a MD happy state. I prefer to think positive.

    • As I said in the post, we want access to both CNMs AND CPMs. I am not a midwife, I’m just a huge fan of the midwife model of care and believe if we had more practicing, autonomous midwives of every credential we would see better outcomes for mamas and babies in our state. The CNMs already have permits to practice in NC, the CPMs do not and are being arrested because of it. The NC political world has been given a very thorough education about home birth and the CPM credential by NCFOM and their lobbyist over the last several years. And I asked folks to call the CNM leadership because they were the ones who agreed to include unnecessary language in their bill that would make it even more dangerous for non-nurse midwives to practice here – it was a conscious choice that is not okay with me. The CPMs do not need to stand behind the CNMs, nor should the CNMs stand behind the CPMs. We prefer to think everyone should stand side-by-side. United.

      As Nancy Koerber so eloquently pointed out in her comment above, 30 years of trying to get licensure is about as slow as one can go. Baby steps have failed to get the job done. Time to march! We know the real problem here is the physicians, this is a turf war over women’s bodies and it has to stop. But in order to be most effective, we need everyone working together to make things better for mamas and babies. Not working against each other.

    • Thank you for this response. Shows some love towards the CNMs in this state who have worked incredibly hard to serve women and their families.

      • We have always shown our CNM sisters love and appreciation. Some of us have assisted them in obtaining collaborative agreements and some of us have had partnerships with them for many years. We refer folks to them and do all we can to assist them, counsel them, and support them in their legislative challenges. In this case, we have simply responded to the inclusion of language that has increased the penalty and also included language that all midwives fought against in the original licensing bill that licensed CNMs-to keep midwifery out of the Medical Practice Act. When that language is removed, you can be assured that CPMs and many homebirth families will loudly support their legislation.

    • ‘what is wrong with at least getting the CNMs licenses and letting them lead the way?’ you ask…is 30 years of broken promises not enough for you? Where has the leadership of the CNMs got the CPMs in 30 years? We see very clearly where that attitude has gotten us! How about looking at the reality – in EVERY state where CPMs have got legislation passed, the CNMs got autonomous practice almost immediately afterwards! No wailing and crying here – we are getting our stuff taken care of. Please, dont confuse assertion for whining – we will not be bullied by NCACNM anymore than we will be bullied by NCMS or the OB/GYN society!

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