The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

A Direct-Entry Midwife Explains Her Training

Greetings from a real, live midwife! How trained are we? It depends. I am a direct-entry midwife. I got my training the time-honored way: through an apprenticeship. I have augmented that training with Carla Hartley's Ancient Art Midwifery Institute Midwifery Home Study Course. I do not have a degree, nor do I particularly want one. Birth is not a medical thing. It is not an illness, and there is no pathology involved. Doctors (and their recent counterparts, Certified Nurse Midwives) are trained to look for what's wrong, and have a very hard time understanding that birth is a natural process, one that we were created to do. (It doesn't matter what religion one is, either. I think we can all agree that whoever/whatever created us knew what they were doing!) Funny thing is, after all that training, college, etc., the vast majority of both doctors and CNMs haven't got a clue how to deliver a breech, or twins! (That's why many of the major hospitals, such as Mt. Sinai in Chicago, have hired Ina May Gaskin, a direct-entry midwife from the Farm Commune in Tennessee, to come in and teach the interns how to deliver a breech, or twins.) Most doctors only get one to two hours of nutrition training in all of their med-school time, but I have spent hundreds of hours studying nutrition so that I can help the women I serve avoid most of the pregnancy complications that doctors create through bad nutritional counseling!!!

In some states, direct-entry midwives can obtain licensure through vigorous testing at the state level. (Texas, New Mexico, South Carolina, Colorado, California, and some others). In my state of North Carolina, we are flat illegal!!! So, without references, it makes it really hard to "prove" our qualifications, unless we have gotten certified through MANA (Midwives Alliance of North America). In illegal states, where it has been decided by legislators that women don't have the right to choose where, how, or with whom they have their babies, we risk just about everything to help these women get the birth experiences that they want, even though we could go to jail for it. Doctors, on the other hand, and often CNM's, won't even risk their schedule to stay with a woman an extra hour!

Not all direct-entry midwives are decent. Sometimes women just get "birth fever", and decide to start representing themselves as midwives. They have no business attending births! But any decent midwife can provide references. And you can get a listing of midwives from places like Midwifery Today, or NAPSAC (National Association of Parents for Safe Alternatives in Childbirth). For the record: the World Health Organization states that all "normal" births should be attended by midwives, not doctors! Also, the US consistently ranks at the very bottom of the list of infant mortality rates among industrialized countries. The ones at the top? Those in which almost all births are attended by midwives: Sweden, Netherlands, Denmark. Study after study have shown that midwives have CONSISTENTLY BETTER outcomes than doctors. Probably because we see birth as a natural thing, not something scary that we need to manipulate and control. (And to be fair, many CNM's agree with this, but are required to work under a doctor whether they like it or not.

Sorry to be so long-winded! But you hit my soapbox button! So, one last thing: all CNMs can deliver in hospitals (and some do homebirth, too), and in states where midwives can get licensure, they, too, can usually deliver in hospitals. It just depends on the political climate, and how powerful the AMA lobby is there. So, no, you don't have to have a homebirth if you have a midwife. And if you're that frightened of midwives (BTW---why?) please don't use one!! It's YOUR BIRTH, and you need to be totally comfortable with your "caregiver". Midwives and homebirth aren't for everyone, but thank goodness we have them, because I am terrified of doctors and hospitals!!!