You are on the money. Home birth midwives come in all kinds of flavors. Some are certified nurse-midwives (CNMs), some are certified direct-entry midwives by NARM (CPMs), some are licensed midwives (LMs), and I don't know what their training may be or who is the licensing body, although perhaps someone else who follows this board does. (If so, please educate us.) Some, as you say, are not certified by any organization so who knows what their qualifications are. In a few states direct-entry midwives are still illegal. I have no idea what people put down on the birth certificate in those states. I don't know what the unassisted home birthers put down either. I don't know what midwives do in cases where identification could mean big trouble for the midwife, for example, home VBACs. In short, as any objective person would understand, no conclusions can be drawn from a CDC-generated chart about the relationship between direct-entry midwives and home birth outcomes, especially these days when the only option for a woman with a prior c/sec, breech baby, or twins who doesn't want to be forced into cesarean surgery against her wishes is to have her baby at home.
-- Henci |