Lindsay and other friends,

I forwarded your midwifery question to Farra Swan, ND, who practices
obstetrics here in AZ and teaches at SCNM. I've done 2 rotations with
her and many of us SCNM'ers have had the privelege of assisting with
births with her. It's a phenomenal experience and I personally would
hate to see us give up this part of practice. I am forwarding her
response with her permission.



As the first OB resident at Bastyr, I was (with Tim Birdsall) involved
in the accreditation of Bastyr as a midwifery school in WA . For
those of you old enough to remember our history, many of our elders,
including Dr. Bastyr, Dr. Niles Ettinghausen, Dr. Babnick, etc.
delivered babies. When WA state required midwifery licensing (thus
reducing the ND scope of practice). a number of ND's (Joe Pizzorno,
Les Griffith, Charlie & Leyardia Black) sued the state for and won the
right to take the midwifery exam. The rules were then changed to
require graduation from a 3-yr. midwifery school (like SMS). After we
successfully demonstrated that Bastyr fulfilled the requirements and
was accredited, I was the first LM from Bastyr. Since then, the
midwifery program has grown under the direction of Morgan Martin and a
number of dedicated ND's have committed the time and energy to
complete the program and carry the principles of Naturopathic Medicine
to the women and children they care for.
I have been living in AZ and delivering babies here since 1983. I
initially had a midwifery license here but gave it up because there
was a conflict between the scope of the 2 licenses and as an AZ LM, I
would have had to follow the regulations of the lesser license. Since
AZ has a progressive ND license, including almost full prescriptive
rights, we can treat our pregnant pts as appropriate without referral.
That is obviously an indication of the difference in our training and
scope of practice.
I also teach the OB course at SCNM (and have been doing so since
the beginning).I understand that there are not overwhelming numbers
of us who get the advanced training and are willing to maintain the
lifestyle of delivering babies, but I am absolutely shocked at the
possibility that OB/ midwifery would not be considered a part of the
naturopathic curriculum. Where does good health begin if not
preconception/pregnancy? Since most of our pts are women and women get
pregnant, how handicapped will we be if we do not have decent clinical
knowledge of pregnancy? As we are seeking increased licensing and
scope of practice, what will it mean if we have such an obvious
deficit in our education?
What is also not being considered is what the early MD's who stole
childbirth from the midwives knew: work with pregnant women and the
whole family will become your pts. A large percentage of my practice
is the women, children, family, and friends of women whose babies I
have delivered for 25 years. I have never really advertised and have
built a successful practice from referrals.
As the obstetric community is getting more restrictive due to
fears of malpractice, who represents normal birth? With the current
high c-section rate and increasing conservatism about VBAC, is it
really important how a woman delivers? I have been requiring my
students to write their own birth experiences and may someday write a
book about how our births affect us. I was a c/sec in 1947 and never
bonded with my own mother. Does it really matter to the woman who is
has the power for her birth? Does it affect bonding? The increasing
incidence of postpartum depression? What has birth become in America
(see Marsden Wagner's new book). Are we going to give up our voice and
philosophy in support of women and children just because there are not
large numbers of us willing to get up in the middle of the night?
Is there a difference between naturopathic midwifery and other
midwives? CNM's still practice in an allopathic system. Non-ND
midwives don't have our level of training and don't do family
practice. Our profession holds very high standards. There are many
herbalists, but we had Bill Mitchell, who didn't just teach botanicals
but inspired us all. Do we want to forfeit the role of inspiring
women/families? Is this any less important than doing IV's and
esthetic medicine?
We have an arts fair twice a year here in Tempe. Two years ago I
was buying a mosaic plaque with a saying from Mother Theresa. I told
the artist I was going to hang it in my office. She asked me what I
did. I told her I was a naturopathic physician/midwife. She became
excited and told me she'd had two homebirths. Her first midwife was an
ND. She said she'd had a long difficult labor but her ND didn't give
up on her. After the birth, she said she was completely
transformed---as a woman, as a mother, and as an artist. ...
Do we want to lose this?
Farra Swan