US vs UK midwifery

true but regulation ensures safety and competency which is something CPM lacks.

Ilithyia- the US has a high rate of interventions but those numbers are based on obstetrician led births which is the vast majority, CPM midwifery in the states is much more holistic and natural centred then either UK or Canadian midwifery which is much more in line with Nurse midwifery in the states in terms of medical intervention. The CPM training is a lot less focused on what interventions can be used and how to work with the natural body, it isnt uncommon to hear UK midwives called medwives here in North America, which isnt meant to be derogatory but the system is much more aligned with medicine in the UK then the CPM system in the USA. There are a lot less regulations for CPMS to conform with, for example AROM and due dates, CPMs do not have to conform to trust policy but generally have their own policy which varies from midwife to midwife.

So, How do CPMs deal with obstetric/neonatal emergencies the, if you dont mind my asking Starrlamia?

they are trained to deal with them (in much the same way you would in the UK, depending on the emergency they may be able to handle it completely alone, like PPH with oxytocics, or they will do basics to ensure that they can do a safe transfer) and transfer to hospital (as the vast majority of CPMs do home births or birth centre births only). I dont know the difference in training between CPMs and CNMs in regards to handling emergencies, Id imagine they are very similar.

Ilithyia- yeah there are a very small number, but I dont think it is unfair comparing the two systems.

Do CPMs take complex women or are they referred to obstetricians? You have to remember that we as midwives in the UK are the main care co-ordinators for high-risk women as well as those who have straightforward pregnancies. We can all give lovely, holistic care which works with the body to low-risk women, we too are good at that! In my opinion though, providing women whose pregnancies are outside of the norm with holistic care and a good birth experience takes just as much skill. We might be called 'medwives' but sometimes intervention really is necessary and managing and providing the care in those situations is a large part of our role here.

No they dont take on high risk cases however that risk can be determined differently according to state and midwife, and isnt regulated as much as it is in the UK. When comparing to the two midwifery systems one should only look at low risk and not high risk care, otherwise it would be inaccurate.

But if high risk and low risk catagories differ then the comparisum has to be drawn across both, or in some other way. I think the various ways of qualifying and practicising as a midwife in the USA, CPM midwives included does need standardising but this is complicated by each state having it's own laws.
I think it is important to learn from each other and not to assume that our way is the best way.

I wonder if we can see the differences in terms of US midwifery being more traditionally born out of mothers supporting eachother with their experiencial knowledge, and , if I'm right, in the UK the first regulated midwives were infact childless nuns wanting improve conditions for women birthing in poverty. In this way could this be a reason why the UK is more perscriptive?

I disagree, not only are states making it difficult by having seperate laws but there is very little standardization in education, very few schools are MEAC accredited and there is no way of knowing if the other schools actually teach essential skills required for midwifery.

That could be, your comparison makes sense, however CPMs are vastly different in training and practice, it is hard to compare them completely. Since CPMs are strictly home birth midwives without the use of a lot of things that are norm in the hospital (EFM, oxytocic induction etc) it makes their practice pretty different and much more reliant on natural ways of doing things.