Aloha my name is Clare Loprinzi, I am a Traditional Midwife and Indigenous Practitioner going back five generations in my Sicilian ancestry, my people come from the Sicani, the Northern Africans. I am a warrior, a mother and a nonna, a mammana. For 45 years I have worked as a Traditional Midwife. I am strongly speaking out against the new “rules” and “changes” that NARM and honestly MANA too are putting forth to align themselves with the medical establishment (the US now has the highest infant and maternal mortality rates in the industrialized nations). It is alarming to watch an organization that started out embracing all midwives, asked me to come on board to preserve the traditional route of entry when NARM first started, now showing the characteristics of fascism and oppressing once again the Traditional Midwife model of care.
Below are the letter trails to MANA and NARM I wrote after I realized that they were demanding that I take classes that a Traditional Midwife could never embrace. I know many are also against this and many are encouraging me to once again speak up. I encourage or we encourage many to speak up and stop this change.
June 2, 2017
Aloha MANA and NARM boards,
This letter is responding to two different letters written to Clare Loprinzi in the last 18 months, concerning new classes and changes that are mandatory for CPMs and especially how this effects Traditional Midwives and midwives that use traditional modalities. It is also in response to the avoidance of MANA taking stand on cultural insensitivity concerning midwives selling cultural ways of native peoples and the disrespect shown to the native host culture. It is written mostly in the “we” with Traditional Midwife Chonitia Suhailah and OB/GYN Dr. Jade McGaff writing with Clare and also because it is the voice of hundreds concerned with MANA/NARM recent changes. The “I” answers are from Clare Loprinzi, in response to letters she received from MANA and NARM.
We are speaking as a Traditional Midwives or midwives who work mainly with traditional modalities and have deep respect for these cultural ways and from an OB/GYN. The old midwives that we have been blessed to touch greatness told us to speak the truth. I blessed to start so young as a midwife and have so many of the Native American, African American, my direct lineage to Sicani (Northern African) Traditional Midwives in my life, and many traditional midwives all over the world. I am a citizen of my ancestral country, Sicilia, and it is my responsibility as a Traditional Midwife to preserves our way of birth, it is important to the world, to peace, to strongest survival of our next generations. Traditional midwives work the precautionary principle, are deeply connected and carry on traditions. We work without ultrasound because for us it is violence to the baby, disconnects the baby and midwife and is a form of war, made to bomb submarines and has killed much life in our sacred oceans, an ancestral connection to birth. These recent changes of cultural competency classes, NRP and mandatory 100 more hours of medical classes for CPMs would have a deep impact on us, those courses would be culturally insensitive and make sure we all stepped out of MANA/NARM. It is sad to see MANA become to us like the AMA was to MANA.
We have deep concerns with the newer changes concerning the CPM certification. I joined MANA because I was asked to preserve Traditional Midwives in this organization. Ann Frye asked me to edit her book and also to help with the writing of the first NARM examination to PRESERVE TRADITIONAL MIDWIVES. She told me I was the only traditional midwife she knew that could read and write. The title traditional midwife holds responsibility and accountability. Ida Darragh and Debbie Pulley wrote to me concerning the questions I had, I cut/paste their words for clarity sake. Ida was encouraging for me to stay as a CPM and Debbie was not. I was never asked about all the changes that they were to make, which will remove the traditional model and replace it with the medical model for all. Midwives carrying drugs, using ultrasound and taught in institutions with the direct entry apprenticeship now gone, with traditional midwives gone. As you read these responses we ask you to re-examine what you are doing with your organizations and to share this with others unless you want to bury the beginning MANA mission and go back in history to those who went against the traditional midwives. The least inventions have the best outcomes in birth and those who use the least interventions are the Traditional peoples, who will always survive and preserve our ways. Humbly we say, we do not need you but you need us to be here strongly protecting the traditional birth. It will be a choice you make. Here is our response that reflects the voice of hundreds if not thousands worldwide, thank you for taking the time to read it.
Debbie and Ida’s writing to me will be within “ and in light print…” and my answers in BOLD writing. I start with Debbie’s email.
“Hi Clare, Thanks for writing, and for giving us a chance to respond to your concerns. I can answer several of your comments. If there are things you want to discuss with MANA then you would need to go directly to them. You can write to firstname.lastname@example.org, or to email@example.com. For NARM, you seem to be rejecting the requirements of a Cultural Competency course and the CPR certification. We do not argue that you need a special course to work with the traditional culture in Hawaii, and agree that your extensive work there is a likely indicator of your competence in that culture. NARM’s requirement of a cultural competency course is not about one specific culture, but about understanding how your own culture and background affect your understanding of other cultures you might work with. The idea is that the course should help us understand how to work with any culture we might be called to, and would increase our ability to work with all cultures, both now and in the future. As a CPM, your understanding of cultural competency would help you work not only with traditional Hawaiian families, but contemporary Hawaiian families as well as inner-city black populations or suburban white populations or Latino populations in the US, or to take your skills to any country in the world and better understand how to recognize the cultural differences and how midwifery care can best be provided. That’s why a course in cultural competency is required for all CPMs.”
A Cultural Practitioner is taught and knows cultural competency. Half of my bloodline is of African descent. My practice with birth has been with inner city African and Native Americans, Native Americans from reservations, African Haitians, Asians, Chicanos, Gypsies, Mediterraneans, Balkans and Caucasians. I have helped birth all over the world, almost literally. My immediate family reflects most of those mentioned bloodlines. This would be typical for other traditional midwives, we would encourage MANA and NARM to become more aware of what a Cultural Practitioner is, that a traditional midwife is also a cultural practitioner, as our requirements are strict and connect back to the roots of the people’s we come from and that we are recognized in all cultures. We communicate though language, dreams, dance and recognize each other. It is motherwit as Onnie Lee Logan said (she was my mentor). To ask a CPM who is a Cultural Practitioner to take a course on cultural competency is ignorant and disrespectful and an organization should be more culturally sensitive especially if that is what they want from the midwives in their organization.
Debbie Pulley CPM wrote,”
“I’m not sure why you consider CPR certification to be wrong for you. All CPMs should be regularly certified in both CPR and NRP in order to better handle emergencies with the mother or baby. We all hope to never have to use these skills, but they can be live-saving. I don’t really understand why the course was painful for you to take. This is knowledge about anatomy and physiology related to anticipating or treating cardiac arrest or shock. It’s a basic course required for almost all health care providers. You can’t be exempted from the cardiopulmonary resuscitation course.”
Traditional Midwives have been taught lifesaving skills and we carry this knowledge. The NRP course that you have now imposed on CPMs is considered dangerous from the Traditional Midwifery view for many reasons and the techniques would do more harm than good for newborns. We would advise MANA and NARM to become educated. Our ways with resuscitation are deeply connected to the baby, not working on a baby, but bringing the baby to breathing, working with the baby that is deeply connected through an ancestral connection. We have been taught massage and specific places we work on the baby, but again nothing like the NRP techniques. We cannot work with fear or doing things because we are afraid, it is deeply connected to love and prayer. We do not judge the standard that some would feel comfortable doing (CPR/NRP) but again cultural sensitivity means you would respect that we do know what we are doing and why we clearly make this choice.
Debbie Pulley CPM wrote,” As professions evolve so do the requirements. Many of us started out as traditional midwives. We worked with mothers during the pregnancy, birth and postpartum periods. We did not do anything “medical” such as labs, suturing, or meds. Through the years most mothers started expecting more of midwives. The CPM was created to bring some of that knowledge into play. A task force meets every five to ten years to review the process and make recommendations. I believe there were over 100 CPMs at the last Task Force meeting. The Job Analysis is done every five years.
Debbie stated she and others started out as traditional midwives and they made changes to work with drugs, suturing, and CPR. It is correct to say that they were midwives, but incorrect and culturally insensitive to say that they were traditional midwives.
Debbie went on to say, “ Ms. Margaret Charles Smith was a traditional midwife and a wonderful woman. She worked with what she had available at the time. My thoughts are if she was practicing today she would do what is necessary to get her CPM and would be happy to have the opportunity to learn NRP. In as nice of a tone as I can reflect in email, you are the one who really needs to make the choice. Do you want to keep up with these changes or continue to practice as a traditional midwife as Ms. Margaret Charles Smith did many years ago without the advantage of the options available to us today?
Ms. Margaret taught me because I was traditional, along with another traditional midwife who have worked with for many years, Chonitia Suhailah. Although she shared with many, those she taught the deeper things of traditional midwives were already traditional midwives. She shared much with us and we spent years together, I stayed at her place and she at mine many times. She asked me to write to MANA years ago when we were together in Alabama, where she stated why she was against licensure and what it would do to the Traditional Midwives. Her request was never honored and that insulted her, she mentioned that many times to me. I contacted MANA at least twice for her concerning that issue. It is beyond disrespectful to say that she would do whatever she could to get her CPM. Ms. Margaret was trained by a Traditional Midwife, who was also a slave. If you knew her births, her first birth, you would never say this. Her knowledge and our traditional knowledge of what to do to resuscitate a newborn baby are the same, our techniques were the same. This NRP course that I took and will never take again because it is so wrong, is nothing she would want to take. There were so many questions that had the wrong answer for traditional midwives, it disgusted me, and infuriated me, I had to go back and take it twice and answer the “wrong answer” to make it correct, to pass. A traditional midwife has to be honest because lying interferes with motherwit, our ways are ancient, are strongly rooted. Traditional Midwives have the word traditional because we come from traditions. We carry these traditions proudly and do not want to change. Our ways are deeply connected to the forces of nature and spirit. If a traditional midwife believed in this NRP course that you have mandatory, they could not use the title Traditional Midwife. If you knew our ways you would understand. At lease you should respect us and culturally show sensitivity.
Debbie wrote, “Do you want to keep up with these changes or continue to practice as a traditional midwife as Ms. Margaret Charles Smith did many years ago without the advantage of the options available to us today?”
To read this was insulting and extremely culturally insensitive to Ms. Margaret and to us. A traditional midwife goes deeper into her work, into her way, into her connections to her traditions, as they are truth. They will never changes as the NRP changes. Many of us grew up in a family of Cultural Practitioners, taught the way to work with breath when one was born and died. All my lineage prior and after me was born and died at home. I was blessed to have CPR instructors who respected me and passed me because I clearly demonstrated that I knew my skills. Ms. Margaret and I taught a course together on resuscitation of a newborn. I can say again she would never had wanted the CPM title if it meant to go against her traditional ways. It would kill more babies than help them as the spirit of the baby would be tortured instead of embraced and honored. We do not view these ”options” as an advantage. Another thing traditional midwives don’t do is waterbirths, for both cleanliness issue and also the hot/cold issue, that was clearly taught to us by the old midwives, but intuitively we knew this. Our advice is never speak for a Traditional Midwife, show her more respect, unless she told you to speak for her. We would encourage you to look at the statistics that Traditional Midwives hold, especially Ms. Margaret, she was greatness. She was connected from the first birth she assisted, and she worked until that baby breathed. Please we ask be careful about talking for her, it is offensive to say the least.
Debbie wrote,” You also said “I was surprised that the response was ” if you do not agree with this, maybe you should not be a CPM.” I know email is hard to hear how someone is trying to get a message across. The key is you are a traditional midwife who decided to become a CPM. The CPM has requirements that have evolved through the years. Every major change is determined by the Job Analysis and/or the Task Force. These changes are not something the NARM Board can override. A task force meets every five to ten years to review the process and make recommendations. I believe there were over 100 CPMs at the last Task Force meeting. The Job Analysis is done every five years.
MANA and NARM have a choice to honor and respect us. I was asked at the beginning to be here so that Traditional Midwives would be honored and respected and welcomed. There is a course on MEAC credits from my Mamma Primitiva Program called the “Wisdom of Thirteen Moons,” It is well received by CPM’s. You ask me if I want to stay as a CPM. We ask you, do you want all midwives to use, drugs, disrespecting the placenta by not speaking well of an ancestor, use of ultrasounds, believing in the myths of IUGR. Do you want to let go of us, who have been here since the beginning, who work as traditional midwives? We do not need the cultural competency class, as we teach it and live it. We cannot take a NRP class that is so damaging to the survival of a newborn compared to the skills we have been taught. Dr. McGaff has been an ACOG certified OB/GYN for 35 yrs and she would not want to take this course. This course is for those we work in the hospitals. We would never take classes on drugs, machines used in birth to further our education, as it would not and it leads to fear based birth. So another hundred hours of CEU based on medical training for us? Midwives who use some traditional modalities may or may not want to take these courses, but not traditional midwives.
We encourage the MANA and NARM boards to read this letter, to re-examine time timelines, protocols, standards and the respect of traditional midwives and all midwives who work with traditional modalities. Midwives understand that the Job Analysis is not on a determined schedule, to look at this situation similar to a completely dilated mother at 0 station that goes back to 7 cm because something is not right and has an opportunity to make right. To do the right thing and look within yourselves and reexamine where you are bringing MANA/NARM and MEAC. The changes we have heard you are implementing now, and again in 2020 will decide midwives for the pursuit of money and recognition in the medical world. If MANA/NARM want to make all these changes, why not just become CNMs or a CPM under the ACNM license. For example, the acupuncturist licensing board in Oregon is under the Medical Board. But the CPM these days, or a lot of them and surely where MANA/NARM is heading are very similar to the CNMs that I know. Why duplicate an organization that is already standing and there are plenty of good CNMs, why not make the 100 hours up to their standards? When you have made changes on charting, using drugs in birth, ultrasounds or water-births, you now have to fill out information in those spaces you have on the charts. We understand why you want the changes, but in doing that you get rid of our “core”, that is the traditional midwives. We would encourage you all to step back, bring us into your inner circles of dialog so you can be at lease hear what we are saying, understand our knowledge and input, reexamine what you are doing. We hold traditional ways. We are moving forward with connection of Traditional Midwives worldwide, there are many and we are strong. As we all saw the movements that are growing are embracing the native thinking, that is what is the traditional midwife, we are crucial to the healing needed in this world.
We write all this in truth, in respect and with the ancestors of our traditional bloodlines and other native midwives ancestors behind us. Dr. McGaff is a board certified OB/GYN, she has worked with all kinds of midwives for years. Midwives made her wake up to natural birth but traditional midwives brought her back to the sacred births, one where the baby is delivering. Jade taught with Chonitia, Clare, Ms. Margaret, and many others traditional midwives for ten years at the Mother Oak Conferences. We want our words to be understood, to be taken with respect for all the traditional midwives that still work around the world and for those who will come. Traditional Midwives are coming together worldwide, MANA will decide if they want some of them in their organization. We will be vocal about the stand MANA/NARM makes with us. We hope for a positive outcome. We do not need to be in the same circles of friendships, but we do need to show respect to each other. What we are seeing is disrespect for cultural practitioners, the Traditional Midwives, we hope for that to change.
These are the letters writing in 2017, They did not answer back to us when we asked to meet with them, as we had met with MANA on a conference call. (they said they supported us but have done nothing, no walking their talk either. MANA also said that it was soley NARM but that is not true, US MERA is NARM and MANA.)
In the last several months Clare has written to NARM to ask where she can file a complaint against the NARM board, they answered once telling her to go on the NARM site to make a complaint against a CPM, again she wrote saying it is not against a CPM for her practice it is against the Board of NARM. No answer.
We encourage all to RISE.
Clare Loprinzi Traditional Midwife, CPM
Chonitia Smith Traditional Midwife
Dr. Jade McGaff, OB/GYN
Speaking for hundreds and thousands behind us