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Thursday
Aug142008

Miami Dade College knifes midwifery program

Miami Dade College has shut down the Midwifery Program, a move announced August 8 at a Medical Campus meeting. The college cited low enrollment and high costs. A news release issued by Florida Friends of Midwives pointed out that the program is the first and only one of more than 200 degree-granting programs eliminated because of cost-cuts.

Melissa Chin Casey planned to enter the program this fall. “Miami Dade College doesn’t understand that we didn’t choose to be in this career program just to have any degree—this is our passion,” she said. “It’s insulting and cruel for the administrators to say the program was cut because of low enrollment…we are practically beating down the door for them to let us in. As a public education institution, they have failed this community.”

The Direct-Entry Midwifery Program was the first in the country to be offered at a public institution, placing opportunity before students who might not be able to afford more expensive programs at private colleges and universities. The program was selective, training approximately 80 midwives since its founding in 1994.

The irony of this move must not be missed.

For centuries, long before there were OBGYNs and ultrasounds, long before there were PPOs and a trend towards socialized medicine, midwives delivered babies that formed the foundation of this country. I once interviewed a midwife in the South Carolina Lowcountry. She had delivered hundreds of babies in an area where there wasn’t a doctor for 50 miles. As the U.S. has progressed towards a more impersonal style of medicine, where time with a physician is officially rationed by an insurance provider, midwives offer a mother-to-be a personal and compassionate option.

The FFM release says the most recent Florida Medical Quality Assurance annual report states 115 active licensed midwives practice in The Sunshine State, with an estimate of 11 percent of births attended by midwives. Between 2005-2006, licensed midwives grew by 5.5 percent. The Florida Council of Licensed Midwives reported a caesarean section rate of 6.3 percent, compared to a 36.64 percent statewide average in hospitals. Crunch those numbers and the cost-savings, state-wide, are a no brainer.

The value of the midwifery program at Miami Dade can not be crunched bean-counter style. For one thing, the value of such a program extends far beyond the boundaries of a city made famous by cop and robber TV programs. The spirit of that college is in a sense at stake—Miami Dade was Florida’s first integrated junior college, providing educational opportunities to many who were the first in their families to seek a college education. Providing the midwifery program goes straight to the heart of a technical college mission—to provide expert skills for jobs and professions vital to  the community. Dismissing the program is like taking a knife to the heart of the college’s mission.

I spoke this morning on the phone to Nermari Broderick, press officer for the Florida Friends of Midwives. Broderick told me students entering the program were required to pay fees by early August rather than the customary late August date most community colleges permit. This year 20 students had already paid when the program’s demise was announced. Some students had already relocated to prepare for the fall term; others had taken out loans to cover tuition. How do you place a numbers value on killing the dreams of those 20 young people whose education would benefit countless future mothers and fathers?

Some religious faiths prohibit a woman from seeing a male doctor. Isn't skilled midwifery offered by a female the best that the U.S. can do for those who come to our shores legally, seeking refuge from political chaos, in some cases from genocide?

Every day I see government squander my money and yours. But sometimes I see a program that is so valuable I can actually take pride in the use of taxpayer money. Miami Dade’s midwifery program set that community college apart from many others, by providing training for a practice as old as mankind. That a college would make a decision to abandon the program is an insult to mothers, to women, to the community and to the students who aspire to participate in what is inarguably the holiest process in medicine—bringing a new life into the world.

[Photo courtesy of Florida Friends of Midwives; some text from news release FFM Aug. 14, 2008. Text and editing by Kay B. Day.]

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Reader Comments (11)

I think Miami Dade should be ashamed of what they did to these students. The school is inconsiderate and should be held accountable for their inconsistencies.

August 15, 2008 | Unregistered CommenterSharry

This is a very bad reputation for MDC; they don't understand how much they have put a damper on this situation. Miami Dade's decision should be reconsidered.. A friend of one of the students..

August 15, 2008 | Unregistered CommenterJerry

I am a graduate of Miami Dade and have assisted over 300 families in their births since then. I am ashamed of them for their unethical and discriminatory decision to close the Midwifery Program less than a month from it's class start date.

August 15, 2008 | Unregistered CommenterChristina

Thanks to all for weighing in. I've shared this with a number of others, including organizations and members of the media. I'm hoping the college will reconsider--there's just no simple way to gauge a program like this.
The benefits far outweigh the costs. best, Kay

August 15, 2008 | Unregistered CommenterKay b. Day, admin

I was horrified to learn recently that African American mothers in Miami-Dade County are two and a half times more likely than others to loose a baby before his or her first birthday. Midwives can directly and positively change those statistics. I'm so glad to have had my children with midwives. I weep for the families that will be deprived of affordable, accessible and culturally sensitive care from the midwives that would have completed the MDC program. Thank you for covering this story.

August 19, 2008 | Unregistered CommenterMad Mama

The statistics you used are for all midwives in the state not just licensed Midwives. That 11 percent represents the Certified Nurse Midwives in the state and the licensed Midwives. CNM's far outnumber LM's by 5 to 1. We need to watch the information that is sent out so that credibility is maintained.
I am saddened by the loss of this program as it decreases the options women have for birth in Florida.

August 19, 2008 | Unregistered CommenterRachel D

Rachel, I'm not sure I follow you. Are you saying CNMs do not have to be licensed? I'm asking because the stats I quoted are directly from the FFM release. I confirmed the release via a phone call. I also checked the Florida
Medical Quality Annual Assurance website--there are references to licensing without breaking midwives into categories.

So I'm confused by your assertion. I'd like to know more if you'd explain the differences in the two categories of midwives and any source you can point me to for stats.

If both are licensed, the stats as they are stand. I understand there may be differentials within terminology, however, I'm not sure those are applicable in this statement.

best, Kay B. Day

August 19, 2008 | Registered CommenterKay B. Day, Editor

CNM's are not licensed the same way that LM's are. They are advanced practice nurses that are licensed by the board of nursing. CNM's are nurses that have a BS in nursing then post graduate education for 2 years in midwifery and women's health. They are not governed by the midwifery statues in the state - which are much more midwifery friendly! then the BON is. The stats are lumped together LM's and CNM's - most CNM's deliver over 100 babies a year- some up to 300. So the math would show the percentages are mainly CNM births given the numbers of CNM's and LM's. As you have noticed even the states stats are not sure what the differences are.
CNM's can comanage high risk moms with MD's where as LM's are licensed to provide care for low risk moms and births in homes and birth centers. I think it is important for the general public to understand the differences/similarities between the two types of midwives so they can make the right choice for themselves.
The Amerian College of Nurse Midwives has a good web site as does the Florida Council of nurse midwives.
best, Rachel

August 19, 2008 | Unregistered CommenterRachel D

To be really technical, CNMs do not have to have a BSN. They can be RNs (ADNs) with a bachelor's in another subject area, who then pursue nurse-midwifery at the graduate level. Although they primarily practice in hospital settings, CNMs also own some very prominent birth center practices, particularly upstate (in the North). Women's Health can be combined with Midwifery at the grad or post grad level, however, realize that they are two distinct educational pathways.

And the "right choice" is any choice that empowers the woman and produces healthy babies!

August 22, 2008 | Unregistered CommenterBW

Thanks for information about the differences within the profession. This enhances understanding of the figures in the original release I quoted. For the public to understand what is a fairly complicated process there would need to be some sort of effort that is expressed in reader friendly manner. I'll look into the prospect of doing something on this in weeks to come. I think a public education effort by midwifery orgs in general would not only help mothers-to-be, it would also help our healthcare system. best, Kay

August 24, 2008 | Registered CommenterKay B. Day, Editor

If you are in the corner and have got no cash to go out from that, you would need to take the ******Because that will aid you for sure. I get student loan every time I need and feel great because of this.

ED NOTE; SPAMMERS CONTINUE TO POST NONSENSICAL MESSAGES ON OUR WEBSITE FOR A SITE CALLED LOWEST RATE LOANS. WE WILL ALWAYS REMOVE THOSE LINKS BUT WE'LL LEAVE THE MESSAGES JUST SO YOU CAN SEE THAT ON THE WEB SOMETIMES PEOPLE USE NONSENSE IN AN EFFORT TO PROMOTE OTHERS.

June 9, 2010 | Unregistered CommenterOwens25Nettie

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