Churchhoney

Well, this is what they say about the test. And it suggests that it's a somewhat more formal process. Although it's hard to tell. .... The test is required by all the states that license CPMs, apparently. And I'm not sure that 28 states would all accept as a qualification a test you can take entirely with a crib sheet. .... But who knows, I suppose. tep 2 - Certification When the applicant has completed one of the approved educational routes of entry, the applicant may apply to become a Certified Professional Midwife (CPM), and take the NARM Written Examination. The Written Examination consists of 300 multiple-choice questions . This examination is computer-based and administered in two, 3.5-hour sessions. The NARM Written Examination is the final step in the CPM certification process. This examination is also administered as the final part of national legal recognition processes. The NARM Written Examination is only given in the United States.

Well, the association has to do enough to satisfy the states that actually do allow these folks to practice legally. They want to keep up their standards to the points that no states will withdraw their approval of CPMs practicing and, they hope, that more states will open the doors to them ..... So they do have motivation to keep up some standards, such as they are. That's not a terribly unusual form of oversight for trade and professional people's associations to have, really. I'm sure the group itself doesn't use "primary" and "assistant" interchangeably. Doing something like that would be cutting their own throats. If you want to practice in this field -- which already has tons of doubters -- it wouldn't be in your interest to create a system that allowed utterly unprepared people to practice. ... I do wonder whether individual "mentors" do that, though. That's what I wonder about the Jill situation. I'm sure it's not what NARM's leadership intends, since they'd clearly like to enhance their reputation, not drive it terminally into the ground. But I can see Venessa or somebody blurring lines and fudging stuff to "help" mentees get their certification. It wouldn't surprise me at all if an individual did that. ... It's really just the sheer numbers of things Jill was supposed to have done that make me scratch my head, considering how little practical stuff she seems to have done in the last three years or so. But I suppose that may be because when I think of getting this experience, I think of somebody trying to get the experience in a fairly compressed time period, close to when they sought certification, so that you'd be doing the stuff intensely. That, to me, would make the experience more valuable. But I suppose that what really may have happened is that Jill had this list of experiences over a three-year=plus period or so that actually pretty much ended three years ago. .... That's my question. Because obviously the group association wants to make sure that people have some experience being the primary midwife -- because obviously you desperately need some of that if they're going to certify you as someone who can go out and ... be a primary midwife. .... Like you, I don't remember much ever being said about Jill taking that role in births. And I would think that as you shifted from the "assistant with supervision" to the "primary with supervision" that would be a big deal, and you'd mention it -- or show it on tv or whatever. It's just very odd to me that they'd keep that quiet. I don't see why anyone would.

That's cause they're all at Sotheby's and Christie's. Silly.

See, I kinda expect that a fair number of people who are wildly infatuated with the Duggars and Jessa have said exactly this. And a lot more have said -- Squeeeeee! I have an autograph of Jessaaaaaa! I'm going to keep it under my pillow! I wish I were just like her! The delusions of fandom are hard to overestimate, I think.

It's NARM -- the CPM association. So, a standard-setting body made up of CPMs. .... You don't have to take any classes for their certification. You just have to read, basically. You get the information for the exams out of books, not classes. Plus, you do this practical stuff. .... I do wonder about the numbers, though. Not about the assistant ones -- she clearly was doing that and would have been able to do that many certainly. ... But I don't recall anything being said about her being the primary caregiver for a bunch of births and exams, and she actually needed more of those than in the assistant category. Given that Venessa (or whatever her name was) got her license pulled sometime in there, so that Jill would probably have had to find a new mentor. Plus, she clearly did stop when her involvement with Derick began. So, given all that, it seems like a heck of a lot of primary-attendant stuff to have done, with the flux that was going on. That's 135 exams and 20 births as primary attendant. That's a pretty big time commitment, in my opinion, considering that her mentor was kind of out of the business during that period, so she might have had to arrange a lot of the stuff herself -- make the appointments and everything. And if you're primary attendant at a birth, that's going to be a somewhat open-ended time commitment each time. AND, it seems that most likely would have been in her courting/engaged/wedding-planning period, too, when she was all in a whirl. And she stopped her practical work altogether once she was married, did she not? I would think that those 20 babies in the photo were the 20 she delivered as primary -- except, as I recall it, they stated her role in their births in kind of modest terms. And if she had actually been the primary midwife for those 20 babies, why wouldn't they have put it that way? Plus, she's a Duggar, so I'm puzzled that I don't remember stuff being said about her actually doing a lot of work as the primary caregiver. Just seems to me like something they'd brag about. (heck, seems like something anybody who was doing this would brag about; I'd brag about it, I think.) I'd just like to see a timeline that shows when she did all this stuff and how that schedule interlocks with her courting/wedding planning/now-I'm-married-so-I've-stopped-doing-anything period as well as with the Venessa-loses-her-Arkansas-license period. Because I can't make much sense of it. She may well have done all this stuff, but the main thing I remember from the most recent years is her NOT being involved with delivering babies.

Maybe she's a changeling and that's why she looks so depressed all the time. She can't believe the fairies dropped her off at the Duggar house, of all places, and because she's not a Duggar she's the only one smart enough to realize what a hellpit it is. Why in the world does this idiot network feel called upon to offer salaries to some of the most boring people on the planet? Is there really nothing else they can film?

Having to sign other people's headshots isn't a good omen for your chances of being a Hollywood icon, Bin.

So it's to take some of the burden off of Grandma, then? lol

Still Not Dead (Yet, But, Unbeknownst to Themselves, the Duggars Are Currently Helping to Kill Him Off)

Yep. Unfortunately, this kind of thing tends to happen in communities where there's a lot of fundie (or otherwise establishment-hating) influence. IN those places, non-medical midwives tend to be acting based on their "faith" and/or ideology, rather than common sense. So just as with people in such communities who refuse to get their kids medical care or call community prayer sessions while otherwise ignoring somebody in a diabetic coma or don't vaccinate, etc., etc, it tends to be hard to get get prosecutions to go anywhere. In a community like that, you've usually got lots and lots of people who reject common sense in favor of "faith," and they're not just parents and midwives but the people on the police department and in the courts and on the juries, too. Basically, you've got two mindsets in health practitioners outside of medical institutions, I think. -- Some see their roles as dealing with basically normal and natural situations that don't actually require medical intervention, and people like that tend to be alert to signs that a situation is turning dangerous and are happy to turn it over to medically trained people who know what to do. These are people who see medical-institution workers and community-health workers as two sides of the same coin -- both involved in helping with people's health but appropriate for two very different kinds of situations. They don't hate healthcare workers or science. In rural areas of developing countries you really really need such people because it's hard to get enough medically trained people in there. But then you've got the other kind who are so steeped in their "faith" or some other ideology that they're -- consciously or unconsciously -- hostile to science and medically trained people. And their biases can pretty easily make them override their perceptions and try to ignore medicine altogether. I think this kind of non-medically-trained midwife is probably particularly prevalent in countries like the United States where you have such a strong conservative-faith presence .. (I would note that, in my opinion, some medically trained people have biases of their own. Overtreatment for a lot of things is another major health problem in this country, and it can be as dangerous and unhealthy, not to mention expensive, as undertreatment and dumb stuff that some people embrace cause it's "natural" or godly. Common sense and an open mind would be good for everybody when it comes to health care, seems to me.)

They're becoming a theater family, clearly. ... Too bad Marjorie opted out. Remember the mime. I'm liking my idea about the All Duggars All the Time Theater for Branson more all the time.

I think some helpful light may be shed on the inner lives of these young people by this blog by the wonderful Cynthia Jeub. It's a blog entry where she comes out as bisexual. A couple excerpts: "I had my heart broken twice before I realized I’d been in love. That might sound like an exaggeration or melodrama, but it’s actually possible thanks to the wonders of purity culture. "When I was a teenager, I read and re-read books like Sarah Mally’s Before You Meet Prince Charming, Eric and Leslie Ludy’s When God Writes Your Love Story, and Debi Pearl’s Preparing to be a Help Meet. "They kept me strong in my dedication to never think about sex, or to think about members of the opposite sex. I had my obsessions and celebrity crushes, but if the image of seeing someone naked ever entered my mind, I’d fight it out with quoting the Bible.... "Blame doesn’t fall on any one person for how I controlled my thoughts.... "Surely I didn’t love my best friend when I started college. He didn’t love me, so I told myself to “guard my heart” and push away all emotions of attachment. At the same time, our late-night conversations kept me going through my darkest depression and most intense stress. I finally told him that I needed space to figure out why the sight of his name gave me such indecipherable pain. "It would take me months to unlearn what purity culture had taught me to do: conceal all desire, even from yourself. "So it was that I fell in love with a man, and didn’t realize what had happened until afterward. I just assumed I was straight because I was attracted to men. It never occurred to me that I might make the same mistake twice, equally blinded to my desires toward a girl....." https://homeschoolersanonymous.wordpress.com/2015/09/23/purity-culture-and-my-sexuality/ One can only imagine how contorted this whole mess gets in the minds and hearts of kids like the Duggars who don't manage to flee the way Cynthia J did, who aren't as intellectual and reason-driven or as well educated as she.

Not if you come from a family whose heads have been completely warped by being on reality tv for years and years. (after the warp job was started by their parents' personally unbalanced/cult-encouraged behavior, of course) Wonder what it will take to start correcting their multiple delusions. It'll certainly be a massive job. And of course they're not going to start now, even, because -- TLC to the rescue! Very scary for them, really -- and the worst part is that they have no idea. You can tell from his speaking style and self presentation that he'd be an absolute natural at acting. And, of course, his great ability to understand and empathize with the feelings of the many kinds of people an actor plays would also be a huge help. .... Wow, Bin. No wonder this was your ambition. Cripes.

Well, notice that I said that, with it, I judge that she'd probably be competent to assist and learn from other non-medical midwives who have been working for many years. I completely agree that she wouldn't be qualified to do anything on her own or be the primary caregiver in any situation. Or to work around any kind of birth that can't be handled by a non-medical-trained midwife. I was arguing against the oft-made statement that what she has -- if she has this certificate -- is the exact same thing as a doula has. It's not. It's more than that. People keep saying that she could take the written test with no practical experience. And unless they lied or got others to lie for them -- and of course that's not out of the question -- she couldn't have. THe other thing that I was trying to say is that, for Jill, it would have taken a significant amount of time to get that experience -- if she indeed has it.

Well, if she actually is a CPM, certified, then she has had a significant amount of practical experience. (This is why I've been in doubt about whether she actually has attained the certification -- over the past few years it's kind of hard to see how she could have assembled this much experience, in my opinion, but anyway ...) According to the NARM website, she would not even have been able to register for the written exam until she had completed the following: "Document the fulfillment of these requirements on the appropriate NARM application forms. Phase 1: Births as an Observer 10 births in any setting, in any capacity (observer, doula, family member, friend, beginning apprentice). Phase 2: Clinicals as Assistant Under Supervision 20 births, 25 prenatals (including 3 initial exams), 20 newborn exams, 10 postpartum visits as an assistant under the supervision of a qualified preceptor. Phase 3: Clinicals as Primary Under Supervision 20 births, 75 prenatals (including 20 initial prenatals), 20 newborn exams, and 40 postpartum exams as a primary midwife under supervision. Continuity of Care births are required in this phase." Then: "Upon fulfillment of the above requirements you will be sent a Letter of Completion of NARM’s Portfolio Evaluation Process, which will qualify you to sit for the NARM Written Exam." Then, after you pass the exam, you do Five Additional Births as Primary Under Supervision And then you get the certification. http://narm.org/entry-level-applicants/ When she would have done all this, given the stuff that's gone on, I don't know. But if she does indeed have the CPM certification then, yes, she has a reasonable amount of practical experience. I would think, in fact, that that much experience could qualify her fairly well to go to Central America and help out as an assistant and learn from the local non-medically-trained midwives, of whom there are many in rural areas, who'd have plenty to teach her from their much longer experience plus knowledge to impart about local conditions and health practices and so on. I can see her eventually being useful in some capacity if she went there as a trained learner with all the experience that a CPM certification apparently provides. If not, though, then not. And, of course, provided she actually is pretty fluent in Spanish. Although I don't know when that really would have happened either. Are they lying about the CPM certification or did they get somebody to fudge and attest to experience she doesn't have to get the certification? Well, they've lied and fudged before. On the other hand, she's been working toward this for years, so maybe she has done this stuff.

Could be, I guess. And if so, I hate these people more than I already hated them. Doesn't really matter though. I already hate Jim Bob and Amy. A lot.

I imagine she did know this. She can't really attend births inside of medical institutions in most countries (perhaps not in any countries.) The whole point of CPMs is that they attend births that occur outside of medical institutions. In the United States, that often tends to mean that they attend home births with mothers who, often but not always for reasons of their faith, are opposed to hospital births and the medical establishment generally. Around the world, however, many many people have forever given and do today give birth outside of medical institutions because they live in rural areas or otherwise don't have access to medical institutions. And lay midwives have always assisted in those births, and in many many cases assisted very ably indeed. The world is full of lay midwives who take their work extremely seriously and do a damned good job of it. Now Jill's an idiot largely, in my opinion, because she's a Duggar, born and raised in a family that doesn't believe in reason or thought at all. But Jill's deficiencies don't mean that no non-medically-trained midwives are worth anything, in my opinion. Not at all, actually. They're worth quite a bit in many places, always have been and likely will be for a very very long time to come. That's not to say that everyone is a good one. But neither is every neurosurgeon a good one. Somebody was at the bottom of all those med-school classes, too. When we hear outrage from medical workers about why thus and such person with thus and such training should never ever be allowed to do x, y and z, I think we always should take it with a fair-sized grain of salt and look carefully at both sides of the issue.Because, as someone who's observed this for quite a long time, I'll tell you that here may be no more vicious sniping on earth than the sniping among different groups of health care providers about what exact kind of training and experience make some one qualified to do this, that, and the other thing. The long drawn-out battles between psychologists and psychiatrists, anesthesiologists and nurse-anesthetists, doctors and nurse practitioners, primary care docs and specialist physicians, hospitalists and surgeons, radiologists and surgeons, etc. testify to this. The medical field has always been and still is the scene of massive infighting usually aimed at keeping some other group of workers from doing the work that one group of workers now has a monopoly on getting paid for. And the best answer is never simple and hardly ever is black and white for or against either group of workers in question.

I think that's a really sensible thing to ask .... I'd be inclined to posit it myself if I ever saw anything that I would call concern for or interest in her kids coming out of Michelle. Maybe we are misjudging her on this one, but to me it seems so all of a piece with all of her other behavior -- handing over six-month-olds to other kids to raise, saying the exact same thing about everybody's birthday, never seeming to remember any family stories except the ones about herself, having 19 frigging kids, not doing the homeschooling herself, etc. I'm an extremely cold fish, so I do often feel like a hypocrite dogging on Michelle for something similar. Nevertheless, I'm pretty sure that people can usually tell in some way that I'm demonstrating concern for them. On the other hand, I've seen family members who truly don't have concern for anyone, and they do things that are just -- different. I remember one member of my family really enjoying herself at her youngest brother's funeral, for example, and it wasn't just that kind of out-of-control laugh situation or someone trying to help everybody get through things by lightening the mood or whatever. She'd found a way to get to be the center of attention among one part of the funeral crowd and she was clearly just enjoying the hell out of it, without giving a crap who was in the casket. I get that feeling about Jim Bob and Michelle a lot -- although, as you say, it could be a misreading. Complicated situation, certainly.

Just accurate. Your piece is spot on, wise and beautifully told as well.

Maybe terminal narcissism? Like her husband?

Well, sure, ego is why they all really have a ton of children, Bates and Botkin and Maxwell and David Rodriguez and the whole rabbity gang. But the entire constellation of religious groups that the Duggars have hung around with and clearly identify with are part of the American fundie tradition that preaches producing armies for the Lord, to out-populate other groups for Christ and to make sure you have enough descendants to dominate governments and other institutions. Every religious and cultural scholar out there knows that this is a strong theological underpinning of the Gothard cult and numerous others. And the Duggars are clearly closely identified with those groups. Why else would they have been featured speakers for years and years at events sponsored by people with these ideas? Just because Jim Bob seldom or never mentions this fact in public is in no way proof that he doesn't ascribe to it. Pretty much all the adherents of this idea know by now that mainstream people find it offputting, appalling and downright scary. So they shut up about it in public, particularly when they're trying to win over a mass tv audience and sponsors. And it's not just the "army of the Lord" people who refrain from mentioning their religious and other convictions. How many public figures publicly state their actual beliefs when they know that those beliefs might spook people whose approval they need for tv ratings or votes or to sell movie tickets? Has John Travolta ever told us everything he believes as a Scientologist? No way. Same thing for Jim Bob.

Bravo.

I'll expand on this thought. Decent people don't smile when strangers are strapped to backboards. I guess that's the difference between decent people and people who have "servant's hearts" and those oh-so-inspiring "hearts for the Lord." I guess the Lord doesn't give a crap when children are strapped to backboards, either. Among the many things that are appalling in this, how can so many who share their religious beliefs not see how the Duggars' behavior again and again casts those beliefs in the most terrible light?

Yay for normality. In later decades, you'll still know mostly nothing but at least there'll be a little bit of something to stand on! Even the little shreds of knowledge we get make those later decades better. Unfortunately, I believe Ben and Jessa have been explicitly taught that, by virtue of the "religious" beliefs with which they've been inculcated, they actually do know everything, and that further information will only be a tool of Satan designed to throw them off course. I think it's likely that, rather than taking tough life experiences as life lessons, they may take them as signs that they're among God's true elect whom the devil has picked out for special persecution. And the answer to that could be Double down! Triple down! Quadruple down! ..... And if that doesn't work, then anger, bitterness. Turning them into normal people who get more clues as time and experience go on could be uphill work because of that, I think. I was thinking of that Jessa entry on the family blog yesterday and her stuff about how JB and M are A Number One Perfection in the parenting department. Says to me that, at this point, she can't imagine that anything Duggar needs the slightest emendation or development. She either has no idea or couldn't care less that many people see her as a very unformed and immature work in progress -- at this point mainly mean, lazy, poorly socialized and generally idiotic. Wonder what it says about you, personally, if the very best parenting in the entire world turned you out like this. But I don't know what kinds of questions she'd ever allow herself to ask about it, no matter what happens.

Living With Narcissists 101