You seem to be making two contrary points: that midwives are trained and skilled, and that they're primitive and unprofessional like mud huts. This is consistent with, for example, someone's pretending to respect their sister's line of work because they're family. Pretty sure you're also afoul of the site guidelines by openly name-calling.

What’s an American equivalent to a ‘prat’?

Interesting question, and I can't really answer it, not being American - "prat" basically means an idiot, but it's quite a useful word because it conveys a real sense of contempt (but often more for the opinion or act than the person responsible for it, in a weird way), and can easily be intensified as in this instance, without actually being vulgar. You can also use it as a verb, eg. "Stop pratting around on Hacker News and do some work!"

I also feel like it was 100% the correct word to use in this instance!

It's a soft version of "idiot". So maybe an affectionately spoken "doofus"?

If you google it, you'll see it's synonymous with "idiot".