So, this is about midwifery and the madness surrounding education, professionalism and the usual list of complaints.
I left this comment over at Sage Femme after reading Midwifery Education and these two other posts:
“I’ve taken the time to read the two blogs and their posts…I feel sad that there is so much talk about money, insurance and ‘needing’ something (education, credential, otherwise) to prove ‘we’ are something that ‘we’ are not. I am not here to be a nurse, a doctor or any other ‘professional’ — I am here to educate, stimulate, empower and guide. I am not here to be paid…though I usually do
I want knowledge, as knowledge carries with it power. However, I don’t want to be forced to ‘do’ something just because I know how. There is, as I see it, an underlying fact, which many never see or talk about and that is: Doctors want us to be and act more like doctors if we are going to be around and Homebirthers want us to be and act less or nothing like doctors if we are going to be around. it can not have it both ways and becoming a CNM is not the ‘middle ground’ or the bandaide.
I also take offense to all the ‘hippie-dippy’ comments. As if those who are less Earth-minded or spiritual are somehow more professional and able to do their jobs.
I don’t want the recognition that comes with being a nurse, because that’s not what I need. I need healthy, happy and honored birthing families.”
As some of you might have figured out from reading things of mine from archives on the old blog, I am not certified or licensed by anyone — I don’t want to be. Once I ‘hand over’ myself to an organization or institution I have to do things their way. I am not even a certified doula, because I couldn’t figure out how to ‘wear two hats’ as a midwife and a doula — DONA is VERY restrictive in what you can and can not say to clients…as a midwife, the knowledge that I have and the advice that I can pass on are not allowed when dealing with a client who is only a doula client and not a midwifery client. So, since I don’t like being limited by artificial means, I chose not to be christened a certified doula or a certified/licensed midwife.
The fact of the matter is, if those around you that you are in the service of think that you are not a competent midwife, that you are dangerous, irresponsible, not ‘professional’ enough, etc., you will know it and you will not be doing much in the way of midwifery for very long. If you don’t like how someone is treating you, you tend to call them out or at the very least avoid them — and more importantly, you usually tell someone else about it. Why do you think there is always that one midwife who ‘everyone’ loves and they tell all their friends about her?
But it’s more than that. If you know you are not capable of doing something, you won’t keep trying to fool others or yourself for that matter for very long. It’s not like midwives are making enough money to risk harm to a mother or her babe — most doctors are. I’m not saying that midwives would act so carelessly, but it is something to think about…money can be fucking scary.
I guess what’s even more important for me and why I can’t relate to the urge for the creation of and the medical establishment’s recognition of University educated midwives is that I don’t want to be a midwife. I don’t want there to be midwives. I want women to be their own midwives. Birth is as safe as life gets. Women used to know how their bodies worked, women used to know how to give birth and what to do if, ‘the cords wrapped around the neck’, ‘I feel faint’, ‘I’m bleeding more than I should be’. We used to have the knowledge of who we are and what we are capable of…we used to know what to do when things got messy. Sometimes mothers die and sometimes babies die and that’s the way it is, but that is for another conversation altogether. We can know these things again and do these things again if there are women (and men!) out there to pass on that knowledge and rekindle the flame of self-preservation within each and everyone of us. We used to have community, tribes and villages – all full of women who knew what the hell was going on. We don’t have that and that is exactly what we NEED. More women should be educated in women. Plain and simple. We need more guardians of birth, less midwives and more doctors who realize the reason they don’t see natural spontaneous births is because they don’t want to sit on their hands and wait around for them to happen.
America is ranked so low on almost every aspect of medical care in the world (there are 41 other countries with better infant mortality rates than us), but we are one of the most technologically and medically advanced nations in the world. We have more toys and techno tricks than we know what to do with. I’m not saying that there are never times when something outside the usual birthing mother’s house should be implemented during labor, but rarely should labor start out with hooks, tubes, monitors and drugs.
I am not done with this, I could go on for ever, I think, but I have to stop somewhere. Please let me know how you feel.
I have to agree with you on many points. We have certainly gotten away from the innate knowledge that was once commonplace. How do we get back to that? How can we help each woman restore her inner Midwife? So much fear now surrounds birth that honestly, it’s amazing anyone even attempts to do it anymore. In my doula practice and aspirations of someday being a Midwife, I strive to bring at least a snippet of that knowledge back to women. I have hopes that someday the pendulum will swing back again for women. Someday women will be confident in their birthing abilities and the fear will be gone. Until that time, may each birthing family in need be blessed with a caring, competent person (whether it be an OB, Midwife, Doula, or trusted friend) to help them find their way during the childbearing year.
Comment by Happy Homebirther — March 3, 2008 @ 12:17 pm
I came to your blog from the very comment this post is about, because I thought it was right on the money. It annoyed me that the two most prevalent trolls on all the homebirth blogs had to put their inane spin on it, but ehh, that’s what they’re here for, I guess.
I like what I’m reading. I’ll be back for more.
Comment by Jill — March 3, 2008 @ 10:34 pm
I just accidentally came across some comments on another blog about how ignorant us homebirthers are and how everybody should be licensed and regulated. I left feeling sick to my stomach. So nice to come here and read this, thank you.
Comment by Linda — March 28, 2008 @ 1:10 am
Linda- You are welcome…all licensure does is promote the penning of one midwife against another, when the mama-baby should be the main focus.
Comment by michele james-parham — March 28, 2008 @ 2:08 am
Hi everyone: This is Kneelingwoman over at Close to the Root blog. I am probaby the person who started the recent round of discussion about education. Navelgazingmidwife’s current blog is strongly referenced to my blog. What I have said about Midwifery education is this: that IF midwifery wants to be a recognized, sustainable, insurance reimburseable, health care profession; it will have to find a way to place it’s educational process in the University system. I am NOT saying that I think that Midwifery will necessarily be better off for becoming said profession; only that if the goal of MANA/NARM is to do these things ( and it is ) then they are going to have to alter their system of educating midwives.
One of the things that concerns me deeply, after 25 years of involvement in homebirth midwifery, is that we are, by and large, a profession comprised of middle class white women serving middle and upper middle class white women. Most women of color, or poor women, cannot afford an “apprenticeship” or attendance at an MEAC accredited school (most of which have annual tuition exceeding those of any State University in the country and do not qualify for federal financial aid ) only to end up with an almost meaningless credential and nontransferable education ( meaning: if the goal of establishing a “midwifery” practice ie business, does not work out as something that can support them financially; and 80% of homebirth midwives in this country make poverty-level wages; they will find themselves having invested a substantial amount of money and time and non of it can be recouped or transferred to another professional endeavor. A woman who graduates from an MEAC school and decides to return to college will be starting from ‘scratch’ with none of her midwifery related work transferred as credits. In addition, while it is very easy to assume when one is 25 or 30 and starting out in midwifery that “retirement” is a long time off and who worries about that now? Trust me, when you are 50, and your husband has left you or died; you will suddenly be very worried about how you are going to support yourself with no retirement account, no health or life insurance. In short, homebirth midwifery as we have known it; is not something that is “safe” for women as a profession because there is no way to make it work unless someone else ( typically, a well employed husband or partner ) is bankrolling your work for you. I have been married for 20 years and a midwife longer than that; I have yet to make half the amount of money my husband ( a high school teacher ) makes in a year. I have no way to provide anything else; no health insurance without his job. No 401K contribution.
I too, practice as a homebirth midwife–non interventive, all care done in my clients homes, focus on healthy mothers and families. I also have an undergraduate degree and am completing an M.A. in counseling. I have 4 children, two of whom are in college. I also believe that the primary reason we are not reaching more than the 2% of the population we are now serving is because our education and training simply do not resonate with mainstream values. It is a fallacy to conclude that a different and more standardized education would necessarily or absolutely, “medicalize” midwifery or destroy homebirth; indeed, in places like New Zealand, it has created a very healthy, rapidly growing and flourishing profession of Direct Entry Midwifery with complete subsidization by their national health service; happy moms and happy midwives! They worked diligently for many years with midwives, consumer groups and other health care providers to accomplish their goals and if they can do it; so can we. American women deserve better than the maternity care system we have; we have to decide if we are willing only to serve those few who want a homebirth or work towards insuring that all women can have a midwife to serve them; in every setting. That does not mean everyone becomes a CNM but it does mean that we get over our idea that because we don’t want to work in the hospital setting; there is nothing to learn there. We do have to collaborate, from time to time, with Doctors and Nurses and continueing to retreat from that reality only further marginalized midwives and the families that count on us to serve them. More education or a different education is just different; not bad.
Comment by Kneelingwoman — March 30, 2008 @ 11:58 pm
KneelingWoman, possibly you can read the follow up post to this one. It goes on to further explain, explore and probe various aspects of this topic.
“I also believe that the primary reason we are not reaching more than the 2% of the population we are now serving is because our education and training simply do not resonate with mainstream values.”
I disagree. The real issue is that women are not educated on their options, the safety of homebirth and especially the fact that most women do NOT ‘need’ a midwife or other ‘professional’ standing over them and taking control of their experience.
There are things which I do NOT do as a midwife that I would be ‘forced’ to do, simply to acquire/keep a license if one was a available. I can not respectfully and authentically serve those who call on me, if I have artificial limitations placed on me. Plain and simple. Forcing me to act in a certain way (usually out of habit and not scientific evidence) in order to serve a HBing woman, doesn’t allow true freedom of choice or informed choice for that woman…let alone what it does to my personal character, liberty and integrity.
Demanding more out of the participates of a kludged system doesn’t fix it…Adding more burden to their shoulders doesn’t fix it…Allowing them the freedom to actually DO what their community is asking them to do, can and will fix it.
Comment by michele james-parham — March 31, 2008 @ 5:31 pm