“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.

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.

I like what I’m reading. I’ll be back for more.