by Jan Tritten
© 1998 Midwifery Today, Inc. All Rights Reserved.
[Editor's note: This article was written for the book Paths
to Becoming a Midwife: Getting an Education. 2d ed. Edited by Jan
Tritten et Joel Southern. Eugene, Ore.: Midwifery Today, 1998.]
I love midwives. I love all other practitioners who help women experience the best
birth possible. I love the birth process and getting to know it better. I feel great
joy when women have a good pregnancy and birth as well as a good start with their
new babies into breastfeeding and mothering. Midwives are germane to this miracle.
But what is a midwife? Who can be a midwife and how do we define her? Do we have
a right to define her, she who has been caring for women in birth since the beginning
of creation? She who is called by God, not by us?
I look around the world and see that despite midwives, the medicalization of birth
has taken over in all but a few places. One exception is the Netherlands, where they
don't do triple testing and still have a predominance of homebirth. But in my country,
the United States, despite all our hard work a dangerous medicalization of birth
has almost completely taken over. CNMs are fighting against this over-medicalization
in hospitals, as are those midwives who do homebirths. Although there are other very
small movements in different parts of the world, many countries have no counteraction
against this dangerous trend.
The empirical midwife movement in the United States is
one of those few islands where technology, money and brainwashing haven't
taken over common sense, evidence, and woman centeredness. The brainwashing
process has never gained a foothold because the lay midwife's training
is not within the medical model. This re-creation of "authentic midwifery,"
a term coined by Dr John Stevenson of Australia, is a unique contribution
of these lay American midwives. Just as Microsoft mogul Bill Gates could
not have done in Europe what he did in the United States, Ina May Gaskin
could not have done what she did. Both needed to think way outside the
box and then have the freedom to move their ideas forward. American freedom
is a unique concept whose roots run very deep and straight back to the
Constitution. Through the Bill of Rights, Americans were given freedom
of religion (separation of church and state) and the right to the pursuit
of happiness. Birth is connected to both in that we have the right to
the spiritual leader or midwife of our choice. Ina May calls birth a sacrament,
and many others call it a miracle. So, should midwives alone define who
the midwives are, or should families have a part in choosing?
American freedom was also strengthened by the free speech
movement of the 1960s. "Challenge the status quo" was a rally call that
creatively moved birth forward. Becoming the status quo wasn't the desired
goal, because those who represented the status quo were the ones who blocked
us. We continue to need our great outside-the-box thinkers. They are the
people who keep us honest and strong. They are the ones who point out
that the emperor wears no clothes. They admonish us when we nonchalantly
use Dopplers although ultrasound is not proven safe. They remind us to
think through our birth routines. In many countries, no credibility is
given to consumers of healthcare because they aren't professional health
practitioners. Yet, consumers often know more than practitioners but are
written off as knowing nothing. In France and other countries, such attitudes
have made it difficult to get a birth movement going.
Let me be more explicit about my love for midwives. I love
all midwives. I love CNMs, CPMs, LMs, CMs, unlicensed midwives, self-proclaimed
lay midwives, private birth attendants, traditional midwives, Amish midwives,
aspiring midwives and student midwives. We need them all desperately.
Each plays an important role in our eclectic culture. I have spent the
last fourteen years with Midwifery Today to protect and promote all midwives.
I truly believe diversity is our strength and should be protected with
our lives. The decriminalization of midwifery is the responsibility of
us all. The battle cry that rises against this diversity is "how can we
protect the public without mandatory licensing or certification?", but
considering what happens to 95 percent of birthing women and babies in
this country, it's an absurd notion. Protect them—don't worry about the
stamping and approving of midwives. Worry how we will lose midwifery to
co-option. Strengthen the self-disclosure and informed choice (of midwife)
process. Fight the situations in which women are being abused and babies
are being damaged for their whole lives as a result of what happens in
pregnancy, birth and postpartum. Please don't fight and undermine each
other. Find strength in difference; we based a whole country on that concept.
This is America, land of the free, home of the brave (midwife). I can almost guarantee
that if we make licensing—CPM, CNM or whatever—mandatory, another group or organization
will rise up that will serve women better. Limiting midwifery through involuntary
licensing will ultimately limit our freedom to serve families based on what we know
is right. I much prefer we learn to protect women by protecting and standing up for
each other. I love the fact that MANA includes and stands up for all midwives, and
Midwifery Today will continue to do so as well. Valerie El Halta has said that some
draw a circle and leave us out, but I'm going to draw a circle and include them in.
We need to create that circle, a big circle that includes every kind of midwife,
because we need every single midwife-hearted person to work in his or her sphere
of influence to make needed changes in birth. If we can't have unity, let's go for
harmony. Let's celebrate our diversity, stretch high the torch of liberty, and welcome
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