Making the New Way
by Jan Tritten

© 1991 Midwifery Today, Inc. All rights reserved.

[Editor's note: This editorial first appeared in Midwifery Today Issue 19, Autumn 1991. Reprinted in the book Life of a Midwife

Most of us come to our birth practices through a deep need to make birth better for women and their families. The experiences that led me into midwifery were my first two births—or the differences between them.

The first of my births represented something of the trends to come in hospital birth. My daughter was born quickly enough in the hospital to avoid most of the current technological invasions. But the few gross invasions that did occur directly pierced my soul and festered there with feelings of guilt and a deep realization that there are no second chances to make this experience right. In the slip of a needle, it was done.

Through the first four years of baby raising and loving, there was yet the lingering sense that something had been terribly amiss with her birth. Wasn't there a better way? And why—after living through the 1960s when we challenged virtually everything—hadn't we challenged modern birth practices? Little did I know that such a challenge was already under way, and I would soon be a part of it.

In 1976 came another pregnancy, and I thank God that I found a doctor who talked me into having a homebirth.  I had a lovely homebirth, and then I knew there was a better way. And I was determined to help anyone in my community who wanted this better way to have it, too.

Through that successful homebirth, and the years of attending births as a midwife, a great healing has taken place within me. But there is still a scar, one that is yet sensitive when I see or hear of unnecessary technology invading birth. Even so, where the births of my children taught me to appreciate non-interventive birth, my midwifery practice taught me that the bottom line is safety: How grateful we are for the technology that saves our mothers and babies in extreme circumstances!

A society that values human life quite naturally develops the devices necessary to save lives and improve the quality of life for each individual. But there is no question that at a certain point the use of this technology may diminish the very quality of life it is meant to enhance. Therefore we have an obligation to bridge the distance between old and new, independent and interventive ways of birth—and craft a use for innovative technology which is compatible with traditional birth, a use which sets natural birth as the normative standard, one which subordinates the technology to the measure of mother and baby's physical, psychological, and spiritual well-being.

Immediately, the paradoxes of our insistence on freedom of choice in birth become plain. For some women, that well-being may arguably include their freedom to choose a drugged, monitored labor with an episiotomy, and their babies in the nursery. And who is to say that a woman should not have that choice? And what about her baby? Is he or she a person who deserves protection? Does he or she have a choice?

Or perhaps the appropriate line of questioning for midwives and educators who are committed to natural birth asks how mothers become so afraid of birth in the first place. I often dream of the possible miracle of the emancipation of an entire generation of birthing women: Whether you are a midwife, childbirth educator, or birth assistant, it is your attitude of being "with-woman" that releases women from the fears that mess up births. Give every mother a with-woman who has the time and training to work with her and her family about their fears, and make this a national standard—and watch the statistical imbalance between the numbers of interventive, medicated or cesarean births and the numbers of natural births self-correct.

Where fears remain to obstruct the natural courses of births, there will remain a ubiquitous use of technology. Choices—no matter how educated or informed the consent—are not real choices when they are made within the context of fear. When a mother embraces a procedure along with its dangers, we are bound by our relationship to her to make sure the freedom of her choice is not compromised by anxiety. In protecting the integrity of her choice in birth, we find we exponentially affect the quality of birthing in general: Mothers who have fears also hand down fearful attitudes about birth to daughters—and to every other woman who will listen. But each woman who gains the confidence to birth as unhindered or freely as her biological circumstances will allow—she will go on to encourage her sisters and daughters with birth words and images which resound with all the potential strength and beauty of birth. And so, with-women, we must make the new way our way—better, one birth at a time.

Jan Tritten is Editor-in-Chief of Midwifery Today magazine.


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