Photo by Eneyda Spradlin-Ramos
Marsden Wagner with Midwifery Today conference attendees

Editor’s note: This article first appeared in Midwifery Today, Issue 110, Summer 2014.
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To Marsden Wagner, my friend

Marsden was a colleague, a great Midwifery Today writer and speaker, and a dedicated supporter of midwives, but he was also my good friend. His love for midwives and midwifery was profound, so it is easy for me to imagine him now in Heaven helping to birth us into our new and permanent home. As a son of a preacher, he would play “Amazing Grace” on the piano for us at conferences, and he lived his life with such amazing grace and purpose that the void left by his passing is palpable.

After the terrorist attacks of 9-11, I fell into depression, which is unusual for me, and when Mardy found out about my state, he admonished me for not calling to talk things over with him and told me to be sure to call if I went through anything like that again. I was touched by his concern, but that kind of concern was manifested throughout his whole life as he spoke the truth about midwives, babies, birth, and the medical system. He believed we should not succumb to industrialized birth practices, often using the word “medwife” to describe how we should not become. He came out strongly against things like Cytotec inductions, unnecessary cesareans, and other abominations. I remember him giving us strong warnings against weakening authentic midwifery.

Mardy never minced words and was passionate about the things in which he believed. Midwifery Today was really blessed in having such a strong advocate of both our organization and midwives. Mardy and I were in Hawaii, Japan, China, Denmark, and many other places together, trying to change the world one midwife at a time so that they could change the world one baby at a time. At our retreat in Hawaii, Mardy gave me the most unique compliment. He said, “You know Jan, your gift is seeing the strengths and abilities in others.”

The first thing Mardy would do at each conference was apologize for being a man. He stated that he would never be able to feel what it was like to have a baby. He believed no man could really understand birth the way women could. He also believed women were the only ones who could be “experts” in birth and, therefore, midwifery.

Mardy’s intensity was his strength. He raced to get his last two books out. There were things he wanted to say to the world of moms and midwives before he retired. Born in the USA and The Birth Plan were his last two books. They are as relevant today as when they were first written. He still speaks to moms through those books. His other book, Pursuing the Birth Machine, is classic but sadly out of print. If you can get a copy of this book, do it.

Mardy was a man who was genuinely for midwives. He did all he could to put us forward and help us reclaim our God-given place beside women. He also did all he could to keep us on track and not jump the track to medicalization. I miss him so much. When my work on earth here is done, I look forward to the day he helps me birth into heaven!

Rest in Peace my dear, dear friend.

— Jan Tritten

P.S. Oh, and he loved his cocker spaniels and had four of them. I have one, too, so this is another thing we had in common!

I don’t know of anyone who has worked harder and more effectively to champion the cause of midwifery and to better maternity services than my friend and mentor, Marsden Wagner. What can I say about this dear, tireless, brave man who fought so hard on so many fronts to make birth better for women and their babies? I first met him when he traveled to The Farm back in the early 1980s to learn about our midwifery service. He made so little of his own credentials that I didn’t realize until later that he was a doctor and a perinatal scientist who worked for the maternal-child health division of the World Health Organization (WHO). In the mid-80s, he invited me to be part of a consensus group sponsored by the WHO at Esalen Insitute in California. Judy Luce and Lester Hazell (author of Commonsense Childbirth) were part of that group. He liked getting public health scholars and officials in the same room with midwives and childbirth educators.

What I appreciated most about Mardy was that he could not stand injustice, bullying, or ignorance, and was willing to rip the masks off and expose bad behavior by those who had too much power. He kept shining the light on the obstetrical backlash that opposes a much-needed strengthening of the midwifery profession in an increasingly technological world, knowing that medical colleagues sometimes have to hear such truths from one of their own. Whenever he got a chance to speak to doctors who were blind to the importance of midwifery, he spoke his truth and presented powerful evidence for it, no matter how strong the resistance was to hearing him. Unpopular as he might have been with many, he found physician allies all over the world whose consciences were awakened to strengthen the cause of humanized birth. When certified professional midwives turned to him for help in passing legislation that would protect their autonomy here in the US, he educated us on how to fight to pass more favorable legislation. He exposed the global witch hunt whenever he found it, always reminding us that the struggle for control of maternity services involves the huge underlying issues of money, power, sex, and choice. Nothing will be handed to us, so we’ll have to fight for whatever we get.

What a good life you led, Mardy. Thanks for showing us how to fight!

— Ina May Gaskin

Marsden Wagner was a passionate defender of women’s rights in childbirth and a tireless advocate for humanizing maternity care and making it evidence-based. He was a galvanizing and charismatic speaker who made his points with drama and effect! Before he went to speak in almost any country, he would ask the childbirth activists there to get him exact statistics on local intervention rates, especially cesareans, and he would use those local stats in his talk to point out the deficiencies in local care in precise terms. That took a great deal of work, but he was always happy to go that extra mile. His books and articles influenced, even radically changed the thinking, of thousands of people, including many obstetricians. He was one of the primary worldwide leaders of the childbirth and midwifery movements and will be recognized as such for decades to come. He was always willing to help in any way he could—I saw him interviewed for many documentaries and remember well one long interview in a grassy field where he was getting bitten by mosquitoes. The taping didn’t work and when the interviewers asked him to do the whole thing over, he agreed even though he was exhausted and miserable from the bites because, as he said to me, “I am a nice guy!” And he was—kind and loving to all his friends and always willing to help out however he could. He will be sorely missed!

— Robbie Davis-Floyd

I will always remember Mardy as a performer, whether lecturing about the essential role of midwives to us believers or to a group of skeptical senators in California. I loved the way he steadily built his point and then gave us the lowdown, hitting the punchline hard. I also recall the time that he told me I was a better writer than he, but that he was a better speaker. I picked up the gauntlet and from that moment forward, my speaking skills steadily improved as I emulated his way of speaking from the heart and always with passion.

Serving as an expert witness time and again in our legal struggles state by state, his help was immeasurable—he was our hero. When asked what he considered the most pressing issue for midwives, he answered without hesitation, “Autonomy.” How right he was.

Plain and simple, I deeply loved and respected Mardy; I celebrate his life and wish him peace. Truly, a remarkable man!

— Elizabeth Davis

Marsden Wagner: a champion of midwifery!

Marsden Wagner was a man on a clear global mission: to replace destructive maternity care practices with woman-centered midwifery care in order to improve the health of mothers and babies everywhere. A blunt and magnetic iconoclast, he spoke the truth or, it may be more appropriate to say, he preached the truth! He often told his audiences he was the “son of a preacher man,” and his passionate and animated talks were more like sermons containing facts, figures, and science, mixed with just enough hellfire and brimstone to fuel his arguments and rivet his audience with his message. His impeccable credentials within the World Health Organization provided him with opportunities to address and be listened to by the most powerful leaders in maternity care. Yet he also made time to address and inspire the midwives and their supporters who provided the backbone of the care he advocated.

We have lost a tireless and charismatic spokesperson for midwifery, yet we can continue to be inspired by his message. May he rest in peace.

— Penny Simkin

W hen I first met Mardy in the early 1980s, he was speaking to a group of midwives in the state to which I had recently moved. I had traveled two hours from my home to hear him. I was very new to my craft within my community and was hoping to meet like-minded birthkeepers that day.

I made an impassioned appeal for my/our need for sisterhood and, because I was not a licensed midwife at that time, I could feel the ice run over the audience like the spreading of frosting on a cake. I sat down with an overwhelming sense of hurt, sadness, and defeat. I had received another not-so-welcomed expression at a previous gathering and was hoping my feelings were simply a manifestation of my own insecurities. After I spoke, Mardy and Penny Simkin openly expressed a need for all types of midwives, including unlicensed birth attendants. After the lecture, Mardy seemed to perceive my heart and moved through the crowd, put his arm around me and kissed the top of my head. He expressed the warmth and kindness I had been hoping for and made the rest of my day and trip worthwhile! Little did I know that years later Marsden and I would be associated with other like-minded teachers through Midwifery Today.

Another thing I would like to say is that I cried when I heard of his passing, because I had always hoped to speak more to him about one of my passions in midwifery: autonomy. He saw the need when long ago it wasn’t truly realized. We need your visionary insights more than ever, Mardy! I hope that what he imparted can be part of his lasting legacy as we rebuild those walls that can be easily shaken. I pray I will see you again, dear friend!

— Carol Gautschi

An anecdote to illustrate the personality of Marsden Wagner

It happened in July 1986. Marsden Wagner and an American midwife visited me in London. I invited them to come and see a family two days after a homebirth. The mother and her boyfriend were squatters. The housing conditions were so rudimentary that the community midwives had not agreed to attend the birth. The midwife accompanying Marsden and the young mother had a passionate chat. Marsden, with his long hair, wearing a blouson jacket and jeans, was just sitting on the floor, silent.

Some days later the young mother told me how impressed she was by the American midwife who came with me. She added, “By the way, who was the guy who was sitting in a corner?” I was obliged to explain that he was Dr. Marsden Wagner, responsible at WHO for maternal and child health at the level of the whole European region…!

Marsden and I had many common points. One of them is that we took part in the sudden emergence of the MidwiferyToday phenomenon in the 1980s.

— Michel Odent

The first time I met Mardy, he was on a stage. Microphone in hand, he was explaining to several hundred people why he thought it was that doctors had come to fear childbirth in general and birthing women in particular. The reason, as I went on to hear him explain many times over the next couple of decades, was that women who are birthing under their own steam are immensely powerful. According to Mardy, the predominantly male obstetricians were terrified of this power and thus sought to do whatever they could to subdue, contain, and control it.

This section of his talks never failed to have the desired effect amongst midwives and birthworkers, and Mardy was an amazing speaker who captivated audiences both through what he was saying and by the ways in which he said it. He always took time to research the local issues and politics ahead of going to speak anywhere, which meant he was brilliantly prepared and consistently able to get to the nub of the issues. Moreover, while many of us used our days off from speaking in foreign climes to explore the local area or sit by the pool, Mardy was generally missing in action because he had, of his own volition and usually at his own expense, arranged to meet with those who were standing in the way of local midwifery autonomy, birth choice, or both.

I learned a lot from working with Mardy—about birth, about speaking, about politics, and about the importance of knowing when to speak out and when to use more subtle approaches. More than once, when we were in committee meetings together, he used the fact that I was sewing or knitting while I listened to gently draw people’s attention to the knowledge and skill that was held in midwives’ hands and the importance of respecting these midwifery skills. Marsden had such respect for women and midwives. He was an amazing champion, an original, an amazingly passionate and insightful man, an incredible orator, and a wise friend and mentor to many. He will be so missed but always remembered for the incredible work he did for women, babies, midwives, and birthworkers everywhere.

— Sara Wickham

I first met Marsden Wagner in Melbourne in 1993 when he came to support my colleague Dr. Peter Lucas. He was a gorgeous man, both soft and strong, and he was fabulous with the media over here in Australia. He always did his homework to get local statistics, sometimes undercover, and he generated some great headlines. (e.g., “Having an OB attend your birth is like having a paediatrician babysit your healthy 2-year-old”).

He was heartfelt and a powerful advocate for mothers, babies, fathers, and families all over the world, and he leaves a great legacy for all of us.

— Sarah J. Buckley

Marsden lived his knowledge and insights with grace. He shared information and wisdom in thoughtful, clear intention and brought hope to possibilities. He helped midwife consciousness and action for women and birth. Thank you, Marsden!

— Harriette Hartigan

Marsden Wagner was my friend and teacher. I first met him when he testified in my (and Mary Sullivan’s) defense in a court case in British Columbia in 1986. When we asked him to testify, he requested that we send him our notes and chart from the case. He took our notes to a physician and a midwife in Europe, where he was living at the time, and asked them to review our paperwork. He didn’t tell them that the baby had died of an unforeseen shoulder dystocia complication right at the end of the birth process. The notes ended minutes before the complication. Both of his chosen practitioners said to him, “We would not criticize what the midwives have done from these notes.” That was when he became part of our defense team.

In the years following, he and I had many reunions at midwifery conferences. We ended up on the same plane going to one conference and I remember telling him how much I admired him and how important his work was. He replied, “Gloria, you and all the women who actually go to the births are the ones that I admire. You keep me going and I stand in awe of you.” I was so touched by that acknowledgement. Another time at another conference, he said something that has helped me through many tough places in my career. He said, “I’m only in this movement because it’s a parade that I can dance in. If you can’t enjoy this work, don’t do it.” He wasn’t passionate about birth in a suffering way—he loved babies and he wanted to move obstetrics in an intelligent direction that would serve all of humanity, and he had fun with the journey.

Thank you for your life of service, dear Marsden.

— Gloria Lemay

I first met Marsden in the 1980s when he, as a WHO representative, came to my then place of work, the Clinic of Gynaecology and Obstetrics in Szeged, which was one of the Hungarian WHO Research Centres.

The way he spoke about possible changes and a possible revolution in obstetrics was very similar to the dreams I had in my mind while I was working as an obstetrician, isolated in the traditional high-tech hierarchic system. Meeting him gave me the final encouraging push to step on the way I had already chosen. We can say that, in this way, Marsden was a key figure in the changes that took place not only in Hungary, but as an aftermath in the whole Eastern bloc as well.

On behalf of the Hungarian women, with love and thanks,
— Ágnes Geréb

What I will miss most about Marsden Wagner is his sense of humor. Everyone who has participated in a Midwifery Today conference knows we all wear name badges. From the first time I first started working with Mardy, he would stroll up to the registration desk, I would hand him his packet and name badge and he would say, “Badges? We don’t need no stinking badges!” And then we would both laugh. Sometimes he would put it on just to please me and sometimes he would have on the coolest t-shirt and complain that the badge would put holes in it.

Wherever your next journeys take you, Mardy, when they ask you for your badge to get in, just tell them, “Badges? I don’t need no stinking badges!”
— Lora LaPorte

Mardy, you were a father figure, a colleague and a brother to us midwives.

As our father figure, you were a protector and a supporter of us midwives. With your brilliant mind, your willingness to explain to the world in simple but elegant terms the reasons why midwifery-based care was vital, and your willingness to travel the world to defend us midwives in legal suits, you have been a tireless and unconditional provider of nourishment and support. You were a true colleague in the way you did team work with us, never feeling superior to midwives and always travelling the distance side-by-side with us all around the world in our many international conference adventures! As a brother, friend, and fellow human being, you will always be missed.

Mardy, in your jeans and wavy white hair and beard, your astonishingly sweet blue eyes and your outstanding professional history within the WHO and as a medical doctor, we are forever grateful to you for helping us pave the road of medical recognition for midwives around the world!

— Naolí Vinaver

Marsden Wagner; what a man!

You have to be a real man—a great man—to speak truth as Marsden did with such eloquence. As a perinatologist, he understood the process of birth. As regional officer for maternal and child health in the European Regional Office of the World Health Organization, he advocated to improve the safety of birth for mothers and babies. As a doctor, he saw the difficulties inherent in a medical system that insists on treating normal birth as a medical condition. And as a great man, he was willing to endure the criticism of his colleagues while he educated the world about a better way to provide maternal and child health care.

Marsden Wagner saw that the commercialization and medicalization of normal birth was the reason for America’s poor maternal and neonatal statistics. We trail every other industrialized nation in birth outcome and have the highest rates of maternal and neonatal mortality. We are the one developed nation where the “business of being born” means mothers and babies are harmed by inappropriate medical care.

Marsden Wagner worked to develop the concept of “appropriate care for birth,” which says that every woman should have access to necessary medical care, but that no woman should be harmed by unneeded or unwise medical care. He stood against the strong tide of an obstetrics profession that often seems to adopt technological innovations first and ask questions about effectiveness and safety much later.

Marsden understood that normal birth is a physiological process, not a medical procedure, and losing this distinctive difference is one of the core causes of the abysmal statistics in the US. He also realized a simple truth: Midwives are better at doing normal births than are doctors. He wrote, “Science has proven that for attending low-risk births (that is, births without complications), midwives are not second-class obstetricians, but rather obstetricians are second-class midwives.” (from his book Born in the USA)

What a man! What courage it must take to see a major flaw in your own profession and be willing to point it out to the world! And furthermore, to ask it to change!

Dr. Wagner understood that normal pregnancy and birth is the special focus of midwifery. Abnormal birth is the special focus of medicine. When doctors specialize in births that require medical care, midwives can provide the best care for normal women. And the most effective way to improve birth outcome is to encourage and support midwifery.

Goodbye, Marsden Wagner. You were a great man and will be sorely missed.

— Gail Hart

I admired Marsden’s ability to take time to explain issues in order to help me help parents advocate for themselves. He was a strong voice for maternity services in the US and around the world that involved optimal care for motherbaby. Marsden said, “Childbirth is not a medical issue; it is a social issue that may or may not have medical consequences.” He shared his knowledge with me freely in order to help parents advocate for themselves. His strong belief that maternity care will become fully integrated into social and family services only when it has escaped the hospital will always live in my heart to continue this work no matter what comes.

I miss him.

— Eneyda Spradlin-Ramos