Some conclusions on midwifery

I've thought about this for most of the last decade. When I first heard of the term "midwife", I immediately thought of a caring, wise woman helping out at a birth. Simple, right? Then for a few years I espoused the idea that surely, women were better off in other countries because they had midwives (somehow or another in those years I was always talking about how progressive Europe was). And then, for a long time, midwives today aren't like midwives in the past: of course they carry oxygen! They have everything short of forceps, epidurals and c-sections! And then I had a midwife-assisted birth that ended in panic, and I came full circle back to the simple idea of a "caring, wise woman helping out at a birth".

I live in New Brunswick, Canada. Our province passed midwifery legislation in 2008. We have yet to recruit any midwives (in Canada, you can only be a licensed midwife with a four year bachelor's degree in midwifery, offered at a handful of universities in the country, none near us). Before legislation, there were unlicensed, private midwives who did a tiny number of births. There were a tiny fraction more who just did it at home unassisted or with friends who were not considered midwives. Tiny, tiny number. Although there was always a certain fear that they might be prosecuted, this never happened, and there was no legislation prohibiting midwifery. Once midwifery legislation passed, our Health Minister at the time stated that all midwife-assisted births would take place at hospitals, with the "possibility" of homebirths sometime in the future. WTF? Then, there was also the comment in the paper by a midwife who headed up the push for legislation, where she said that anyone who now attends births without a license will be doing so illegally.

I actually preferred it when midwifery was in the "grey area" here. (As an aside, our Medical Act clearly stated that midwifery was NOT practicing medecine without a license until 1982, when that section was removed.) Women have been sold the line that legislated midwifery will allow women of all social classes/financial means access to midwives, as they'll be covered by our universal healthcare. That isn't the case in other provinces that have done this- women who access midwifery care are more likely to be white, university grads, professionals with good incomes. There are, of course, exceptions, but that is the majority. In Quebec, I recently heard that midwives will not attend primips. WTF?

Some would argue that some licensed midwives would go against their licensing body in order to provide a woman with a VBAC, or breech birth, or multiples. I can't agree to this statement. As I understand it, wouldn't that put them at risk of losing their license? Isn't there some oversight? Well, they argue, if a woman really wants an unhindered birth, she'll find a way to get one with the "right" midwife. How far does a woman have to go to find someone who is willing to help her with her birth? For years, I took personal credit for the fact that I had a successful, natural vaginal birth in the hospital with my first born...in retrospect, I recognize that I was incredibly lucky to stumble upon the doctor who provided my prenatal care and attended my birth. Many other local doctors say they believe in natural birth, but I would estimate our c-section rate to be about 25% and our epidural rate must be about 75%.I was incredibly lucky to stay home until I was 7 cm dilated. Part of it was mental preparation but most of it was luck, because I meet women every day who prepared their asses off for their natural births and ended up with anything but.

I had an unassisted birth last year. Part of the reason I gave birth unassisted is because there are no midwives here. I am on several UC forums, and it always saddens me when women, like me, are making the ultimate decision to UC because they don't have access to a midwife. It makes me sadder still when they are choosing to UC because no midwife would attend them, due to risk factors/licensing requirements/etc. I honestly feel that most women who are seeking a midwife-assisted homebirth have researched themselves to death about whatever their risks/problems/worries are. If they are seeking you out, YOU MUST BE THERE! And by YOU, I mean please, someone, answer their call. When it really comes down to it, what women really want is a sister to love them, trust them, protect their space. If you are doing that, no one will need to license you, and a certificate on your wall doesn't make you a midwife. The fact that you surround your mothers in love and protection does.

It is now after midnight in my timezone, the witching hour. I once read an interview with Ina May Gaskin, and she said something that really stuck with me. I wish I'd kept the quote, because I've never been able to find the interview again. This is what I understood from it:

We have to remember that we are the great-great-granddaughters of the women who survived the Witch Hunts. We know how to cut down, criticize and accuse our sisters. We will turn them in if it means our survival. We bow to male dominence, and a male god.


I think it's time we start moving in a different direction, one that honours and respects the real needs of women and values the women who practice this profession.