Whose Blog Is This?
Log onto Squarespace
« Shameless Plug | Main | Foolishness & Mayhem »

Kneelingwoman's Post

So, I try to be eloquent, but sometimes another blogger puts what I want to say so perfectly, I am almost embarrassed that I tried to stutter the words at all.

Kneelingwoman - Michelle - wrote a post that got eaten the other day, but, happily, she re-wrote the entire long piece. (We told her to write in Word!)

Please, please go read the entire post - Back to the Garden. No matter your stance on midwifery education, you are sure to be reminded of - or learn - something that will impact your calling/profession immediately.

Excerpts (and I did take a lot of her words, but there are more... wonderful words on her blog. Please go read them):

- We are a fractured profession with relationships constructed around a false front of unity in a central theme; but not of a shared reality.

- ...I see Midwifery taking on the dynamics of a highly dysfunctional family. Midwives who "color outside the lines" or who fail, in some way, to ensure that "outsiders" don't know "our" business; are threatened, bullied, maligned, blacklisted or, in some other way, isolated and rejected by their peers. Just as in family systems where whole lives are lived in closely guarded spaces of secrecy and anger and the one who begins to tell the truth becomes the scapegoat; so it often is in Midwifery. In an ironic twist; all of these things are fueled by fear and, as all Midwives know, fear is the enemy of birth--of a person, an idea or a profession.

- moving to another letter written to me by someone in the Midwifery leadership a week or so ago that tells me that "the BMJ study proves that more education doesn't improve outcomes" and "I don't see that CNM's have any more economic security; a lot of them are losing their jobs so I don't see how a University education of the kind you're proposing insures anything". Sighing deeply, I respond that I hadn't thought that the BMJ was designed to prove that contention and therefore, can't. I comment that a CNM, as a Registered Nurse, is still very employable, with a well paying credential as a Nurse even if she can't, regretably, find a job as a Midwife. A direct entry midwife, in contrast, may have nothing else, no other education or training, with which to make a living. I think that's a very big problem and I find it very concerning that the people in "leadership" positions in Midwifery can make such unsupportable comments or fail to see the connection between a broader, more diverse education and a more viable and sustainable, Profession.

- We need a midwifery that is cooperative and accountable to the other health care professions with whom we MUST collaborate and work alongside to ensure safe practice!

- The fear that drives the rejection of examining new models or promotes a rigid clinging to concepts of "apprenticeship" and "woman centered care"as sacred cows; or the idea that altering our education to meet new needs and desires takes something away from midwifery, is preventing the labor from bringing something to birth! We are a "post dates" pregnancy holding off any intervention until there are no more choices left. That is not wise. That is not being "with women". It is telling the women--the vast majority of women, that what matters in midwifery is the midwives alone; our comfort level and our standards. It seems, and is, inflexible and exclusive; not diverse or expansive.

- Midwives have to stop fearing that our inner-workings can't bear the scrutiny of physicians, legislators or the public. Sending up a warning flare or browbeating midwives who speak to these issues into submission and retraction does not solve a problem related to how we are perceived by those who will, in large part, determine our future. We have to remain transparent and open and accept criticism if needs be. We may need to change the way we do some things if we want to grow and remain viable. We should not fear hearing those criticisms nor should we attempt to restrict those who think we really need to take a second look at how we're doing things. We cannot continue to practice in isolation from the rest of the health care system while insisting that they include us! Midwifery is not an island and it most certainly is not some maternal paradise where all women are safe and welcome! For many women, mothers and practioners alike; midwifery becomes a place of uncertainty, financial and social insecurity and professional stagnation! That is not a sustainable vision; these are the marks of an unsustainable profession that won't get serious about examining it's preconceptions and conclusions to see if they work over time.

- We have gone overboard in telling women to trust their bodies and birth and we have not done a good job educating women about the inherent wildness and unpredictablity of birth. We seem to not know how to backtrack on this position without risking a wholesale return to the idea of allowing fear to dominate women's thinking about birth and the resultant potential "loss" of midwifery clientele. My response to this is, very clearly, "we have to find a way" because babies are dying and women are suffering because they are not taking any risks into account when they plan these births.

- I feel like the woman 'stuck' at 8 cm's who has moved every way she can; changed positions over and over, moaned and rocked and, now, reaches out for the hand of her midwife, her mate, her friends nearby.......there is no comfortable place until the deeper movement begins; the pushing and the force that brings birth.

- I think most of you know, by now, that I never write to inflict damage or pain but, sometimes, as in all birth, there is pain. I have found it deeply painful to see what I've had to see over these last two weeks. To not speak to it would be to reinhabit an old life; a way of being learned in childhood--of secrecy, of never owning my own ideas and thoughts because I believed the threats and the attempts to control and I believed that my voice didn't matter........we grow up and, if we're lucky and someone helps us, we learn that these things aren't true.

- We have to set an example of peaceful reconciliation and inclusivity; a true and generous inclusion that knows that all birthing women matter and knows, as well, that Midwifery is a wise, old woman---a Crone now---who can embrace paradox, hold the tension between conflicting and overlapping needs and become a true force for good for women and families.

(end quotes)

Michelle's words, so poetic and enfolding visions of birth, touched me deeply. Not only because she quotes me and knows of my own experiences in my pulled down piece ("Midwifery Education,") but because she, a "seeing" woman, recognizes nuances I had never considered.

As a woman who was abused as a child, I absolutely see the Truth in what she says regarding our speaking out about the need for more education in midwifery is exactly parallel to a child spilling the beans about incest; disgust, disbelief, anger, manipulation, teasing, threatening and withdrawing of love, support or even acknowledgement. How is midwifery supposed to survive at all if the participant midwives can't even speak with kindness to one another? What happened to human decency? My initial responses, even, mimicked that of a hurt child... apologetic, thinking I was wrong, embarrassed that I'd opened my mouth and feeling shame that I betrayed The Sisterhood.

But, I shook my head and cleared the angry fog out of my brain and saw that I hadn't done anything wrong! I spoke my Truth. MY. MINE.

Listening to those that critiqued my removed piece was a really interesting study in human communication. I see where some people could feel anger and frustration at what I wrote and that I was "dissing" midwifery altogether. I'm hoping my WHO piece puts that to rest. I do acknowledge I probably could have written a (somewhat) less inflamed post, but I wrote what I felt/feel. And, after all, it is a blog - MY blog - and my opinion isn't the be-all-and-end-all to midwives, students or apprentices. Sometimes, my writing provokes. I'm certainly not trying to provoke violence (of which I feel some people danced quite near to), but am wanting to provoke thought, wonder, curiosity and solutions. What the heck is so wrong with that?

I'm not wanting to sit here and defend myself (again), but it's all tied in together. This educational component and the subsequent disturbance of the mention of such education reflects on ALL of midwifery - those that agree and those that don't.

What I am coming to realize is that maybe it isn't just education that midwifery needs, but some serious classes in Ethics and Professionalism.

More on that in a soon-to-be post.

Reader Comments (12)

Amazing. Just extraordinary. Thank the earth for you both. I feel like I have so much to tell you--in a private email, perhaps, if you'll allow me?

I'm so grateful to have found your blog.

March 27, 2008 | Unregistered CommenterMommy Dearest

I just think Midwifery needs to be heard so that change can occur in all obstetrics and birth. It's really like the homeschool movement I have seen. Parents are leaving a bad system, and are teaching their children out in the world. Many are using the things that have historically worked in education...wrote memorization, reading (and more reading and more reading), phonics work. Some are hiring people to teach in areas they are skilled in. Others are going to training sessions and are taking their children willingly to get testing. All of this is for the well being of their child. It's not "all or nothing" to the parents in education. Now, I'm seeing public school begin to respond. Public schools are now offering programs to homeschooled children like signing up for a few classes (maybe Science and Math at school but English and Religious Studies at home). There are distance learning programs that allow parents to teach a curriculum at home. I believe homeschooling is making public schooling look at itself in different ways, and is possibly improving the whole system. I think midwifes and home birth can do this. If there is mutual respect, and understanding of what is good about hands off birthing, and when it's most excellent to have medical intervention, and an understanding that women want a safe birth and also want to have a good memory of the birth day...we can go a long way. I am just a woman who has had six babies in the hospital, and have never experienced a midwife/home birth. I know though how abuse can happen in the hospital setting. I personally do not have the trust yet to stay at home, not just yet. My ideal situation would be to have a loving midwife with me throughout the pregnancy for prenatal care, and then have a midwife and possibly a doula in a birth center or hospital. I would like to have the midwife with me for the last two hours of my birth, to not leave so that my baby is not caught by a nurse scrambling and yelling at her partner in the room to help. I would love for meconium not to scare the midwife to death, and to be able to hold my baby right away and for me to have a birth plan accepted because the midwife has shared with me what is wise to keep in and what is best to keep out, and we've decided together in trust. If birth proves to take a natural and wild turn, I would like to trust my midwife enough to step aside if I need intervention she cannot provide OR for her to intervene in ways that work that OB's may not use because of lack of practice. Ideally, I would feel I've done all I can to protect my child, all I can to give my baby the calmest and safest birth possible. Ideally, the midwife and staff would not be at odds with one another but would be working as a team to provide the appropriate care. Then I would birth without feeling guilty for anything I said, or anything I didn't say. I would know that most of the things that happened did so because the care givers really cared. If mistakes occured, I would be understanding (and I am, trust me, I do understand) because I would have built trust and would know that everyone was trying. Of course, this is my ideal birth. Home is not where I feel I can get the best of both safety and midwife care. I believe I can experience a safe birth at home, but if something goes wrong, I prefer to be close to help.

Bless you for digging into this issue. Maybe you can change things by meeting on realistic grounds. We women are needing someone to try to bridge the gap we keep falling through!


March 27, 2008 | Unregistered CommenterAnonymous

Thank you, Barb. Blessings and Peace. Michelle.

March 27, 2008 | Unregistered CommenterKneelingwoman

What I am coming to realize is that maybe it isn't just education that midwifery needs, but some serious classes in Ethics and Professionalism.

Classes which are included in university training for other professions.

I'm glad I've stumbled upon your and Kneelingwoman's blogs. I'm an apprentice-trained CPM with a university degree in another discipline and was feeling very alone in my opinions about the need for direct entry midwives to have more formal education. I am very dismayed at NARM's firm stance that what we have now is just fine. Shouldn't we always be constantly evolving toward something better?

March 28, 2008 | Unregistered Commenterhippiemidwife

I am just so happy at times like these for the blog-o-sphere....my own dear midwife getting to share her awesomeness with the world at the click of a button, and my fave-for-years Navelgazer, "knowing" each other, its all too cool. You great writers blow me away. All of this discourse is so so good, you guys. So, so necessary.

I had/have "hush hush dont talk about that you bad girl" stuff in my own life, and yeah, the tendency to fall all over myself apologizing for EVERYthing I ever think or do or like or believe in has been a hard hard habit to break. But just know, that it is more important to just say IT, the truth, whatever it is, than to try to please and appease the invisible "dissaproving adults" by being compliant, complacent and quiet.
Happiest Friday to you both, grinning from ear to ear...

March 28, 2008 | Unregistered CommenterHousefairy

I have faithfully read both blogs for the past six months or so - and I'm blown away and so appreciative of this discussion.

I have no irons in the fire except for the fact I've given birth to 8 children in a hospital setting that has violated my privacy and interfered with my ability to birth.

At 42, my fertility is coming to an end, but I am desperately concerned for my daughters and future daughter in laws.

I want them to be able to have a safe, peaceful and private birth at home - a place that will enable them honor their birth process - a place where they know and have selected those that will be attending them - BECAUSE IT MATTERS - yes, I'm yelling - but it does matter and women have a right to decide who will attend them - not just get the nurse / dr rotation roulette.

And, I want them attended by qualified, trained midwives who can easily transport them to a hospital setting when it's warranted with no negative repercussions.

I've listened to the fall out from homebirths who have had to transport - and it gets so ugly and women are treated with cruelty many times.

I want there to be a more respected relationship between homebirth midwives and the rest of the medical community.

I could go on - but mostly I just want to thank you for the discussion.

mom of 8

March 28, 2008 | Unregistered CommenterMichelle

I've been reading your blog for around a year or so now, Barb, but have never commented. I've enjoyed reading about the births you attend, about Dr. Wonderful (and wishing we had one of him around here!), and now about your journey into the world of nurse-midwifery.

I am a mom in the course of my births has grown to love pregnancy and birth. I've considered a DEM route even though this would involve my family being uprooted to move to a state where the legalities wouldn't compromise my ability to be employed. I felt much like you said you felt when contemplating becoming a midwife for the first time. I've been reluctant to do anything towards starting nursing school. Mostly because, I am finally happy to admit, I doubted my self and my capabilities.

No more. Your words have inspired me and I am planning on enrolling in a vocational LPN program this fall. This is a small step, but the first one in my journey to becoming a CNM. I may take a roundabout way to get there versus a four year nursing program, but I know it's the path that is best for me. And I'm confident I can do it and that it is what I am SUPPOSED to do, and your words are part of the reason I've got this newfound confidence.

From the bottom of my heart, thank you.

March 28, 2008 | Unregistered CommenterAnonymous

Can I tell you now how you FILLED my heart this morning!

On my birthday, nevertheless!

What a beautiful birthday present.


March 29, 2008 | Unregistered CommenterNavelgazing Midwife

I became a direct entry midwife because of the instutional abuse I suffered. In the process of self healing I ended up on the midwifery path helping other women. I propose that the years and years of education required does not improve outcomes or humanize the process- I was mistreated by the best experts. The study of patient abuse hasn't even made much of a blip, what we do know from studying medical schools and nursing schools is that abuse occurs regularly to the students no matter what stage of education they are at. OK what do we know about abuse- it gets passed on. Please please make more of an effort to require midwives to enter the system , it is already rocky enough. What i have seen is the CNMs are working as RN so they have masters in education and use nearly no clinical judgment. If 1/2 the states don't license midwives. then women in those states are required to get a nursing job or a CNM in education how many home births are attended in those states by a legally licensed and medically educated individual? nope mainstream medical education is not reaching the populations that want serving- and we see with the growing UC movement that requiring direct entry midwives to become more like the medical system only disconnects them from the consuming public. great thoughts but I am just not going to agree with you.

March 30, 2008 | Unregistered CommenterAnonymous

I want to say a bit about accountability and medical professions. what do you think the biggest reason people sue their doctor/nurse/midwife for? Unhappiness with outcome and care. Where is the professional accountability? The doctor who carved his name into women kept practicing for a while not just one incident and whoosh his career is over. You can be a addict and a provider if you are in treatment, or seek out treatment before you go to your professional review, even if you steal drugs/divert drugs and use them yourself- it takes a lot before a "professional" is truly accountable. The place people have sought help is civil court and suing has ended up causing 1/3 of women in our country getting c=sections there is absolutely no accountability in this system.In the game of self-protection and increased surgical birth that causes 4 times the maternal deaths and 2-3 times the infant mortality, not to mention fertility, misscarriage and an increase in lifethreatening conditions in subsiquent pregnancies who benefits how are they being accountable to true care?

March 31, 2008 | Unregistered CommenterAnonymous

I have enjoyed reading the discussion about education. I can't speak as eloquently as others and won't even try. I'm not a political activist. I'm not trying to change the world at large, only the small sphere in which I interact.

Before I became a CNM, but knew I wanted to be a midwife, I viewed the world of midwifery as one big group of differeing layers, in which all were important. Now, I see things differently. Now it seems as those many perpetrate the 'us against them' mentality. When I say us against them, i refer to lay or direct entry midwives versus CNMs. Some of these posts certainly make me feel as though I couldn't possibly be a "real" midwife because I chose advanced education. How does this benefit midwifery as a whole? How will those outside midwifery respect us, when we can't respect each other?

When I am asked about lay midwives, I speak in a positive and supportive manner. I never present myself as 'better', just a different layer.

April 3, 2008 | Unregistered CommenterCiarin

pretty cool stuff here thank you!!!!!!!

August 27, 2010 | Unregistered CommenterLeupoldEst

PostPost a New Comment

Enter your information below to add a new comment.

My response is on my own website »
Author Email (optional):
Author URL (optional):
All HTML will be escaped. Hyperlinks will be created for URLs automatically.