The Trust Birth Conference is going on as I write this. Throughout the year, I was asked if I was going to attend since it was so close to my San Diego home. No. Still feel “trusting birth” is asking for being disappointed –or worse. I continue “Respecting Birth” –understanding that birth has a power of her own, but that power can be unpredictable and wild at times. That unpredictability is why midwives are hired to attend births. I suppose if you trust birth, especially, implicitly, you could merrily skip through your pregnancy and birth without a midwife.
Pamela Hines-Powell, SageFemme, spoke at the conference about how midwives can help UCers. (UC = Unassisted Childbirth) After her session, she put her UC Contract up on her blog and it was this contract that has gotten my knickers in a twist. Mind you, I respect Pamela very much and enjoy her blog, yet her thoughts and beliefs definitely move me to think and write more.
Pamela writes in part: “A non-refundable midwifery care deposit of $500 ensures that Pamela Hines-Powell will be available to answer questions or concerns, order desired labs or ultrasound, collaborate with other healthcare providers during the course of pregnancy, birth and postpartum. This fee also ensures that she will be on call for the birth, whether or not she attends the birth.” She goes on to outline different circumstances where she might attend the birth at the client’s request or even transfer to the hospital with them if that was needed. I’m glad she has a limitation that says, “If an emergency arises and the midwife feels the safest option when consulted is a transport to the hospital, she has the right to refuse to attend the birth at home.”
Over the last week, the NIH VBAC Conference stated new guidelines to increase VBACs, yet the reality is docs and hospitals continue limiting them (refusing them) to a significant portion of women. A woman’s right to birth how and where she wants to have been in the forefront of the discussion. Intertwined with the issues have been references to reproductive rights, a woman’s sole choice of who touches her body (even if the baby is in danger) and what would constitute informed consent (and who defines it).
The UC supporters embrace these same considerations; that women have a right to birth alone, even if it endangers the baby, they decide who touches their bodies and one cannot be pro-choice without being pro-UC. It’s an interesting concept and one that certainly makes me pause, trying to wrap my mind around that logic.
I think I could squint and see my way to agree that autonomy and choice are valid reasons to UC (not that anyone cares if I think they are “valid” or not), but where I get perturbed is when UCers pull midwives into their autonomous world.
I just cannot figure out for the life of me how a UCer can call themselves a UCer if they consult with a midwife. Pamela equates consulting with a midwife as if a homebirthing woman needed to consult with an OB, say, for antibiotics. That she still is a homebirthing woman, but needs outside information/help to keep them on their path towards their goal.
But, the U in UC is unassisted. Un. NOT, assisted. No help. No one assisting. No one helping. Not, U-except-when-I-need-the-help-of-a-midwife-C; that would be called assisted. I don’t care if all the midwife does is tell a woman who calls herself a UCer how to listen to heart tones, that’s giving assistance. But, if a UCer calls a midwife in the throes of labor? If the midwife comes to deliver the placenta? To suture? How is that considered unassisted? Is it merely a badge of honor to say you birthed unassisted? That the midwife sat in the other room, on the porch, in her car, in her house?
And what of a midwife who joins in this game of semantics? Is she the UCer’s midwife? Is she the UCer’s consultant that just happens to be a midwife? Is she the Un-Midwife?
Why is a midwife smart enough, skilled enough and experienced enough to consult with, but not cool enough to have at the birth? How come “trusting birth” comes with the parentheses “unless I need a midwife to pull me out of danger or fear.”
(Sometimes I don’t like it when all I do is ask questions, but asking and getting answers helps me formulate my own answers.)
Recently, I’ve written that I serve women. That that is my role/job/calling: I serve women. But do I really serve women? All women? If I can help a woman find help terminating a pregnancy, be a doula at abortions and sit for hours with a woman having a miscarriage, why is it such a stretch for me to reach out to the UC community? Why does it sound like I want to punish the UCer for making her choice to birth alone?
Why am I being so black & white about this issue when I can so easily see the gray in almost any other?
I’m sure that part of it has to do with many UCer’s arrogance about their knowledge and abilities to avert complications or use wishful thinking to eliminate anything negative from happening at all. The puffed out chests, bragging that they don’t need anybody sours my desire to offer assistance – because I am “anybody.” So, if they don’t need anybody, don’t need anybody!
Caveats abound. “I don’t need anybody until I need: to know my blood type/to see if I have a UTI/to get antibiotics/to order an ultrasound/to see if my water broke/to determine the baby’s position/to check that my 40-hour labor is still normal/to help me decide if I should go to the hospital/to come help with my not-nursing baby/to deliver my placenta/to sew up my torn vagina/to do the newborn screen/ad forever.” This isn’t not needing anybody. This is needing somebody; apparently, a midwife.
I’ve been told it’s my ego that pushes me to be so hard-assed against UC. That I need to be needed, want to be wanted and revered as The Midwife. I’ve looked deeply, trying to make sure it isn’t an ego thing and, (perhaps egotistically), I just don’t see it. For me, it is wanting others to be true to their word, to accept the responsibility they swear they want and to live with the consequences they promise they are willing to live with. That UCers lure midwives into their worries and complications, dumping them over the midwife’s head and walking away squeaky clean annoys me terribly.
I guess, in the end, I have a real hard time with taking advantage of a situation and a relationship, using it for a one-sided benefit and expecting the other person, the midwife, to welcome them with open arms and then being banished when she is no longer needed or wanted. But, when she’s needed again, she’s expected to smile and offer her skills and experience (and license). Over and over, I see a midwife’s exploitation, her very name being maligned, but her love and attention wanted… at the UCer’s beck and call.
It's that dichotomy that bugs me the most. Be true to your word. Do what you say you're going to do. Walk in integrity, not half-truths. I promise to keep doing the same.