Drawn to deliver

I've gotten a lot of questions recently about my push (no pun intended) to become a midwife and its relevance. I think a lot of people who ask me why on earth this is something I would want to do see it through the same scope of scrutiny that the majority of the public in our country does: that a midwife is a glorified nurse, someone who tries to do the job of a doctor with less pay, less education, less experience, and in a more dangerous setting with far more things going wrong. And to a degree, I can't fault them, because that's really all the general public ever hears about midwives. The media throws around all the horror stories, tales of home births gone wrong, of midwives who abuse their position of power over a patient, or of (and this in my opinion is the worst) otherwise fully trained and accredited midwives who try to practice in a state where either their entire profession or their chosen route is somehow illegal and although nothing bad has ever happened, they're turned in for practicing medicine without a license.

When that's all anybody sees or hears, who can blame this country for having such a negative view of midwifery?

The sad thing is, I can't. And believe me, I'm not looking at this from a completely rosy perspective; I understand that things can and do go wrong during otherwise normal birth processes. I understand that no two women or births are alike, and that a woman's supposedly low-risk status isn't a reason to stay on my toes and listen to that voice in the back of my head that wants me to be ready for any possibility. I get that there will be some patients, unfortunately, that I will have to turn away - not because of an inability on my behalf, but because for whatever reason the information they've presented to me or that I've gathered through examining them indicates to me that they might be safer in a more medical setting where the potential care they would need is readily available. I know those things and I've come to accept them, whether or not I want to.

And I know, too, that even the accreditation process carries some inherent risk. I'm a part of a Yahoo group for new and student midwives, and there has been a discussion going on recently about an unfortunate woman who was working as a student (as-of-yet unlicensed) midwife who showed up to a birth before her preceptors (teachers/more or less the women she was apprenticed to). She had everything set up and was ready to go, waiting for them to arrive, but while they were waiting, the baby crowned and showed up a bit faster than anticipated. The parents insisted that despite not having the birth attended by a licensed midwife, that they not transfer (this is where, perhaps, some things were questionable, but without all the details it's hard to know for sure why the parents decided this, and why the student agreed). Afterwards, there seemed to be some pieces of the placenta left over in the mother's uterus, and she was beginning to hemorrhage - so the student, thinking fast, did what was medically necessary to stop the bleeding. Mom and baby were fine. After the fact, a doula at some point discussed the happenings with other midwives, and the student ended up reported to the authorities and was charged with several felonies, including - you guessed it - practicing medicine without a license. Because of this charge, she'll never be able to finish her schooling and become a midwife, and will never be able to hold any state license for any medical field.

Now, working off of core facts, there is a HUGE question here: should the student have continued to honor the parents wishes and acted as she did, or should she have taken a step back and refused to provide any care and called 911? Obviously the choice has already been made, but there are a lot of technicalities here that I think would make this decision difficult for anyone, experienced student or new. It's one of the many problems that I may or may not personally face, and it's impossible for me to say for sure what I would have done (I'd like to think I KNOW what I would have done, but we always say that about ourselves without likely ever finding out the truth). I may face worse problems, bigger problems, along the way. May every god and goddess in every pantheon forbid it, I might well face the death of a client and/or her child. I can't even begin to process that concept, because it's just too "out there" for me, but it is a possibility, however unwelcome and tragic and horrifying.

But it's part of the job. Doctors face the same thing, only they rarely have to worry about consequences from a family because, if they've proven themselves competent and they've done everything they have to to satisfy their insurance and hospital policy, then most of the time, they're off the hook - even if a bunch of medical interference is what might have contributed to the death in the first place.

And it's something that I'll have to accept, something I'm working on accepting even now, when I haven't even been accepted (that's a lot of accepting) into the nursing program at the college I'm at. I'm still taking prerequesets and applying. I'm not even a quarter of the way there yet.

So why, despite all of these horrible things that could or might happen, do I still feel called to become a midwife?

Because I know how beautiful and amazing birth can be. Because my experiences have been not-so-great, because I've learned the trauma of having someone by your side who has pledged to help protect you from the unnecessary who then steps away at the last minute and chooses to be less than supportive. Because I have been bullied into decisions and interventions that I know (thank you, hindsight) were unnecessary or potentially harmful. Because even after making up my mind and setting my jaw and telling my OB what I would or would not allow, I was still told that in the long run my wishes were secondary to hospital policy, or "what was allowed". Because I know that my experiences and the experiences of so many other women who are now completely jaded to the birthing process do not have to be the experiences of EVERY woman. Because I know birth can be better, happier, more relaxed, and can be allowed to progress on its own without inherently risking the safety of anyone involved. Because I know and believe that women and babies deserve better, and should have better, but that it will take an entirely new generation of midwives who are able and ready to fight the system of heavily medicalized births that have become so common in so many areas.

Because I can, and I want to, and I think it's right.

Isn't that the biggest reason that anybody does anything they believe in?

On the Matter of "My Parents ___________ and I Turned Out Fine"

I hate that phrase. I hate it because it insinuates that whatever we learn about life, parenting, or existence is irrelevant, somehow invalidated by the fact that our parents or relatives did things differently while we were growing up, and since we were fortunate enough to not suffer any ill effects that we're aware of, the way things were done for us must be good enough. The logical fallacies here are insane, and to me painfully obvious, but many parents may as well be wearing blinders to this topic.

So why doesn't anybody seem to understand why this reasoning is faulty? Let's consider a few things that often seem to factor into a person's usage of this defense.

First, people typically hate implying that somehow their parents raised them in a sub par way, or that their parents - despite not knowing any differently - were taking a potentially life-threatening risk while raising them. And I understand that need to believe, because most of the time, to a point, the reasoning is true: our parents did the best they could, and usually they didn't have the information or access to information that we have. Their choices were informed to a fault. Today, though, we're lucky enough to have the ability to research almost any choice or option, and there is no end of accessible opinions, either online or in books. So where do we draw the line and decide what is a choice made out of ignorance, and what is a choice made of WILLFUL ignorance?

For me, the line is drawn right here, right now. There is no excuse anymore, no excuse for not knowing or wondering - no excuse for accepting tradition. And why should we, when tradition means cutting off parts of our sons, or allowing doctors who are notorious for not disclosing all of the necessary information to make a truly informed decision as to our medical care inject us with harmful substances, then lie about or neglect to mention their potential effects on ourselves and our children? Why should we allow tradition to be the early forced evacuation from the womb of babies who otherwise have no medical need to be born early? Why should we risk the lives of children, of mothers, of families everywhere by ignoring the blatant, obvious benefits of breastfeeding and breastmilk, benefits that have been proven time and time again through numerous studies, while we tout formula as being somehow equal, if not better? Why do we do all of these things?

Because it's easy. Because the idea that somehow our parents might have made mistakes is beyond us; because we want to imagine we were given the BEST, instead of labeling it as what it truly is: the best that was POSSIBLE. That does not make it the best of all circumstances, or the absolute best option regardless of other choices that could have been made. It is almost legitimate to say that the parents of a boy circumcised  in 1978 made that decision because at the time it was simply something that wasn't discussed in any circle, medical or otherwise, it was just an accepted truth; today, only 55-65% of newborn boys are circumcised for secular reasons, and it's figured that this number is dropping sharply every month. The difference, of course, is that now people are openly discussing circumcision and its harmful side effects; men who were circumcised as children are willingly coming out and explaining the pain and trauma they've experienced throughout their lives thanks to a choice made by someone who assumed control over their body. Mothers are being ASKED if they wish to circumcise their sons; while this is far from perfect, it's better than the previous assumption that it would be done. There are forums discussing it, websites and books and magazines and organizations dedicated to the idea that the ability to circumcise should be the choice of an informed adult, and not a choice made for a helpless newborn.

The idea of bodily autonomy is becoming mainstream, and is edging its way into becoming a legitimate, accepted topic of conversation among parents and medical professionals.

So is the fact that circumcision used to be so common that it was often performed without permission or informed consent a reason to continue to do it? Is the fact that a majority of the adult (18+) male population of the United States circumcised (likely at birth), completely unaware of what they lost through circumcision, and thus willing to speak out and say that somehow circumcision at birth is "okay", a good reason to continue to advocate for it?

Of course not. What worked for our parents - our grandparents - our ancestors ten or twenty times removed - is not necessarily the best choice for us. It is no reason to accept that the previous generation's "normal" should be the "normal" that our children grow up with; no reason to willingly blind ourselves to the truth because we don't want to consider the idea that maybe, just maybe, the choices of our parents were not the BEST choice. Best POSSIBLE is no excuse for us now, in the information age; if we are able to provide the BEST, it is our duty as parents, as mothers, as fathers, as caretakers, as those who have given birth and witnessed birth, as those who assist and those who deliver, to make sure that if we are CAPABLE of providing the BEST that we do so - and that we ask every possible question along the way.