Traditional Midwife

Just what is a traditional midwife? It's used often, and a formal definition seems a bit condescending and maybe not at all what the women who use it intended.

I believe that many midwives use the "traditional midwife" label as a way to set them apart from the growing profession of midwifery. Perhaps they want to make it clear that they do not use medical testing or pharmaceuticals as part of their practice. Perhaps it's a desire to state that they, unlike other midwives, trust the processes of birth completely.

Whatever it is, whatever it means to each person, is very different.

As much as I like the idea of traditional midwife, in today's world, we are no longer traditional. We drive cars, we have access to knowledge and information that was not known even fifty years ago. As midwives, we have a broader understanding of herbs and alternative therapies on a chemical level. Traditional midwifery implies a different role in the community - and a different role at birth. To say that there are traditional midwives practicing in the US today is a misnomer. There may be some granny midwives in the deep south, but they are slowly leaving this world.

I'd like to propose a new idea: A new movement of midwifery...that of the Modern Midwife. As midwives, we know too much about the intricate physiological process of labor and birth to continue interfering with women. Whether it's learned in the classroom, through self-study or from a more experienced midwife, we all are aware of the delicate hormonal balances present in labor and birth. It's been written about extensively.

If we know all this, why do we continue to interrupt the process? Why are midwives still directing women in how to breathe, what position to be in, doing routine vaginal exams and trying to induce labor or hurry labor along? Why all the rules? Why all the observation?

Obviously, the current way of practicing midwifery fills our ego and need to be wanted and appreciated in our community. I'd like to challenge those involved in birth work to love, want and appreciate YOURSELF. Don't go looking to your clients for this affirmation or attention. Clients readily give over that power, and many midwives happily receive it. Don't. Turn it around. Let your client know that this is the kind of power that will help her in labor - it does no good to hand it over to someone else.

I would imagine the New Modern Midwife to be someone who uses appropriate tools when desired by her client, holds the space so the woman can find her own empowerment (rather than the belief that a midwife can empower a client - only an empowered midwife will inspire an empowered woman!), and recognizes that each family has different needs from the next.

The New Modern Midwife would question routine beliefs - not only looking at evidence-based information, but what is inherently *right* for that particular woman. She will challenge herself and research the hows and whys, but will be hesitant to interfere with the natural process because it's believed to help...she will use her hands only when she intuitively knows it will be beneficial. Things like routine suctioning (even with meconium), perineal support or massage, and active management of a normal third stage will be processes that she lets go of.

We know TOO much to say we're traditional midwives. Two hundred years ago, midwives were much more hands on and directive than they ever needed to be. Just like current midwives. We need to recognize that we have more knowledge - which doesn't mean we need to override the delicate flow of birth, but to feel comfortable in honoring it. The true challenge will be really listening to the research that claims women's bodies innately know how to birth - without our help. Giving each family honest CHOICE in their care, rather than living in fear of state protocols, will be another difficult bump in the road to the New Modern Midwifery.

Rather than using a term that describes what midwives WERE, I propose that we use a term that accurately describes who we are NOW and who we WANT to be. I believe change is possible. It must happen - or we will end up modeling the type of care women are so desperately wanting to get away from.