Barb's blog has a new post entitled Midwifery Education , a spin-off from a conversation that has been happening over at another blog (which I have to admit I haven't had time to read at all).
I have so much to say to this post, including the desire to read the referenced blog to discover where the origins and thought processes are of these two midwives.
Access to midwifery education and the homogenizing of midwives is something I feel very passionate about for many reasons, most rooted in feminism, entitlement and classism. Unfortunately, I'm in the midst of laboring women, getting over a cold, being up all night and getting ready for the Trust Birth Conference. Suffice to say I think it may take me a couple days to organize my feelings, my thoughts and my words.
Spoke at a statewide mini-conference yesterday about Autonomous 2nd and 3rd stage. It was a nice training for the Trust Birth Conference, even though I was suffering from a cold with DayQuil on board. Overall the response was positive and it reinforced issues I want to cover at the conference in California.
I leave for the conference on Thursday afternoon with my dear friend, Linda. I'm thrilled she will be joining me at the conference - and sharing a room with me, a client of mine and a wonderful doula from Seattle.
I'm so excited to be in an environment of people who are truly passionate about changing the world by speaking birth truth. It is a bit like that fantasy slumber party scenario I wrote about years ago...only I'm missing Sara Wickham and Cornelia Enning. Rixa should also be on that list, but I wasn't aware of her gifts at the time I wrote the entry. With some chocolate and a glass of red wine perhaps I can gather them all in my room for a brainstorming session. You can bet I'll be taking ALOT of pictures and blogging along the way!
Was up late last night with friends, celebrating the receipt of a grant which one of our good friends will use to produce an exhibit about an artist friend of ours (does that make sense?). Had a wonderful dinner of Macademia nut-encrusted MahiMahi with mango sauce...came home at 2am and was called to a labor at 4.30am. We came home almost twelve hours later since the labor was easing in and out - and surely our watchful eyes were not helping anything.
Slept for a bit, went to dinner with my girlfriend and then to Target. Now I'm here, knowing that I need some serious down time instead of getting all those swirling thoughts put out on this blog. Once I feel articulate and concise I will be back to share some of my feelings.
There is a mom that was due around Valentine's Day that hasn't birthed, two VBAC moms waiting in the wings (one of which is doing labor work), a first time mom and two other moms planning their second babies, second homebirths, all due within the first two weeks of March. While it's not within my control, I selfishly want these women to either birth before I leave or wait until I return. I realize that either way March is going to be a busy month, followed by a full schedule all the way through August. We knew that I had this time scheduled for the conference when they hired me, I'm always knocked over by the level of attachment I feel towards my clients and how very difficult it is to leave them - even if they are in wise, caring hands.
Off to snuggle with my girlfriend and watch some junk TV.
Happy March!
Midwifery Education
Saturday, March 01, 2008at 9:51 PM
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16 comments:
Thanks for sharing link to Barb's current comments. Important to see the ways that some are thinking, to be prepared. How extremely sad to read it, though!
I'm anticipating reading your thoughts on it as well. I won't lie - the posts of late among the birth community I read on Blogger have left me... confused?... perplexed?... nervous? I'm not sure - but something is going on with the spirit of midwifery among many that just doesn't feel right/settled anymore.
I've taken the time to read the two blogs and their posts...I feel sad that there is so much talk about money, insurance and 'needing' something (education, credential, otherwise) to prove 'we' are something that 'we' are not. I am not here to be a nurse, a doctor or any other 'professional' -- I am here to educate, stimulate, empower and guide. I am not here to be paid...though I usually do :)
I want knowledge, as knowledge carries with it power. However, I don't want to be forced to 'do' something just because I know how. There is, as I see it, an underlying fact, which many never see or talk about and that is: Doctors want us to be and act more like doctors if we are going to be around and Homebirthers want us to be and act less or nothing like doctors if we are going to be around. it can not have it both ways and becoming a CNM is not the 'middle ground' or the bandaide.
I also take offense to all the 'hippie-dippy' comments. As if those who are less Earth-minded or spiritual are somehow more professional and able to do their jobs.
I don't want the recognition that comes with being a nurse, because that's not what I need. I need healthy, happy and honored birthing families.
Pamela,
Why the sarcasm directed at kim?
I happen to agree with her. Pittsburgh midwife's statement is incredibly selfish. Do you see that?
No, actually, "DiDi", I don't see that.
I'm disappointed that my attempt to remove my snarky response to "Kim" removed her post because it makes clear that her reading skills (or comprehension?) are below par.
As midwives, our goal is never a romantic birth, or a trendy experience. Our goal is always a healthy mom, healthy baby. PittsburghMidwife did not say that the health of mom or baby came last, or that it wasn't important. I am not even sure where "kim" pulled that from.
So, no, I don't see that. It is insulting to women who have homebirths - that somehow they are selfish and don't care about the safety of themselves or their babies. That they are just being trendy and don't have a brain.
That, to me, is insulting.
As a midwife, I assist women in their goal of a healthy pregnancy, healthy labor, healthy birth, healthy baby. If we get to do it at home then it's icing on the cake. The focus of safety and experience for mother and baby are not separate. The experience of the mother and baby is not much if safety and health/risk is disregarded.
To twist the words around makes it insulting.
I can't see how pittsburg mw's comment about wanting "healthy, happy, honored families" constitutes any due regard for safety. Her first word in that sentence was "healthy"....right? Besides, how does anyone imagine that acting/refusing to act in ways that harm the baby could leave any family feeling 'happy and honored', no matter how much the birth experience met their emotional expectations?
But beyond that I find myself so extremely mystified by this false argument which attempts to place 'safety' in opposition to 'mom's/family's experience'. There is much talk on this topic concerning adequate education of homebirth mws--but in hearing those arguments, it always seems to me that there is a distinct lack of education among the medically inclined when it comes to this point about 'safety vs The Experience'.
I say this because the research on the biochemistry of both the relaxation response and the effects of fear on the body--research concerning the impact of emotions on the body, ongoing now for at least 40yrs--is pretty clear on the facts: that a person 'having a good experience' is a person whose every bodily function is working far more efficiently than the one who is NOT having such a 'good experience'.
The above, of course, puts things quite simplistically in the interest of keeping it brief. But if anyone is in doubt about the essential truth of it--and is truly interested in becoming educated--then I suggest that you undertake such a study.
In fact, there IS no opposition between 'safety' and 'experience'. These matters are quite intimately and intricately connected and anyone who wishes to work--or simply advocate for--with a matter as likely to involve deep emotions as pregnancy and birth, owes it to self and all to become fully informed.
Don't worry Pamma, I will wait until you get back if I don't go by the time you leave.
I decided that I need you after all. Jerm and I both do <3 <3 I refuse to do it alone, and I refuse to do it with a stranger. So yeah. We can be selfish together! But because I want to birth like... yesterday, I probably wont give birth 'til May or something ridiculous.... Either way, you won't miss it.
-Katie (I can't get this damn thing to not say Katherine. Damnit.)
Pittsburg midwife also started out saying
"so much talk about money, insurance and 'needing' something (education, credential, otherwise) to prove 'we' are something that 'we' are not"
Money. I am infinitely jealous for Pittsburg Midwife that she can afford to dismiss money as something surely only those greedy materialistic midwives would 'want'. So those who find they wish to earn however modest a living at practicing midwifery just aren't passionate enough about it? Please think again if this is what you are implying.
Education. "To prove 'we' are something that 'we' are not"? Not what... educated? I'm not sure I get it.
Credential. I don't see how lay midwifery would not remain a wonderful option for a very few select mothers, myself definitely included: I just might very much enjoy the care Pittsburg Midwife has to offer. But I'm painfully aware of how rare a creature I am! What's wrong with rallying midwifery behind a unified public image of a strong, independent profession, represented by credentials that most birthing women find inviting, confidence inspiring, and YES affordable?
Thank you so much for linking to these discussions and continuing them into the comments section. When we set out to pursue this vocation, it's helpful to have others who speak frankly about their experiences. It is vital to me to be brought back down to earth every so often about what an uphill battle and a struggle it can be to do this work.
-M., who has been reading this blog for ages and finally started her own so that she could post comments.
Judit, I agree with you on many parts. I do charge money for my services - I am not one of those midwives that does it just for the love of birth. My time is valuable, as are my skills and knowledge and I am rightly compensated for all. With the demands of family, bills and time it would be too easy to start becoming resentful if I wasn't asking for what I'm worth.
I work into my fee some freedom to take on low or no cost births for families. IMO, cost should never be the final decision regarding birth choices.
Education is prudent - however, the way we get the education varies so greatly that it seems difficult to standardize it across the country. Perhaps one day when we have national health care that could change - perhaps. Every midwife and student midwife I know places education in high regard for their practice. Continuing education in this profession is vital, as midwives know.
Yeah, I know... midwifery education does vary across the country, and I can only imagine how daunting the task of standardizing it must seem. But setting aside for a moment how in the world we would get there, I think a graduate degree in (direct entry) midwifery that is recognized nationwide would be a wonderful thing. The post by Barb that you link to is just about her getting a CNM, and I have nothing but my best wishes for her in that pursuit. Who knows if accredited direct entry midwifery education will happen in the lifetime of any of us? My daughter's lifetime? (Just shoot me here now if it won't!) But I bet most of us reading here agree that it's preposterous that the only nationally recognized midwifery credential is tied to an advanced degree in nursing. Kneelingwoman has argued for a university-based independent midwifery education and I expect that when you have a chance to join in that discussion you will have valuable ideas to contribute to it, Pam -- I'm looking forward to hearing them!
I value education. But, at the same time I value freedom. In Kansas women are free to choose where and with whom they give birth. Midwives are not regulated and I love that! We do not have to worry about anyone telling us how a woman can give birth, when a woman must give birth, or any of the other stipulations that are put onto regulated birth attendants. We still have practicing CNM's and CPM's but that is a choice that each midwife has made based on their belief system. I am a lay midwife and I intend to be a lay midwife until I die. I would be very upset if there was a nationwide system that regulates midwives. I would be run underground. The families that choose to use lay midwives would be in the same situation as they are now in many states. Women want and need choices. Birth is a normal, natural process that should not be regulated by any governing body. Your path as a midwife is a personal choice. There must be many midwives to appeal to many people. But, by insisting that one type of midwife is superior to another,is to essentially take away the freedom of choice. I honestly believe that much of this about money and competition. Any "profession" is driven by those elements. That is why I choose not be in the profession of delivering babies. Rather, I am a sister, a friend and (GASP!) a spiritual guide through a journey that belongs solely to the families I serve.
Hi Pamela, I have been trying to follow the debates about midwifery in the USA and most admit to being rather confused about whats going on. Is there any chance, when/if you have time, you pop across to my blog and explain things for those of us who live down under? Thanks a lot Sarah
Hi Pamma: This particular conversation ( on midwifery educaiton ) is actually a long time gone now....but, I was following some old threads and that landed me here; I've not had the privilage to see your blog before although a couple of people have mentioned your blog to me. I recently retired from midwifery; I worked for many years as a JM ( Just MIdwife ) and was able to avoid the NARM maze etc. My posts on midwifery education, and my position that to create a truly autonomous, sustainable and non-elite profession of midwifery that can serve all women in all settings probably means the establishment of a graduate level, University based program which would mean that women of color, poor women etc. would find it both appealing and accessible as there would be federal monies available for financial aid etc. Currently, only white, middle class women can "afford" either an apprenticeship or attendance at one of the NARM school ( a few of which cost more than some of our ivy league Universities! ). My hearts desire would be to maintain midwifery as an entirely local, woman to woman health care option with the best "credential" recognized to be that given by the women and families themselves--a stack of references at least 30-50 thick that other women and families can look at and then contact the others for confirmation! Alas, we live in a country that requires very particular credentialing for health care professionals and, unfortunately, that means graduate school ( you can't even be a physical therapist or occupational therapist without an M.S. anymore and the other medical professsions are rapidly following suit; the ACNM wants entry level to become a Phd by 2015 for CNM practice for heaven's sake ) I think the idea that we can grow midwifery by apprenticeship and CPM is probably just not realistic. That, in a nutshell, is what I've been advocating. I would like to see midwifery establish itself as true community based health care by having women obtain undergraduate preparation in an area of "Human Service" interest for them ie. social work, psychology, family studies, sociology etc. followed by graduate level midwifery training with clinical done in all practice areas: home, hospital and birth center. The "graduate" midwife would then decide on her particular "track" and vocation and that's where she would practice upon graduation. All of this assumed health care reform and someone obliterating the AMA of course but, why not dream big! I hope to hear from you sometime! Very nice blog you've got here.....
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