What if. . .

Last night, I sat down on the floor in my daughters’ bedroom and cried.  My heart is broken.  Reading the letter from the NC OB/GYN society was like a punch in the stomach.  Coupled with this picture I saw on Facebook,

I felt like nothing we are doing is going to be enough to truly change things.  If midwives cannot find their way to forgiveness and understanding until 2030, I don’t see how we can possibly get anywhere with improving maternity care in the US.  What will maternity care look like in 2030, when my children are thinking of having babies?  I can’t bear to think that it will still be like it is today – with care providers fighting amongst themselves over the ‘quality’ of their educations, while mothers and babies suffer the consequences of a system based largely on fear and ego.

After I wiped away the tears, I went to get out the stencil we cut out of plastic for painting our logo on car windows to prepare for Friday’s event.  In order to protect it, I had placed it between two pieces of poster board.  One of the poster boards was an original protest sign from nearly three years ago, a bit of our past.  The other was this collage, a vision of our future:

In January of 2010, a group of fed up mamas sat down in the living room of our midwife friend and flipped through a stack of magazines looking for images that spoke to us.  We were envisioning what our future birth center would be like.  And here’s what we came up with. . .

Imagine a big, wooded campus with two buildings sitting next to a stream or lake with a path that meanders next to the water.  One building is the birth center where all women go to see midwives from the time they start their period to the time they stop having one.  All pregnant women come here to see the team of CNMs and CPMs, and have the option to give birth at the birth center or at home, only seeing an obstetrician if they become too ‘high risk.’  Centering – group pre-natal exams – is also an option for everyone.

The second building is the wellness center.  A team of practitioners (social workers, massage therapists, acupuncturists, etc.) have their offices here.  There is also a large room for yoga, childbirth education classes and various support groups.  A self-esteem class for young girls is taught after school. At age 15 each girl is paired with a doula with whom they attend births. While doing this they can see what their bodies are capable of and will experience being at a birth before they, themselves, give birth for the first time.  The girls will also attend the New Parent Support Group so that they can see what having a baby is like, first hand.  Maybe they will want to sit in on the Wise Women sessions to learn from their elders. . .

What if women could go to a place like this from the time they were babies?  A place where women supported one another, where young women learned from old women?  What if we all witnessed women at the most powerful time of their lives – giving birth – and were not afraid?  What if?


12 thoughts on “What if. . .

  1. I LOVE YOU Kirsti…thank you for all you do, your heart is GOLDEN! with you in this til the end (and it’ll be before 20damn30 my friend!)

  2. What if… 2030 is _how long_ they think it will really take to get legislation passed in every one of the blinkin’ 50 states. What if… the forgiveness you imagine is being put off has actually _already happened_ and that’s what brought the motion. What if… your dreams are already come true?

    • That’s about 2.7 states changed per year. I agree that it feels like a long time to wait and a shorter goal would be more energizing. The fact that the motion exists at all is encouraging to me.

      • Encouraging yes, but in the state of NC things are not sunshine and lollipops between the midwives. And obviously the physicians are downright hostile. . just makes it hard to see the declaration to “explore” collaborating as a reason to jump up and down.

  3. What a beautiful vision and what a peaceful and supportive idea for a place of care. But, as a homebirth CNM who is used to taking the surroundings placed in front of me and the woman (of any age) complete with all of the baggage she brings to our relationship, I can tell you that the site is just not that important. Is it beautiful? Oh yes. Would we all like women’s health care to look like this? Certainly. But the relationship, the friendship a midwife establishes with a woman and her family is going to lead to that birth experience I know can make a heart sing long after the work is done.

    Midwives and midwifery organizations are going to continue to be separated by walls of distrust and rhetoric until we all realize midwifery is a profession worthy of education and skills that embrace the science and art of our knowledge and our singing hearts. Of course that does not need nursing as an entry, but it does need education as an entry. We will never have the physician organizations, the politicians, and the state laws behind us until we acknowledge and legislate for ourselves that, in this country, women and babies matter! They matter too much to allow unlicensed practitioners to provide them health care, they matter too much for midwives, the professionals uniquely suited to bringing the best care, to infight about them, they matter too much for lawmakers to ignore them.

    If we “professionalize our profession” and bring our professional selves to our lawmakers, we can rightly ask them to change our laws. And, if your amazing vision of this warm health care campus for women should come into being it will be a model for all of our states. Meanwhile, I promise you that our care can diminish the fear and lead to a safe and beautiful birth even when plans go astray.

    • sorry, midwife friend. when this ‘motion’ comes on the heels of the consensus statement from ACNM, MANA and NACPM, I’m calling bullsh**! It
      is one thing to make nice in a public arena; another thing entirely when the same song is sung to a very different tune behind closed doors and with ‘your own kind’. How people really feel becomes all too clear when they think nobody is looking! Couple of questions for you – education and skills? already been answered by people much more qualified to do so than your average nurse-midwife. The curricula writers, credentialing agencies and certifying bodies are more capable than most to determine what is an appropriate knowledge base and skill set – so that makes the oft-cited ‘concerns about education’ a moot point. Then, your comment about ‘unlicensed practitioners’? Does that apply to midwives who are actively seeking licensure? Does that apply to midwives who are being obstructed in their licensure activites by other midwives, medical practitioner groups and political lobbies? It is easy to fall back on trite arguments – it isn’t easy to justify the actions of a protectionist trade organisation like ACNM. Sorry, just calling it like I see it!

      • Andrea, I am only responding to a big issue in the letter from the NC OB/Gyn society ~ the issue of “professional” midwives. There is a very clear set of criteria for a profession and it includes education, and I think that issue needs to be addressed to make any headway with them. I also have seen sad outcomes in hospitals steming from interference with natural labor; I have had 2 sad outcomes at home related to something I did or didn’t do out of 3500 babies and I know of others from very skilled, experienced midwives. None of us, and that includes doctors and midwives, is perfect and none of us has the right to play God so finger pointing really goes nowhere. Answer their points in a manner they understand and hit the legislators with their “professional” designation too.

        I am not involved with the ACNM; I consciously CHOSE to go to nursing school solely for the purpose of becoming a CNM. Choice. I am not interested in making my choice an issue for any other midwife, nor am I interested in curriculum writing. Midwives in my state (Pennsylvania) have many difficulties too. But the state of political affairs in this country has reached the point where committees and motions are the (slow and frustrating) way to get anything accomplished. If we want anyone, NC or PA legislators, professional medical societies, professional midwifery societies included, to consider us professional midwives then we have to follow criteria of a profession.

        I am sorry I cannot answer your questions on licensure as I don’t know what the requirements for licensure are in your state. I had no intention of getting involved in any details here; I just had a praise for the women’s place concept and an observation on “professionalism” since it was a big issue in the letter from the medical society. Licensure in PA is available to any graduate of an accredited school of midwifery who has sat a national certifying exam. At this time that is the ACNM exam (which may be taken by CPMs). We have our own problems to work on.

        I didn’t practice midwifery before I was licensed but I have a number of friends who are doing so. Some have worked hard and long to become educated through different routes but others have read a few books, attended a few births with others, and printed up business cards. I would like the criteria for licecnsure to stop that sort of practice. No legislator or other professional is going to consider a practitioner with that sort of background a “professional”.

        I am sorry I got your ire up; I made no comments in my original reply pertaining to the ACNM and responded more to the doctors’ letter. Best wishes for every success in your fight to keep homebirth an option for NC women.

  4. I too found this statement encouraging. I know things feel really hard right now in our state, but I remember sitting in that living room creating that collage, and I will forever remain bopeful that out of the chaos, great things, beautiful things will come.

  5. When discussing education of midwives particularly versus physicians it is important to differentiate education emphases: Midwives education is focused on what is normal for 2-3 years. Midwives probably have a better understanding of what is happening physiologically than many physicians (had this reinforced recently when an OB told me not to assume OBs know what oxytocin does beyond labor contractions & milk letdown). Midwives also envision birth in a broader context of family & society. Med students & OBs’ education has little focus on NORMAL pregnancy & birth and Ina May states it well when she says most birth providers have not seen a normal birth, Medical education focuses on the medical, what can go “wrong” and how to prevent or treat that which is wrong. Thus, everyone needs a fasting blood sugar at 28 wks because some mothers may have undetected gestational diabetes or everyone needs an ultrasound to check for anomalies even if it will not change the course of the pregnancy. When the focus is on the what ifs there is no room for the natural or for honoring the amazing abilities mothers & babies were given to birth & care for one another. There is more scientific evidence that leaving pregnancy & birth alone with very close risk assessment (but not necessarily technological assessment) is the best care we can provide. We, all birth care providers, need to trust our abilities, our instincts & not just what technology “tells” us in the care of pregnant families. We also need to respect the paradigm from which birth care providers come. To be certified midwives have been through a very rigorous course of study based on the research evidence, the honing of professional judgement and the understanding of patients’ values and desires (and cost) (evidence based practice is a combination of all 4 components NOT just research). Therefore as certified midwives, certified doulas, certified childbirth educators let us stand on our education of and appreciation for NORMAL, Natural birth & help others (legislators, physician colleagues etc) understand our paradigm is complimentary to the medical paradigm and just as legitimate. And, both paradigms have at their core the safety of mother, baby & family.


  6. Pingback: What if. . . | Birth Activist Collective

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