Several weeks ago, 18 people - women, men, mothers, fathers, and children as well - met at the home of a local supporter of midwifery and birth choice. We met because we are concerned about the current state of the birth climate in this region. We met because we want our rights, our choices, our bodies and our births honoured and respected.
I can't get into all of the specifics of what motivated us to meet with little warning, what events precipitated this meeting, nor all of the details that were discussed, because there are some...issues of legality. Suffice it to say that we, a group of consumers and birth workers and advocates are not only concerned about some of the trends in midwifery in this province and this region, but are also prepared to stand up and take action.
Over the several hours of discussion that ran late into the night (it was pushing midnight by the time my ride - and new friend - left) there were several recurring themes. What constitutes informed choice? How do we define it? Are we consumers, and if so, what are we consuming? Do we consume a product or a service? And if it is a product, what is it?
Many medically-minded advocates have penned articles or scripted news segments arguing that birthing women and men have unreasonable and unrealistic expectations of birth, that we have delusions of entitlement and have hedonistic visions of candle-lit, "perfect" birth experiences, and that these expectations have led to a culture of litigation among dissatisfied consumers post-birth, and a culture of fear and defensive medicine amongst obstetricians. One of our concerns discussed at our meeting was that such a climate is no longer exclusive to obstetrics, but is disturbingly present within the current practice of midwifery as well.
The point was also made that the modern face of midwifery in Ontario is obstetrically-born. We have virtually no (I know of only one) direct-entry midwife in this region, which is to say that only one of our local midwives learned and trained purely through apprenticeship. All newly-licensed and registered midwives in Ontario must be university-educated, through three-year programmes at only a few schools in the province, schools with limited spaces for students. The academic curriculae are based on a medical-model, and while a thorough understanding of human physiology and biology are - obviously - helpful in attending and assisting births, the resident fear in the medical model appears to be seeping into the culture of our midwives. How can this be? What can we do?
It isn't enough for women and men to simply say "We want a change." We need to find a way to not only effect that change but to support it as well. Anyone with eyes open to the climate of birth in North America and the Western world in general knows that we are socially trained to fear birth, to see it as inherently dangerous and risky. We can not simply demand that our midwives - women (and men) who have been largely been born and raised in this same climate of fear - ignore that fear, withstand the pull of that fear on their spirits and act entirely differently. We must acknowledge the great task that stands before our midwives, the great challenge they face in not only assisting families to have safe, positive birth experiences but also be brave and courageous amidst the majority of the birth-working community (id est doctors and nurses) who have been taught so effectively to fear birth and all the natural outcomes thereof.
But what can we do? How can we as consumers, as clients, as mothers and fathers, as men and women, as families and citizens, support our midwives? How can we help them be brave and courageous? How can we assist them in feeling the passion and zeal they had when first they decided to pursue the path to attending and assisting births? How can we nurture their livelihoods and nurture their souls?
We didn't come to any specific conclusions during our meeting. What we did acknowledge is that this will be an ongoing process: there is no quick fix, and supporting and upholding not only today's midwives but the entire art of midwifery is something which will continue to be of great value and importance. What we begin today must continue for generations.
"You are in the process of being indoctrinated. We have not yet evolved a system of education that is not a system of indoctrination. We are sorry, but it is the best we can do. What you are being taught here is an amalgam of current prejudice and the choices of this particular culture. The slightest look at history will show how impermanent these must be. You are being taught by people who have been able to accommodate themselves to a regime of thought laid down by their predecessors. It is a self-perpetuating system. Those of you who are more robust and individual than others, will be encouraged to leave and find ways of educating yourself-educating your own judgment. Those that stay must remember, always and all the time, that they are being moulded and patterned to fit into the narrow and particular needs of this society."
ReplyDelete-- Doris Lessing, "The Golden Notebook"