Thursday, January 12, 2012


Recently I've seen discussions arising in the midwife communities, maybe more like debates, actually. Between the "Trust Birth" camps,and midwives that have taken an approach that is looked upon as more medical. It isn't a new conflict. These issues have divided midwives for many years. I've observed, and been involved in, these discussions since very early in my career, and I know it's been going on since well before I became involved in the birthing culture.

I think discussions like this can be healthy. I hope that as midwives, they inspire us to look at ourselves, question ourselves. Sometimes they inspire change. For many of us we'll come back to the belief that what we're doing is right.

But the conflicts can be frustrating to see, because I believe that as midwives, we have so much more in common than in opposition. For the most part, we pretty much all trust birth. I wouldn't be attending home births, and I'm sure the rest of the midwives wouldn't be attending home births if we didn't believe in the essential nature of birth as a safe process.

But if we believed nothing ever went wrong we wouldn't obtain training to deal with the rare complication.

Because birth is a natural process, it is mysterious. You can count on that. It can be unpredictable. In the same way that we don't know when we'll get our first freeze or what to expect of the summer monsoons, we don't know when labor will happen, how long it will be, what it will look like for each individual mama and baby. That's nature. But we can have clues.And we know that it's good. Almost always. And I think we agree that we should be prepared for any times when assistance is needed.

So, here is what I have to say about Trust Birth vs the so called "medwife" conflict.I think we're missing the point.

Maybe what we're forgetting is that it isn't up to the midwife to decide what's right for each mom and baby. The midwife's approach should be somewhat insignificant. A midwife should be able to a chameleon, changing in different situations,ready to rise to the needs of each individual mamatoto (mother-baby unit), each family. I think what I love most about midwifery is the opportunity to meet each woman where she is at, and to see the growth and empowerment that happens, no matter what her needs are.

I love it when a couple comes in, already well prepared and knowing what they want. All they really want is a guardian. When I'm working with them, I believe that my favorite births are the hands off births, where I listen to the baby's heart beat and otherwise mostly serve as a witness, as mom follows her birthing instincts, she and dad recieve the baby into their own hands. That's awesome. So peaceful, so beautiful, and they could have done this without me. yes! It's perfect.

But maybe they really are not my favorites. Maybe my favorite births are the ones where the young mama comes in to interview me.Home birth is not what she really wanted. She can't afford a doctor and a hospital birth, so she's going with a midwife because she has to. Or she just wanted a doula. And as she sees me for care over the next few months, I see some lights come on. She starts trusting me, and then,she starts believing more and more in herself.The idea that birth is safe slowly begins to sink in, but still with reservations. This woman will need a lot of reassurance, and much of it in the form of things that are offered by modern medicine. She needs a couple of ultrasounds in order to believe her baby is okay. She needs a little additional lab work to trust that her body is healthy. She wants a pap, not because she knows what it tests for, but because her friends all had paps when they were pregnant.She'll schedule her doctor visit because she needs to hear a doctor say that she's healthy enough for a home birth.

And in labor she needs a lot a emotional support, checking the baby,and Lots of hands on. She wants vag exams. She needs to know she's progressing. So I'm going to do a lot of vag exams. Go ahead and call me a medwife. This woman has hired me to be that for her. For her, having a baby at home is a big step - a huge step. She does not want someone standing in the background knowing that everything is okay. She wants her baby suctioned, so, yes, I will do that if it will help mom to relax and bond with her baby. And it's all good. It's better than good! It's perfect.

This is actually the mom that will probably be most empowered by her birth experience. This is the mom who will learn the most, grow the most and experience healing on deep levels. And she may or may not know that, but she knows she did it and she's thrilled with that. Often we develop a connection for the rest of our lives.

I love trust birth births. They're validating and healing for Me. They feed my spirit in a way the others don't, but hey, it works both ways, really. Witnessing and being involved in such an amazing process always feeds my spirit, no matter the approach to birth.

When it comes to these conflicts between which approach to midwifery is best, I think it's a moot point. I'm reminded that many of us believe that the right midwife exists for each woman. So it seems like midwives often attract women whose philosophies match their own. That's wonderful. But as for me, I think maybe I'd get a little bored serving only one group or another. I just thrive on seeing the women that I serve chosing their own paths, doing things their way and learning that their way is always the right way.