Living exposed

In the birthing community, women study, read and generally try to “know it all” in order to avoid being humiliated or gossiped about.  Much of what we think is fact is absolutely ridiculous but it’s spouted and re-spouted like the word of God.  Degree after degree is attained and door stopper books are accumulated.  Education is important but what is behind the insatiable quest to outstrip everyone else in stockpiling maternity trivia?  Language and concepts that started off being an authentic expression have been twisted and turned in order to keep rape obstetrics in place.  “Family centered care”, “the midwives model of care”, “choice”, “empowerment” —just think of all the words and phrases that have been hijacked and turned into pure pap and then fed back to us to keep the cesarean machinery whirring.  Even the word “midwife” has been co-opted and used to describe work that has nothing to do with supporting the health of the greatest number of women and children.

 “How can I go to births, make a difference, be famous and brilliant AND never have to go to court?”  That question will entertain you endlessly and it niggles at the brain of every birth junkie.  I spent a great deal of my life entertaining that question, too.  Endless spirals of solutions to the problem:  become a registered nurse and a lawyer, become a CNM and a nun, move to Portland Oregon and become president of the Oregon Midwives Association, become a Physician and then just practice as a midwife. . . . . there are many possible strategies.  The only problem is that none of them work.  If they did work, everyone would do that and then life would be grand.  I remember when I stopped strategizing for personal safety:  I heard a Midwifery Today tape that included a talk given by Sister Angela, a Catholic nun and a CNM who practices in Waco, Texas.  Someone in the audience asked Sister Angela if she had ever been sued.  I waited for the answer.  Of course, a respected Catholic Nun and Certified Nurse Midwife like Sister Angela would never have been sued.  But, lo and behold, Sister Angela replied

“Yes, honey, I have been sued and I want to say that if you’re a midwife and you haven’t been sued, well, line up and take a ticket because your turn is coming.”  She went on to say that she had received papers that she was being sued and she knew what to do . . . call the insurance company.  When she called the insurance co. there was a message saying “the number you have reached is not in service”.  The insurance company to which she’d been paying her malpractice premiums had gone out of business leaving her with no coverage.  She said that after that she prayed about the whole situation and asked God if she should carry malpractice insurance. God said “No”, so she has never carried insurance for her birth centre in Texas since.

From her experience, you might want to stop twisting yourself into knots in order to be safe.  There is no safety to be had in birth work.  No amount of butt covering will avoid the fact that you’re not perfect. If you do something, you will be attacked and, if you don’t do anything, you will be attacked.  If you have a certificate, someone will want to take it away from you and if you aren’t certified people will make that wrong.  It’s possible to embrace the attack and have some fun with it.  In the groups that I work with, we clap and cheer when one of our peers is berated by a doctor or thrown out of a hospital —this means they are having an impact!  It means they have thrown a spanner into the cogs of the obstetric machinery and someone has woken up enough to be upset.  Anger is a higher state of consciousness than being fast asleep.

One of my favorite philosopher’s on this subject is Helen Keller. Helen Keller became deaf and blind as an infant and was taught to communicate by a particularly gifted teacher.  Here’s what she says about the notion of having a nice, safe, comfortable life:
Life is either a daring adventure or nothing. Security does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than exposure.
Helen Keller (1880 – 1968)

30 thoughts on “Living exposed

  1. yet another wonderful post! as i find myself being drawn ever closer to immersing myself into a life of midwifery, this very thought keeps wriggling in the back of my mind. i find i keep reminding myself of one thing. there simply are no guarantees. not in birth, in life, or in death, and all anyone can do is follow their instincts.

  2. Another good post — just a slight correction — Helen was not *born* blind and deaf; an illness (possibly scarlet fever) left her without sight and hearing at 19 months of age.

  3. Gloria

    This is very refreshing to read and very true. Thank you. I hope people read and understand it! I think as well, that in light of the increasing government control that is exerted over birth and midwives in particular, you took a very bold and strong stance against that and if more midwives would offer that and step away from the regulation (as you know that has just escalated here in Alberta too)and willing to take the risk, women would be better off. When we all stand up against what is wrong with birth and how it is approached, maybe we can be strong enough to overcome the atrocities that continue to happen to this day.

  4. Wow. Just what I needed to hear today.

    Lately I’ve been feeling like I’ve got a disaster waiting to pounce on me. Not because I’m inept or ignorant, but just because I’m human. Add to that the fact that too many women look to the midwife as their savior or hero, and it just makes me uncomfortable about any little thing that might go wrong.

  5. This message rings as true today and is even more needed now that ACNM has seen fit to make a heinous statement about CPM’s deeming the credential as questionable due to the variety of pathways available to get it.

    Well you are correct Gloria… there is no safety, except in co-opting all the good ideas and words and phrases and generally making up the standards as you go to keep the riff-raff out. HA! But what happens when the “riff-raff” stops caring what the elite think?

    We really need some perspective in this day and age about midwifery. Thank you for sharing yours!

  6. Let me clarify it is ACNM that has deemed the CPM credential to be questionable because of the variety of pathways to it. I read what I wrote and it was not clear. Thanks for bearing with me.

  7. Pingback: Gloria Lemay » CNMs Don’t Want to Play with CPMs

  8. I love the “spanner in the works” imagery! Beyond that, Gloria, the truth is that the endless prevarication about the issues of “Midwifery” certification, legalization or not, a license or not is all about fear. Everyone is afraid of being blamed or held accountable and we aren’t willing, in this country, to simply allow Midwifery to “be”. We’ve had great regional integrity in Midwifery in the U.S. for years. Some States were legal and licensed. Some illegal and underground and everything in between. Nowhere has Midwifery been “safe” to practice and it won’t be different when all 50 States are on board, having been “PUSH’ed” into certified/licensed Midwifery now a requirement not only of law, but of “sisterhood”. Those of us who continue to believe that Midwifery is relational; that it is a private agreement between a woman/family and another woman who is knowledgeable and skilled in the art/science of Homebirth Midwifery is being utterly lost, subsumed in this “PUSH” ahead to…what,exactly? Oh yes. Government oversite and third party reimbursement from insurance companies who will ultimately determine what our services are “worth” in the health care marketplace. You and I are now Facebook Friends but I’ve followed your work for years with great admiration. In truth, I don’t know how to practice midwifery anymore because the women and families I have served have become just as fearful as the midwifery community when they hear about midwives being prosecuted or parents being accused of neglect for having a home birth. I will gladly take any encouragement you might give me because it’s gotten very dark and cloudy on my side of the birth bed!

  9. Sorry… what I meant by regional integrity ( and failed to complete that thought ) was that the different States dealt with Midwifery as an environmental reality; we’ve all done Midwifery in ways that have suited the women and families of our respective areas and “nationalizing” a certification or assuming that every State in the Country should do the exact same thing challenges that integrity in my view. What needed to happen prior to NARM, even, was for individual States where Midwifery was clearly illegal to work to get those laws off the books; had that happened, we would be in far better shape today in the U.S.

  10. “Midwife” this really cool word that has all this meaning means “with woman” we attached all sorts of things to its meaning. We do that with Spanish words say like “salsa” ooo we have sauce or gravy… anyway the “lady who hangs with the birthing women.” Or the lady that knits in the corner….sister, mom, grandma, friend… just a late night thought…. oh or elephant that swings the trunk (from the 2010 conference)
    Love your posts Gloria!

  11. thank you, gloria for speaking the truth in general, and about birth work. there are no securities, and i think getting sued in the US is worst that in canada (unless things have changed since i left.) here, one can get sued by a trespasser for slipping off one’s steps (it’s happened to us). go figure, right?
    for midwives working on the edge, they may want to consider “not owning anything”… then, there is nothing to loose. all big, rich investors do that ~ why not use their own tools?

    • In the Canadian system it’s more difficult to sue for malpractise than in the U.S.
      We also are a bit kinder when arresting midwives —no guns drawn or being forced to lie face down on the floor while our terrified children watch the house be ransacked as has happened in the U.S. Here, they come to the door, apologize and then search your house.

      The longest, costliest trial of midwives in the world did happen here in British Columbia, Canada, tho. From 1985 to 1991, my partner Mary Sullivan and I were prosecuted through the Canadian court system and finally fully acquitted by the Supreme Court of Canada. The government in power was very right wing and the College of Physicians & Surgeons of BC jumped at the chance to prosecute midwives. That combination was daunting.

  12. Every post I read of yours gives me such hope. I have had these same thoughts for some time… But feel quite alone when I express them to most birth people. I will be a midwife someday and hope I can always remember who I serve…

  13. Gloria I’ve been mulling over this topic lately myself. I’m not yet a midwife and I don’t know what kind of midwife I want to be when I am. Great reminder not to base my decision on fear though.

  14. I’ve been attacked physically and verbally, sued, and had charges brought against me by the California Med Board that were never based on anyone’s health or well being.
    I was very fortunate to be successful with home birth and a birth center simultaneously and was open about not having licensure.
    Did it suck to be attacked and sued/charged? YES.
    Did it cost me big money and huge stress? YES
    Do I regret being a midwife? NO!
    For those of us who answer the call to be with women in birth, there is no easy path. Not all births will flow as envisioned and not all babies will survive. You will be at risk of all of the above. The witch hunt continues and to that and you, I say become who you are meant to be! Trust your choices, ally yourself with other brave women to offer/receive support.
    If midwifery is your calling, embrace it without fear. It’s work we choose because it has profound meaning and it also “chooses” us. This is sacred work that we have done for ever. It is our birthright. Claim it.
    In love and respect to sisters,
    Tai Carson

  15. In addition, there is the problem of access–what the parents do or don’t have access to, depending on which kind of midwife they choose. I have been intimately involved with parents who chose to have an unlicensed midwife in a very hostile state. For two weeks after the birth I was under a great deal of stress, trying to help this couple find their way through the maze of getting access to medical help that they legitimately needed, access to the PKU test, and access to the birth certificate registration, trying to do it all without lying, and all the while with the potential but real threat of DCFS hanging over our heads if the wrong person happened to find out the wrong bit of information about us. I agree with Gloria, but I ask that midwives with limited access prepare the parents for what they will need to do after the birth in order to work their way through the system in the outside world safely.

  16. The same is true for lactation consultants. The fallacy of evidence-based medicine is so seductive that everyone fears being seen as not practicing according to such “standards”. Heaven forbid we take risks and ask questions and try things clinically that are not “evidence-based”. As if we have forgotten that most of what works in birth and breastfeeding comes about from being present with mothers and babies.

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  19. So true. It’s a calling. And no prophet is honored in his own country. I am a midwife despite persecution, lawsuits, unjust charges, near bankruptcy, and the loss of my license in my so called “legal state”. The powered that be do not like the competition, someone who believes in true informed consent, women in charge of their own care, or those of us who in general refuse to follow the dominant paradigm.

  20. I’ve never read this one before!

    “There is no safety to be had in birth work. No amount of butt covering will avoid the fact that you’re not perfect. If you do something, you will be attacked and, if you don’t do anything, you will be attacked.”

    I like this one, Gloria. I can’t believe I haven’t read it before.

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