Thursday, April 10, 2008

the gentrification of midwifery

so if you didn't know yet, the CNM is the new it-girl on the blogosphere.

she's educated, totally hip, and yet still so adorably nurse-y.

there's manymany of these ladies here and they're all going thru hell trying to pass that big ole test with a capital B.

i think it's nice. and heart-warming (maybe i'll be one of them one day!), but i find it also very very disturbing.

not disturbing because they exist. i think it's great. they can provide care to a more diverse group of people than most direct-entry midwives can, accept insurance claims, and take higher risk mamas.

i find it disturbing that some people in the midwifery community think it is necessary to be a CNM to be a safe midwife. this is simply not true. i think we are taking some serious steps backwards. being a nurse doesn't make you a safer midwife. nor does going to grad school.

experience makes a midwife. this is a time-tested reality. i don't give a fuck what letters are behind your name.

there is something horribly wrong going on if the new model of midwifery care only extends to midwives that also happen to be nurses. birth is normal. in the vast majority of cases, the birthing family doesn't need anyone around at all. in the veryvery small amount of cases in which something bad happens that CAN be remedied by someone other than the birthing family, EXPERIENCE is what will help that person know what to do and help them to remedy it in a safe and effective way. no amount of letters behind their names, years of schooling, schmoozing, and assimilating they've completed will help them in that situation.

and again, don't get me wrong. i think CNMs get a comparatively good amount of supervised experience before they are "allowed" to set off on their own. CPMs don't require nearly the same amount of apprenticeship. but to judge a midwife by the letters (or lack thereof) behind her name is to put your faith in a patriarchal system that is bound to fail.

our mothers' grandmothers and their grandmothers before them knew birth and they have given us the gift of that knowledge. they hid it deep within the darkest, safest, privatest place they knew of in the only place it can never be stolen by men or power or greed. it is in our souls and spirits, in our hind-brains and our DNA.

we don't need any patriarchal institutional hierarchical system to tell us how to give birth, where to give birth or with whom to give birth. we don't need any credentials or anyone with credentials to tell us. we don't need any JCAHO standards guiding our paths.

just trust. and the experience of the generations of grandmother-midwives who came before us.




i was worried that working in L&D would make me more scared of homebirth or unhindered birth. on the contrary, it has absolutely validated all of my worst fears.

1 comment:

Question said...

Right on! I couldn't agree more. I think as care practitioners it is our responsibility to inform ourselves to the BEST of our abilities and there is certainly no 'best' way to gather that information....and as women hiring midwives, we need to find women we trust holistically. It's all about balance... and the institution of the CNM in many ways plays into the patriarchal 'medicine knows best' meta-narrative that has historically kept women from being agents of our own health care. On the other hand, sometimes the system needs to be changed from the inside out and thank goddess there are CNM's out there doing just that!