Women’s bodies have been the talk of the town (more than usual) for the last few weeks. Funding for Planned Parenthood is under attack. Michelle Obama, who is promoting breastfeeding as a method of reducing childhood obesity as part of her campaign to help get America’s kids healthier, is being lambasted by the right for not minding her business. And just in time for Women’s History Month, controversy is brewing over the arrest of Emily “Amy” Medwin, a midwife who is accused of practicing without a license here in Charlotte.
Medwin is a certified professional midwife whose certification is recognized in a number of states, just not in North Carolina. In my mind, Medwin, who was arrested previously in 1998 for practicing without the proper N.C. midwifery license, knew the risks of continuing to practice. The larger issue here is, why doesn’t N.C. recognize certifications from other states?
It is so interesting that folks are always wanting the government to stay out of the personal lives of its citizens — except when it comes to women’s bodies. America has a long tradition of being obsessed with women’s bodies, having demarcated them as the property of men for hundreds of years. If women want to have a midwife during their pregnancy, then they should have the right to do that. They should have the right to select the midwife that they want whether she or he is here in North Carolina or certified as a professional midwife somewhere else.
For some reason, there is a common belief or misconception that midwives are subpar or somehow not properly trained for deliveries. According to the organization Citizens for Midwifery, “a midwife is a trained professional with special expertise in supporting women to maintain a healthy pregnancy birth, offering expert individualized care, education, counseling and support to a woman and her newborn throughout the childbearing cycle.” Their approach to childbirth is often different — and more holistic — than that of an obstetrician, and some women want that during childbirth. Others want an obstetrician and a midwife. The choice should be that of the woman who will actually be bringing the child into this world.
The idea that midwives, most of whom are women, are somehow not as well-trained is rooted in sexism and racism. According to midwifery scholar Lisa Koers in her article “Benefits of Midwifery for Low-Income Women,” by the turn of the 20th century, “Most practicing midwives were immigrants from Europe or Mexico, or were southern-born African Americans and were recognized as being better trained than American physicians to oversee childbirth.” Xenophobia was rampant during this time, so a campaign to eliminate midwives began, blaming them for increased rates of maternal and infant deaths. Koers adds, “Data was ignored that not only demonstrated the quality of care provided by immigrant and African American midwives, but even proved their outcomes to be significantly better than those achieved by doctors.”
During that time, physicians helped pass laws requiring a medical degree to practice obstetrics, even though multiple reports concluded that American obstetricians were poorly trained. In an effort to improve the profession, the hospitalization of all deliveries was required and accompanied by the gradual abolition of midwifery. The denigration of midwifery was tied to discrimination — something other than the care of the actual mother and child — which leads me back to my point.
This controversy should not be just about Medwin’s arrest — it should be about ensuring that the care of the mother and child is primary during pregnancy. A woman should have the right to choose the people she wants involved in her pregnancy, whether it’s an obstetrician, midwife or both. A woman who has been certified as a professional midwife, particularly in a neighboring state, should be able to practice here or at least have a reasonable path to certification here in N.C. It does not have to be this difficult. What is difficult is letting go of the need for the government, made up largely of men, to control women’s bodies. Unfortunately, this case is not going to cure that disease.
This article appears in Mar 1-7, 2011.
You might think that the serious injury of a baby would be an opportunity for soul searching in the North Carolina homebirth community, but you’d be wrong. The North Carolina Friends of Midwives) view this as an oppportunity to promote the interests of CPMs. No one knows whether the baby will live or die, but homebirth advocates have already “moved on” to the really important issue, the fate of the midwife.
That is what is known as “reframing the conversation.” North Carolina homebirth advocates aren’t going to persuade anyone of anything by discussing the babies injured under the care of CPMs. They don’t even bother to try to justify the conduct of the CPM, her medical judgment (or lack thereof), or the appropriateness of a homebirth in either case. That argument is a total loser, so effort is expended to divert attention from the homebirth disasters.
In fact, Russ Fawcett, the president of NCFOM sent out an urgent message to the NCFOM mailing list:
“URGENT Request
This message in being sent to all NCFOM members.
The leadership of NCFOM is moving to change the direction of the media. We will be crafting a new press release that is ENTIRELY focused on Wednesday’s Birth Freedom March and legislation, with NO mention of the investigation.
At this time, please STOP ALL COMMUNICATION WITH ALL MEDIA INQUIRES that may arise that have any connection with Amy. Direct all media inquiries to myself (Spigget@aol.com) and Amber Craig (ambercraig@nc.rr.com).
Friends – I think this has been very successful, but not without concern over worsening Amy’s circumstance. Nevertheless, there is a lot of positive press out there, and some negative, but had we done nothing, it could have been all negative.
Please DO NOT CONTACT OR DISCUSS with any media outlets until further notice. This includes leaving comments on newspaper, television and other media’s web pages. It would be better to miss an opportunity at turning around a bad article, or celebrating a good one, than to negatively affect our need to now change the conversation. Please direct any questions about media to myself, or Amber Craig…
Thanks,
Russ”
Only homebirth advocates could consider the life threatening damage sustained by infants at homebirth as an opportunity to rally support. According to them, the problem is not that babies are injured and die at homebirth. And the problem is not that CPMs have less education and training that midwives in ANY other first world country. The real problem, according to homebirth advocates, is that these underqualified, dangerous practitioners who have already hurt babies don’t have legal sanction.
Even as the latest injured baby struggles for its life in a local hospital, Fawcett and NCCFOM have figuratively rushed to bury the baby and support the CPM instead.
The certificate thing is not a particular attack against that one profession or women. This kind of stuff happens for doctors and people from all different work areas.
I want smaller government in most areas. In this case the states should just get together and make a single certificate for all states. I do think if money is going to change hands that the midwife should be certified.
An example of over reach would be requiring people that braid hair to be licensed. This of course is the case for people that braid hair in some states.
Good points Amy. I myself would be worried about complications. If you are at home then you do not have access to the best technology to save a child in distress.
Nsenga seems to have turned this into a political battle instead of a battle for the lives of children. Most times there is more to a story than the liberal press is telling you.
Just a heads up to all that are reading.
The good “doctor” Amy has been up to her usual internet trolling and has pasted that same twisted comment in every article she has been able to find. I doubt she even read the above article.
So a friendly PSA and reminder to those who actually bother with facts and truths about home birth and midwives…DON’T FEED THE TROLL (“dr.” Amy)
Excellent article! Many great points raised. Women deserve the choice to birth their babies how they see fit.
NC does allow couples to home birth. The law just prohibits them from doing it with the help of educated, trained assistance. So, for NC, it’s not about safety.
Thank you for addressing the true heart of the issue. This is a women’s rights issue. Women have the right to give birth wherever they want, and they should retain the right to hire help of their choice in that endeavor.
Wonderful article! Thank you for focusing on the real issue. Women have the right to choose who attends them in labor. Period.
Thanks for this article. I appreciate that you have actually taken the role of informing and not defaming or jumping to conclusions before knowing all of the information about this.
I am often saddened to see that there are still people out there who are stuck in the system. A system that remains unwilling to ask women what they want, but would rather “tell” women what “they” think is good for them.
I am glad to see that in this article you have not done what the system would prefer and have instead remained open to what the choices are for women.
Thank you for your fair and well researched article. Women’s bodies have been grossly politicized and it is far beyond time that a woman’s right to decide her own care and the care of her own baby be respected. And that more professionals become legally recognized and available in NC for that care!
Certified Professional Midwives are highly trained to recognize the signs and precursors of complications well before they arise. In those cases their training is to immediately transfer to appropriate medical care. CPMs are trained in neo-natal resuscitation and in managing hemorrhage. Planned home births are prepared in advance with quick transport options to the nearest hospital if necessary.
However, the latest technological advances are not at all the safest thing. In many cases, they can cause more damage than good. And it is indeed a woman’s right to decide if she wants technological intervention in her child’s birth or not. It is called informed consent, which is practiced in home and hospital settings. That law already exists. Let’s just make more trained professionals legally available in NC because women and families are going to continue to birth at home, either way. The safest management of this is to provide more highly trained professional midwives to care for them!
Great article! I’m glad you outlined why midwifery became illegal in the first place – a smear campaign against midwives. Outlawing midwifery was not evidence-based medicine then or now.
Another example of the sexism being practiced in American medicine: the two most commonly done surgeries are c-section and hysterectomy. Why is it that the two most common surgeries are ones done on the reproductive organs of women for conditions that are rarely life-threatening? It hardly seems possible that each doctor would intentionally go out to remove such a vital part of a woman’s body but it makes me ask what kind of culture finds that acceptable?
The historical development of physicians into obstetricians is a great reminder of how training can give you extra skills in order to be of service. Those physicians went to France (and perhaps other countries) to study midwifery so they could come back to the U.S. and attend births. However, they needed to convince women that their homes were too dirty and that they could have drugs that would take away all their pain. It happened. The only question I have is how long did that take? How long will it take for women to have a full range of safe and satisfying options for birth?