Quite a bold heading, I realize. But how many of you realize the SAD, sad truth about midwifery in this country….that in many states, it is not POSSIBLE to get a license and practice as a midwife. It is not POSSIBLE to be practicing legitimately, no matter how legitimate or studied or practiced a midwife might think herself. There are places, such as Chicago, or Cincinnati, OH (2 places I have lived BTW) where a midwife has every chance of being fined and/or charged for simply doing a professional service for women that have chosen her to do so for them. Can you believe that in places such as this, the politics and legislation are so “behind” that basically the government would rather a woman attempt an unassisted birth than hire a(n) (illegal) midwife? If you happen to live in a place where this is NOT the case, consider yourself (in some ways) lucky.
I am not advocating for licensure across the board for all midwives. I fully realize, being licensed myself, that by doing so we have definitely invited the “establishment” (the more medical one at that) into our lives–it affects what women I can and cannot help here in Arizona, and I don’t LOVE that. But after seeing my former preceptor deal with the repercussions of living in an illegal state and being an “illegal” midwife, I swore I would never voluntarily put my family in that situation. But it is a hard call, and an individual call, because the women in these places deserve options too.
In all places, it seems, midwives struggle to be “legit”. Whereas here my struggle is not being able to attend VBAV births, my midwife sisters in Ohio fear for themselves and their families by simply being named a “midwife”. They may or may not even be attending births, but because they have in the past, they are always on the radar. This is the modern day witch hunt, my friends. To pretend it is anything less is denial and naivete. The CPM standard has been accepted by many states, but not all. So, is it fair that a CPM in Ohio should be subject to criminal charges for providing the same service that a midwife in say, Colorado, does? (And also, this is not to say that a birth attended by an “illegal” midwife was anything other than safe and lovely. It hardly matters. A midwife in an illegal state can be investigated for no other reason than she is suspected for having practiced “medicine without a license”. Which can mean she took a blood pressure reading, or did a vaginal exam. Outcome unimportant.)
But this brings me to an interesting point which I have seen myself and which I see my midwife sisters in illegal states struggle with as well. License or not, a midwife who is out practicing should know what she is doing. But because the lack of licensure can make that standard ambiguous, there are women practicing as midwives who, well, perhaps, shouldn’t. I hate to say that because it is largely a judgement call. We call all be the best and worst and what we do, especially through the course of a career. So, perhaps I should narrow it down and say that there are women out there, attending births with little to no training. Many have the belief that birth is so safe, there isn’t really a need for them to learn or do. They simply need to be with the women and help her navigate her own emotional/personal issues, and if she does so successfully, she will have a successful birth. It hardly matters what the reasoning is, but without any standard, it is close to impossible for a consumer (a mama) to figure out if a midwife is for real, if she has actual experience, etc. And so it only muddies the situation in an illegal state. A woman in Ohio wants a homebirth. Say she just moved to the area. What is to keep her from inadvertently hiring a midwife who has no experience? How does she recognize a midwife that does?
Again, I am not advocating for across-the-board licensure. Ideally, licensure should be voluntary. It really isn’t about one midwife looking better or being more educated on paper than her sister. It is about, once again, (common theme here) GIVING WOMEN CHOICES. How can we do that by calling ALL midwives in a place “illegal”? (I am mainly talking here about midwives trained in homebirths, as nurse-midwives, CNMs, are legal but most often do not attend births at home). Women need to have choices. Because, despite what you may think, not every woman is going to WANT a licensed midwife. But some will. We need to respect both sides of the fence, and offer as much information as we can to women about who we are and what we offer. Once they see there is a choice, they will investigate it and choose what is right for them. It is no different than homebirth not being for everyone–many women would choose a birth center if that were an option- they still want a natural experience outside of the hospital.
So, my dear sisters in Ohio, Illinois, Indiana and elsewhere–I feel your pain, and your fear. May we be able to meet halfway, rising to a legitimate place in ALL states, that a woman ANYWHERE in this country has the choice of birth attendant, whether that be licensed or certified or neither.
