Rogue Midwifery: By Kirsten Andergerg

I stumbled across this article by Kirsten Andergerg on the Susan Weed herbal ezine website and wanted to share it with you all. I think that she brings up some really key points that I hadn’t thought of before– lower class treatment, Spanish (or other language) speaking midwives, really helping others and being there for women– whether they are poor or rich, white or brown, Single or Gay or in a Heterosexual monogamous relationship, etc. [Here is the link for the Susan Weed article site: http://www.susunweed.com/herbal_ezine/December04/index.htm ]

Childbearing & Mothering … 
Rogue Midwifery 
by Kirsten Anderberg

Rogue Midwifery: Birthing Babies on the Sly 
By Kirsten Anderberg 

Women helping other women deliver babies is as old as humanity. It makes sense. So why do mainstream doctors and hospitals act like midwifery is some radical, dangerous, medically-irresponsible quackery? In Scandanavia, the UK, and the Netherlands, female midwifery is a thriving occupation. Yet in America, it has been constructively outlawed as a profession, for 100 years. While I was in labor, during my home birth, I actually asked the midwives, “Are you sure this is okay to do at home, and not in a hospital?” They said, “Kirsten, think about it. THIS is the way women birthed for thousands of years before doctors and hospitals.” That made sense, but I had to ask, due to my years of American medical brainwashing.

My midwives were rogue outlaws, in many ways. They fully understood the political activism involved, they fully appreciated the anarchist nature of what they were doing. They birthed approximately 200 babies in the Seattle area, between the years of 1980 and 2000, and they did so with no licenses, and no medical credentials. They delivered my baby at home, illegally, and I am eternally grateful. When I gave birth in 1984, there were no hospitals allowing midwives to birth in them, no insurance plan would pay for a midwife, and Swedish Hospital was the only hospital in Seattle “experimenting” with birthing rooms. There were no single or gay mom childbirth classes, so I quit going to childbirth classes, as they were filled only with middle-class, heterosexual couples.

One of my midwives, Miriamma Carson, was bisexual, spoke fluent Spanish, was a radical activist and feminist, and she offered me a safe place, when nowhere else felt safe. For $300, I was given private childbirth classes with other single moms, and pre/post natal exams, as well as a 30 hour labor and home birth attended by two midwives. When I had trouble paying it, Miriamma let me barter cooking dinners for her kids instead. I could never have afforded such superior health careunder the status quo, for-massive-profit, medical system.

Both of my midwives, Miriamma and Barbara R., had sons living at home while they were midwives. And they helped homeless teens often. One night Miriamma’s son woke her up at 3 am, saying he had stumbled on a teen girl, in a car, behind the 7-11, in labor. She would not leave with him, so he asked her to wait, and said he would send his radical midwife mom to help her. Miriamma grabbed her birthing kit, and charged out the door towards the 7-11. Miriamma delivered the baby, in the car, in the middle of the night, with dignity, no questions asked. The girl refused to leave with Miriamma, but Miriamma invited the girl to her home, and gave the girl her home phone number before she left. I am wildly impressed by this. Some would say that was irresponsible of Miriamma, and that she should have called the cops, or CPS, or forced the mother into a hospital. But Miriamma understood the difference between trauma and empowerment, and via her gift of birthing assistance without authority trips, she often saved women unnecessary trauma, allowing the joy of birth to prevail.

Once Miriamma had a woman who only spoke Spanish, in labor, in her car, trying to drive her home for the birth. They got stuck in a traffic jam. Miriamma called her nearest friend and told her to prepare a room in their home for a birth. She got off at the next exit and drove to the friend’s house, where the woman had a healthy birth. Miriamma spent years living in poor Mexican villages, and she knew there had been mass marketing of corporate baby formulas in Mexico, as well as in the U.S., shaming poor moms away from breastfeeding. So Miriamma asked the friend whose house they had landed at, to start breastfeeding in front of the new mom, who just delivered, to set a positive tone for breastfeeding. Miriamma was very good at finding healthy ways for moms to learn from each other.

These midwives were also incredibly gifted at networking. They led me to Doctor David Springer, one of the first M.D.’s to graduate from John Bastyr’s Naturopathic College (www.bastyr.edu/), with an N.D. He became one of Seattle’s finest holistic health pediatricians and took grand care of my son for 18 years. They hooked me up with La Leche League (www.lalecheleague.org), when I had breastfeeding problems. They taught low-income moms about the WIC program. They facilitated safe homes for domestic violence victims. They arranged safe abortions when asked. As a matter of fact, Miriamma took me to a safe abortion clinic, when I asked, years before she attended my birth. She bought the equipment abortion clinics use, and hid it in her basement, when she feared abortion may become illegal again. Miriamma is from a long line of radical women who saw access to safe birth control, abortion and delivery, as a woman’s right. Emma Goldman took formal training in midwifery in 1895, and was saddened by the plight of women with unwanted pregnancies, as a matter of fact.

Long have the fields of midwifery, women’s health care, witchcraft, and feminism, been associated. In the article, “Witches, Midwives, and Nurses,” (www.blancmange.net/tmh/articles/witches.html) by B. Ehrenreich and D. English, they say, “Women healers were people’s doctors, and their medicine was part of a people’s subculture. To this very day women’s medical practice has thrived in the midst of rebellious lower class movements which have struggled to be free from the established authorities. Male professionals, on the other hand, served the ruling class…

Witch hunts did not eliminate the lower class woman healer, but they branded her forever as superstitious and possibly malevolent.” Calling self-help, preventative and traditional medicine a “radical assault on medical elitism,” traditional healers named “King-craft, Priest-craft, Lawyer-craft and Doctor-craft” the “four great evils of the time,” according to the article. By the 1840’s, medical licensing laws had been repealed in almost all of the states. But by the 1900’s, racism was also playing into the sexism, classism, and medical elitism, and since it was mostly immigrant and poor women who were having and assisting home births, white women of the Victorian brand, were asking for the white male doctors in sterile hospitals for birthing help, not poor immigrant midwives with birthing experience and herbal knowledge.

And elite, white, women doctors, such as Elizabeth Blackwell, turned on the women midwives too. The article says in 1910, 50% of all babies born in America were delivered by midwives. And although traditional medicine was primarily a political and economical issue, the mainstream medical profession tried to say it was a medical and/or scientific issue. The medical profession has attacked the autonomy of midwives as health care providers, yet DIY women’s health care continues, as a liberating force.

When I was about 20 hours into labor, I started wimping out, and asked to go to a hospital for drugs, as I was exhausted, and sick of the pain. But my midwives reminded me that if I went to a hospital, the midwives would be locked outside, I would be forced to do a lot of authoritative things I would want to rebel against via doctors, and it could end up in a C-section. Those threats kept me at home trying to birth naturally, which finally did happen. And I am so thankful for them talking me through it. Miriamma died in the mid-1990’s, due to cancer. It was an emotional loss for the community.

Her memorial had a cast of hundreds. Woman after woman bore witness to how Miriamma saved her life when in crisis, giving her dignity and comfort, when many of us had felt like “untouchables.” Whether we were homeless teens, battered wives, single welfare moms, gay moms, Spanish-speaking moms; we were all welcome on earth, according to Miriamma’s open-arm policy. We all deserved superior health care. We all deserved safe births and breastfeeding without stigma. Due to these beliefs, my midwives were two of the most radical anarchists I have ever met.

My friend Beth, in Santa Cruz, Ca., gave birth to her daughter, at night, on the sand, at the beach, with the help of her friend/midwife Moon Maiden. Birth is a tremendously powerful event and being drugged in a sterile hospital with paternalistic doctors is not the ultimate birth experience for many of us. Many of us want to birth, with our friends and families, in nature, without drugs. And such freedoms around birth are barely legal, if at all. So rogue midwifery continues on, under the radar of the mainstream, as political activism, as feminism, as alternative health care. Even with the recent advent of birthing rooms and licensed midwives, this field is a rogue one at best. Even mainstream midwifery resources, such as Midwifery Today magazine (www.midwiferytoday.com ), and Midwives Online (www.midwivesonline.com ) have a very anti-authoritarian tone. Doctors are not women’s bosses, and radical midwives understand this. Groups such as the Radical Midwives group (www.radmid.demon.co.uk/ ) in the U.K., see midwifery as a political issue, as well as a health issue. Midwives have been doing this as long as humans have existed. No laws can change it.

 

Kirsten Anderberg is the mother of a draft-aged son, an activist, feminist comedian, and prolific journalist/writer. She discusses police accountability, midwifery, accommodating vegetarians at winter holiday events, teens’ rights to political dissent, street performance, medicinal uses of stinging nettles, and much more. You can find her articles in Infoshop.org, Alternative Press Review (altpr.org), Utne.com, Zmag.org, Adbusters Magazine, Hipmama.com, Slingshot Zine. 
Here’s a link to many of her articles: angelfire.com/la3/kirstenanderberg/

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3801 Lancaster

This is a documentary about a man who was performing back-alley style abortions in PA. He is currently in jail awaiting trial for 8 counts of murder. This is what women will face if abortion is outlawed across the board. These kinds of barbaric, back-alley brutalities is what they will be offered. And they will go. And they will die, and they will not be able to have more children if they don’t die. But to see this, where it’s LEGAL and supposedly regulated by our all-powerful, all-knowing national medical board? It is a disgrace. The fact that these women were treated this way, right under the nose of the government, who turned a blind eye? It sickens me. I believe that women need to take back their bodies, their right to their bodies, but they should not be handed this kind of treatment in return. This is not what they deserve. Abortions are like prostitution, it has been around for millenia, and will continue to be. Abortion clinics apparently aren’t being regulated and investigated. If they were being kept in check so that monsters such as Kermit Gosnell are not left to their own devices, tearing apart communities and women’s lives, things like this wouldn’t happen. If sex education was taught in schools instead of removed from them, if midwives and doctors were to teach girls and women about contraception and family planing and girls were taught about their bodies and not taught to be ashamed of them from a young age, this wouldn’t be our world. Midwives were who you went to for abortions, in the early days. They knew the ways, and the herbs, and they were there for you, as a woman. They didn’t leave you broken and bloody drugged to the state of amnesia in a dirty office surrounded by the corpses of late-term fetuses. They took care of you, they were a counselor, a healer, a shoulder to lean on. Midwives today should be able to step up to the plate to resume this role, and doctors who perform these services need to return to a women-centered mode of practice if we are to change anything. All abortion clinics should be checked, all claims of malpractice immediately investigated without second thought, this… this is an outrage.

To License or Not to License?

11/25/2014 EDIT: this was written a few years ago and since has been slightly modified from its original content. Another version of this article was published in SQUAT Spring 2014 magazine. There was also another article submitted by someone else that is a counter-argument supporting licensure requirement.

This is a question that has plagued the midwifery community for years. Those behind the “Big Push” want to legalize midwives, but with licensures behind them. Advocators such as Carla Hartley, among others, believe that while legalization of midwifery across the board is a must, requiring licensure will spell the end for mother’s rights in regards to their births. Those who advocate for licensure of midwives, which would make “lay” midwives and other direct entry midwives (DEM) who do not have a nationally (or state-wide) recognized license such as Certified Professional Midwife (CPM) illegal practitioners, argue that licensure sets “a standard” and “proves that the midwife underwent apprenticeship and training”. They also point out that with a license, midwives could be covered by insurance which would open up so many more families to homebirths. While this all may be true, I believe, along with those who advocate for legalization without forced licensure, that the downfalls outweigh the benefits. Here are some reasons why:

• Licensure puts restrictions on practice. It gives those who require the license the ability to put in place legal restrictions and subsequent ramifications if those restrictions are not complied. For example, a licensed CPM (in some states, not sure if it’s in all states), is not allowed to attend “high risk” births, such as those of breech or multiples, in a home setting. She is required to refer her client to a doctor for her prenatal care and delivery in a hospital setting. Which leads to our next big issue:

• Licensure limits women’s birth options. As seen in the previous example, when limitations are put on licenses, and thus midwives, it puts limitations on mothers. It limits who she can birth with, and where. It gives her an ultimatum. I could even go as far as to agree with Ina May Gaskin in her thought that such restrictions on midwives led to the rise in women seeking unassisted births—they’re having a breech and can’t have a midwife attend them for risk of legal ramifications for the midwife and they don’t want to birth in a hospital via required Cesarean? Maybe she’ll just birth at home on her own.

• Licensure, though it may set a “standard” and “proves that a midwife underwent training and an apprenticeship”, only sets a bar—the lowest setting on the wrung that must be met, skill and knowledge-wise, in order to pass an exam and receive a license. This exam does not, nor the license, tell what kind of midwife the license-holder is, nor the true extent of their knowledge, expertise, skill, and experience. It does not say how many years she apprenticed or studied, only that she did enough to meet the minimum requirements. In my search for the right midwifery training program for me, I have come across the following many a time: “This program only provides the basics and meets the minimum requirements set by MANA/NARM in order to pass the exam to receive CPM status.” I also have come across the following on sites such as that for the Michigan School of Traditional Midwifery: “Many students find that they are knowledgeable enough to take and pass the NARM CPM exam before they’ve even finished the 2-3 year course offered (but in order to receive a Diploma of Traditional Midwifery, they must finish the course in its entirety).” What does that tell you? That many programs out there will give you enough knowledge before even finishing to pass the licensure exam!

• Licensure also makes it harder for midwives who do not train through “MANA/NARM/MEAC accredited midwifery schools” to get licensed. I do not think that you should be required to attend only certain “approved” schools in order to become a midwife, or to become licensed.

• Licensure could allow midwives to carry drugs such as Oxygen and Pitocin, and numbing medication for sutures. But do we really want our midwives to be using these? I thought that seeking a midwife was to escape the medicalization of doctor-overseen births in hospitals? Not to mention, just having a license as a midwife (such as CPM) should not make it ok for a midwife to carry drugs such as those and others routinely used in hospital settings, especially when the proper use and administration of those drugs and management of labor after their administration may or may not have been covered in any amount of depth or detail in their “midwifery training program” (this is not the case, however, in some states such as Washington where midwives must take pharmaceutical training). If midwives want to carry drugs and be able to administer them, which I do not think that they should, but everyone is different and there may be mothers who want a home birth midwife capable of doing so, they should seek specialized training classes that certify in the use of those drugs, independently, not be allowed to carry them because an umbrella license allows them to without prior and specialized training.

• In regards to insurance coverage, this can be a tricky area. Once I saw that a family couldn’t justify taking the money out of their vacation fund to pay for a midwife! Others say, why pay a midwife when I have insurance who will pay for a doctor? They don’t really think, don’t feel so adamantly in their hearts, that a homebirth is what’s best for them and their baby. Or maybe they’re secretly harboring a fear of an out-of-hospital birth brought on by the Birth Fear that permeates our Westernized culture. Or, they’re being bullied by their partner. A bit drastic, but I know women who have sold their furniture and then some in order to pay a midwife so they could have a homebirth. I have yet to meet a midwife that does not do a “sliding scale” or a payment plan, etc. in order to help make it easier and more affordable for parents. I’ve even known a midwife to consider a partial barter of services. Midwives are midwives because they want to help women, not for the money. But the majority of midwives have made it their career, how they put money on their table and food in their children’s bellies. But many midwives out there do try to make it as easy for parents as possible, while still making at least a meager living, because they want to help. Also, not to mention that insurance companies dictate practice. Just look at doctors. Insurance companies set limitations on practice, liabilities, etc. In the words of Ina May, “Why should insurance companies continue to get away with limiting the skills that a health profession has always previously required of its members if they were to be considered fully trained?”
Personally, I do not think that mandatory licensing should be sought for midwives. I think it should be an option, but should not be required. For instance, in Utah midwives have the option of getting licensed or not, and either way they can practice legally. However, depending on if you’re licensed or not, you have certain quidelines you are supposed to legally follow. For instance, an unlicensed midwife could attend a breech birth at home, whereas a licensed midwife could not. A licensed midwife could carry and administer drugs such as Pitocin, whereas an unlicensed midwife could not. This type of practice is seen similarly in Oregon and Maine (in Maine CPMs can carry 5 different drugs for homebirth use, whereas non-CPMs cannot) and gives mothers and families a full spectrum of care-provider choices from unlicensed midwives all the way up through OBs in hospitals.

I think certification can be a good thing, but that still leaves out those who self-study with an apprenticeship, those who don’t attend an “accredited midwifery school”. (Certifications are received from completing school programs and may have different titles depending on the school. They show that the student finished and graduated from said program). People like to see papers. It’s true for anything. But papers do not prove the worth of the person who has them. It does not show their skill, their experience, or anything of the like. It is a piece of paper that makes people feel like that person is more “professional” or more “qualified” only because they have it, not because they know they are. And the more well-known the source of the certification, the more comfortable the clients may be, again regardless of seeing relevant proof of skill or knowledge. This should not be the case but is for many professions. (This carries over to doulas as well).

I believe that mandatory licensure of midwives in order to obtain legal status is not a good idea and should not be pursued. I think that it should be offered as an option, but not a requirement. I believe that families, especially mothers, should have all available options to choose from in regards to where and with whom she births, if anyone. They should be able to interview midwives of multiple backgrounds and training styles, regardless of certification or licensure or lack thereof, or what “style” of midwifery they were trained in. They should be allowed to make the best decision for themselves and their families, based off of presented evidence of the midwife’s background, personal skill, and training, regardless of what letters she has behind her name; what they are looking for regarding care (such as suturing or non-suturing, able to carry drugs or not, good relationship with local hospital, allowed to do breech at home, etc); past client testimonies and recommendations; and their own feelings regarding the care provider– even if those feelings change at the last minute– in their decision making as autonomous parents involved at the forefront of their care. I believe that the heart of midwifery training– academic training regardless of ‘schooling’ type coupled with hands-on apprenticeship with a senior midwife– must be preserved as the most ancient and authentic form of midwife training.

Some say that not making midwives get a nationally-recognized (or even state-recognized) license will allow un-trained “Wikipedia” midwives to run rampant calling themselves “midwife” and taking on clients. And this could very well be the case, but I doubt it. Because those “midwives” will be weeded out. By other midwives sure but mostly by mothers and families. I saw a case just of this instance based out of Michigan, I believe, where there are no requirements for licensure. A “midwife” who had no real, extensive training, nor apprenticeship, was going around calling herself a midwife, which she could legally, and was taking on clients. Many other “professional” midwives were outraged and scared. Which is rightfully so, but it was ultimately up to the parents to really look at who, and what, their midwife is. We can spread the word through our communities about such practitioners, if you would call them that, and we can try to warn families. But ultimately it is up to them to weed out the bad ones from the good. Which did happen in this instance.
Another large part of choosing a midwife (or doula, or any professional you will be working with intimately over an extended period of time) is how they “click” with you– their style, their beliefs, their personality, their “energy” even. This is oftentimes the critical turning point in a mother’s choice between care providers. If her choices are significantly whittled down due to legalities, her chances of “clicking” with the right care provider go down drastically. What if there is only one homebirth CNM in her area and all the other DEMs in the area are almost impossible, if not completely impossible, to track down (or, there just aren’t any in the first place) and she’s left deciding between a hospital birth, a homebirth with a CNM she perhaps doesn’t care for, or possibly she finds only one CPM who will attend her “under the radar”? This is usually the point when many women give up and give birth at a hospital, or they show interest in, or even undergo, an unassisted birth whether or not they came to that thinking it was best, or their only option. (Not only does this dampen a woman’ ability to choose between many care providers to find the right one for her, but it also drastically reduces the amount of women who can even be cared for by a midwife in the first place).

Mothers shouldn’t be forced to make such a huge and potentially impacting decision as to where and with whom they birth as dictated by legislation. And every woman should be allowed to make whatever decision she deems appropriate and best for her, her child, and her family, without fear of legal repercussions for herself, or for her midwife if she chooses to have one.

The Big Three (Actually, Four): Part I

The Big Three (Actually, Four): Part I

The Midwife: Ina May Gaskin

Website: http://www.inamay.com/

Authored Books:

  • Birth Matters: A Midwife’s Manifesta
  • Ina May’s Guide to Childbirth
  • Ina May’s Guide to Breastfeeding
  • Spiritual Midwifery (4 editions)

Biography/History: Ina May is a name that many in the “natural birth” and Midwifery world know quite well. “Ina May Gaskin is sometimes referred to as the “midwife of modern midwifery” because of the role she’s played in the rebirth of that profession in the United States” (1). She has been on the circuit so to speak since the 1970s when she helped found The Farm with her husband, which still to this day is a functioning commune and birth center. She was among a group of 200 who set out to venture forth across the United States with her spiritual leader-husband and along the way, she began to teach herself and train with doctors in regards to midwifery. Throughout the years and over the course of over 3,000 births having occurred at the Farm, 1200 of which were attended by Ina May, the Farm has put out some of the best statistical information regarding safety and homebirth, even and especially so in regards to “high risk” births such as vaginal breeches and multiples. Over the years she has worked with the doctors of the area and women have come from all over, even from other countries, to birth at the Farm under the care of Ina May Gaskin. She has been featured in multiple sources and tours the country performing seminars.

Beliefs:

  • Ability to birth: “Those who are used to the birth ways of other mammals know that it is easy to cause complications during labor by disturbing the mother. If we put horses, goats, and cows through the restrictions and indignities that most laboring women in U.S. hospitals are routinely subjected to, the animals would surely have as many complications as we do. The astonishing thing to me is that we have come to believe that our human bodies are not as well designed for birth as other mammals’ are. Really it’s our brains that can pose problems: we alone among mammals have the ability to scare and confuse ourselves about birth.” (1)
  • Health during Pregnancy: “To accomplish this [a Cesarean rate of 1.7% over the last 40 years], we had to make sure that pregnant women had good nutrition and a healthy amount of exercise, and we needed to do everything we could to reduce the amount of fear surrounding birth by demystifying the process. All of these measures together have made the good outcomes at the Farm Midwifery Center possible.” (1)
  • Hip to Baby Ratio: “But my partners and I have found that c-sections are very rarely necessary because of a mismatch in size between the woman and her baby. Having helped a number of women with what appear outwardly to be small hips give birth vaginally to ten-pound babies, I know that appearances can be deceiving. I have encountered fewer than ten cases out of three thousand in which the baby was actually too large to fit through the maternal pelvis. It happens most often with diabetic women, whose babies can sometimes weigh more than twelve pounds.” (1)
  • Active management of labor and arguments against it (book review): http://www.inamay.com/book-review/active-management-labor
  • “Why should insurance companies continue to get away with limiting the skills that a health profession has always previously required of its members if they were to be considered fully trained?”

― Ina May Gaskin, Birth Matters: A Midwife’s Manifesta

  • “Gardeners know that you must nourish the soil if you want healthy plants. You must water the plants adequately, especially when seeds are germinating and sprouting, and they should be planted in a nutrient-rich soil. Why should nutrition matter less in the creation of young humans than it does in young plants? I’m sure that it doesn’t.”

― Ina May Gaskin, Ina May’s Guide to Childbirth: Updated With New Material

  • “The way a culture treats women in birth is a good indicator of how well women and their contributions to society are valued and honored.”

― Ina May Gaskin, Birth Matters: A Midwife’s Manifesta

  • Unassisted Childbirth: “Ina May Gaskin speculates (“Some Thoughts on Unassisted Childbirth”, Midwifery Today, Issue 66) that the “extremism” of the choice to give birth without a medically-trained attendant has perhaps arisen in response to the extreme medicalizing of childbirth in the past decade.” (2)

 

My Take: Ina May’s Spiritual Midwifery was the first book I ever read about “natural pregnancy and childbirth”. I found it on a library shelf while I was 16 and pregnant. I devoured the stories, but never got to really finish the book until my second pregnancy, at the age of 19, when I bought it not just because I was pregnant, but because I have wanted to be a midwife since I was pregnant the first time, and Ina May was all I knew. I wanted to be how they had been, wanted to live that way and birth that way. I wanted those psychedelic, spiritually-laden births, and to help other women to have them. I was actually reading her Guide to Childbirth book when I went into labor with my second son. I find a lot of her articles (which can be found on her website) eye-opening and she stands for many things that I agree with. I recommend reading her books, and someday would like to travel to the Farm to see it for myself and to meet her in person. I hear things here and there about people disagreeing with her approach (she is a lot more hands-on in birth than I would care for, but there are women out there who want that, or at least think they need it), or claiming that she attacks UC-ers (which I have yet to find a copy of the article she wrote in regards to UC, or any updated opinions voiced by her since 2003, I did however find the aforementioned quote). I think that if it were not for women, and midwives, such as Ina May, Midwifery may not have survived in the United States.

Sources:

(1) http://thesunmagazine.org/issues/433/oh_baby

(2) http://www.mothering.com/community/t/571061/ina-may-on-uc

NOTE: As I come across further information, this may be updated.