The Language of Midwifery

On a side note, we spent a good deal of time this first semester learning abbreviations and medical language. I feel like I’m learning a whole new dialect when I write things on my test like “At 18 wks the FH is 2 FB ↓ U.”

Whew!

Classes are finished, assignments turned in, presentations made, and final exams completed. Wow am I exhausted. But I am very excited about everything to learn in the coming year and the progress to be made. Time to hibernate a bit, love family and friends, and do lots of good and hard thinking about my role in midwifery and where I’m heading. Very exciting. And I’m thrilled to have enough time and brain space to actually do some deeper thinking about things and not just memorizing the frequency and timing of contractions in the various stages of labor.

Racism and Birth Outcomes

Please go and read this brilliant post by Guerrilla Mama Medicine –> Sick and Tired: How Racism Impacts Pregnancy Outcomes. This is the first time I’ve seen the impact of racism on health laid out so clearly in relation to birth and pregnancy outcomes.

Anti-Oppression Work and Midwifery

Anti-oppression work, diversity work, and a open-eyed look at our own areas of privilege is a crucial part of midwifery education, not only for working with clients across the board but for forging successful ties with fellow midwives and other colleagues. In the direct-entry midwifery world I feel that it’s a topic that is not often explicitly talked about, which leads to problems. When we don’t talk about it, we assume it doesn’t exist. If it doesn’t exist, why would we need to examine ourselves and our own beliefs, behaviors, and interactions with others?

And when that happens, you get a situation like we currently have. Direct-entry midwifery in the US is the domain overwhelmingly of white, middle class, straight women serving largely white, middle class straight women. How can we pretend that we serve all women when this is the case?

To be fair, some of this is beyond our control. Until we have a healthcare system in the US that allows for insurance reimbursement for the services of direct-entry midwives, we will be understandably limited in who we can serve based on their incomes and financial status.

But when it comes to who feels comfortable, safe, and welcomed in a homebirth midwifery practice we start to get into questions of race, racism, and privilege (not to mention class and heterocentrism). Serving all women is not just making yourself available to them, but also means working to make sure that your practice is actively inclusive.

I don’t have the answers, but I do have some ideas on what needs to happen:

• We need to serve more women of color
  • This means that we need to have practices that feel welcoming to women of color
  • This also means we need to understand and practice cultural competency
  • We need to help women of color view direct-entry midwifery as a valid choice for their prenatal and intrapartum care. This is a big hurdle in some locations particularly because of some shady and racist dealings beyond our control – like the government providing midwives (largely white CNMs) in the rural south to poor Black women because they believed midwives to be less well trained (and therefore cheaper) than doctors. Or the government giving depo provera to Black women as a form of temporary sterilization because it viewed these women as A) unworthy of reproducing and B) not competent enough to make their own choices about their own car. Shitty things our government has done that may not be our fault but that we nonetheless need to actively work to combat in order to stop being complicit with these actions. Start by learning about the reproductive justice movement.
• We need more midwives of color
  • One of the first ways we can change this is by being more inclusive of the way we educate direct-entry midwives.
• We need to radically change our midwifery education system:
  • Raise the levels of women of color enrolling in midwifery education programs
    • I look around at the class pictures of previous classes at my school and am shocked to see almost entirely white women (or women of color passing as white, hard to tell from just a photograph). I know my class is more diverse than previous classes, but only just. And while Maine is no Los Angeles, it’s not as white as you might think.
  • Raise the levels of women of color graduating from midwifery education programs
    • When I can count on one hand the number of women of color the oldest direct-entry midwifery school in the nation has graduated, we’re talking about a serious problem. One that is insidious in midwifery education and has been a problem for a long time.
  • Ensure that all midwives graduating from MEAC-accredited institutions participate in in-depth anti-oppression training by trained and skilled facilitators. Most of the trainings currently available are insufficient, poorly taught, and/or irrelevant to the work we need to do. This needs to change so that we can:
  • Turn (white) midwives into anti-oppression activists. Get them involved with the reproductive justice movement. When midwives understand oppression on an institutional level and can examine their own privileges, they will understand why it is so critically important that we tackle this issue as a group.
  • Help midwives understand that by becoming radically inclusive, they are putting one more chink into the armor of the allopathic, western medical system that works on an oppressive sexist, racist, top-down power structure. To be a midwife in the US is to be an activist. Period. To be a midwife should also include being a reproductive justice activist.

So those are my few ideas. I hope to continue to deepen and flesh them out in the coming years of my training and practice. I hope to be able to make some real change in the right direction. What do you think? What are your ideas? How can we come together to make a better and more inclusive Midwifery Model of Care for all women?

Happy Thanksgiving!

Happy Thanksgiving to you and yours today! We just got our very first CSA box (ever!) yesterday, which seemed only too appropriate for this time of the year. Lots of potatoes, arugula (although I prefer the UK version of calling it “rocket” because it sounds way more fun), beets, carrots, all sorts of good and delicious things. I hope today you are eating good and delicious things surrounded by wonderful friends and family.

Graciousness

Maybe it’s because it’s Friday the 13th and everything feels a bit off lately, but today I am in such awe and the breadth and depth of the human experience.

Maria at A Mom is Born wonders what the world would be like if women knew how beautiful, amazing, powerful, and strong they were before going into labor.

And my thoughts are with Molly at Citizens for Midwifery and the news of her miscarriage. However, I am amazed at the beauty of her statement: “I was surprised to discover that some of the same feelings of empowerment were also present after a “natural home miscarriage” as with a natural home birth–I felt strong and brave and like “I did it myself!” as well as amazed at how well my body worked and knew what to do.”

I feel like I’m moving into a space where I need to be consciously more gracious with both myself and others. It’s just feeling like that time of year.

To Let Myself Go

To let myself go
To let myself flow
Is the only way of being
There´s no use telling me
There´s no use taking a step back
A step back for me

To Let Myself Go by Ane Brun

 

Palpating Pregnant Bellies

Palpating pregnant bellies is incredible. Today we were given the privilege and honor of practicing palpation skills on the bellies of 4 pregnant women ranging from 12 weeks to 31 weeks gestation. It was awe inspiring.

We practiced Leopold’s Maneuvers today, felt for the fundus and the rest of the uterus, felt for position and lie, listened to fetal heart tones with our new and shiny fetoscopes, and measured the uterus. I was able to work my way from the woman with the earliest gestation in order up to the woman with the latest gestation. It was surprising how much of a difference there was between even 1 week gestation difference or between women who were pregnant for the first time versus those who had given birth before.

And I haven’t even begun to tell you what it is like to feel a fetal head in a woman’s pelvis, to touch the butt of a fetus and feel the fetus kick and move away, or to know for sure that this is where the back is and here is the shoulder. Like I said, it was awe inspiring and I am entranced. I can’t get enough of it all.

I can’t wait to practice and improve my skills, to get to the point like my instructors who can place their hands on a woman’s belly and know right away what they are feeling. Our instructor likened it to learning how to read. Remember back in the beginning when you had to sound out each letter before your brain learned how to recognize a whole word at once? I’m having to think “What is this part? It’s rounded and hard, but does it move side to side? Is it a butt? Is it a head? And I totally wrong and it’s just a shoulder? If this is the head, that means the butt is over … here. Got it. Oh, NOW I can feel the back, it was there all along ….”

All-Mother, my hands are truly yours. These hands that heal, that will one day catch babies and that are currently learning how to feel life moving within the womb truly belong to you.

Marriage

The day Prop 8 passed in California, I found myself at a protest march in Long Beach marching with hundreds of other grieving and dismayed Californians. Today I find myself living in Maine after a similar vote on One, again dismayed and grieving. It seems Mainers come from a different breed than Californians. There are no riot police yet, no promised protest marches that will shut down traffic in Portland. There was one very mild mannered and New-England-polite round of speeches held at city hall that I attended with L. today.

I am still baffled by the right of the majority to remove the rights of the minority. If we had put it to a popular vote, I doubt the Lovings would have been allowed to get married either. It baffles me that at the rally today I listened to a man tell me I was not being “Jesus-like” because I was for gay marriage. I refrained from telling him that I didn’t think that hatred and discrimination was a very Christ-like characteristic at all. What does it mean when the American citizens of 31 states have rejected a basic human right for me and my fellow queers? (And if you think it’s just about the right to a piece of paper, think again.)

If  you have time, make your way over to Cat Chapin-Bishop’s blog for a moving guest post about one man’s view of defending marriage. He has the best idea I’ve heard all day:

The way to save our marriage would have been to take all that money spent on anti-gay television ads, and give it instead to cancer research.

At the protest marches in Long Beach, my favorite protest sign said “Gays 0, Chickens 1″ (for an overview of Prop 2 and the chickens go here). Somehow I feel like the chickens have won again.

Too Big For My Skin

They might try to call you a witch because they cannot grasp the magic you possess.

HT to Stand and Deliver for this incredible video.