Ethical Birth Work

I was an intern at a maternity clinic a quite few years ago and I had some interesting experiences there. One young woman came to get some experience as a midwife, so that she could decide if she wanted to make the jump from being a doula, or if she was going to move to physiotherapy instead. On her first afternoon, the clinic was very busy, and she was led to a room where found she was the only midwife (not even!). She became depressed over the six weeks I knew her, and she left miserable and feeling violated.

I was very interested in what was happening. I have had a dream all my life of returning to Uganda where I spent my first three years, and working alongside the TBAs there to provide maternity care. I am fascinated by how organizations work, and I love to see how particularly women's organizations unfold, and how we keep (or not) bullying and aggression out of the ring.
I have travelled to many places. I have so many memories of different places and different people. I remember being led up a rocky path in the mountains of Morocco when I was seventeen, by two young women. We found a stream and drank, and spoke with our eyes and hands. We laughed. I gave them my earrings.

In Africa, a few years later, a young woman ran to me carrying her baby. I knew he was dying. She thought I may be able to help because of the color of my skin. I couldn't.

I travelled on my own, avoiding danger or fleeing when necessary. I used my polite manner and my eyes and hands to communicate friendliness, and I was never hurt too badly.

Years and many experiences and chapters later, I decided to finally get my certification as a professional midwife. My visit to the maternity clinic was one step along the road. One night, at around three in the morning, I was in a birthing room at the clinic. I was not supposed to be "primary", but the woman who was on for that night was exhausted from a hard birth, so the head midwife told me to assist. The birth was difficult, and the head midwife told me to enter the woman and manipulate the baby's head so that he could be born. I had my hands in the woman, when the boss midwife entered the room, tapped me on the shoulder, indicated that I should leave, and she had another intern take my place.

She was having a power struggle with the head midwife. Her ego was too big to fit through her pelvis, that's for sure!

But what about the woman giving birth? How did she feel when my hands left her, there was a tense emotional moment, and a new person's hands went in? Did she feel violated?

I have no interest in manipulating baby's heads, actually, I believe they get born better if they're left alone. But I also believe that the epicentre of the birthing room HAS to be the mother who is birthing her baby. A birthing room is no place for politics to unfold. Aggression and rudeness do not belong there. Love belongs. Peace belongs. Honor and respect belong.

There is a wider discussion going on right now in the midwifery world, about how this plays out in the bigger world picture of midwifery today. Student midwives from North America are traveling to poorer countries to earn their qualifying numbers so that they can become certified as professional midwives. Is this right or wrong? How can we accept a student midwife's desire to do good, and screen out the "number whores" (these are the students who travel to other countries simply to get their qualifying numbers, giving little thought to the women they are working with or for).

There are many small clinics all over the world where courageous, passionate, dedicated and professional midwives work every hour of every day to improve maternity care for the women they serve. Let's not throw the baby out with the bath water! For many of these clinics, paying volunteers from rich countries are one of the few ways they manage to stay solvent. But we do not need students to travel to other places so that they can experience a woman dying...birth is not reality television.

I believe the answer is within. If you go into every birthing room with love in your heart, respecting the other people in that room and honoring the birthing mother, then you will find yourself unable to use a birthing mother as a number, a statistic, or an educational tool. Women who give birth are worthy of the greatest respect. Let our politics play out elsewhere, away from the new baby, away from the birthing mother, away from the birth room.