Remembering Dorothea

I am deeply saddened, as is the MANA community of midwives, by the loss of Dorothea Lang, CNM, MPH, FACNM, past President of the ACNM.  She was a courageous and inspiring midwife pioneer, an outspoken advocate for ‘a midwife for every mother,’ an inspiring nurse-midwife educator and mentor to hundreds of students and young midwives, and a visionary leader in the quest for alternate paths for professional midwifery education. 

It was always a pleasure to talk to Dorothea because she was full of ideas for the midwifery profession. In her very civil and well-mannered way, Dorothea was not afraid to let her (strong) opinions be known. She was intelligent, innovative, thought provoking, and persuasive. She had the acumen to imagine a future for professional midwifery in the US and was not afraid of the decades of hard work it took to manifest her vision. 

In 2014, at the International Confederation of Midwives (ICM) meetings in the Czech Republic, I had an opportunity to spend an afternoon with her. On this occasion the conversation was markedly different. Dorothea did not speak about her ideas, she spoke about herself, which was unusual. Three of us — Diane Holzer, an Irish midwife, and I — sat spellbound as Dorothea told story after story of her life. 

Dorothea was born in Japan in the early 1930s. Her parents were missionaries. The experience of living in Japan shaped her life’s work. First, her parents taught her by example to live a life of service to humanity. Second, she learned early in life that birth was a normal process. Her mother had six children and Dorothea was the oldest girl. As a child it was Dorothea’s job to run and find the midwife when it was time for her mother to deliver her sibling at home. And third, Dorothea observed that the midwives of her village received great honor everywhere they went. People bowed to them, told them secrets they never told anyone one else, trusted them to care for their infants and their families. As a result Dorothea decided quite young while she was living in Japan that she wanted to serve humanity by being a midwife. 

At that table in the Czech Republic in 2014, Dorothea told us that when she came to the United States for her college education she learned that there was no direct educational route to midwifery at universities, and that she must first be trained as a nurse. She was not happy about that but she did what she had to do. She said, “If you want to effect change you have to play by some of the rules so that you know when you can bend other rules.” 

Her whole life Dorothea remained a proponent of alternative college routes (such as allied sciences) to midwifery and not just nursing. Later as the ACNM President, Dorothea told us, “My beliefs put me in opposition with some of my colleagues who were staunchly dedicated to the nursing route for midwifery.”  

Dorothea told us, “Access to midwifery education does not have to be through nursing. But professional midwifery education must include all the sciences and all the competencies necessary to meet the international standards.” 

Dorothea excelled in her chosen profession. She became powerfully influential in her home state of New York, on the national midwifery scene, and even internationally. The ACNM has posted a beautiful tribute to Dorothea with the details of her professional accomplishments. 

What I really remember from that last conversation with Dorothea over wine — actually three of us had wine, Dorothea had tea — was her mood of both pride and melancholy as she recounted the moments of importance in her life. The pride was for all that had been accomplished; the melancholy for all that was yet to be done. Dorothea said, “You young midwives need to remember this. Go where the women are. Some of you at MANA thought I was against homebirth. I was not. After all, I saw my mother give birth at home and I was totally inspired. I always liked how spunky you homebirth midwives were.” 

With those deeply penetrating blue eyes fixed on us she continued, “But my point was, if 98% of US women are having their babies in hospitals, then midwives must be focused on caring for women in hospitals. If most women are going to need reproductive healthcare, and gynecological care, and menopausal care, then midwives must learn those skills and be the ones to provide those services.” She added, “The profession of midwifery is designed to serve women, their whole lives. So get out there where the women are!”

During that conversation I encouraged Dorothea to write her memoir so that her incredible stories — so integral to the development of professional midwifery in the US — would not be lost. She laughed and said, “No, I am not going to do that. Remember I had a different vision for how midwifery could be. I saw what it could look like from my time in Japan. And no matter how I tell my story someone would not be happy. At this point in my life all I want is peace.” 

I believe it’s true to say this. For Dorothea, making trained midwives accessible to all women and ensuring that midwifery was well integrated into the US maternity care system was her life, her passion, her raison d’être. 

She said, “For me, midwifery has been the most wonderful way to serve families and to serve the world. As hard as it was at times, as challenged as we were, I have no regrets with my chosen profession.” 

For over six decades and across several continents Dorothea had a fire in her belly for midwives, for women, and for families that could not be extinguished. Her main regret in her last weeks of life was that she would be missing the ACNM meeting, which she had attended every year since 1958. That’s almost 60 years!

After a long, fruitful, and fulfilling life, Dorothea went into hospice in April 2017. She spent the last days of her life at her beloved cottage on the Hudson River. Friends reported that she was most happy and most at peace at her cottage, just watching the ships on the river and listening to the trains go by. Dorothea passed away peacefully at her home on the afternoon of May 16, 2017. She will be deeply missed by so many who loved and respected her, and by those whose life she touched in large and small ways. It was Dorothea’s request that any donations in her name be made to the A.C.N.M. Foundation.