In December 2014, the Midwives Alliance Core Competencies were revised using gender inclusive language in order to better reflect the diversity of midwives and the clients they serve. The Core Competencies establish the essential knowledge, clinical skills and critical thinking necessary for entry-level practice for direct-entry midwifery in the United States. They provide the basis for the CPM. The Core Competencies and the Midwives Model of Care™ assert the client’s absolute right to self-determination and bodily autonomy, and promote quality care provided by culturally safe, autonomous, community based midwives.
Concerns that gender inclusive language could potentially harm women led to an open letter to MANA in August 2015 from “Woman-Centered Midwifery” asking that the revisions be reversed. MANA responded:
Whereas pregnancy, birth and breastfeeding are unique to the female sex, there are those who seek midwifery care who do not gender identify as women. Considering the national initiatives challenging health care professionals to provide gender neutral services and gender inclusive health care materials, we committed to a document reflective of these national trends and consistent with our values. In the process of crafting these revisions to our Core Competencies, many of the midwives involved found ourselves undergoing a paradigm shift and realized that many of these issues and practices apply more broadly to include other family members. Changing to gender neutral language reaffirms the midwives’ goal with relationship to the whole family system. Inclusive language helps us all learn to be more aware, sensitive and humble to the needs of each family system and the devastating effects of marginalization. No individual wants to be singled out or identified as "different" or less worthy. As long as a single client is excluded from the midwifery community, all clients are potentially vulnerable to discriminatory treatment.
A rebuttal to the Open Letter posted by “Birth for Everybody,” begins:
The authors of this letter would like to preface our response to the “Open Letter to MANA” by conveying the following: We honor and uphold the right to self-determination and bodily autonomy for all people. We believe that as midwives, our purpose is to support parents and babies throughout the childbearing year, taking into account the unique physiological, psychological, and social well-being and needs of each client. It is our work to provide individualized education and counseling, as well as client-centered prenatal, intrapartum, and postpartum care. We understand the importance of providing compassionate, holistic, and culturally sensitive midwifery care, and we strive towards making the Midwives Model of Care™ accessible for every person and family who seeks it, regardless of race, ethnicity, religion, ability, sexual orientation, gender identity or gender expression. We acknowledge the disproportionate effects of transphobia on those with other marginalized identities such as being a person of color, low-income or disabled. Many racial health disparities that concern midwives and impact our communities are experienced in greater numbers by people who are both Black and transgender. These lives especially are in need of the kind of respectful, compassionate, and individualized care midwives can offer. We assert that we can honor the power of the female body and at the same time extend this reverence to all people who are pregnant and giving birth, and that to do so is in full alignment with the heart of midwifery.
The final paragraph reads:
The signatures below indicate affirmation and respect for people of all genders; full agreement regarding the use of gender inclusive language in the MANA Core Competencies and in all documents regarding the profession of midwifery and provision of midwifery care; and the welcoming of transgender, genderqueer and intersex people into safe, culturally sensitive, shame-free reproductive health care. We do not refute the “life-giving power in female biology.” Rather, we support a larger vision that includes the provision of midwifery care to all pregnant and birthing people.
The letter has been signed by over 1,500 people. You can read Our Response to the "Open Letter to MANA from Women-centerd Midwifery in its entirety and add your signature HERE