My MANA roots were established sitting at the feet of Linda McHale, long-time MANA board member, hearing her stories of early MANA days and learning the importance of standing up for midwives and for our profession. Some of my most difficult lessons came from realizing that midwifery in itself is a political act when all I wanted to do was help people have babies. Twenty years later, I am honored to serve as the president of MANA.
Today, I think about what systemic change is needed so that we can get back to focusing our energy on helping people have babies.
In many states and at the national level, dedicated advocates are working hard to secure options for birthing families and sustainability for midwives. Whenever we participate in the legislative process, compromises are inevitably required. How do we, as a community, decide what is essential to midwifery? We must not compromise the heart of our care.
We, as midwives, are at a crossroads. While we can all agree on the need for systemic change, how are we engaging in the process, with the larger system and with each other?
We often use words like fight, control, power, (as in fight for women's rights, take back control of our bodies, em-power women.) What if instead we use communication tools and words that are more reflective of where we actually want to be: ritual, consensus, power-within, sustainability, joy? What if we had a very simple vision from which all of our work could evolve?
How can we, as midwives, create the change that is needed to hold space for what is essential about birth? We need to return to our stories to guide us.
What is our story as midwives?
Midwives create space where individual stories unfold. We hold that space open in patience. We witness. We attend, acknowledge, accept, appreciate, adjust, and accompany. This is the art, the heart and soul of midwifery. This is the sacred in birth.
The sacred in birth is essential to the story of midwives, and to the stories of birthing families.
Though some of us may also bring our faith to our work, I am not referring to the religious aspects of sacred. Sacred also means to be “devoted exclusively to one service,” and to be “entitled to reverence and respect.” It is this service, reverence and respect that are sacred and essential to our work.
Research tells us that the over medicalization of birth in the United States drives rising health care costs while we continue to have poor health outcomes, especially for mothers and babies of color. And the story continues as the over-medicalization of childbirth has spawned narratives filled with fear, trauma, loss, and the dehumanization of a process that is inherently healing and life affirming. It is time to reverse the birth culture that has stripped birthing people of their autonomy, their dignity, and their joy. Obstetric violence is a human rights violation that goes unpunished worldwide. We must shift the cultural narrative that birth is only safe in a hospital setting. It is time to bring the sacred back to birth. This is what we do.
How can MANA support your story?
We ALL need and deserve midwifery care! People want and deserve a midwife who looks like them, or a midwife who shares their culture and values, and we know there aren’t enough midwives who meet these utterly essential requirements of equitable care. We need access to education for those who want to be midwives. We have an obligation to ensure that the people who are the most marginalized have a voice and can get the care that ought to be considered a basic human right.
In order to do this we need to first look deeply at ourselves, and our national organizations, and examine how we have been a part of the systemic problems of institutionalized racism. Dismantling, re-envisioning and creating new systems that are truly equitable can only happen through that internal work. MANA is doing this work within our organization and with others in the country committed to dignity and human rights for all birthing people.
The critical and groundbreaking work of the MANA Division of Research is helping to tell our story as well. The most recent research on Relative Risk is giving us guidance on the systems changes that need to happen to protect the sacred work we do. Illuminated are the importance of integrated and respectful care, of autonomy for both practitioner and client, and practices that assure better outcomes.
As individual midwives we love what we do and we struggle in many ways. It is barely possible to maintain our health. (The last time I tried to go to the dentist I had to cancel three times for births and they told me I couldn’t come back until I had a month with no births! Really?!) Last year at our conference Dr. Michael Klein got huge applause when he stated, “It takes three midwives to have a life!” MANA is committed to working to help you to sustain yourselves as midwives. We are working on projects in research, reimbursement, practice autonomy, and expanding education and offering educational opportunities through conferences and webinars.
We need to sustain each other! Join us at MANA/CAM 2017 in Long Beach, California November 2-5, 2017 for our joint conference, COLLABORATE. MANA IS the place that midwives of ALL credentials and all traditions can call home, where you can have space held for you, where you can be attended to, acknowledged, accepted, appreciated, and sustained. What do you need for sustainability? We would love to hear from you what sustainable practice and sustainable midwifery means to you. Please post your responses and we will take action! MANA supports you in creating your story!