Midwives of the Revolution

Explorations, analysis, and reflections on reproductive health, birth, and midwifery from a feminist, marxist lens

Transition

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It has been so long since I have put anything in this space. So much has happened over the last year for reproductive rights, workers, immigrants, healthcare access, the political mood and movements, and my personal and professional life has not let me keep up with it here. Though I have had my best work-life balance of my professional life so far over this last year, I’ve had a hard time squeezing in time for writing about my experience or my thoughts about what’s happening in the world.

A lot of what is hard is that my dear mother has really been on my case about protecting my professional identity, and about being ever so careful about how I present myself on the Internet, in spite of my attempts to remain as anonymous as possible here. It’s incredibly hard, as someone who has so many damn opinions and for whom my profession is a major passion of my life, to figure out how much I can say about what I think about things, while preserving myself professionally. Are there enough disclaimers in the world to cover me and protect me from losing my job, or offending my clients, or not getting some job in the future? Probably not. So I hold a lot of ideas in my mind and wrestle with what is appropriate enough for me to put into print.

Hopefully this is.

Well, I’m doing it. I’m transitioning. A very welcome, but also a terrifying change, from intrapartum care only in the hospital to not only full scope (GYN and OB) care but to homebirth. I have been working over almost the entire last year mainly in a very large private academic medical center that I previously thought of only as my city’s “baby factory” because so, so many people deliver there. I have also been moonlighting in a similar role in a small Catholic community hospital in my neighborhood that primarily serves Black and Latinx patients. These were both very welcome changes from the major challenges I encountered at my previous position, and my life over the last year has allowed me to settle into a fairly reasonable routine that works well with my family and activist lives.

But now my dream job has started, and my world is being uprooted, but for the better.  in the most delightful ways. champagne

Why am I making this change? I’m giving up a 36 hour workweek with hardly any stress about my job, for being on call 20 days a month for a position that I care about deeply and find spiritually satisfying. I’m giving up about 100 miles a week in bike commuting (often schlepping my daughter on the bike trailer) for having to always be close to my car and driving all over a large metro area to I can get to labors and births in a timely manner. I’m giving up a position that allowed me to make a midwifery stamp and positively impact my patients during their labor, as I provide physician extender service as part of a resident team, for one in which I will partner with a team of midwives to develop relationships with our clients, who have invited us into our homes for the most intimate moments of childbearing. I’m giving up watching how the medicalization of childbirth, while “evidence-based” and in highly skilled and talented hands, so often leads to much higher rates of complications than one should see in otherwise healthy people, for a birth setting in which emergencies can still happen, and the operating room or assisted delivery or complicated resuscitation is still a 9-1-1 call away.

Sure, I’m giving up some personal comforts (and admittedly, proximity to emergency help), but I am leaping into what I am hoping will be a tremendous adventure that will train me to be so much more skilled in what I care about: normal birth with healthy people. It’s a tremendous honor to be seen for my skills and potential, and to have been chosen for this practice. There’s only one way to know if this is my perfect fit, and it’s to try! So, here’s to doing my best at trying!

Author: queermarxistmidwife

I am a nurse-midwife practicing in full-scope (reproductive health and birth care) in a community birth setting in the Midwest. My clinical practice is an extension of my longtime commitment to social reproduction (a close cousin and friend to intersectional -- perhaps synonymous to, depending on who you talk to!) marxist feminism and reproductive justice activism. I write anonymously to protect my job security and make clear that these are my personal opinions, and to make clear that I am also a professional whose personal opinions can also be separate from the care I provide. (While I personally believe in abolition of the prison industrial complex, I still have clients that are cops/married to cops [etc.] and maintain respectful, compassionate clinical relationships with them.) I was called to midwifery circuitously, through my love for reproductive rights and an interest in providing abortion care. Then I met midwives and learned about the intertwined legacy of midwifery and abortion, and I fell in love with birth. In my practice, I have worked as a primary care midwife in a Federally Qualified Health Center and campaigned fiercely for true midwifery in a hospital setting rife with obstetrical violence (and lost that fight!). I have learned how to bring midwifery care from the belly of the beast in a large teaching hospital that functions in many ways as an assembly line of medicalized birth. I have also had my heart broken by my own midwife when I realized that my dream job in home birth was actually a nightmare in many ways. I have found healing through communities of midwives that work to support each other through the traumas of toxic healthcare workplaces. I am constantly learning, working on my personal and professional growth, and striving for accountability, particularly as an anti-racist that benefits from white privilege. Midwives of the Revolution is meant as a nod to Marx and Engles's writing on the process of social revolution, as well as an aspiration to be among the midwives fighting to transform the perinatal health system in the context of the struggles for reproductive justice. The social revolution it will take to win reproductive justice will have to involve birth workers, other health workers (unionized, and not; professionals and not), educators, abolitionists, environmentalists, and of course childbearing people and families. I love the way that Marx's collaborator Engles (a brilliant philosopher and activist in his own right) describes the dialectical process of childbirth, which, for me, also undergirds my commitment to bodily autonomy and reproductive justice. To paraphrase, some of the events that midwives are called to may be "violent" or forceful, like childbirth -- not unlike revolution and social struggle: The fetus is negated by the neonate, who can only be brought about by the force of childbirth. The midwife facilitates that transition, as force (or social struggle) facilitates the transition from one form of social relations to another. Scolding the philosopher Duhring, Frederick Engles defends the social force required to fundamentally transform society: "Force, plays yet another role in history, a revolutionary role; that, in the words of Marx, it is the midwife of every old society pregnant with a new one, that it is the instrument with the aid of which social movement forces its way through and shatters the dead, fossilised political forms." (Anti-Duhring, found here: http://www.marxists.org/archive/marx/works/1877/anti-duhring/ch16.htm#087)

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