Midwives of the Revolution

Explorations, analysis, and reflections on women's health, midwifery, and politics from a feminist, marxist lens


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[Some] Breastfeeding Moms Can Now Do More!

There has been much jubilation this week in the women’s health and lactation (and tech) worlds this week as a brand new “smart” breast pump that will be hitting the market this Spring got the tech world excited at CES 2017. While the Scary Mommy blog and Association of Women’s Health, Obstetric, and Neonatal Nurses were beside themselves with joy over the new Willow breastpump, I believe a healthy dose of skepticism about this type of product is in order.

What’s the big idea? It’s quiet and discrete–you can wear it under your bra, it’s wireless, and it has some cool tech features. It’s being pitched as a way to multitask while pumping. Imagine easily commuting, going to the movies, making dinner, or cleaning the bathroom while pumping! Great for busy nursing parents, right?!

willow-breast-pump

Willow has a beautiful design,and if such technology was developed and made available in order to actually improve working parents’ lives, including, say, being a covered benefit under state Medicaid programs that would actually help working class and poor women meet their breastfeeding goals, that would be great! And, you know, if it came with gains for our side like the Fight for 15 movement is fighting for, it would be even more meaningful.

Don’t get me wrong–as a supporter of human milk for human babies and a former (and possibly future) pumping and working mama, I am for easing the burden of expressing milk when needed. For instance, as a nursing mama, I did bring my electric pump to the opening night of Star Wars: Force Awakens last year–went straight from clinic to the movies and plugged in during the previews and opening credits! This pump would have indeed made my expression of milk easier. The critique that follows is more about lower wage women than about professional workers such as myself that could likely afford the Willow. In regard to the Willow, we must consider the following not just about our own potential personal use of the pump but about what it represents.

  1. Moms are under pressure more than ever to Do More. You’ve heard that cute phrase “mother’s work is never done”? Or perhaps are familiar with the concept of the “second shift” of women* having two jobs–one (usually under-) paid at work, then going home to be mainly responsible for housework and childcare? With the devaluing of care and women’s work generally, nursing mamas are producing even more value for the economy by making food for their infants that doesn’t have to be paid for (unlike artificial milk for babies, which can be exorbitant but is paid for by programs like WIC). This product allows the pumping parent to Do More while pumping. Sure, that may be convenient and beneficial for many mamas struggling to feed their children, whether working outside of the home or not. However, it strikes me that this product is a symptom (not a creator) of the general societal expectation for mamas to be Super Mothers. In this time of neoliberalism and very few social resources that would actually help parents raise healthy children like, say, socialized high quality daycare/other childcare, postpartum in-home nurse care, excellent local public schools, accessible healthy food for families, walkable safe neighborhoods, paid maternity leave (for at least 12 months like a civilized county) etc.–mothers are still expected to Do Everything to raise healthy children by: breastfeeding in spite of all odds, prepare homemade meals for our kids every night, and sacrifice everything to be the right kind of mother who balances career and parenting. No such standards are ever applied to men/fathers because Sexism.
  2. willow-working-mom

    Ah, the working pumping mother! She’s so efficient and beautiful and productive! You hardly notice she’s a working mother! Makes you wonder if the manufacturer looked at the federal laws on pumping before launching this marketing campaign, or if they are directing it to capital. 

    Let’s be real. While mothers who can afford it (see point #3, below) would likely benefit from a pump like this to get more done at home–though most pumping moms I know do most of their pumping while at work, except exclusively pumping mamas–the real and direct beneficiary of products like Willow are the corporations that don’t really want to support their employees’ right to undisturbed pumping time on the job that is (for now) guaranteed under the Affordable Care Act. Makes you wonder if the creators of Willow have just been waiting for the ACA to be closer to repeal in order to promote this product. In every circle of breastfeeding parents I have been part of, there are constant questions about workers’ rights to pumping time. Many people resort to working through pumping time (though not as discretely as they would with the Willow) because it’s just not practical to take proper breaks to pump (I myself usually did charting while pumping because there’s always charting to be done, and the extra charting time lessened my time staying late). This will only get worse if nursing protections are lost with the almost inevitable upcoming ACA repeal. Bad news for maternal and child health–and workers’ rights. But here’s Willow, and ready to accommodate your upcoming loss of rights! Wouldn’t you like to see your midwife while they express milk for their child?! Or have your latte prepped by a properly productive multitasking discretely pumping barista? Or groceries rung up by a pumping cashier?

  3. Retailing at over $400, plus and astonishing $0.50 per single-use milk storage bag, Willow will be cost prohibitive to the vast majority of working mothers. For a product that will make it easier to make pumping parents work through their pumping session, the least capital could do is subsidize this product. In a rational world, corporations would be made to bear the burden of the cost of such a product, rather than consumers. Sure, eventually, Willow would benefit under the current ACA requirement for health insurance to provide lactation benefits. But until then–or after, if/when ACA is repealed under the next Administration–Willow will be a privilege of a small minority of wealthier professionals who can afford it. I wouldn’t consider Willow a “game-changer,” as it’s being touted, unless and until it is free to all pumping parents who need it in order to meet their breastfeeding goals.
  4. Finally, one question about this product that I’ve seen raised by lots of mamas on breastfeeding forums has to do with the actual science of milk production. Willow claims that it senses letdown and then switches to expression mode (not far off from Medela’s technology), but many pumping parents have expressed (um, sorry) concern that it can be hard to actually produce more milk while focusing on things other than nourishing the baby you love. That’s why many people don’t like pumping–you are always having to measure your output against your baby’s nutrition needs for the next day, and for many, the pressure of making enough makes this a stressful rather than satisfying process. The pressure many of us feel to pump enough in our stressful parenting and working lives does more harm for milk production than good. Some may feel better getting things done while pumping rather than staring at the pump as it fills up, but I question the physiologic good of hooking a mama up to a pump so she can be disconnected from the thing her body is doing (expressing milk) while her mind can be focused on doing something else. This seems to suggest that our nursing bodies are just machines for milk output. Most of the writing I’ve seen on increasing milk production (and I have ear a lot of it while struggling with it personally) suggests focusing your mind on your body and your baby–prety much the opposite of what Willow encourages. I am reminded of the pumping women in Mad Max: Fury Road, who I swear must have all been taking domperidone–making milk for the society and able to do little else. They needed Willow to up their capacity as contributors to the patriarchy!

    fury-road-pumping

    Imagine a post-apocalyptic world with human milk a major source of sustenance and Willow at the ready to integrate pumping people into other productive endeavors!

  5. I hope the next phase of the women’s and reproductive justice movement will fight for paid maternity leave, and more collective solutions to infant nutrition and maternal health than are currently on offer under capitalism, and more specifically, neoliberalism. I hope we will be fighting for more leisure time for workers, so that we could start to imagine technology not to benefit the bosses and the war on women, but solutions for the common good and public health. Willow seems to me a symptom of a particularly American problem, whereas a society that actually values maternal-child health and in which mothers and workers actually have rights, would produce, say, workplace-based nurseries where nursing parents can feed their babies on demand and not be shackled to a pump during the workday at all. Or, say, hospital-grade pumps you could just hook up to (BYO parts), and more lactation lounges at your workplace or public locations like cafes, libraries, bars, etc. De-stigmatizing and promoting breastfeeding is not about individual decisions to nurse or breastfeeding in public, but must be part of changing the infrastructure of our society, and fighting sexism at every step, so that women’s reproductive work (pregnancy/parenting/nursing) can be separated from her life in a healthy, holistic way (yes, nursing parents and other mothers do need to get out of the house/be away from their nurslings sometimes).

    Some of these solutions exist in social democracies, and many of them have not yet been won anywhere, to my knowledge. Let’s not lower our horizons to hoping a product like Willow will lift busy nursing mamas from our drudgery, but use this as a way to vision a better way to integrate the needs of nursing dyads into society.

    *I am using “mother” and “mama” and “women here for linguistic ease. I do recognize that not all breastfeeding parents identify in these ways, and I seek to honor that in my writing. Most of the theoretical work about social reproduction and the second shift focuses on the care work of “women,”  and sexism has generally underpinned the war on mothers specifically. In the framework and sense of solidarity that I would like to put forward here, I do generally refer to women/mothers, because an attack on women and mothers generally underpins the war on parents of all genders, including gender non-conforming and trans* parents. I hope that as the movements for reproductive and gender justice grow in the coming years, they will help us develop more useful and inclusive language that helps capture the shared and also distinct experiences of sexism, misogyny, etc. of gendered oppression. And I hope you will read my piece with understanding and generosity toward my linguistic limits.


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The Loneliness of the First Trimester

On Thursday, I was pregnant. Seven weeks and six days of gestation. This was a very carefully timed, meticulously planned, and surprisingly quickly achieved pregnancy. On Thursday, I was happy. I had attended a meeting after work, hearing a report back from a protester that had been in the streets of Ferguson, Missouri, and analysis of police violence and the new phase in the struggle against American racism and police terrorism.

And then, I was bleeding.

I didn’t know, I couldn’t know, at first, if I would be the one in two women with first trimester bleeding, or the one in ten pregnant women overall, that would have a miscarriage, or spontaneous abortion. But I knew enough to identify that sign of bright red bleeding that doesn’t stop, when I had no risk factors for other causes of first trimester bleeding, meant I was losing this pregnancy. 

And so, by Friday, I wasn’t pregnant any more. 

And, since I’m not allowed to take any days off work until I’ve been at my job a complete six months (and I’m just three weeks shy of that), I went to work caring for women on Friday, while my uterus emptied. I felt myself bleeding while listening to a young mom’s baby’s heartbeat for the first time, celebrating with her and her beautiful partner. I patiently explained the speculum exam to a terrified young woman, and did a six-week postpartum checkup and got to coo over her gorgeous baby. I counseled an older woman on the risks and benefits of sterilization versus long-acting reversible contraception. I tried to have a normal day, when I wanted to be home, mourning. 

It’s only Saturday, and I’m still pretty devastated. I was supposed to attend my city’s SlutWalk protest, where a year ago, I had given a rousing speech tearing apart sexism. I wanted to be standing with my sisters and comrades in the streets. But more so, I need to heal.

***

I have been musing quietly about the loneliness of the first trimester since I peed on the stick weeks back and had the delightful moment of reading “pregnant” on the digital screen. The feeling was so different from the myriad other times in my life when I had taken the test in anguish — especially the one other time when I had a positive result, in midwifery school, and knew I was going to have an abortion. I was, this time, elated. 

But there is convention in our society to stay quiet about that positive pregnancy test until the second trimester, regardless of which choice we plan to make about the pregnancy. We know that people won’t really understand the complexity of our feelings about the pregnancy, and that we don’t want to tell everybody the bad news, if we end up needing or wanting an abortion, or if the pregnancy ends in a miscarriage. And so we tend to suffer through many discomforts of the first trimester, in silence.

I remember telling some of my comrades and friends what was going on, when I had the unplanned pregnancy years back. Because I am part of a community that embraces reproductive rights, I was fortunate that it was fairly easy for me to tell people at the time that I was planning an abortion, or that I was still dealing with some of the medical issues related to my abortion the few months after it started. I have since publicly spoken out about my abortion many times, working to de-stigmatize the experience that three in ten women will experience before the age of 45

Telling abortion or miscarriage stories can be a powerful way to break the silence. But it will take more than telling stories to break the stigma.

Telling abortion or miscarriage stories can be a powerful way to break the silence. But it will take more than telling stories to break the stigma. Art by Favianna Rodrigeuz, Just Seeds Cooperative

At that time, however, I didn’t talk openly about what was going on outside my activist network. But I did have a fellow midwife student classmate and friend who turned out to have an unplanned pregnancy at the exact same time as me. We turned to each other one day after class with our secrets: “I’m pregnant.” Neither of us felt good about it. We were both in the first of our two year program, and planned to go full time. There was no time for pregnancy, birth, and parenting, and both of us had partners that were full time graduate or professional school students. It was terrible timing. We each made different decisions, however. I ended my pregnancy, while she continued hers and is parenting this beautiful child, who is almost three now. 

The other difference between us was that none of our classmates knew that I was pregnant or had an abortion, while they eventually found out about hers, when she started showing and eventually had the baby during the program. We both knew that even in a midwifery program, people weren’t emotionally intelligent enough to deal with a sister midwife’s pregnancy to respond appropriately to our news. So we both kept quiet, attending class while coping with our own pregnancy challenges.

I have wondered sometimes if we would have felt that way if we were attending school in a more politicized or radical time, say at the height of second or third wave feminism. Interestingly, I was able to talk about it with my faculty and preceptors, who all had trained as midwives in more political times and were very accepting of my decision.

If a group of midwife students can’t be mature enough to be present with each other during pregnancy, who can be?

***

This time around, I spent much of the initial weeks of pregnancy being silently excited. I talked about it with few people: my mother, my partner, my nurse-midwife team, and one friend, whom I had asked to be my birth doula. It was strange not revealing the news when talking to friends and family about this big thing that was going on in my life. Many times, I wanted to tell more people. It was humbling to now be experiencing life as a “pregnant patient,” much as I had appreciated the experience of being the “abortion patient,” knowing that this would make me a more compassionate nurse-midwife.

And I continued with my life — bicycling, gardening, going to protests, working long hours, cleaning my house — while thinking about the little life growing inside me. Fantasizing about the home birth I expected to have in early April with the fabulous team of midwives I had chosen to care for me. Talking with my partner about changing the guest room into the baby room over the winter. Getting excited about the cousins our baby was going to have, given that my sister in law is pregnant with her second, and my brother and his wife might be trying to conceive soon. Planning with my partner how we were going to cleverly announce my pregnancy on Facebook and to friends in person. Looking forward to the excitement and congratulations we could expect from family, comrades, and friends. And trying to imagine what it would be like to meet that tiny creature my partner and I had created. 

***

I was starting in some ways to relish the privacy of the last couple of months. It has meant more time for introspection, self-care, and focus. I have needed that inner space to deal with some significant changes to my body and my changing life priorities. 

Like sobriety. I chose to stop drinking around the time that I believed I was ovulating, in the first cycle we tried to (and did) conceive. I genuinely enjoy beer, wine, and the occasional cocktail, but since beginning my new job for the last few months at my job, I had also relied on that delicious glass of wine after work to help me unwind. Being sober means having to actually face all the trauma I see at work, and process it in some other way. And this is a pretty drug- and alcohol- heavy society we live in, so not drinking or partaking in any drugs can be pretty challenging, socially and personally. I have loads of patients that aren’t able to cope with life without substances, and continue drinking and using (marijuana, mostly) during pregnancy. Like many women facing the prospect of complete sobriety for 40 weeks, I worried that I would be tempted to drink and felt guilty for even thinking it might be hard to stop.

Fortunately, I have felt pretty good about not drinking and have enjoyed the challenge of sobriety. But I also dreaded social situations in which I would normally be drinking, worried someone would ask why I am not having my customary glass (or three) of wine. What would I say if someone suggested I was not drinking because I was pregnant? Would I choose to tell them? Would I lie? Would I tell them I didn’t want to talk about it? Fortunately it never came up. (For the record, peeps: Don’t ever ask someone if they are pregnant! They will tell you if they want you to know!)

Another major chemical change occurred in my body as I prepared my body for pregnancy by weaning myself off the anti-depressant I had been taking the last few years. That drug had really helped me through some major difficulties the last few years, from completing my midwifery program, to facing my midwifery board certification, to an extended job search, to the major transition of this new and difficult job I eventually landed and accepted. I am fortunate that my depression is well enough managed, and I am stable enough to face stress without the help of this wonderful pharmaceutical product or alcohol. Mostly I owe that to years of therapy and yoga practice that have enabled me to access pretty decent coping skills, along with an extremely supportive partner. Nonetheless, it felt very difficult to stop drinking and to stop taking this antidepressant at the same time. In hindsight, I may have done it a little differently, but it worked out OK. 

Mainly, the changes in my body with the new pregnancy made me feel extremely vulnerable. I knew I had little control over if this pregnancy would continue successfully or not — knowing what I do about rates and causes of miscarriage. For the first few weeks, I could hardly believe I was really pregnant! Every trip to the bathroom, I feared seeing blood on the tissue paper. Every little tiny cramp or feeling in my pelvic area felt like it could be something wrong with the pregnancy. And since I only experienced momentary twinges of nausea, I looked forward to them, as proof that I was in fact pregnant. I caught myself looking at my breasts in the mirror and sometimes touching them to make sure they were really growing, and tender enough. Loads of women face extreme nausea and vomiting in the first trimester and are completely miserable, whether or not the pregnancy is desired or if she plans to continue it. I’m fortunate I was at least feeling well. 

And when the proof was there, out of nowhere — sustained bright red vaginal bleeding, cramping, and passing tissue — it was clear that it was all over, in a flash. One day, a pregnant patient, the next, a “miscarriage patient.” And I had to believe there was nothing I could have done differently. It wasn’t my fault. It just wan’t going to work out this time. 

***

These are some of the things we don’t talk about when we talk about pregnancy, planned or unplanned; desired, undesired, or ambivalent; spontaneously aborted, continued successfully, or electively aborted. These are some of the things we don’t talk about because we have internalized the messages of the war on women. This war psychically imposes a social and cultural expectation that all women naturally 1. want to become a mother and should embrace every chance at motherhood, no matter the circumstances; and 2. adjust and cope in a healthy way to the emotional and physical challenges of pregnancy. And if they don’t, there is something wrong, or even criminal in her thoughts or actions. Yes, lawmakers have proposed criminalizing miscarriage. Yes, every year, dozens of laws in every state of the United States are proposed and pass regulating women’s bodies and restricting abortion. Yes, laws primarily aimed at Black women  criminalize drug and alcohol use in pregnancy (see Dorothy Roberts’s Killing the Black Body).

Yes, this impacts popular opinion, and shapes how people–even and maybe especially women themselves–understand and talk about pregnancy, abortion, miscarriage, and motherhood. And mostly creates the circumstances for not understanding what it is to be pregnant, or how to empathize with a woman who is pregnant, or wants, does not want, or who cannot achieve pregnancy or parenting. 

***
I was grateful I was pregnant on Thursday, and still sad that I’m saying goodbye to that little embryo that I hoped would become a fetus and eventually the baby I would get to parent. I am nervous about what happens next. Will I be able to get pregnant again right away? What kind of loneliness and fear will I face the second time around? Will I make it past the eight week mark next time? Will my readers and friends respond compassionately to this post? 

I feel like I’m in a good enough place emotionally to be able to share my miscarriage story, alongside my abortion story. And like coming out about being queer, or about having had an abortion, I hope that by telling my story, I can contribute to de-stigmatizing something that our deeply misogynistic society doesn’t understand. 

But it takes more than being able to tell the story, for those of us for whom it is safe to do so, to change cultural values around pregnancy and sexuality. We have to end the war on women if we want to shift people’s consciousness and foster solidarity with the challenges people face during pregnancy and parenting. How could we do that? It means opposing every state/federal/local law and institutional policy that aims to decrease women’s bodily autonomy and impose control over women’s sexuality. It means being in solidarity against every form of sexual violence and coercion. It means fighting to end the New Jim Crow. It means demanding comprehensive sexual education for all children. It means standing up for a living wage, the right to union representation, and dignity on the job. It means building a movement for immigrant rights and to tear down the borders. It means calling for free quality childcare and the valuing of care work. 

Some of these things might seem far-fetched and maybe even only tangentially related to my story. Maybe you think I am coming out of left field?

But there used to be a saying in the women’s movement that really meant something, though it has ceased to bear any resemblance to its original meaning: “The personal is political.” In its best sense, it meant that our personal struggles as women or as women of color, weren’t ours alone, but a reflection, or a symptom, of the broader racism and sexism in society. In the era of neoliberalism, we are meant to see our problems as isolated from each other’s, and mostly as a reflection of our own personal weaknesses and inner failings.

More and more, however, I am seeing my personal struggles as intimately related to the structures of social oppression, and I’m tired of bearing them alone. When I fight against the war on women, or against the war on the poor, or the war on people of color, it’s personal. It’s deeply political, as well, but when I think about the circumstances of my reproduction, it’s also deeply personal. 

***

The last women’s movement, like the civil rights and Black Power movements, changed culture dramatically — but throughout my entire lifetime, the right wing has undertaken a sustained attack on the progress those movements made possible. It is my hope that we can build new social struggles from the ground up, that take up some of the demands I mentioned above, and more. Yet most of all, my hope and my argument is that the voices and demands of ordinary people as we struggle with our “personal” issues must be at the forefront of these movements — rather than the tepid Democratic Party politicians and NGO leaders who have been too afraid about upsetting the right wing that they have done nothing but compromise while our rights are under attack.

After all, it was- not well-meaning liberal politicians that made Roe v. Wade possible, but the fact that women took to the streets to tell their own stories about illegal abortion and forced sterilization. Those movements put women first — not the careers of politicians or career “activists.” Change happened, then, and it happens now, from the bottom, up. Or, as the late, great historian Howard Zinn put it, “What matters most is not who is sitting in the White House, but ‘who is sitting in’ — and who is marching outside the White House, pushing for change.” 

I don’t think the first trimester, or any part of pregnancy or parenting, has to be lonely. I know that people can develop deep empathy and solidarity with each other’s struggles — and we see a glimmer of that in every mass movement, from the revolution in Egypt to the capitol occupation in Wisconsin, to Occupy Wall Street, and even how people looked after each other in the immediate aftermath of Hurricane Katrina. We have to foster that in our communities as much as we can, but more so, we have to organize movements for reproductive justice that put the demands, voices, and strategies of ordinary women and other people who can get pregnant at the forefront.

Being part of those social movement traditions is what makes me feel a little less lonely as I grieve my lost pregnancy and look forward to the future. 


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How I Got Here; Or: Why I Am a Nurse-Midwife

Now that I’m here, I’ve jumped through the hurdles of getting my degree, passing boards, getting licensed, and becoming employed, I thought it would be nice to reflect on how I got here. It’s easy to take for granted sometimes, now that I just wake up and go to work every day. But I’m doing what I set out to do! I’m midwifing! So…how did that happen?

Back in the day…

My background is in languages and literature. I studied English and Spanish in undergrad. Like many undergrads, I had no idea what I would do when I grew up…Like many women, I thought I was “bad” at science and hadn’t really taken myself seriously in that regard. When the nursing shortage blew up in the mid-2000s, my mom suggested I look into nursing. I didn’t really think it was for me. I had the old-school pre-feminist movement (and very middle class) idea about nurses as doctor’s handmaidens and couldn’t see myself doing it. But then I started looking into it, and taking my prerequisites for nursing school (adventures to tell of another day), and more and more found it seemed like the right next step for me. Hands + heart + science + possible unionism + healthcare activism…that I could get into.

I originally planned to be a WHNP. When I started nursing school, I had never attended a birth, and I really didn’t know much about midwifery. I liked the idea of working with women, but I didn’t want to try to get into a program/field that I wasn’t as passionate about. I knew folks who were planning to be midwives, and they were excited about Ina Mae Gaskin and doulas and home birth. But I was in my mid-twenties, and no one I was close with had had a baby yet, and these topics were remote from my experience. The abortion world was more my bag, and I knew that as a WHNP, I could possibly train to provide early aspiration abortion or at least do lots of cool family planning work.

Trust Women Tiller

Then, I fell in love with birth and also realized that, as I later saw expressed beautifully in the documentary After Tiller, trusting women and being pro-woman/pro-abortion was midwifery. The issues of birth and family planning and abortion are inextricably linked. And, from a practical standpoint, I realized that it made sense for me to provide pregnancy and birth care as well as the other family planning and gyne care I would do as a WHNP. Why hand off patients to another provider to attend the birth, when I could actually be the one to be there for the whole lifespan? So, during nursing school I asked the women’s health department if I could switch to midwifery. They OK’d me.

An Alternative Route

For a variety of reasons, my path to practicing midwifery has not been traditional, at least how it’s done “typically” by CNMs. According to tradition, an RN works in labor and delivery, then goes to midwifery school, then works as a CNM. When I finished my nursing program, nursing jobs in labor and delivery were hard to come by. I got one interview on a hospital unit but did not get the position. I applied to dozens of others. I also had put out my feelers for work in abortion care and managed to get a position through a student colleague connection, at the abortion service in the county hospital.

My first nursing position was a nightmare, but it paid the bills for my first semester of midwifery school and gave me valuable insight into the lives of women seeking abortion in fairly desperate situations. I then got a scholarship so I didn’t have to continue working as a nurse during my program, but it required me to complete it in two years. I babysat for a wonderful family and watched their family grow throughout my graduate studies. Then, as I was completing my final semester of my masters program, I landed another position in abortion care, which eventually turned into a broader family planning nursing role. That is the last job I held until beginning this current job.

After I passed my boards (got certified by the American Midwifery Certification Board), I again looked for jobs around my city. This time around, I had more interviews and got a lot more interest, but still, employers and even my mentors questioned if I could work as a full-scope (meaning: catching babies, not just working in the office) CNM without having worked as a nurse in labor and delivery. Some suggested that I should swallow my pride and try to get such a position and then try again in a year or two for a full scope  job. It was a full six months between my initial interview and my start date for the position I landed, and there were times that I considered this option. Luckily, this position came through, and I got to do things the way I originally thought I could (more or less).

Acceptance

What is midwifery? Is it only possible to be a midwife if you’ve been a nurse during hundreds of births, many of which were probably complicated or high risk? I don’t think so.

It’s hard being one of the handful of people who graduated from programs like mine, that allow you to graduate without having to work labor and delivery, having to prove that you belong and that you can hang with the more experienced nurses. But I am not alone, and I’m grateful for others who blazed the trail before me — whether they intended to or not.

Midwifery is a whole lot of things.* True, the only births I’ve attended are the ones where I was doing the baby-catching (or doing labor support in a few instances). I haven’t seen a ton yet. My career is young. I am humbled by all I have to learn. But I have also worked in women’s health for over six years, and have learned compassion and to not judge women’s lives and choices. Midwifery is trusting women, it’s listening to women, and it’s being present with women. You can’t learn that from a textbook or demonstrate that on a board exam, but you can show it in the type of care you give. I am confident that, as one quarter of women in the United States will have an abortion before the age of 40, my background in abortion provides a ton of useful clinical and emotional skills to be a good midwife. Good midwifery care has to include all phases of the reproductive lifespan, including abortion. (And hopefully one day CNMs will be legally allowed to provide spontaneous and elective abortion care in all states!)

Now

Tomorrow will mark three months as a practicing CNM, but I think I’ve been practicing the midwifery model of care for more than that. I respect that other midwives took other paths — and they may have done so out of their own necessities. I hope that as I enter the birth setting again in a few months, when I get my hospital privileges, I can continue to safely develop my labor and birth skills and humbly continue my journey with new mentors and teachers.

 

*There are, of course, other paths to midwifery outside of nursing. I respect direct-entry or certified midwives, but I don’t claim to know much about their paths. I can only speak as someone that went the CNM route, and know that non-nurse midwives have their own contributions to women’s healthcare that may differ from where CNMs might be coming from (e.g. Ina Mae Gaskin).


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Abortion should be available on demand, without restrictions, for everyone who needs it. I believe that while society still places limits on what a woman may or may not do with her own body, while women’s sexuality and reproduction are still in effect controlled by the state, any discussion of equality or empowerment is a joke. – Laurie Penny

Sums it up.

http://towardfreedom.com/51-global-news-and-analysis/global-news-and-analysis/3542-abortion-should-be-free-safe-and-legal-for-everyone