Midwifery

In some ways, being a midwife in our current culture is truly a quixotic profession. Especially for those of us who practice in the mainstream of health care. I often envy colleagues who have free-standing birth centers or attend families in their own homes. It doesn't help either, that there was a nearly successful campaign to completely eliminate midwifery as a profession in the USA. Some days it feels like I am dancing on a tightrope with no safety net. Other days I feel like the rope in a tug of war. The war is one of culture and belief. There is a saying in midwifery "Birth is as safe as life gets." Yes, it is, but life has only one guarantee - it eventually ends on this earth. We have a culture that no longer accepts risk or pain except in 'extreme sports'. Why is it acceptable to risk injury and death for football or other sports, but not for a woman to risk the same for the sake of giving life? I have great awe and respect for those women who have endured cesareans or other difficult births not just once but repeatedly. At the same time, I have disdain for the culture that coerced many of these women into the first (often unnecessary) cesarean. I also have grave difficulties with women and their families who want to plan and control their birth through scheduled induction of labor or medically non-indicated cesareans. And yet, I also have a professional obligation to advocate for women to have the birth experience that is best for them. I also have to work within a system that is focused on cost-effective and lawsuit-proof care. Then I also add in my personal ethical and moral standards, and it really gets sticky sometimes. Did I say rope in a tug of war? How about a sweater being fought over by a pack of dogs!