UNITY, DIVERSITY, DIVISION & IDENTIFICATION

You know, I would probably not ever bring up the topic of UNITY of midwives on my own. It is complicated and I am convinced it is pretty much implausible. But, on an increasingly frequent basis I am being told that I am dividing midwives and that my rhetoric is creating an "us/them" mentality. I am admonished to join with others who are "working for unity among midwives" and I have been pronounced guilty of wide spread alienation.



And there are those in my camp who think that unity is the answer. "If we could just unify....if we could all come together." "If... if.... if...." I love them, and I understand what they are wishing for.....but I think longing for unity is pretty much a waste of time. That being said, this is attempt #1,001 to explain my take on the complexities of unity.

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UNITY & DIVERSITY, DIVISION & IDENTIFICATION


I wrote an article on unity and diversity for my students a long time ago.




I pointed out in that original article that diversity is a great thing. In context, our relationship to that word is actually one of the two major impediments to unity among midwives. First, we serve a diverse group of women. Accommodating diversity is what we do.




At the time that I wrote that original article, the majority of midwives recognized the value of serving autonomously. Most acknowledged the conundrum of attempting to unify such a diverse group who serve such a diverse population.




They understood that a bit of caution might be warranted concerning the pursuit of unity. Unity might come at the high cost of wholesale homogenization of a service that really should be personalized to meet the needs of the individual client.




Unity was a passion for some, but I don't remember "unity" being used as a pointy finger to disparage anyone who has a dissenting opinion, as it is today.




My original article proposed the more loosely articulated goal of being unified in our desire to serve autonomously. Autonomous practice is the only way to honor the diversity of our clientele. Serving families in their own unique situations, with their own individual needs, is actually a benchmark of midwifery, isn't it?




The second impediment is that, in reality, unity of any large group, is pretty much impossible. No matter how much we might long for the Kumbaya idea of unity for midwifery, in real life, unity is pretty rare. Here's why: unity requires that all who were previously in disagreement, acquiesce to only one desire. It is the changing of our desires that is the hold up. That is what prevents us from glomming onto a singular philosophy or goal for any period of time. It is DESIRE that determines where we stand. I will explain that in a minute.



Before we argue for unity, maybe we should give some thought to how we define it. Is it "all for one and one for all?" I don't think so. The cry for unity is usually code for "Shut up and come over to our side." or "Stop disagreeing with me." .... or "Don't make me come up with an argument. I am comfortable here in my little bubble." It is rarely a meeting in the middle. When it comes to parents' rights, I am not sure that it is possible to define "middle," and frankly, we don't have time to look for it. Parents' rights are diminishing as we speak, and those who are demanding that I work for unity, are responsible for a large part of that tragedy.



And you have probably noticed that those who are telling me to UNIFY are NOT volunteering to do so with me, rather, the instruction is for me to unify with them and to stop causing trouble.



Believe it or not, I don't intentionally cause trouble, but it seems to be a by-product of telling the truth* and encouraging others to do the same. Admittedly, I am pretty vocal in my challenge for people to do the research and then take a stand. I won't deny that. But, I really find it incredulous that I would have to point out that I did not create any division. Division was here long before I was. In fact there is division within the divisions. But hasn't there always been? And actually, I want to propose that division is a GOOD thing when it means that I step away from what I don't like and stand for what I DO like. Right?



And I am not just talking about midwifery; division is part of the human condition.



Divisions are inevitable because:



WE SORT OURSELVES INTO GROUPS BASED ON WHAT WE WANT!



For most of my life, I had it out of order: I thought that I wanted something different because I believe something different. Now I am convinced that beliefs are more likely to be predicated on wants, rather than the other way around. I WANT something different for parents, AND for midwifery, than the majority does, apparently. Since I want something different, my beliefs are born from my wants. Therefore, my rhetoric and my actions and my alignments are all determined by what I want. Identification and alignment with those who want what I want is logical. So, it is only common sense that I would distance myself from any group that wants something I don't want. I will not be investing my time or resources into support of any organization that doesn't want what I want. In that context, division is necessary, isn't it?



WE SORT OURSELVES INTO GROUPS BASED ON WHAT WE WANT AND WE SORT OURSELVES INTO GROUPS BASED ON WHO WE WANT IT FOR!



The group with whom we choose to identify will be determined by not only WHAT we want, but by WHO we want it for. For me, it is absolutely, positively, unequivocably about WHO is served: the mamma, the baby, the family. I want mothers to know the truth* about birth, and for them to be served by people who know the truth* about birth.


I want:


• parents to own birth and I don't want their choices to be made for them. I don't want ACOG, ACNM, AMA, MEAC, NARM, MANA, The Big Push, or any other group making decisions on their behalf or creating laws that disenfranchise them.


• every individual woman to make her own birthing DECISIONS (not assumptions) based on TRUTH (not lies, gossip or birthfright.)


• widespread acknowledgment of the sovereignty of parents to decide where and with whom they birth.


• every woman to be able to make all the decisions about her birth and her baby without having to stomp her foot or raise her fist, demanding the right to do so. No woman should have to fight to experience the biological function of birth where and with whom SHE chooses.


I am very clear about what I want, so why on earth would I relinquish what I want for the sake of unity?


Unity is NOT my end goal, and frankly never has been. My goal is to tell the truth* to as many people as I can, for as long as I can......and then hope that my efforts, and those of people who want what I want, effect something positive for birthing families.


So I am back where I started with this: In order for authentic midwifery to survive, the desire for unity must be trumped by the desire to serve individual women, autonomously.



Unity for the sake of unity could be, actually probably always is, counterproductive. What will be lost for our grandchildren if unity is seen as paramount to the rights of individual midwives to serve individual parents?


And ultimately, I want to encourage every person reading this to consider carefully who you stand with, what you stand for, and who you stand for. Don't be afraid to be identified with a principle, or a purpose or a cause. If you can't stand with a group on principle, work toward the purpose or support the cause, join a different group. If you feel like sneaking out the back door when standing with your group is not popular, then you should find another group to stand with.....a group who wants the same things you want, for the same people you want it for. There is real
integrity in that.


* The truth about birth is that it is a normal function of biology. Pregnancy is not an illness, birth is not an emergency, and laboring mothers are not patients. Birth is safer when left alone. Childbirth is not the domain of medicine, or midwifery. It belongs to the woman giving birth.





















There is a line in the sand. I didn't create it, but as soon as I saw it, I chose a side and stood there, and now I stand and stand and stand. Admittedly, "my side" is the minority. There are not so many of us, but I can pretty safely assert here that we are not about to stop wanting what we want for parents and babies, in exchange for what the majority of midwives want for themselves.

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Carla Hartley is a friend, a midwife, a defender of mammas and birth...she is also the owners of Ancient Art Midwifery Institute and the founder of Trust Birth.


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Midwifery Licensure

I have never for one second understood the rationale of licensing midwives.



What those who are pushing for licensure want, and what they get, will eventually be two very different things.




• They may start out with part of what they want: power and third party reimbursement. But professional equality and respect cannot be legislated and will never happen. So mark that one off the list.

The only place midwives will ever work with doctors is under them; CNMs are not considered equals.

Why do pushers keep telling me that they will gain respect and work side by side with docs as equals? On what planet?

And it will be an easy thing to reduce any power with the creation of licensing boards. And that alluring carrot of third party reimbursement can, in no way, be guaranteed for too long. Many insurance companies are refusing to cover home births attended by any kind of midwife, papered or not. Medicaid won't be far behind. Why would they pay for something that private sector insurance won't cover?

• You can try to sell it to congress as something good for women, but it has to be repackaged and that is a whole "nother" rant.

• It is also a fallacy that licensing of midwives will create greater access for women to midwifery care. It will NOT create greater access to authentic midwifery care. It will create a new profession, because authentic midwifery is antithesis to government control. Authentic midwifery serves only the mother, with no one in between. In the long run it will not benefit poor women, many of whom WOULD NOT HAVE CHOSEN HOME BIRTH. It actually holds potential to force poor women into home birth who would rather birth in the hospital. That is not the way to promote midwifery.

• And along those lines, do you really trust the government to make the best decisions for your family about anything? Do you want them controlling the most intimate and feminine of all biological functions from a desk somewhere? It will create a lot of red tape. Don't we have enough of that? Eventually this licensing idea will go the way of all other things controlled by any government. How long until woman may not choose their own licensed midwives but rather they will be assigned by zip code. The number of women who "qualify" for a home birth with a midwife will decrease, even faster than it already is.



How much more obvious could it be that licensure is a disaster in the making?



• Most CPMs aren't too concerned about their future in all this pushing because they are "in", right? Well, read a little history of the licensing of midwives in the south. That will give you a little less confidence in your safety. And the plan is already afoot to make it far more difficult to attain or maintain a CPM. How many of you who are CPMs today, will welcome a new requirement to maintain your CPM and/or licensure that involves years and years of college? Think you need a Masters Degree to be a good midwife? Well you might have to have one to be an "official" midwife within just a few years.

• The argument often railed at me is that midwifery needs to be like everything else. Really? Is birth like anything else? Should we lump it in with healthcare? (______________ leaving space here for you to think about the success of healthcare in general and what midwifery would look like as a part of that______________) Look at education and social work and related fields where the educational requirements for employment are escalating at a rapid rate. Do you really think that if you ply your way into the government controlled system that CPMs will escape that same kind of structured increase in educational requirements?



ARRRGGGHHHH! All that makes me crazy....



But here is what gives me even more concern:

• If we buy into the idea that midwives need to be regulated or licensed we are saying that midwives are likely to be dangerous and SOMEBODY needs to watch them.

• And then that those without paper need to be eliminated, which is whose objective? Not just the medical community, and the government, BUT The Big Push and others who seek to monopolize midwifery. Those opposed to woman centered birth is not just "them" anymore.....it is a lot of "us."

• And where, oh where, did we get the idea that licensing and regulation produces better midwives? In fact, from where I sit, it has just the opposite effect. When a credential is the goal, rather than the acquisition of knowledge and wisdom, the credential will replace knowledge and wisdom in significance. I can tell you that this has already happened, just as I knew it would.

• When the issuing organization has the power, rather than the mother, what happens to the mother's ability to make ANY decisions for her birth or her baby? Mothers own birth. Not NARM nor The Big Push nor any of the organizations who are at this moment speaking on the behalf of all midwives. Their presumption is that they are speaking for all midwives but actually they are only speaking FOR the midwives they have approved. I am guessing that half of them don't realize what is being pushed on "their behalf."

• And where are the mothers in this? They are completely left out, though they are held up as the beneficiaries of this fiasco. Yes, I know some are pushing, but they have not likely read the fine print. They think that it is all about legitimizing and freeing midwives. I understand that. But what will happen is that mothers will lose rights and freedoms while midwives gain some and when they lose some. As long as this is about midwives, the power will rest in the hands of the state and not in the hands of the owners: the mothers.



AND THE PUSH FOR LICENSING IS WHOLESALE PROMOTION OF THE LIE THAT BIRTH IS DANGEROUS AND ITS COROLLARY: SOMEBODY OTHER THAN THE MOTHER NEEDS TO BE IN CHARGE!



That is the most lethal aspect of this whole push. Once we hand midwifery over to anyone to regulate and control, we are turning mothers over to someone to regulate and control.

Regulating midwives is, in effect, regulating home birth and regulating mothers.


I may not be able to stop what is happening but I will never have to apologize to my daughters and granddaughters for having been complicit with stripping their birthing rights away.

I see the Trojan Horse for what it is and I am not going anywhere near it.

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Carla Hartley is a friend, a midwife, a defender of mammas and birth...she is also the owners of Ancient Art Midwifery Institute and the founder of Trust Birth.

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