so running through facebook, it occurred to me that I know a lot of (mostly) women in the birth sector, most are midwives or doulas, the rest activists.
What came to me is that there is no real forum for all to unite.
MANA is arguably that medium, but its too political. It has an agenda. In the UK they have ARM - Associated of Radical Midwives. These midwives are not some patch wearing activists that are storming the streets demanding what they want. They are average midwives, trained with in the British midwifery system and have fallen to being on a spectrum between obstetric nurse to independent midwife. The name itself denotes political power, but really the organization is about change, and the acronym (truncated from AROM - or artificial rupture of membranes) was something all too familiar to them.
In Canada and the United States, I don't see much unity. We have the Big Push for Midwives Campaign, but that focuses on certified professional midwives and is consumer led. Then we have ACNM (American College of Nurse Midwives) who have gained control of the URL "midwife.org". MANA - Midwives Association of North America represents all, but I don't think anyone could deny the direct-entry focus of their cause, trying to make midwifery a legitimate profession.
What I see from these organisations is a struggle from within to give self worth. The focus is on the group itself, rather than on the care of pregnant mothers.
Perhaps I am coming late to the game and dishonouring all of the work that has been achieved to this point that I can even be sitting here, an apprentice, a student, judging the system within which we live.
Maybe it's my own dissatisfaction within my self for not doing more to promote midwifery, but not just midwifery, access to it, the organisation and distribution of services, insurance coverage, prevelance, supply/demand, the list goes on.
I'm about to start a project that will exam choice of birth place. My null hypothesis is a despotic one, that birth is a white middle class issue.
This is not to say that there are problems with maternity care across all socio-economic or ethnic groups, but that for what ever reason, it is white middle class women that are leading the movement away from hospital birth.
Questions that arise include:
1. access to information
2. access to services
3. financial limitations
4. insurance limitations
5. cultural tradition
These are but a few factors that may influence a woman's choice of birth place.
Over the next while I will conduct a review of the literature that has been published on the subject. My plan is to analyze MANAstat information to find trends in the utilization of midwives. I would like to incorporate a maternity care survey to help further glean insight into this question.
Today midwives are returning as holders of community knowledge. Protectors of all that is natural and healing on the earth. But is this really true of all midwives? Do lay midwives, CPM, LM CM CNM all have access to the same knowledge?
Do we all practice under the same system of beliefs?
Returning the point I raised at the onset of this, what are midwives doing to join forces to help extend access to their services to a broader population?
First we need to recognize that as midwives today, the large majority of us are white, and most likely fall into middle class. Once we accept this disparity on the behalf of the caregiver, we may begin to understand the disparity in care being provided and received by consumers.
This is just a intro to the topic. One I will continue to address in the coming months as this project unfolds.
Comments, suggestions, thoughts and beliefs are welcome.
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