Yes, Meepycat--as Hermione Granger once said: "well spotted!" I am not trying to be a good advocate for midwifery--not exclusively-- nor even as much as my desire to advocate for safe birth and happy families.
Anyway, to me, this active self-empowerment and self-advocacy has to start WA-A-A-Y-Y-Y before an 'emergency point' is ever reached at birth, when a woman (as you astutely point out) is simply not able to think straight. When people do empower and inform themselves, they are just much less likely to need to 'think straight' in an emergency birth situation. This is because EITHER they will already have reached well-placed trust in their provider (instead of 'blind trust'), OR, they will have avoided an emergency in the first place--through self-care as well as self-advocacy.
I am trying to advocate for happy families and safe birth anywhere and with anyone, by trying to help de-construct our standing mythos concerning health care and personal power. That mythos is that the most important parts of knowledge belong to providers, and that therefore the power should rest with them. Generally in our health care, we are grossly under-informed and give way too much power to our health care providers. But no one needs a medical or midwifery degree to know 'enough' for making good decisions; and giving up all of our power is always a mistake.
Boiling it down to a couple of basic points, IMO:
1. of first importance to a safe birth is sufficiently informed and fully self-responsible self-care--ONLY a woman can grow and a birth a baby.
2. 2nd, know your midwife or doctor very well: ask the hard questions before you hire someone, don't take flimsy reassurances for an answer to important questions. Don't go on your friends' happy experiences--find out the down side because every practitioner has one. Risk is part of life, and birth; we can't eliminate it but we sure shouldn't dismiss it from our minds because we 'like' a mw or OB, or know happy former clients.
3. Insist on fully informed consent, all the way through care. Make real decisions based on evidence along with your own values, rather than taking anyone's word for it. MDC is full of stories of moms/fams who do this!
4. Insist on exercising your own intuition and being respected in that. Your care provider should be trying to elicit your intuitive knowing, and should find your hunches as important or even more so than their knowledge or intuition.
Meepycat, I'm pretty sure that a lot of midwives would agree with you--that I am not being a good advocate for midwives
Unfortunately, some mws are just as happy as any OB is, to be the Hero to families and don't want pesky questions or any interference with their decisionmaking. Luckily, advocating for midwifery is not my intent even if it wins me no friends in the professional sphere. Safety is my biggest concern.
Pulling this world out of the mess it's in, by encouraging greater self-empowerment by individuals in all realms of life, is my larger goal.
Yes, all mws and health providers SHOULD be competent; we should be able to trust them a lot--with our lives, in a real sense. And no matter how skilled a provider is, giving them all the power has turned out to do us all a lot more harm than good. Hey, great if there is someone to sue or prosecute if things go badly, right? But as for 'responsibility' goes--well, only the family will have to 'be able to respond' to events in their own lives. Giving up our power to midwives, OBs, or anyone isn't just a mistake--it's the grandest delusion of all, given that only a family will live now and forever with their choices, giving up all power turns out to be far more destructive than helpful.
Who do you want to be, if tragedy occurs at your birth? Someone grieving, who feels entirely ok about all choices made, and trust placed...or someone grieving who has someone to blame/prosecute--and who may 'win' the case but STILL has to live with possibly poor choices made and trust misplaced?