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#31 of 52 Old 12-06-2006, 10:30 PM
 
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well I was not intending to be offensive I was attempting to say how I understand or view her perspective-- that she and the women around her basically did UC- birthed together or alone without any training or even the benefit of what we take for granted as information now- and that at some point they decided to seek out some help, get more information- this was before there was the internet to go to. So my guess is that if she thinks of women who UC as being like her and her friends/family when they started the farm- this is how she comes down on the side against it-- more having to do with re-tracing the life path she has already been down... Now that is not exactly what we are doing and our experiences are very different from hers just by the very nature of information available to us today.
in some ways it is like trying to talk to my grandparents about vaccines we might agree on some things but there are just things that they are not going to get and I am not going to completely understand about them either- we share similar values but our experiences are in passing-

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Ina May on UC?
After reading Laura Shanley's book, I'd like to read Ina May Gaskin's comments on UC for myself. Does anyone have a link to something along those lines? Or can you tell me more about it, if you've read it yourself. Thanks!--
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#32 of 52 Old 12-06-2006, 11:16 PM
 
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So once they had a real choice, it was to combine obstetrics with a personal approach, in a non-clinical setting. This was of course a huge improvement over hospital birth at the time, at least spiritually speaking. They had a mortality rate comparable to the hospital's -- out of 1000 births, there were seven stillbirths and eight more neonatal deaths, some of which occured after transfer to the hospital. (It breaks it down further in the book.)
What book is this? I would be interested in reading it...
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#33 of 52 Old 12-06-2006, 11:47 PM
 
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Spiritual Midwifery

I have retired from administration work, so if you have a question about anything MDC-related, please contact Cynthia Mosher. Thanks!
 
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#34 of 52 Old 12-07-2006, 04:05 PM
 
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But how would a midwife handle those situations outside of a hospital setting? Wouldn't catastrophic rupture (is that the same thing as uterine rupture?) and placental abruption both be handled via c/s in a hospital setting? Shoulder dystocia is the only complication I'm aware of where a midwife's skilled hands can make a difference at home.
A severe hemorrhage requiring medication also comes to mind. I think there are probably also situations where a skilled midwife may be able to detect a problem through experience with lots of normal and abnormal labors, through observation, checking heartrates, etc., leading to timely transfer even if she can't solve the problem at home (and conversely, may be able to tell that something iffy is not a problem needing transfer).
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#35 of 52 Old 12-07-2006, 04:17 PM
 
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tie-dyed:
i don't know really what judgement your tossing onto me. I have no qualms with a woman choosing an OB, a midwife, or her grandmother's best friend if that's what she wants. And, i never said that there was only one way to consider or think about birth. Just because i see it as a sex act (in part) doesn't mean that i think everyone does or should.
Wow. Can I point you to your own sig line? I was taking exception to the idea that midwives in general suppress UC because it would cost them clientele.

I think you got that point, because:

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Finally, to my quote, the construct that i was asserting was in reflection of Ina May's assertion, as quoted by FLB, that only 10-15% need, that is require, medical attention of some sort (midwife or OB attention). This means that 85-90% of the population *can* have safe UCs because they don't require attention. It doesn't mean that i think that they *should* or they're wrong for choosing otherwise.
You agree with it.

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truth be told, if 100% of the women believed that they didn't need medical attention and could do it on their own, then fewer would be choosing hospitals and midwives as the "safest" way to birth. Instead, they would be choosing it for other reasons (such as those you mentioned for wanting a midwife) or for actual medical need (that 10-15%). It would be a free choice. And there would be less demand for midwives and OBs. Thus, fewer jobs.
Yep. Except that OB's, not midwives would be the first to go. Their attrition rate is already pretty high bc of insurance premiums. Now they handle a vast majority of births, but if women were aware of the safety of birth many would choose UC and many would choose CPMs/DEMs. Midwives' clientele would likely rise.

In any case, all of this involves social changes that would take many years, likely several generations to change.

The only thing I took exception to was the assertion that midwives are working to prevent UC for economic motivations above all else. And I stand my that assertion.

I'm not sure why you think I'm judging you or me or um, anyone.
But thanks for the whole condescending about "judging myself." That wasn't *at all* unnecessarily rude or unfairly judging : /sarcasm
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#36 of 52 Old 12-07-2006, 04:26 PM
 
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One problem is in the terminology. People who call birth sexual are usually (but not always) defining that in a very much more basic way (i.e. pleasure, primality, and a host of hormone-driven physiological events such as blood flowing to the vagina) than people who don't, who associate it with things that are felt to be taboo in most contexts, including birth.
This is an interesting comment. See, I don't necessarily consider extreme pleasure, primality, and physiologic responses to events to be necessarily sexual. I consider them ecstatic, sometimes mystical. If a full-body state of pleasure and primality is a sex act, then I've had sex in church. And synogogue. And lots of places where I was alone and not engaged in sexual thought or act.

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It's a shame that we don't have an analogous word for "sexual arousal" that applies to the birth act, because language affects perception so strongly. If you can't name it, it's hard for it to exist in the head.
How about ecstasy? Actual I've learned a bit about this word recently in a scriptural context (tried to start a thread on it in religious studies but it died a quick death). Religious ecstasy, birth ecstasty, prophetic ecstast, sexual ecstasy: the state of otherness, of connection with that which is greater than the ordinary self is present in them all, only the context changes.
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#37 of 52 Old 12-07-2006, 05:20 PM
 
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This is an interesting comment. See, I don't necessarily consider extreme pleasure, primality, and physiologic responses to events to be necessarily sexual. I consider them ecstatic, sometimes mystical.
Ecstatic is a good word. It's something that needs to be explored more. This is new territory (well, at least as far as having been suppressed for so long,) and I think people are really just trying to latch on to something that helps them explain what it is about birth that makes it more than just a mechanical or just a spiritual act. For most people, maybe, who don't have ecstatic experience in church (or whatever non-sexual ecstatic experience,) sex is the closest they are able to come to explaining what is like to not be able to enter this thing fully because of inhibition or a sense of being watched, and it feels especially applicable because (unlike with the ecstasy one might feel in church) this pleasure and primality involves the genitals and sexual hormones and is connected to the act of conception.
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#38 of 52 Old 12-07-2006, 05:21 PM
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tye dyed:

most of the statements in your initial post had nothing to do with your "assertion" that you stand by--I was taking exception to the idea that midwives in general suppress UC because it would cost them clientele--but instead are a series of bizarre statements about birth not being a sex act for you and about wanting a midwife because you see birth as a female act. and, your thoughts that midwives are safe. I have no idea what these had to do with the construct of your assertion. I still have no idea, unless you're implying that i'm judging women (midwives or those who would utilize them) for their choice.

and if you are implying that, it would mean that you "feel judged" and then i asserted a simple "if-then" statement which syntaticly implies that you can dismiss the satement, instead of it being "condescending or judgemental" toward you to assert that it may be the case.

second, i never asserted that midwives are working to prevent UC for economic motivations above all else. rather, i was reflecting that this midwife, and those who agree with her, likely are so vehemently against UC in part for economic reasons. I do not think that it is the primary reason, or even the secondary. I also know that it's not the case of all midwives, as i know many who do support UC.

So, i'm not sure how from my quick statement, you gathered that i was stating that midwives are working to prevent UC for economic motivations above all else.
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#39 of 52 Old 12-07-2006, 05:24 PM
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also, isn't it possible for a woman to see birth as a 'female act' and a 'sexual act' and a 'spiritual act' and a 'family act' and a 'primal act' and a myriad of other types and kinds of 'acts' all at once?
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#40 of 52 Old 12-07-2006, 05:38 PM
 
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For those of you without access to the article, here's some excerpts from it. She starts off: "In this article, I will discuss the meaning behind the choice to be one's own midwife." She gives a short history of modern unassisted birth (as she sees it) then launches straight into a story about a birth that she believes would have ended badly if not for her involvement.

The mother desired a UC, but had gone to 42 weeks without going into labor. Her mother "was well aware of the possible risks involved to the baby" and pressured her to go to the hospital, which the daughter refused, but she was able to at least talk her into having Ina May do an induction, who was aware of the situation and relieved to have the woman now in her care.

During the painful exam she told Ina May "she wasn't sure why she had been so opposed to the idea of having a vaginal exam throughout her pregnancy." Implication being (in context, otherwise I don't know why she would have included the comment): why, how silly of her to not have wanted a vaginal exam, and even she realizes it now. At this point I'm putting myself into this woman's situation and thinking: If I was tired and beaten down by lack of support and fear and had Ina May's hand up my vagina and she asked me, "So how come you didn't want any vaginal exams done during your pregnancy?", I doubt I would have had the emotional energy or assertiveness to explain it to her. I probably would have just given her a weak smile and shrugged just to get it over with. This is the sort of thing I see over and over in the stories in Spiritual Midwifery -- assessments made about what is going on that to me seem very unperceptive and presumptive.

Anyway, on with the story. When Ina May did the cervical exam she found the mother's cervix very high and posterior, but because she was overdue, they induced (she doesn't say by what method.) "For the first six hours the baby tolerated labor well. Still, the mother's cervix opened very slowly and the baby's head remained at a very high station, considering the strength of her rushes." So you've got strong contractions pushing a baby against a cervix that isn't ready to open. Well, the mother and baby began to show signs of not tolerating the labor (or the induction, depending on how you look at it,) and they transferred to the hospital where a cesarean section was done. There was thick meconium staining and the baby was "visibly dehydrated".

Ina May writes: "I pondered this case for weeks after the baby's birth, aware that his grandmother's intervention had almost surely saved his life. [...] The mother's threat to carry her daughter to the hospital, despite her repeated wishes to be left alone, seemed to be the factor that broke through the daughter's reluctance to having skilled care during labor and birth. It also caused this young mother to question her feeling that she alone was the final and best authority on what as transpiring with her body and her baby at this particular time." (Which Ina May clearly feels was a good thing. I find that last bit really egocentric and dismissive of the mind-body connection. Assuming the baby needed to be born that way, who's to say that the mother didn't feel something wasn't right, and that it was why she finally consented to professional involvement?)

So, what can we learn from this? I guess, that babies can die if they go to 42 weeks gestation, so it's best to induce then, and if you're UCing you won't have somebody to tell you that and do it for you. Therefore, UC is inadvisable.

Immediately after this story, Ina May launches into the attacks on Laura Shanley, some of which I mentioned in my letter. Then (and ironically, given the possible questions about the validity of her interventive approach to assisting birth) she writes "What bothers me most about the avid promotion of unassisted childbirth is that these advocates generally neglect to concede that following their advice could possibly bring harm to anyone. Each one writes that her experience with unassisted childbirth was completely positive and asks her readers to believe that their experiences will be equally wonderful." Doesn't that sound a lot like something a doctor would say about homebirth midwifery advocates?

She goes on to mention the Motherhood Remembrance Quilt (www.rememberthemothers.org) she assembled blocks for. "Two of the blocks represent women who died during an unassisted labor and birth. One was a first-time mother who died from postpartum hemmorhage at the age of 19 in a college dormitory and the other, a woman who had given birth nine times previously, had succumbed to eclampsia and a ruptured liver during her unassisted tenth labor." So one was quite possibly uneducated, poor, without support, and/or trying to hide the pregnancy, and the other was gravely ill. And this is relevant to what most of us are doing and how we approach birth, how?

Next, evidence from the early days of The Farm. "Anyone who reads Spiritual Midwifery attentively will also notice that the second and fourth babies whose births I attended could easily have died if their mothers had had unassisted births." The first baby she's speaking of was born five weeks early weighing five pounds. She "gave a small cry and then turned blue." They didn't know what to do but pray. Then Stephen (their sort-of spiritual leader or guru) walked in, picked up the baby, and simply breathed into her and she turned pink. The mother or her own husband couldn't have done that simple thing, of course. The other baby doesn't seem to be identified by number, but I assume she's talking about the one who was born two and a half months premature at under three pounds, and was taken to the hospital to be kept warm in an incubator and tube-fed (amazingly, she was breathing on her own and "her heartbeat was good and strong".)

Ugggggh, OT but looking through some of these stories again, some of the stuff that went on and some of the attitudes, it's just crazy to me that they are upheld as such an amazing beautiful thing, such an ideal to strive for. I half wonder if the mothers were so blissed out not because they were treated so appropriately but because they were stoned. The stories are beautiful in the sense that they aren't clinical and cold like the typical birth story of the time (and well, today for that matter.) But you still have things like, "Diane's labor was fairly smooth, even though the midwives had to encourage her to be good to her husband. She was dilating easily. When the baby's head moved through her cervix, though, it was a different story. Diane started screaming. I told her to shut up and keep herself together, but the baby was moving so fast that she wasn't going to listen." Nice.

Anyway, back to Ina May's article. The last story she tells is of another midwife who "was called to assist a first-time mother who intended to have an unassisted birth but became worried when 20 hours had not yet produced the baby. The midwife arrived to find the mother feverish, with long-ruptured membranes and the baby showing signs of infection. A quick trip to the hospital and an emergency cesarean section saved this baby's life and possibly the mother's fertility."

She sums up with the "10-15%" figure, and "Women need to be aware that these are real complications with real causes for concern." Because, you know, most women don't know this. Especially, I guess, the type of woman who would plan a UC.

So there you go. I hope my inserted comments aren't too distracting.
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#41 of 52 Old 12-07-2006, 05:41 PM
 
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Wow. Can I point you *again* to your own sig line?

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your "assertion" that you stand by...a series of bizarre statements...unless you're implying that i'm judging women (midwives or those who would utilize them) for their choice.
But thanks for referring to my concept of birth as "a series of bizarre statements."
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#42 of 52 Old 12-07-2006, 05:55 PM
 
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also, isn't it possible for a woman to see birth as a 'female act' and a 'sexual act' and a 'spiritual act' and a 'family act' and a 'primal act' and a myriad of other types and kinds of 'acts' all at once?
Absolutely. I think it depends what you mean by each of these descriptors. For example, if birth is sexual because it is part of the procreational nature of sex, doesn't that rather leave homosexual sex out in the cold?

I certainly regard sex and a spiritual act and a sexual act. It's primal as well.

I just think that to use the whole "birth is a sexual act" argument to explain UC is oversimplistic. For example, if/when I UC, I will not want my DH present. Depending on various circumstances (mostly the position of the baby) I might want a female friend present. Most likely I'd be alone. Does this make birth akin to masturbation?

Now, I have no problem with sharing a sexual experience with another woman (and indeed, at my daughter's birth, I did), but it was sexual it its involvement of hormones and genitals, not as an expression of sexual love, which is to me the first thing I thing of when I think of a sex act. Sex with another woman, as with a man, is the sharing of sexual love with a partner in an act of creating unity. Birth, in a way, creates a disunity as the baby seperates from the mother for the first time. Sharing a birth experience is certainly sexual but I have a hard time seeing it as a sex act in that same unifying way.
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#43 of 52 Old 12-07-2006, 05:56 PM
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no, it wasn't your concept of birth that is a 'series of bizarre statements' but that the statements didn't fit the point--and that was bizarre.

also, don't assume that i'm not at peace when i respond to your posts.
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#44 of 52 Old 12-07-2006, 06:02 PM
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i just think that to use the whole "birth is a sexual act" argument to explain UC is oversimplistic.

i just don't understand when this ever came into this conversation. we were not explaining our reasons for UCing in this post stream, but instead discussing Ina May's perspective of UC via FLB's letter in response to statements that she made in a magazine.

thus, i don't understand what it's relevance to the post stream is, why this is relevant to the assertion that "midwives aren't anti-UC because they are concerned about loosing clientele," and why you've assigned this argument to me.

for me, birth is a sex act in part and my preference is to not have sex with people other than my husband. but, birth is also many other things, and i have no qualms with utilizing a midwife if i think it would be beneficial or necessary for me--and i feel likewise about OB care.

what i don't get is how all of these things are relevant to the discussion.
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#45 of 52 Old 12-07-2006, 06:33 PM
 
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Originally Posted by tie-dyed View Post
For example, if birth is sexual because it is part of the procreational nature of sex, doesn't that rather leave homosexual sex out in the cold?
I may be misunderstanding you, but I'm not seeing how that follows. Birth can be sexual, and I can still enjoy sex for its own sake.

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I just think that to use the whole "birth is a sexual act" argument to explain UC is oversimplistic. For example, if/when I UC, I will not want my DH present. Depending on various circumstances (mostly the position of the baby) I might want a female friend present. Most likely I'd be alone. Does this make birth akin to masturbation?
Maybe it's your notion of what constitutes a sexual act that's oversimplistic. When I say that I am a sexual being that doesn't translate exactly to: I have sex with my husband and I masturbate. It doesn't even translate to: and I also flirt and wear revealing clothing, or whatever it is the person does that culture associates with sex/sexuality. It's something much more elemental than that.

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Birth, in a way, creates a disunity as the baby seperates from the mother for the first time.
My experience, having had an undisturbed birth, was that the physical severing of the umbilical cord was incidental. My baby and I were still connected in every other sense; there was no disunity whatsoever. In our motherbaby unit (which I see as having been normal, if not the norm) the baby did not initiate separation until some time well after the fourth trimester, and even then it was in very gradual stages.
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#46 of 52 Old 12-07-2006, 06:36 PM
 
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no, it wasn't your concept of birth that is a 'series of bizarre statements' but that the statements didn't fit the point--and that was bizarre.
See, when you say "bizarre statements" the word "bizarre" modifies the word "statement." How again does "bizarre statements" not denigrate the statements?

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also, don't assume that i'm not at peace when i respond to your posts.
I guess I figured that "peace, peace and only peace" likely referred to the general fostering of peace. I guess I was wrong. It's pretty clear you're more interested in being right that in discussing UC at this point, so I'm gonna bow out of this discussion.
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#47 of 52 Old 12-07-2006, 09:08 PM
 
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Great discussion! Yes, Jesse, Ina May is the midwife I was referring to in my article. I called her when I was writing my book. The word that best describes her attitude towards me at the time is "cold" and I don't think things would be any different if I spoke with her now. Back then she was one of my idols and I remember gushing to her about how much I luvvvved her book! Needless to say, when I finished my book I didn't ask her for an endorsement.

Her article in Midwifery Today was in direct response to an article I had written for MT ("Why Some Women Don't Want Midwives at Their Births" - I can't post a link but you can probably google it). Of course I found her article disturbing, but I wasn't surprised.

By the way, MT asked me to write that article. I didn't approach them, they approached me. And I had a word count I had to adhere to. I literally didn't have the space to address all of Ina May's concerns (even if I had wanted to). It actually wasn't even supposed to be a UC article, per se. It was supposed to be an article about why some women wouldn't want a midwife. And so I thought her criticism was unfair.
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#48 of 52 Old 12-07-2006, 11:18 PM
 
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I don't think that midwives would be out of a job. I think there are still women who are not "there" in their journey yet and need to have support for their choices in order to get "there". That's, in my eyes, what midwives are for.

There are quite a few clients that I've had that have either went off on their own after letting me go to have UC births or have birthed UC after a homebirth with me in attendance. I'm not worried about losing my work, believe me. I've always said that if 90% of the world was birthing unhindered, gentle, unattended then I'd be happy working at our local health food store. It's not about DOING midwifery - it's about changing the transition of birth for women, babies and families. If more people chose to freebirth then that would mean a much happier, loving, gentle planet, wouldn't it? Who wouldn't want that??

It's interesting because when I interview with prospective clients, I bet I lose about 40% because of my hands-off approach (even some midwives in my area say they're "more hands-on than Pamela" because they believe that it's better). Some women are not even ready for THAT. But, it's ok because I know I've planted a seed - and given them something to think about. When they're ready, they'll have someplace to start.
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#49 of 52 Old 12-08-2006, 01:42 PM
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is 'there' the place or idea that a woman would hold that birth is natural, wholesome and inherently safe?

anyway, here's how i think about these "numbers"--

if midwives state "every woman needs a midwife" then 100% of pregnant women get midwives, which means midwives get clients and will continue to get clients as long as clients believe that midwives are absolutely needed. "yes, birth is safe, if you have a midwife."

if midwives state "not everyone woman needs a midwife, but we are highly trained and available for those who do want or need one." then women will get the idea that they don't need midwives. the idea would be "women can birth safely on their own, but we're here if they need/want us." this might encourage them to UC--and say this encouragement means that only 50% of women use midwives.

midwives loose clients. maybe not in the present, but eventually, midwives loose clients.

this is not anti-midwife in any way. it's just the bear bones. if people could, for example, become educated with out going to school, does that not decrease the number of students in schools, and therefore decrease the need for teachers?

one of the reasons that my friend, who is a teacher, is so against homeschooling is "if everyone homeschooled their kids, or even half of the people homeschooled their kids, then i would likely be out of a job!" She's right, afterall. now, this isn't her whole reasoning--but it is part of that reasoning.

this isn't to say that being a teacher, being a midwife, or whatever is 'bad'--i think that school is a good idea in part because not everyone can or wants to homeschool. similarly, not everyone wants to or can UC, and thus midwifery and OB care are important.

but if more than half of the population of women decided that they prefered UC, then yes, ultimately midwives would loose clients. And if, after many generations, the precentages were 'only 10-15% of women who are pregnant utilize midwives" then that means that there are fewer clients to go around. The industry shrinks. Midwives loose clients.

So, in my opinion, it is one of the reasons why midwives, like OBs, hospitals, etc assert the "need" for their services in drastic ways (fueling fear of injury or death). they want to create job security. that's an aspect of it.

is midwifery a luxury? sadly, it is right now. i find that very upsetting. i wish that more insurance companies and that public assistance would support midwifery care. i find it very valuable for women and definately much better than a medical-model of birth. For any woman who doesn't want to UC or doesn't feel that she can, i fully support whatever decision that she makes--but i also wish that midwifery care were an option for her via her insurance or other form of coverage, and not an expense that might force her to choose something other than what she truly wants.
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#50 of 52 Old 12-09-2006, 02:29 AM
 
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Originally Posted by pamamidwife View Post
I don't think that midwives would be out of a job. I think there are still women who are not "there" in their journey yet and need to have support for their choices in order to get "there". That's, in my eyes, what midwives are for.

There are quite a few clients that I've had that have either went off on their own after letting me go to have UC births or have birthed UC after a homebirth with me in attendance. I'm not worried about losing my work, believe me. I've always said that if 90% of the world was birthing unhindered, gentle, unattended then I'd be happy working at our local health food store. It's not about DOING midwifery - it's about changing the transition of birth for women, babies and families. If more people chose to freebirth then that would mean a much happier, loving, gentle planet, wouldn't it? Who wouldn't want that??
This is EXACTLY the attitude I thoroughly love to see in midwives. And if more midwives thought this way (and if their actions followed this philosophy), then I would be a little more likely to acquiesce to my partner's wishes that I have a midwife attend my birth. But as it stands, most midwives don't feel this way or if they do, they're not allowed to act in complete compliance with their personal philosophies due to licensing strictures. Because of this, I am really uninterested in having a midwife present at my birth, especially here in Ontario where midwives tend to be highly medicalized.

Were I ever to be a midwife, this is the sort of midwife I would strive to be: someone who helps women get to a place where they feel comfortable in their autonomy. I'm so glad for midwives like you. Thank you for existing and doing the work you do!

With respect to Ina May, I used her books as a much-needed stepping stone. They were the first books I read on the topic of homebirth. Since then, I've done a tonne more research and soul-searching. I've looked back on her books and can't help but feel a bit repulsed at her actions and attitudes throughout all the birth stories. She's got great information, all of which has reaffirmed my choice to UC. Gotta love the irony...
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#51 of 52 Old 12-10-2006, 08:57 PM
 
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My midwife/dear friend is in her late 50's. She has been around quite a while and delivered almost 700 babes.

The only way that she has become more 'medicalized' (for lack of a better word) is in meeting state licensing requirements. The requirements for midwives have gotten quite ridiculous, even to the point of causing her to want to retire early several times because they tend to make mws more invasive than she wants to be.

Maybe there are outside, governmental forces at work over a period of years?
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#52 of 52 Old 12-11-2006, 12:21 AM
 
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Hi, everyone! I have to ask that everyone please keep the conversation to the original topic. Any topics that have come up during the discussion would best be spun-off into their own threads. Thanks

Any personal criticisms directed to specific individuals participating on this thread need to be taken to PM at this point or they will be removed in an effort to keep this thread on-topic and on the board.

Please feel free to PM me with any questions, concerns or comments

I have retired from administration work, so if you have a question about anything MDC-related, please contact Cynthia Mosher. Thanks!
 
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