The French Male Midwife

By Barbara Thomas
Issue 143 - July/August 2007

There are planned homebirths and, occasionally, unplanned homebirths. Mine was somewhere in between. My daughter, Ingrid, was born at home in Lyon, France, in the company of two men: my French husband and our French midwife. I'd originally intended to give birth in a clinic with the same midwife, but somewhere along the way, I changed my mind.

Already six months pregnant when I arrived in Lyon from Paris, I found my way to Cyrille Philippe, an independent midwife. Cyrille offered what's called "global accompaniment"—a highly personalized and holistic approach to pregnancy and childbirth in which a woman has the same caregiver before, during, and after the birth. The alliance can begin as early as with a couple's first questions about fertility and conception, and last through the first several months of a child's life.

I imagined a male midwife as a middle-aged hippie with a greasy ponytail, but Cyrille turned out to be a clean-cut man of about 35, who carried a Palm Pilot and rode a motorcycle. His gender, while unexpected, didn't bother me. I just hoped he'd take me on. When I arrived for our first meeting, his brightly painted office was buzzing with pregnant women and breastfeeding mothers. Beyond the waiting area were a changing table and a small kitchen with an assortment of tea and cookies. It was more like a home than a hospital.

"This is the way I see it," he told me. "Giving birth is like climbing Mt. Everest, and I'm your mountain guide. I'm here to help you get to the top." There are different ways of getting there, he explained. You can walk on your own two feet; or you can get someone to carry you (an epidural, an episiotomy).

And if things get really tough, there's a helicopter that will take you all the way up (a cesarean or forceps). In any case, you enjoy a beautiful view at the top.

How could I pass up such an opportunity? I'd never had my heart set on a homebirth, which sounded messy and inconvenient, so I opted for a small private clinic in the suburbs. (Surprisingly, France has no freestanding birth centers.) In choosing a midwife who practiced with full autonomy in a hospital environment, I figured I'd have the best of both worlds.

During Cyrille's birth-preparation classes, we went over such topics as rudimentary anatomy, the first hours of a baby's life (he suggested wrapping the baby in a piece of silk), breastfeeding, and the role of the father. In addition to Mt. Everest, my midwife offered more similes: Giving birth was like running a marathon, where you pace yourself before the final sprint; or like a game of cards, in which the mother, baby, and midwife are each dealt a hand; or like swimming at sea, alternately treading water and battling ocean waves. At times, these meetings were like acting classes in which we slowly shed our inhibitions.

Cyrille dropped by our apartment toward the end of the third trimester to make sure we had adequate sleeping, bathing, and changing arrangements. As amusing as the birth classes were, I felt seriously unprepared, intellectually, about how I was going to get the baby out. The two-hour home visit—during which Cyrille was part midwife, part psychologist, and part interior designer—was a big turning point for me.

I admitted to him that I was afraid—afraid of the pain in general, and of tearing in particular. At the same time, I was wary of any medical intervention. For some reason, it reassured me to hear that Cyrille could himself perform an episiotomy, if necessary, and that if I did tear, he could stitch me up afterward. Even I, a believer in the midwifery model of care, found it hard to appreciate the full extent of a midwife's training until it had been spelled out for me.

Just when all that had sunk in, Cyrille said, "You know, Barbara, what you've done so far and what you're going to do is beyond me. It blows me away. I know the mechanics of it, I've seen it a thousand times, but I'll never know what it is, really."

I beamed with pride. Instead of intimidating me with his medical authority, Cyrille was defending my natural capacity as a woman—which, in fact, had been at work all along. I began to understand childbirth not as an isolated event but as part of a continuum. Pregnancy prepares you to give birth, which in turn can prepare you for later challenges. There just may be some significance in allowing the natural birth process to unfold. I realized that I couldn't control the timing or intensity of my labor, and that no matter how many books I read, my body would always be more prepared than my mind. At last I felt ready to take this leap of faith.