I am the mother of a 4-year-old, a 2-and-a-half-year-old, and a 7-month-old. The two youngest were born at home, into the hands of midwives. I was lucky. I won the lottery. In fact, I won it twice—in two different cities and two different worlds. I am white and middle class and had the privilege of living in an urban center with access to midwifery care.
The first time was in Edmonton, where midwives have hospital privileges and the medical community is familiar enough with them to be quite accepting. The second time was in Lethbridge, where an unabashedly patriarchal medical community presents many obstacles to the only midwives that serve in the area. I was one of the lucky moms to be accepted into midwifery care, which is limited resource here in Alberta, due largely to the current funding model.
A large part of the problem in Lethbridge is ignorance of what midwives do, how they are trained, how they are funded, and so on. This ignorance is not limited to Lethbridge, unfortunately, despite the fact that midwives have been practicing since the dawn of time and have been regulated and/or funded across most of Canada and numerous other countries. However, midwives are still a fairly new concept to Lethbridge, as they only set up practice here a few years ago. The medical community has some learning to do.
In both cities, I birthed at home, surrounded by women and my husband. I was supported, listened to, informed, and given the option to say no to things I did not feel comfortable with or that I felt were unnecessary. I felt amazingly lucky—almost guilty—for having access to the amazing care that approximately 1,900 women in Alberta are currently waiting for as demand consistently surpassed the funding and therefore the supply.
In Edmonton, my midwifery clinic was a ten minute bus ride from my house, right by my husband’s work, and my husband’s boss allowed him to come meet me for many of my prenatal appointments. In Lethbridge, my husband had to take afternoons off to drive our family to our midwives an hour away for all of our appointments. While all of those afternoon drives were inconvenient, they were worth every minute and meant that we were able to have a homebirth for the second time.
I could go on and on and on about how amazing my experiences with midwifery care and home birth were, but the most important thing is that I had choices. I chose to birth at home. Some women birth best in a hospital because that is where they feel safe, but I birth best at home, near my other children, surrounded by women who have gotten to know me. I chose what positions to labor and birth in—contrary to television and movies, lying on your back is not the best, safest or most effective way to give birth. I was asked for my consent numerous times before my midwives touched me.
Women all over the world are not given the same choices that I was given. They are laughed at, treated like children, disrespected, pushed around, strapped down and confined by unnecessary IVs and monitors. They have their perineums cut by impatient medical professionals, and they birth in uncomfortable positions that make their babies fight gravity just because medical professionals would rather not get into awkward positions to catch babies. Their words and plans are disregarded, their birth plans unceremoniously thrown away, and their feelings discounted. Their bodies, hearts, and spirits are broken, and then a child is placed into their arms—maybe immediately, as is ideal, or maybe not for hours or days if there is a medical emergency of some sort—and expected to bypass all trauma and be a mother. Women in indigenous communities especially have had their rights in childbirth taken away by the twisted efforts of imperialist white men and women who tried to “save” them by taking away their midwives and their birthing culture.
So, when you fight for women, remember to fight for the birthing ones. They need your voice.
To help dispel some of this ignorance and bring some light to this lesser known maternity care option, here are some facts:
1. Midwives are highly trained medical professionals who specialize in normal, low-risk childbirth. They provide care up until 6 weeks postpartum, and can requisition all of the same tests that a doctor or obstetrician can. They bring a lot of equipment to births and are certified in infant resuscitation. They can handle most emergencies and are trained to catch any signs of a problem before it ever becomes an emergency.
2. Midwives are not a ‘luxury’ item that greedy women are demanding. Actually, midwives are cost effective and a great way to ease the workload of overworked doctors and obstetricians. The Alberta government pays for prenatal and postnatal care regardless of provider, but the pool of money that doctors and obstetricians get paid from is separate from the pool of money that midwives get paid from. This has caused many to believe that the people who have been demanding ‘better’ midwifery funding are in fact asking for ‘more’ money. No—someone gets paid to catch that baby. A midwife happens to do this at a lesser cost to the medical system, especially if the birth is a home birth and does not require a hospital bed, hospital staff, hospital equipment and costly medical interventions. This is not an ‘extra’ service, which is why Alberta families and care providers have been asking the government to change the funding model so that the money follows the women/baby instead of the provider, so that no matter who a women wants to see for her maternity care it is funded.
3. Midwives are the only licensed maternity care providers in Canada who attend out of hospital births, which includes births in birthing centers, homes, or even hotels. Choice of location in birth is a big part of a pregnant and birthing woman’s overall wellbeing especially if that woman has previously had a traumatic experience in a hospital or does not feel safe in that setting.
4. Since midwifery is regulated in Alberta, women do not have the option of paying out of pocket for a midwife, though recent developments with funding and contracts may mean that some midwives would be able to start accepting private clients and taking out of pocket payments. This, however, has the potential of creating an even larger barrier between midwives and the women who benefit most from midwifery care (i.e., low income, at risk women and girls).