Circling Back to Midwifery

I vividly remember the day I fell in love with midwifery. Of course, it was the day that my baby was born. In addition to the awesome experience of giving birth, I got a front row seat to midwives in action that day. I can still feel the quiet energy of the student midwife in apprentice-mode, watching and learning with so much love and awe and respect it felt like a heat-lamp on a cold day. I felt that kind of awe and respect for my midwives after the birth, when they were huddled together, reverently discussing each stitch of the repair they were making where I tore. Their care for me and my family is forever etched in my memory.

I don’t think that story threatens women, even though it doesn’t contain a gendered pronoun or the word “woman.” If you don’t know me and read that paragraph, you probably pictured a woman, and probably not a woman who is sometimes called “he.” That’s why I tell my story, so that we have more stories, not less.  The beautiful thing is that our stories can co-exist.

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The Midwives Alliance of North America (MANA) recently hosted a gathering for queer and transgender birth workers as a pre-conference offering at their convening in Long Beach, CA. I co-facilitated this event. And while we gathered to talk about midwifery, the struggles of clients and families, and how midwives can maintain their stamina while supporting women and birthing people, people on social media questioned the legitimacy of our presence. They questioned the premise of the gathering, and whether it should be happening at all.

Then they began to question MANA’s decision to include gender inclusive language in their core competencies and conference materials. They questioned MANA’s commitment to women, their leadership and decision-making processes, and they questioned the conference before it even began. As the conference ensued, questions festered and swirled about race and power, history and respect, voice and violation. Questions were raised about my involvement with MANA, and many derogatory insinuations were made.

While it was not my idea to bring gender-inclusivity to MANA, the women who thought of it rightly wanted to consult with a transgender or genderqueer person, so here I am. I’m not spearheading MANA’s gender-inclusivity work, but something separates me from others who are: my gender expression. This is no coincidence. I am a target because we are not equally vulnerable to suspicion. It is always easier to demonize the “other”. It is always easier to assume the worst about someone when they are different from you.

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I envision a time when a diverse body of midwives can work together strategically and in collaboration with supporters to make it easier to become a midwife, remain a midwife, and access a midwife. I envision a future where there are simply more midwives-- of all kinds and for all communities.

I have made it my life’s work to help make this happen.

Some of the things I’ve done are very tangible, simple even. For example, certain practice restrictions in Colorado were creating barriers to remaining a “direct-entry” midwife, so I helped remove those barriers in 2011 and 2016. Midwives couldn’t suture, midwives couldn’t carry or use anti-hemorrhagic drugs, midwives couldn’t carry or use oxygen. So, I helped fix those things.

Midwives often need legal representation, but when they try to find it they can’t find a lawyer who understands the profession, which can lead to bad representation. So, I started the Birth Rights Bar Association to try and develop more knowledgeable lawyers who could provide more high-quality representation for midwives.

Some of the barriers to midwives are universally recognized, like the cost of hiring one, or the cost of becoming one. But some of the trickiest barriers to midwives and midwifery care are the ones some people think of as untouchable. Things like assuming that you can get somewhere (like through midwifery school) if you just work hard enough. Or assuming that it is easy enough to find a preceptor and train as a midwife close to home, because you easily found one who is just like you (or enough like you) in your own community.

These things aren’t historically true for midwives of color, because they have told us so over and over again. My great-grandmother wasn’t disadvantaged in the same way that white, English-speaking, community healers were, even though any woman healer was disadvantaged in the 1920s. As a Spanish-speaking Hispanic woman she had different barriers. We have to remove those kinds of barriers. To do that, we all have to consider if things we hold dear (even our own assumptions) are blocking someone’s way.

Midwives of color experience barriers in mostly-white organizations and spaces, so I try to help tackle those barriers too. Like by coaching white folks to recognize and help remove those barriers, interrupting the dynamics that play out in mostly-white spaces, and building community power with folks of color who are already leading the way.

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Where there are barriers to having and becoming a midwife, I strive to be part of the circle that helps to remove them. When there are more midwives, it’s easier to have one or be one. When midwives can practice to their full scope, it’s easier to have one or be one. When they aren’t criminalized, it’s easier to have one or be one. And removing the barriers of racism to make it easier to have a midwife of color - those benefits of that are vast, including directly improving atrocious birth disparities.

I have a bias toward action. If things start to feel sticky or stuck, I figure things out by trying things out. I don’t just think or say, I do.

It may seem odd, but sometimes this means I wait a lot. It’s a deliberate and active kind of stillness. If you’re ever done improvisational theatre (or watched it), you might know the feeling of the actors listening and waiting until the right moment to jump in. It’s like that. I’ve heard midwives say that the very art of midwifery is not doing anything at all, and then knowing exactly when to step in. Maybe it's like that, too.

I keep trying to do better in my work. I mess up, and I don’t turn away from failure or let shame take over. I just try to look at it, learn from it, adjust, and try again. Having my privilege checked is an essential part of this. To have skin-color privilege while working in and for circles of people without that privilege requires me to be aware of and responsible for that unearned power.

Whenever I am involved in this work, I try to make each circle better: create action where things are stuck, wait a lot, and learn from my mistakes. I constantly practice these things.

And I am in a body that has experienced all of this, and all the pronouns, and birth. I am a person who adores and admires midwives, and is here to support and champion your work. I see many ways forward for all of us, together. I hope that I’ll see you along the way.