Finding Fault in "Limited Choices"

Change is difficult, no doubt about it.  When one door closes, an opportunity arises for something new...dare I say something better?  It is possible.  Sometimes when we don't understand change, it's easy to find someone to blame.  Especially when that change seemingly takes something from us. 

The Greenhouse Birth Center is closing next week...for some a devastating loss, and for others a long overdue wave of relief.  An advocacy group has formed asking for higher standards and safer midwifery practices.  The safety of out-of-hospital birth is under the microscope.  Politicians are talking.  Safer options are coming to town.  Babies have died, babies have thrived, and everything in between.  Media is concerned, as is the State regulatory body.  Resources with accurate information are being developed.  There is no more hiding from the public, the lurking shadows of midwives practicing in unsafe ways.  Women want choice, but they also want those choices to be as safe as they can possibly be.  So what is a community to do? 

There are several things to consider.  First, we should think about why changes are happening in the first place.  Changes are happening because babies are dying that don't have to, plain and simple.  Changes are happening because the foundation of midwifery is cracked, and patched with unethical practices.  It's a bit like erosion, with midwifery as the cliff at seaside that stands tall and proud.  After years of the wind and waves eating away at the surface, slowly cracks penetrate.  Chunks of rock go crashing into the sea.  The mountain from which the cliff emerged, still stands, as do those midwives practicing responsibly.  There is no doubt that the structure is continuously wounded.  The erosion in this analogy refers to is ego, the inability to define risk, and further the inability to admit responsibility.  In many cases, the cracks spread far and wide because of incompetence and fear.   When midwives lie and deceive to skirt accountability, enormous boulders crash into the tumultuous waters below.  A profession cannot stand tall upon these principles and practices.  It simply cannot.  Midwifery, specifically those working in the out of hospital setting, must find a better way to serve women and babies.  It must hold itself to higher standards of education, understanding, perspective, practice, and ethics if women are to rely on it. 

Another question we must wrestle with is considering where fault lies?  Can one person, one family really cause such an uproar?  Some like to think so.  Some like to say it's our fault that changes are on the horizon.  Blame can only be attributed to one family speaking out if  you believe the notion that they are deluded cult leaders who hate midwives and want revenge.  That they are so overcome by grief that they want to take away the rights of others.   Some reason, "They must not see the other side, they must not see that they're taking away our choices."    

Folks, we have seen the darkest side.  A side we wouldn't wish upon anyone, and that is why we speak.  

I have yet to meet a loss or injury family who makes up a story for sympathy.  I've also yet to meet a grieving family who steps into the media to be scrutinized, attacked, and shunned just for the fun of it.  I have yet to meet a loss family who is at fault for taking away the choices of others because they told the truth. 

I have met many families though, who care about people, who care about right & wrong, and who don't want to see what happened to them, happen to others.  I have met many who feel used, manipulated, and duped...whose "choices" were taken advantage of.  Families who share their stories are not persecuting midwives, we are telling a truth that could just have easily have happened to any family.  In making the decision to share our stories publicly, fault is immediately bestowed upon us. It's another burden, along with grief, that we must bear. 

If someone must bear this burden of fault for instigating change, I accept it proudly.  If it is my fault for telling the community what happened to our family, for asking for higher standards, for advocating for safer practices, for suggesting things could be done better, then I accept.  If holding negligently practicing, individual midwives accountable for their actions, means that other mothers in this community have less of a chance of being served by them, and more accurate information about the reality of what is happening in their care, I accept that blame too.  If pointing out to the community, misleading associations between our own state and community, and loss of freedom makes me somehow to blame for misplaced anger, then I accept that.  Only so many babies in our state could be injured or die before someone started to talk about it.  For too long, we thought we were the only family.  Alarmingly, we learned we are not.   If someone or some group of people is to blame, consider the midwives who are practicing dangerously, those responsible for preventable deaths.  

I do understand loss, and I can see that with Greenhouse closing, some are mourning a loss in something they believed in.  What I hope this community one day understands, is that I want something better for all of you than what my family had, and I know it can be done without taking away choices.  It may seem that our choices are limited in the immediate moment, but by raising standards for education and practice, the end result will mean better care, better options, and establishment of accountability in a profession where there is none.  

Change is difficult.  It is especially difficult when it involves people you have trusted intimately, people you think are friends, people who have loved your family and delivered your babies without issue.  The fact is, no matter how great your care was, it wasn't that way for all of us.  It took the most traumatic event of my life to see past the illusion of trust and friendship I had leaned upon for so long.  Something had to change before more lives were lost, and there is more work to be done.  

Instead of misplacing blame because something so many of us thought was real, turned out to be an illusion, we should be asking ourselves: What do these changes mean, and how can we move forward in a way that will simultaneously improve the profession of midwifery for the safety of those who choose it?  Saying women are smart enough to choose isn't enough.  Ignoring the reality of unnecessary deaths and injuries is unacceptable.   Pretending these families are the villains, and midwives are somehow victims is distorted beyond my comprehension.  A shift in focus needs to occur, and it should be about working toward something better for all of us.  Time to talk about solutions.