Dear Midwives...

Dear Midwives,

As a mother who believes in the importance of choice, personal care, and appreciates the gift of life, please hear my requests.  We have much work to do if we are going to improve the state of maternity care in our country.  If your goal is to help women, please find a way to acknowledge the inconsistencies in philosophy and scope of practice that exist within your profession.  Recognize that too many babies are dying preventable deaths in out-of-hospital birth and do your part to change it.  Being a "midwife" should mean something in terms of educational standards, clearly defined scope of practice, consistency within and across your profession, and accountability in reporting outcomes.  How can you accept anything less from the "profession" you hold dear?   

Instead of breeding fear about the hospital, find a way to collaboratively work with the hospital for change that matters. Pregnant women are not pawns meant to advance an agenda.  We shouldn't be choosing sides.  Expectant moms are vulnerable, trusting, and want what is best for their babies.  Please give us evidence based information about the realities of birth.  Let us know that sometimes out-of-hospital birth simply isn't safe and that it is always inherently more risky  Even with low risk, normal pregnancy, emergencies happen and we're at greater risk based on proximity alone.  Be fair and balanced in telling us the risks we are taking in choosing to give birth outside a hospital, instead of only telling us how gentle birth can be.  Tell us that sometimes birth doesn't work and that, when it doesn't, we need help from obstetricians and hospitals. Assure us that we are not failures, as women or mothers, if this happens.  Tell us that some pregnancies and births fall outside your expertise and scope of practice. Tell us that, when they do, you will happily help us transfer to get the care we need.     

It is true, we are all human and we all make mistakes.  The difference is that your mistakes cost babies and mothers their lives.  Please err on the side of caution. Let down your pride and defenses and seek help when it is genuinely needed.  We need you to use good professional judgment on our behalf at all times, especially in the face of crisis.  If you have made mistakes, don't hide behind them, don't continue to practice, don't put more lives at risk, don't pretend like it it must have just been meant to be.  If you have seen others within your profession who are not adhering to safe practices, you have a professional obligation to report them. 

If you believe in serving women in a way that benefits them and honors their well being, please listen to my plea for better care within the model of midwifery.  We need midwives to start holding themselves and their colleagues accountable instead of protecting dangerous practices.  Truly advancing the cause means insisting upon a high standard of care and ethical practices on the part of ALL midwives.  It means insisting that every midwife has the highest degree of education and training so that she has the best tools possible to keep the mothers and babies she serves as safe as possible.  It means requiring all midwives to be licensed, insured, and transparent in reporting all outcomes.  It means admitting your faults and failures as well as your successes, instead of pretending they don't exist.  Please understand that our baby's lives are always more important than the way and the place they are delivered.       

Sincerely,

A mother who wishes her former midwives had heard this cry long ago, so that her baby could have lived.