Who Has the Right to Birth?
The Endless Midwife Catfight
Who has a right to attend homebirths?
This is a question that has long plagued obstetricians, public health authorities, and governments, but the most hand-wringing on the topic seems to occur among midwives, doulas, and birth-workers—which is curious to me.
As a mother—a mother who has forged my own understanding of self-responsibility in the crucible of my nine babies’ births (all at home, the most recent seven of which involved no outside “help”, supervision, or authority whatsoever)—I find the political “issue” of who should be officially sanctioned to support me in my homebirth (or anyone else) not only irrelevant (and contradictory), but laughable…not to mention profoundly condescending.
As a birth-witness myself, who has worked in the field of birth for twenty years, supporting women and families from all over the world both online and in-person, and in my role as the co-creator and co-instructor with Emilee Saldaya of the Radical Birth Keeper School, an online radical midwifery education program (which has over 300 graduates, including several medical professionals including doctors, obstetricians, nurses, and licensed midwives), the question of who should have the right to attend a woman in birth— especially coming from other birth-workers—reveals a lot about how a midwife, doula, or birth attendant sees birth, interprets their own level of importance, and broadcasts very clearly whether or not they believe that women have authority over their own choices.
The appropriate answer to the question of Who has a right to attend a homebirth is very simple: whomever the mother chooses.
Over two decades ago, at the age of twenty, I categorically rejected the opportunity to give birth to my baby in one of the world’s most sophisticated and prestigious maternity hospitals. I shunned the (free) licensed midwifery service available to me, and I went out of my way to find an un-registered, underground midwife with no formal education or accreditation in birth, who happened to be embroiled in a legal battle after having been accused by the government of British Columbia of practising midwifery without a license.
I was told by multiple people that this midwife was “dangerous”, “irresponsible”, “crazy”, and so on—all the usual terms reserved for disobedient women who stand for sovereignty—their own, and other womens’—and in turn, I was called all of those same things for having chosen her.
Hiring her (out of my own pocket) was the best decision of my life.
From the perspective of her detractors though, everything said about her was very true—when one understands birth only as a disaster waiting to happen, as an inevitable emergency, as a risk, and as an event from which women need to be saved, or “delivered” (or at least “protected” by a professional)—a woman practising from the lens of birth as a rite of passage, and as an experience that is inherently safe, who sees her supportive presence as entirely optional, and who knows that the biggest risk to mother and baby is the possibility of sabotage on the part of those invited into the birth-room, and most importantly, who fully trusts and honours the mother’s authority (knowing that birth is always the shadow-side of death)…well, that’s the very definition of insanity, in our distorted, death-cult-obsessed, hyper-medicalized clown-world.
The fact is, if you work in the area of birth, there is someone out there who thinks you don’t have the right to be there; that you’re not skilled enough; that you don’t have enough training, or the right kind of training; or that the way you practice is ill-advised, ignorant, or dangerous.
I’m certainly no different.
I absolutely cringe when I see midwives who have been practising for 15 years or more, talking about their “at-home inductions”, their commitment to melodrama, their assumptions about positioning, and their goofy pseudo-scientific assessments.
I’m even more horrified by every single aspect of the practice of obstetrics. The entire framework of industrial birth is utterly antithetical to pretty much everything that women and babies require in order to thrive.
Yes, on occasion, obstetric technology keeps people alive.
But I have observed that far more often, mothers and babies survive industrial birth only very narrowly, and almost always, with intense, lifelong trauma and instinct-injury (to some degree) to contend with.
When it comes to authentic midwives (or birth keepers, or unlicensed midwives, independent midwives, lay-midwives, self-taught midwives, traditional birth-attendants, etc.—whatever the new term happens to be that we employ to get around the futile but irritating regulations that purport to govern the language we use to describe ourselves, and seek to obstruct our ability to simply support each other in birth), one of the most frequent accusations I come across within the birth-work world, is that there are far too many women who just don’t have any experience in birth, who don’t know what they’re doing, or who are just “hanging out their shingle”, without the proper education, credentials, or life experience to legitimize their specious claims to birth-work.
This is a concern that betrays extreme distrust in the capacity that women have to figure out who and what they want and need (during pregnancy and birth and every other time).
It’s infantilizing, and it suggests a belief on the part of these midwives, that they or the state (or whatever governing institution or guidelines they adhere to) have a monopoly on what constitutes “safety”, “correct” education, and fundamentally, what it is to think the “right” thoughts about birth.
Which is kind of weird.
Because allopathic medicine and midwifery were initially, fundamentally distinct practices.
Unlike allopathic medicine, which is an intrinsically industrial paradigm, rooted in theories and beliefs about the body that were, since its relatively recent inception, deliberately manufactured to poison, to undermine our biological processes, and to establish dis-ease as an expectation (in response to which the toxic pharmaceutical medications doctors are trained and incentivized to proffer provide the pretence of healing, only to catalyze or facilitate other more dreadful forms of dis-ease), midwifery, on the other hand, is a vocation that is simply given by the biological fact that women become pregnant and give birth and often would like the support of other women by their sides who have also given birth and who happen to have a facility for compassionate care, and for the energetic nuances of tuning into the unique time-signature of the birth process.
Midwifery is really quite simple. (And like anything in life, it can, of course, become complex.)
I am far less uneasy about the “birthkeepers” or “traditional birth attendants” who are making themselves available for birth attendance in their communities with very little experience, than I am with the way many of the much more “seasoned” or “schooled” midwives practice.
The general confusion that is evident among so many of them as to what their role really is at a birth, their apparent belief that they happen to be the foremost safeguard against death, and their conspicuously conflicted understanding of how birth both birth and integrity work (under what is often seems like a heavy veneer of a not-insignificant burden of smugness and egotism that I can’t help but think is masking further anxieties) is disturbing to say the least.
All that said, what I personally think about how other midwives or birth keepers are operating, is not, ultimately, any of my business whatsoever.
It’s not even my business if other midwives and birth-keepers are misrepresenting their level of experience in birth, or calling themselves “birth keepers”, or “traditional birth attendants” without having established any kind of real understanding of how to serve women in integrity, or after having attended only a birth or two (or maybe just their own). Nothing to do with me.
This is despite one of the central tenets the RBK school: the necessity of being completely honest and transparent about our credentials and experience (or lack thereof), and the fact that an authentic midwife or birthkeeper grows into that title through the repeated act of showing up for the women in her community; by sitting patiently by a mother’s side as she gives birth, and by taking action when necessary, which, like every other aspect of midwifery is a form of discernment that can never be mastered, or perfected, (and which no senior midwife will agree on) but which is developed through praxis, and, for all of us, no matter our approach or training, by trial-and-error.
Expertise is not garnered by having completed either a 12-week online program, or having graduated from a 4-year medical midwifery program (or anything in-between).
And while I do not often see women actively misrepresenting their level of experience in birth, of course it rubs me the wrong way when I do see women advertising themselves as “birthkeepers” and promoting their birth-business with no actual embodied experience or background in the work apart from the births of their own babies, or a voyeuristic colonial stint in an African obstetrical unit, or, in some cases, plagiarizing or paraphrasing others’ pithy memes about birth and re-cycling them on instagram.
True midwifery is stepped into by repeatedly answering the call from women who see you, and invite you in all your imperfections, to witness them as their babies move through the veil. Over and over and over again.
Each and every time I show up at a birth, I’m struck by how completely new the work is— a new energetic dynamic, a new family, and a new and totally unique human being who has entered the world.
Paradoxically, it is through the repeated witnessing of birth, that we see and attune to its consistencies: its patterns-within-patterns and the vast yet overwhelmingly predictable scope of its rhythms.
As Emilee Saldaya has said, “every birth is just..birth.”
And every birth-worker assumes their way is the best way, and everyone who is showing up in whatever way they do (even those in whom I have personally failed to detect even a shred of integrity) is (obviously) holding the belief (on some level at least) that what they’re up to is just fine.
It’s just not my place (or any other birth-worker’s place) to judge other midwives personally, or to comment on the specificities of whatever bizarre situation has been described online or retold that I didn’t witness personally.
This doesn’t mean we shouldn’t be discussing all things birth--but the in-fighting, the accusations, the dark-side-of-the-moon shade projected onto individual women in public and semi-public spaces…all of this is unbecoming, and frankly unnecessary.
Those who *do* have a right to judge (and I hope they do) is birthing women themselves—the women who will end up choosing someone (or no one), as their primary form of birth-support, and who are the ONLY ones who will bear the responsibility and the consequences of that choice.
We don’t really have to worry about what other birth-workers are up to. Not if we actually trust women.
Because the correction is built into the mechanism. The balance is inevitable. Women talk. The most significant safeguard against “irresponsible” birth-workers, is the fact that every woman is going to tell all of her friends about the kind of experience she had.
Someone working in birth whose frequency isn’t yet robust enough to hold the energy of the work, or whose life is too much of a chaotic disaster to be living in congruence, or who isn’t appropriately resourced to be able to handle the inevitable material pressures of the midwifery lifestyle, or who just really doesn’t know what the hell they’re doing and who isn’t open to giving themselves the grace and the space to take things slowly and to seek out the support (in whatever way) that might be appropriate for them, or who is totally enmeshed in victim-consciousness and is crippled by a commitment to taking everything personally…whatever it is, the result will either be that they don’t get clients, or their relationship with their clients will be messy and fractious, or that they will be removed from the work via karma…or they will learn.
And one of the most fundamental keys to that learning, for each and every one of us in birth-work (and in every other field and area of life), is to get over ourselves, and mind our own damned business.
If this article resonates with you, and you’re interested in learning birth-work with me and Emilee Saldaya and an incredible community of like-minded women, get on the waiting list for the upcoming round of the Radical Birth Keeper School.
And if you’re a mother, a midwife, a birth-worker, or a woman interested in birth, birth-work, and mothering, join my private online community for women, where we regularly debrief births, discuss case-studies, and enjoy weekly live calls moderated by me personally, where we discuss a variety of eclectic topics pertaining to wild pregnancy, intuitive mothering, self-healing, living in congruence, and birth & midwifery. Join The BAUHAUSWIFE BIRTH Community