Dear well meaning midwife,
I’m sure you found your way to this role through good intentions. I imagine you became a midwife through a passion for women, or a call to contribute towards positive change within the birth world. Somehow though you seem to have lost your way. Can you see? Can you recognise that in your attempt to change a patriarchal system, you have become part of the problem – but you don’t have to be.
You can stop reporting women to social services for believing in their bodies and their ability to birth their babies without your help. It is a woman’s human right to choose a wild pregnancy and/or freebirth. Maternity services are not compulsory.
You can stop infantilising the women who ask for your support during their pregnancies, and those who invite you into their sacred birth spaces. They don’t belong to you and they are not little girls you can judge to be good or bad. They are whole women who deserve to be treated as such.
You can stop acting as the gatekeeper. Stop “allowing” or “not allowing” women to make choices that they know to be in their best interests. And what is best for a woman is best for her baby – because nobody cares more about the wellbeing of a baby than its mother. It’s not your job to ensure women are making informed decisions. It’s your job to offer balanced information and above all trust women. They are the gatekeepers, not you.
On that note, you can stop lying to women about the options that are available to them or giving them false information. I’m tired of hearing women tell me, “I didn’t know”. They didn’t know that they could say “no”, or that they didn’t have to go for that scan, or accept that vaginal examination. They didn’t know that your policies aren’t always evidence-based or in their best interests. Do you see how coercive this is?
You can take the time to recognise and examine your personal bias. There is a reason why black women are five times more likely to die in pregnancy and birth than white women, and it is not because their bodies are broken. Acknowledge the systemic racism in maternity services and do the work to change it.
You can brush up your knowledge on what constitutes informed consent before going back into work again. When you carry out intervention without informed consent, it is assault. This might help…
“For consent to be valid, it must be voluntary and informed, and the person consenting must have the capacity to make the decision.
The meaning of these terms are:
Voluntary – the decision to either consent or not to consent to treatment must be made by the person, and must not be influenced by pressure from medical staff, friends or family.
Informed – the person must be given all of the information about what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments, and what will happen if treatment does not go ahead.
Capacity – the person must be capable of giving consent, which means they understand the information given to them and can use it to make an informed decision.
If an adult has the capacity to make a voluntary and informed decision to consent to or refuse a particular treatment, their decision must be respected.
This is still the case even if refusing treatment would result in their death, or the death of their unborn child.”
This isn’t about bashing midwives. I know that wonderful women-centred practice happens. But it doesn’t happen enough. I see midwives fighting for change, but I also see midwives who prop up a system that thrives on hurting women. If you are not fighting against the abuse of women in maternity services, then you are part of the problem.
What can you do instead? Offer women all the information, not just part of the puzzle. Respect women’s bodily autonomy above everything and call out anyone who doesn’t. Trust and believe in women, their bodies and their instincts. Support women who are finding creative and intuitive ways to birth safely in a world that does not care about them. That is what being with women is all about.