As seen at http://feminismandreligion.

com/2011/12/13/1722/

The Paradoxical Perception of Midwifery in American Culture By Stacia Guzzo

December 13, 2011 tags: birthing, midwifery, social justice by Stacia Guzzo This past Sunday night, midwife Robin Lim was named CNN Hero of the Year at a formal award ceremony in Los Angeles, California. The award, which was given after eleven weeks of public voting on CNN.com, came with $250,000 to support Lims quest to provide quality prenatal, labor, birth, and postpartum care for the poor and underserved in Indonesia. She accepted the award amidst a standing ovation, and closed her words of acceptance by simply saying: Every mother counts. And health care is a human right. The recognition of Limor Ibu (Mother) Robin, as she is called by those whom she serves is well-deserved. An American woman, Lim provides midwifery care at the Bumi Sehat clinics which she helped to establish. Each year, she helps thousands of Indonesian women get care and attention during their pregnancies and the births of their children. She began her work in 1994, seeing pregnant women and children under five for free out of her home. As her reputation spread, supporters of Lim, along with local business and community leaders, helped to advance her cause. Today, the village-based Bumi Sehat clinics are located in both Bali and Aceh. They provide free prenatal and birthing care as well as breastfeeding support to any woman who needs it, regardless of her ability to afford it. Ibu Robins words to CNN reflect that her commitment to her cause is an altruistic one: Every babys first breath on Earth could be one of peace and love. Every mother should be healthy and strong. Every birth could be safe and loving. This sentiment seems to be the golden thread of purpose that connects most midwives whom I have met, connected with, or read about. Gentle birth, empowered mother, a safe and loving environment for a little ones first earthside momentssuch is the creed of most women in the vocation of catching babies. Certainly, if you looked at a midwifes tax return, you would see that she isnt in it for the money. And considering her schedule (inability to leave town easily, needing to arrange childcare while at a birth, working for up to 70-hour stretches at a time), it certainly isnt for the convenience. Noas one midwife once told me, midwifery called her. She couldnt deny her vocation, even if she wanted to. It was as integrated into her state being as her involuntary breathing. Less than four miles from the Shrine Auditorium where Lim received her award, a different midwifes journey has taken place over the last few months. Instead of joyous recognition and award money, this story has been one of pain, fines, and conviction. In October and November, midwife Katie McCall spent her days fulfilling 240 of her 280 hours of community service, part of a punishment deemed appropriate by a Los Angeles judge for then-student midwife McCalls choice to stay with the laboring mother when no other midwife could be found available to oversee her at the time of birth and the couple refused to go to the hospital. In addition to performing a potentially life-saving technique to help the baby birth safely despite a shoulder dystocia, Katie also stopped the mothers hemorrhaging due to a retained placenta. A bystandernot the birthing family lodged a complaint to the California Medical Board about Katies decision to catch the baby and tend the mother without a supervising midwife. This eventually turned into a criminal investigation and Katie was arrested and charged with practicing medicine without a license. A jury convicted her despite hundreds of letters of support. Katie, a single mother of two children, was ordered to pay $10,000 in restitution to the medical board, perform 280 hours of community service (including 40 hours of hard labor), had her license (issued in 2010) revoked, was put on probation, and was

forbidden from working in her trained profession. The raw, humbling, and inspiring journey is partially documented in her blog. So what is the difference between how these two women were perceived? Both have committed their lives to helping pregnant women and babies. Both have endured emotional heartache, personal and financial strain, and extreme inconvenience for the sake of their calling. Both are educated and experienced in their field. And yet one of them is upheld as a national hero, and one is sweeping floors at a homeless shelter on Skid Row as part of her community service, wondering how she will support her children without the ability to work in her trained field. I have to wonder if the perception of the public is due, in part, to the populations and locations in which these midwives serve. The one deemed heroic serves poor women in Indonesia; the one deemed felon serves American women that span all races, creeds, and socioeconomic spheres. The first serves a deserving, but removed, Other, and the latter serves women that could easily be our neighbors, relatives, daughters, sistersor even us. Why is midwifery (and along with it the idea that birth doesnt have to be a medically managed event) more easily swallowed when it doesnt hit so close to home? Ive written before on this blog about my belief that every woman deserves the opportunity to be empowered by birth. These two midwives, while standing in stark contrast in the public eye, have both been champions in upholding the dignity of pregnant women. They have stood as holy witnesses when the sacred threshold into motherhood, life, and breath has been crossed. Yet I wonder if midwifery is considered just outside the boundaries enoughperhaps it is considered the care of poor people, or of hippy radicals, or only appropriate for underdeveloped nationsand because of that, it scares us when it gets too close. Birth isnt considered normal in America unless it is in the hospital under the supervision of an obstetrician. And perhaps, in part, that is why Katie McCall was convicted of a felony for her heroic act by a jury of her peers, and why Robin Lim was chosen by America above nine other equally deserving men and women as the most admirable. Weve forgotten the inherent dignity of the birth process in America, and because of that, we dont adequately value the birth servants that sacrifice so much to reclaim that dignity. When considering these two stories, I once again feel the anger of knowing that institutionalized birth (or the perception thereof) continues to reign in America. We dont have a culture that trusts birth as a normal process or trusts birthworkers that arent doctors. We praise the work of midwives who serve in other countries because our bias perceives: Well, of course they cant afford quality health care in that part of the world, so at least those poor people are getting something. Yet the Bumi Sehat clinics provide an opportunity for which every pregnant woman could hope: Our gentle birthing practices put mothers and families at the center of the birthing process by supporting their labor in safe and empowering ways. This gives women the capacity to give birth naturally without the use of medical intervention, which can cause more risk for the mother and baby. Safe, gentle, birthing practices such as water birthing, early skin-to-skin contact between mother and baby, delayed cord cutting and the use of herbs and homeopathic alternatives instead of pharmaceuticals, all contribute to healthier births, healthier mothers and babies. To ensure babies are well-nourished and less likely to suffer from illness or malnutrition, we support breastfeeding at Bumi Sehat. Moments after birth new mothers are encouraged to put baby to breast to enable them to receive the full benefits that mothers milk can deliver. We also send mothers home with breastfeeding support pamphlets to answer any questions they may have once they return home. -taken from the Bumi Sehat website Here in America, Katie McCall sought to provide a space of dignity and reverence as well. Her website expresses her philosophy, stating that she believes her job is one of empowering women to develop their own trust and connection with their bodies and their babies during their own unique journey into motherhood. Unfortunately, our system of justicereflecting the bias of our culturedid not receive her with the same appreciation as the Indonesian peoples received Ibu Robin. Instead, they condemned her. Different cultures, different perceptions of birth, different reactions to those who seek to make it a better experience for the women they serve. Contrasting these stories, it seems clear that a midwifes heroism can certainly be recognized by the publicbut only as long as she doesnt make us stretch past the zone of our cultural comfort.

Stacia Guzzo is a homesteading theologian/stay-at-home mother who received her Master of Arts in Theological Studies from Loyola Marymount University and is currently working toward a Master of Divinity at Fuller Theological Seminary. Stacia has been a teacher and speaker in the Los Angeles Roman Catholic Archdiocese and has served as managing editor for Spiritus: A Journal of Christian Spirituality. Her areas of interest include embodiment theology, ecological justice, food ethics, and the spirituality of birth. Stacias perspective offers unique insight into the raw, fresh theological undertones of every day life; coming from a Jesuit background, she embraces the Ignatian attitude of finding God in all things. In addition to her theological studies, Stacia currently works part-time as a doula, childbirth educator, and apiarist.