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Sexism, xenophobia and midwifery in N.C.



Women's bodies have been the talk of the town (more than usual) for the last few weeks. Funding for Planned Parenthood is under attack. Michelle Obama, who is promoting breastfeeding as a method of reducing childhood obesity as part of her campaign to help get America's kids healthier, is being lambasted by the right for not minding her business. And just in time for Women's History Month, controversy is brewing over the arrest of Emily "Amy" Medwin, a midwife who is accused of practicing without a license here in Charlotte.

Medwin is a certified professional midwife whose certification is recognized in a number of states, just not in North Carolina. In my mind, Medwin, who was arrested previously in 1998 for practicing without the proper N.C. midwifery license, knew the risks of continuing to practice. The larger issue here is, why doesn't N.C. recognize certifications from other states?

It is so interesting that folks are always wanting the government to stay out of the personal lives of its citizens — except when it comes to women's bodies. America has a long tradition of being obsessed with women's bodies, having demarcated them as the property of men for hundreds of years. If women want to have a midwife during their pregnancy, then they should have the right to do that. They should have the right to select the midwife that they want whether she or he is here in North Carolina or certified as a professional midwife somewhere else.

For some reason, there is a common belief or misconception that midwives are subpar or somehow not properly trained for deliveries. According to the organization Citizens for Midwifery, "a midwife is a trained professional with special expertise in supporting women to maintain a healthy pregnancy birth, offering expert individualized care, education, counseling and support to a woman and her newborn throughout the childbearing cycle." Their approach to childbirth is often different — and more holistic — than that of an obstetrician, and some women want that during childbirth. Others want an obstetrician and a midwife. The choice should be that of the woman who will actually be bringing the child into this world.

The idea that midwives, most of whom are women, are somehow not as well-trained is rooted in sexism and racism. According to midwifery scholar Lisa Koers in her article "Benefits of Midwifery for Low-Income Women," by the turn of the 20th century, "Most practicing midwives were immigrants from Europe or Mexico, or were southern-born African Americans and were recognized as being better trained than American physicians to oversee childbirth." Xenophobia was rampant during this time, so a campaign to eliminate midwives began, blaming them for increased rates of maternal and infant deaths. Koers adds, "Data was ignored that not only demonstrated the quality of care provided by immigrant and African American midwives, but even proved their outcomes to be significantly better than those achieved by doctors."

During that time, physicians helped pass laws requiring a medical degree to practice obstetrics, even though multiple reports concluded that American obstetricians were poorly trained. In an effort to improve the profession, the hospitalization of all deliveries was required and accompanied by the gradual abolition of midwifery. The denigration of midwifery was tied to discrimination — something other than the care of the actual mother and child — which leads me back to my point.

This controversy should not be just about Medwin's arrest — it should be about ensuring that the care of the mother and child is primary during pregnancy. A woman should have the right to choose the people she wants involved in her pregnancy, whether it's an obstetrician, midwife or both. A woman who has been certified as a professional midwife, particularly in a neighboring state, should be able to practice here or at least have a reasonable path to certification here in N.C. It does not have to be this difficult. What is difficult is letting go of the need for the government, made up largely of men, to control women's bodies. Unfortunately, this case is not going to cure that disease.

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