Penicillin: our health minister’s hot new wonder drug?

Posted July 18, 2013

Written by Beth Lyons

(This post originally appeared in the Times & Transcript on July 18th, 2013, and is shared with permission.)

Last week, it was announced that the Midwifery Council of New Brunswick (MCNB) would not receive its annual $10,000 funding from the province’s Department of Health. An email statement from Health Minister Ted Flemming explained that, “In this time of change, the department has decided to postpone the introduction of midwives. It does not seem prudent to introduce a new profession in the midst of systemic change . . . In addition, the fiscal challenges make it more complicated.”

Hold up: the Health Department thinks midwifery is a new profession?

Midwifery is actually one of the oldest professions in the world. We’re talking before the Common Era old; I mean, midwifery was a recognized and valued skill set before people even took to having specialized professions. That’s how old-school midwifery is. It’s O.G. (original gangster, that is) obstetrics.

To be fair, it’s not just New Brunswick’s Health Department that believes midwifery is a new profession. It’s a pretty common for folks to think midwifery is “new” in that it’s a practice from days of yore that is being resurrected as a new-fangled trend by feminist hippies and well-heeled yuppies. When viewed in this way, midwifery is liable to be dismissed as an indulgence at best, and a dangerous practice at worst.

The cessation of funding doesn’t thrill me, nor does the assertion that midwifery is new. What I feel the need to speak out about, however, is this general belief that midwifery is a faddish anachronism that may not be a wise primary health care maternity option.

The World Health Organization (WHO) recognized midwives as “the most appropriate and cost-effective care provider to be assigned to the care of normal pregnancy and normal birth, including risk assessment and the recognition of complications.” Note that the WHO doesn’t say that this is only in the case of developing countries with limited doctor and hospital care availability, but that midwifery is the most appropriate and cost-effective option, period.

It should also be noted that midwives aren’t necessarily working away from doctors and hospitals; they can be employed in hospitals and birthing centres, as well as in clients’ homes. In fact, a 2007 study by the Canadian Institute for Health Education reported that “Midwifery-assisted deliveries in hospitals have been demonstrated to use fewer resources than deliveries by other maternity care providers for reasons including lower rates of obstetrical interventions, earlier discharges, lower rate of readmission and reduced emergency room visits."

The move away from midwifery (despite the practice’s safety, cost-effectiveness, and credibility with international public health agencies) was not simply about following the path of progress in modern medicine. Historically, the move from midwives to hospitals was about medicalization of women’s bodies, about taking control of maternity away from women (be they the pregnant patient requiring care or the midwife administering it) and giving it to professional men who could turn a profit.

Am I suggesting that we should forgo doctors and hospitals when it comes to maternity care? Absolutely not. Today there are women who survive pregnancies and babies born that will live because of medical advancements that weren’t available even 10 years ago. Having the option of cutting edge medical interventions is a wonderful thing.

What I am suggesting is that we should consider the history of midwifery and the shift to hospital births presided over by doctors, and what that shift signified.

I am suggesting that — given the fact that the vast majority of pregnancies are low-risk and don’t involve complicating conditions — we need to stop thinking about midwifery as a relic or a fad and consider it (in homes, hospitals, and birthing centres) as a real option for maternity care.

Option is the key word here.

As a pro-choice feminist, I believe in meaningful reproductive choices for women: the choice of when and how often to have children (if at all), and the choice of what desirable maternity care looks like.

For some women, a hospital room with a doctor is an ideal birthing scenario; for others, the least medical setting possible and the services of a midwife are preferable. Women may prefer birth with the support of a midwife for ideological reasons, or because they’ve had traumatic medical experiences in the past or for any number of other reasons.

I don’t believe this choice is inconsequential any more than I believe that midwifery is a new profession.

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