Midwives deliver babies in hospitals. Midwives prescribe medicine. Midwives order ultrasounds, prenatal tests and blood work. Midwives are not the same as doulas, who are trained birth assistants. Midwives are covered by many insurance plans.*
Did you know all of that?
I’m not sure I did when I became pregnant with my first, some seven years ago. Like many other Americans, I assumed that midwives were not really a part of the mainstream maternity care system.
I had no idea, for example, that my insurance would not only pay for a midwife in New York State, but also the entire cost of a midwife-attended home birth if I were to go that route. People are shocked when I tell them I paid nothing out of pocket for midwifery care.
And so it was with great pleasure that I read “Cultural Misconceptions and the ‘Midwife’ Brand” over at, of all places, Fast Company, a business magazine. The piece is written by Sam Ford, a strategist for a communications company — an unlikely source for what I consider to be a hugely important argument: The midwife “brand” needs a boost.
“I think there’s a major disconnect from a branding and marketing perspective with what I would consider a key professional role in the world: the midwife,” Ford says.
Ford writes that he became interested in the midwifery “brand” when he and his wife “accidentally” found themselves under midwifery care through an insurance company referral. He had assumed doctors were the only ones safely and/or legitimately delivering babies. But then he and his wife loved the care they were getting and stayed on, despite “concern” on the part of their friends and family. His wife’s post-date pregnancy was induced on the recommendation of their midwife. They delivered in a hospital. The midwife continually encouraged them to keep an open mind about birth, including the possibility of necessary medical procedures. And she was with them the whole time, giving support and easing their anxieties.
It’s really a wonderful piece and I recommend reading it in its entirety. But I want to quote from the conclusion:
“Many are battling these extreme [incorrect] notions of what a midwife is or does. Advocacy groups for midwives are quite active, and the rise of young mother movements amidst the growing influence of mommy blogger communities have given voice to pushing back against a culture of cesarean sections, of excessive use of medical intervention, etc. But, to me, the battle will not be won until midwives can be positioned not as some new fringe “hippie-mother” movement but as a longstanding and natural part of the human experience, as part of rather than a threat to the modern health care industry.”
I actually don’t really have a problem with “fringe, hippie-mothers.” In fact, some of the older, crunchier women I’ve met in the childbirth community in New York are completely brilliant and not a little badass. But I think his point is really interesting and important.
As a culture, we tend to see only the extremes. We love a good, clear fight, even at the expense of facts. When it comes to birth, there are “the crunchies” and there are “the medicalized maniacs.” But the extremes don’t tell the kind of stories I hear all the time. And that Ford tell us about in his thoughtful piece.
It’s fascinating to think of the “brand” of the midwife purely from a communications/PR point of view. Maybe some innovative, stylish re-branding campaigns could help the midwifery image. (A blockbuster summer movie about a life-giving, luminous midwife played by Julia Roberts?)
But I also think the legal environment could have a big impact. New York state recently improved conditions for midwives, but there are still parts of America where midwives are not welcome. In other countries, where midwives are in charge of most births and doctors only come in if there’s the need for a C-section, the midwifery brand is doing just fine. So maybe if midwifery was more widely supported by hospitals and state governments, we’d see a boost to the public image. (I’d still like to see that Julia Roberts movie though.)
You can read more about midwives here.
*Not all midwives are licensed to practice in hospitals or prescribe medicines; the list here mostly applies to certified nurse midwives or certified midwives. A small subsection of midwives, “lay midwives,” are self-trained and practice outside of the system. Laws about the practices of certified midwives vary by state. Some states are much more pro-midwife than others.
photo: “Parkland Midwives” by Erling A/Flickr