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In the 1970s, a spontaneous grassroots
movement developed to "deinstitutionalize" maternity care and to
"demedicalize" critical life events, such as childbirth and dying. The
interest in hospices and homebirths derived, at least in part, from a
desire to escape patriarchal medical dominance as well as from the
dehumanizing environment of the hospital.
In the early 1970s, women's groups began
learning gynecological self-care and encouraged a revival of lay
midwifery. Feminists argued that womens health care needed to be
demedicalized and women's bodies demystified. They maintained that
childbirth was not a disease and that normal deliveries did not require
hospitalization or the supervision of an obstetrician. There was a
growing interest in childbirth education, breastfeeding, and natural
childbirth. Consumers of hospital-based, mechanized maternity care
began to rebel. Women and families who were pessimistic about their
chances of having a safe and satisfying birth in the hospital began to
explore the option of home births with midwives.
This consumer criticism of aggressive medical
management of childbirth resulted in the advent of the New Midwife, the
apprentice-trained midwife attending homebirths in the Unites States
and Canada. The midwives who attended these births were unlikely to be
professionally educated as midwives; their interest in midwifery was
frequently though personal birth experiences; their training was by
apprenticeship, and their practice was by and large unregulated, either
illegal or not mentioned in the law. Initially, they were not
organized, but worked in isolation in diverse parts of the country,
often unaware of each other.
This lecture will present a brief herstory of the
social context that led up to the emergence of this new midwife, then a
spirited, personal account from the first midwife practicing in New
Hampshire, created by those brave homebirth families of the 1970s. This
talk will address the legal/legislative issues faced by the lay
midwife, the obstacles placed by the medical community to homebirth
practitioners, and how the midwives began to organize, nationally, to
share experiences, support one another, and to learn from each other.
Eventually, from these scattered associations,
in 1982, the Midwives' Alliance of North America (MANA) was founded.
This organization embraced all midwives, regardless of training or
credentials; however, its primary focus became the expansion of
practice rights for direct-entry midwives who attended home births. The
midwives represented by MANA steadfastly insisted on autonomy and the
freedom to practice, and articulated differentiation of the midwifery
model of care from the medical model.
In conclusion: There will be a discussion of
the current political climate and the future of midwifery in North
America. |