At its 2018 annual conference, the Midwives Alliance of Northern America (MANA) honored the lifetime work of three OBOS founders, Judy Norsigian, Jane Kates Pincus, and Norma Swenson, and of Judy Luce, a midwife and longtime contributor to “Our Bodies, Ourselves.”
Because Judy Luce was unable to attend the award ceremony, Judy Norsigian spoke on her behalf, based on her notes below.
I am not able to be with you today, but am grateful to be asked to share some of my reflections. Norma Swenson, my mentor in all things tied to women’s health, taught me that feminism was another name for self-respect; her respectful listening to me over 40 years gave me voice. Norma also gave me the tools with which to think critically about the meaning of “medicalization” as it applied to women’s bodies and experiences.
Judy Norsigian is a relentless and tireless advocate and activist on behalf of midwifery. I was privileged to be her midwife at the birth of her daughter, Kyra, who always called me “my midwife.” Judy knew the difference midwives could make, even when we were illegal “lay midwives.”
With Jane Pincus, my dear friend, I shared decades of writing and conversation about birth. I am grateful for her gift of language, artistic representation, and deep analysis of the wider cultural issues that affect birthing in this society, and all her efforts to create a climate of confidence around birth.
I am 75. While I worked as a lay midwife, then a certified professional midwife, and then a licensed midwife in Vermont and California for over 40 years, I came to a realization at the MANA conference in Portland in 2013, while listening to a panel of midwives, doulas, and mothers: I had ALWAYS been a birthing woman and mother dressed up as a midwife, and this had been the source of much of my struggles. I do not say this to put down midwives or who I am as a midwife, but to elevate and honor the nature of who we can be by speaking from a perspective and history that honors a deeper and wider knowledge, rooted in women’s experience, that predates “evidence-based” as one of the first legitimizing claims midwives often now use to describe their practice. It’s knowledge that grows in relationship when we are not seen as “providers” of care but in a kind of partnership. As Gera Simkins, MANA’s former president, wrote: “The dynamically interdependent relationships that are shared between midwives and the women we serve are like a grapevine, a braiding of interlaced roots, branches and fruit that feed and support one another. What matters to the childbearing woman matters to midwives.”
After the hospital births of my two sons, my “unnatural, natural” childbirths, what I’d learned about my body and birth found voice in circles of women listening to, and sharing, their stories. We were collective experiences seeking language about what we needed to thrive in our pregnancies and birth in a healthy way, that allowed the work of labor to unfold with support and without interference, about what was best for ourselves and our newborns. It was this knowledge and desire that passionately fired and inspired women to “reclaim birth” and the wisdom of their bodies as they sought out midwives and gave birth at home, as I did. We felt compelled to give birth at home because only there would birth be sacred, the wisdom of the body affirmed, and our deepest knowing and wishes honored. These circles were how our embodied knowledge was developed and passed on, not unlike the circles of women who came together to form OBOS.
I want to remind ourselves of that deeper, more encompassing knowing and knowledge that preceded and extends beyond randomized controlled trials and other research that does NOT tell us about individuals or actual conditions in which most women birth, but only about populations birthing in very specific settings and conditions. Those studies also use language that is foreign to those giving birth, and to the physical, emotional, social, psychological, and spiritual experience of birth itself. The “mother tongue” of birth expresses life, health, nature, and normalcy.
Women did “reclaim birth” and their “mother tongue” in a body of knowledge that grew out of reflecting on their experiences. Women knew things that we did not need studies to prove: about prenatal care, care they primarily give to themselves that requires access to good food, safe working and living conditions, emotional and physical support. They identified their need for respect, privacy, intimacy, affirmation, encouragement, and support. They knew they were individuals and each birth was unique as were their circumstances. They found ways to cope with the power and intensity of labor itself, and encouraged others through telling their birth stories.
Some of us morphed into or felt called to midwifery. Even as midwifery roles became more defined for us, our roles were always shared roles; we depended on the knowledge and confidence women had in their bodies, their trust. They trusted me, but I also trusted what they told me. I always learned from the women I served; my understanding became refined and deepened. While we all understood there is risk in childbirth, we did not take a “risk based” (population based) approach to the women in our care. This by definition is the medical model. We knew negative ramifications of anxiety and fear, so we didn’t feed these emotions. Our work was to promote health, confidence, trust in a woman’s body, and the birth process. We knew fear could change everything.
We were also attuned with our knowledge, clinical skills – including touch and listening – and intuition, to signs that the balance of health had been disrupted, or clear indications of pathology/disease were present. This is where the rub comes. We need to be able to consult and collaborate with others practitioners who speak a different language and have a different view of pregnancy and birth, who may not share our values and priorities nor those of our families. In my view, the long road we have traveled to certification, licensing, and, too often, regulation by external bodies favors the adoption of this language foreign to women’s experience. Just calling ourselves providers puts us in a hierarchical relationship that does not prioritize “interdependence” and the “braiding of interlaced roots.”
In our desire to serve women and promote and protect natural birth I think we have to find ways to counter the powerful societal message that pain is unnecessary and has no value, which is reflected in obstetrical practice where 80-95% of women receive epidurals. This devaluing of the felt experience of labor is accompanied by knowledge of what labor and natural birth even look like and how to live that experience and how to support it without major interventions. This focus on pain also increases fear.
I think we can find guidance and inspiration for the future from those who have gone before us. In 2011, Gera Simkins published “Into These Hands: Wisdom from Midwives,” a collection of 25 stories of some of the women who devoted their lives to the work of bringing back midwifery. As Ina May Gaskin wrote in a review: “Bringing back midwifery once it has been forgotten … or marginalized requires recognition of the sacredness of birth, boldness, creativity, and an abiding determination to return birth to women’s domain.” In the afterword to her book, which I quoted earlier, Gera identified thirteen themes that emerged from the stories of these midwives and her own life as a midwife. If I could give one thing to aspiring midwives, young midwives, or even old midwives like myself who can feel sucked into the values and language of medicalized birth, with its risk-based approaches, or who just need to remember where we came from or inspiration for the journey ahead, I would offer her Simkins’ afterword. What Matters: Context. Content. Holism. Nature. Sacred. Relationship. Compassion. Self-determination. Service. Activism. Courage. & Lineage. From all of this, midwives matter!