In an interview today I described myself as a “Pro-choice clinician.” What does it mean to be a midwife, a person who most people associate with the birthing of babies, who is also militantly pro-choice and advocates for free abortion on demand? Some people tilt their heads quizzically, and assume their must be a contradiction when I explain that midwives help women continue much wanted pregnancies, as well as terminate undesired ones, and that all falls under the job description of “midwife.”
Coming into midwifery I assumed that all midwives must be pro-choice. People who are midwives believe that women generally know what is best for them, which I thought would also, obviously, extends to her choices about ending a pregnancy. Wrong.
I traveled to Nashville for the American College of Nurse Midwives annual conference and was appalled to find that Midwives for Life, a caucus group that has been formed within the ACNM, was holding a meeting, just like the Home Birth caucus, the Birth Center Caucus, and many other fractions of midwives doing similar work.
Nancy Fleming, Ph.D, CNM, offers her vision of the philosophy of midwifery care and is printed in every copy of Varney’s Midwifery, one of the foundational texts of Nurse-Midwifery education:
“The heart of midwifery care for women and newborns lies more in the nature of that care than its specific components. Midwifery practice has a firm foundation in the critical thought process and is focused on the prevention of disease and the promotion of health taking the best from the disciplines of midwifery, public health, nursing, and medicine to provide safe, holistic care. Midwives are partners with women in the provision of health care, engaging in a dynamic reevaluation of each woman’s unique health needs. Midwives would rather nurture a woman’s progress with hands-on care than diagnose her problems from afar…
….rather listen than lecture
…rather teach a health principle than treat an illness
…rather empower a woman to join in decision making than decide for her
…rather urge her to speak for herself than to be her advocate
…rather instill a woman with trust in her body than demonstrate the midwife’s technical proficiency
although midwives will do all of these things when necessary. Midwifery is a profession born of a woman’s vision, nurtured in an understanding of women’s developmental phases and committed to assuring women of all populations that it is their birthright to be a part of this unique care.”
After reading books upon books, articles upon articles, and having it ingrained in me by my faculty that a midwife is a person who meets women where they’re at, understands the complications in their lives, and helps guide them through their options without judgement or shame, I was, frankly, horrified to learn that there are a vast number of anti-choice midwives.
Women’s choices relating to their bodies are demonized,every day from every form of media, not to mention the hundreds upon hundreds of attacks on abortion rights that happen yearly at the political level. When a woman goes to see a medical care provider, this person has an obligation to help, not to hurt, thus, being an anti-choice women’s health care provider is unacceptable, in my eyes.
You may say, “But a person’s personal beliefs don’t have to impact the patient. They could be pro-life and still provide good care. It doesn’t matter what they think, all that matters is the care they give.”
However, according to the Guttmacher Institute, 47 states allow providers to refuse to provide abortion services, 13 states allow providers to refuse to provide contraception services, and 13 states allow providers to refuse to provide sterilization services. These laws, all passed post-Roe v. Wade have allowed abortion, as a medical procedure, to be “othered” from regular medical care. Those who provide abortion services are forced to provide them outside regular hospital and outpatient services, allowing those providers and clinics to be systematically attacked. These laws say to women, abortion is an elective procedure. Abortion is not regular medical care. It has become easy for anti-choice providers to dictate their personal beliefs to impact the care that their patients receive. It is no longer mandated for medical students to be trained in abortion care, further pushing abortion out of the sphere of regular medical care.
There was an infographic that was making its way around social media a few weeks ago, and it simply read: Pro-choice is “You know what’s best for you.” Pro-Life is “I know what’s best for you.” I can’t think of a simpler way to explain the difference in worldviews between pro-choice and anti-choice individuals.
The heart of midwifery care is based around the knowledge that women are the experts in their own lives, and all their choices are legitimate ones. If you’re an anti-choice midwife, I don’t see how it is possible to reconcile the very basis of this profession and anti-choice beliefs. I don’t think it can be done.