Friday, February 29, 2008

Won't play nice, anymore.

“Nice” isn’t a term that I am generally described with, to be honest. Yes, sometimes I am described as compassionate, caring or sympathetic. Often I am described as rational, even-tempered or reasonable. You’ll hear passionate, strong-willed and stubborn used upon occasion too but really, rarely do people describe me as “nice”. That’s ok with me, I’ve never consciously aimed at “nice” as a personal descriptor. But like most women in this culture, I still struggle with the “be a nice girl” problem – you know, wanting to be liked, not wanting to cause trouble or difficulty, wanting people to get along, not wanting to offend. Like most women, a lot of what I’m really thinking in my head doesn’t get put out there for public consumption. And in some ways, ICAN has struggled with this dynamic, I’m sure in large part because we are an organization that is almost exclusively women. It hurts us when we are characterized as “hysterical angry women”, because that’s not at all who we are. We don’t want to be controversial, not really. We are all about choices and options, really wanting more than anything for women to have both the choices and the knowledge to make them when it comes to decisions during the child-bearing years.

The problem is, being nice isn’t going to work anymore. And I think I’m going to like that, even as it catches my breath sometimes. There’s a lot going on in birth politics right now – Ricki Lake’s The Business of Being Born is making more of an impact than I ever expected it to. ACOG released an updated statement about homebirth, the really interesting part being that for the first time ever, they supported the idea of births occurring in free standing, independent credentialed birth centers (they’ve always opposed that in the past). They accused women who plan homebirths of being more concerned with fad and fashion that with the safety of their babies and themselves. ICAN countered with probably the most strongly worded Press Release I’ve ever seen from us. And the responses to our statement were wonderful. I think it’s about time someone “publicly condemned” ACOG for their misogynistic and dangerous policies. The AABC recently released a statement about why they are not going to revisit the VBAC study and why they do not recommend birth centers allow women to plan VBACs in a birth center. They determined that we aren’t exactly “high risk” but we certainly aren’t “low risk” either…and made sure they repeated several times the warning that any birth center who did allow VBACs at their facility needs to consider whether it’s worth jeopardizing “low risk” births. I can’t help but wonder about the possible connection between the two statements, especially since most birth centers affiliated with AABC are owned/staffed by Certified Nurse Midwives, who have aligned themselves with ACOG in a (probably futile) attempt to save themselves from extinction (once ACOG turns its sights on them). So, in our new “say it like it is” mode, we pointed out that AABC is sacrificing the women who need them most, the women who will support them when ACOG comes after them, and that once we’ve been picked off, they will come next. We got a lot of good feedback from that and a call from AABC too….seems maybe they want to work with us – on what I’m not sure, since they haven’t said anything about rethinking the VBAC issue.

Sometimes there is confusion about ICAN being a “homebirth” organization – we are absolutely NOT that. Do many of our members have homebirths? Yes, that’s certainly true. Do many women who want a VBAC have no real option other than a homebirth? Yes, that’s certainly true too. If we appear to be a “homebirth organization” it’s as much a result of the lack of other choices as anything. What we really are is an organization devoted to promoting a full range of birthing options for all women, regardless of history. In the process of working on the DC premier of The Business of Being Born, I had to consider and then respond to a request from ACNM for co-sponsorship or some other major degree of collaboration. And honestly, it was a no-go from the beginning. This is an organization that has systematically repudiated (and abetted in the persecution of) non-nurse midwives. Now, don’t get me wrong, I’ve met many individual CNMs who are wonderful women, who believe in birth and support their sisters the CPMs. I’m talking here about institutional biases. The whole issue of why they have such a problem with non-nurse midwives is complicated and basically not relevant to this discussion. What I’d want to encourage ACNM to consider is the big picture of the future – women are going to require attendance from midwives who are not tied to obstetrics. If ACNM really wants to promote autonomy for their members…if what they really want is the ability to be true midwives and not the handmaidens of the obstetricians….then they need to rethink their alliance with the obstetrical community. Perhaps, joining with other midwives, as scary as that seems, would be a better long-term strategy. Because really, there’s no reason to believe that ACOG will leave the CNMs alone. They already eliminate them from hospitals or actually attending births whenever they can. The Big Push might be for non-nurse midwives, but the CNMs will benefit from it too, if they just let themselves actually be midwives and stop worrying about how to preserve their place in the current dysfunctional medical system. I believe that we are approaching a moment when organizations will have to step up and take sides. The question is, whose side will you be counted on? I’d love to retire the term “medwife” and have midwife attended hospital births be something that is available to any woman who decides that’s the plan she needs to make. Really, I’d love to see medicine, even in the form of “nursing” be forever banished from the practice of midwifery. Hey, I dream big, if nothing else.


Laureen said...


Being nice girls, good girls, is what got us here in the first place... "here" being to where the most primal thing a woman can do is being controlled by a group of old men. OMGWTFBBQ.

Me? I aim to misbehave. =)

Anonymous said...

And I tend to be a stinker. Gee, I don't really want to think too long and hard about being perceived as nice or not. I think you make great points, Gretchen, and I'm glad to know that ICAN had the courage to say no to the ACNM in its current state. I agree that CNMs need to identify more with their midwifery roots and less with their obstetric associations.

~ Kimberly