Midwife vs. Medwife
I attended a birth this weekend in the role of doula. This was for a client in a city where I am not familiar with the practitioners, so I directed the family towards several midwives and asked them to make sure the midwives aligned with their thinking. The one they picked seemed great and for the most part, did an excellent job at the birth. Throughout their pregnancy they had a fairly normal quality of care - no excessive ultrasounds offered, no scared “you must do this prenatal test” type stuff.
There was one thing that really rubbed me wrong, though. About an hour and a half after the birth the midwife came in to talk about discharge plans. The family had a little boy so she wanted to talk circumcision. After noting that “it’s not medically necessary,” the midwife spent the rest of her chat talking the family into circ’ing their little boy. I had spent MUCH longer counseling them on the pro’s and con’s of circumcision and they were leaning towards leaving their baby intact. With one very convincing five-minute talk about dirty penises and how painless the procedure is, she lost her credibility with me. But more than that, I lost credibility with the family.
How sad that a midwife has been in the hospital system long enough to be stepping towards medwife.
I meant a cut of the funds, but that was a pun accidentally.
I wonder if this midwife has ever been circumcised, or would suggest it for girl babies? Seriously — what’s the difference? Female genital mutilation has been on my mind lately, since I wrote this post.
@Naomi- I don’t know what drove her to that conclusion.
@Kathy- That’s a great point! I don’t think many people would be on board for having pieces of their genitals cut off. My feels about circumcision aside, this was not informed consent.
While I understand your frustration over the midwife ‘convincing’ the family to go through with circumcision, I was rather offended at your use of the term ‘medwife’. It’s precisely that sort of terminology being tossed around flippantly that continues to promote division amongst the midwifery community. A midwife who must practice within stringent guidelines set forth by physicians or hospitals still can offer value to women. It seems unfair that because a midwife might take a position in such a environment in order to practice midwifery, pay bills, etc. that she be penalized and deemed less of a midwife than one who catches at home or in a birth center, etc. If midwives had the cohesiveness that physicians do, our cause might be furthered, faster.
I am fortunate to work in a midwifery service with wonderful colleagues, including supportive physicians. I am thankful for the opportunity to provide support, education, and knowledge to women - and to be able to follow through at the end of the day. I wish we all could be this lucky.
As far as circumcision - it is a shame that any provider would promote circumcision versus giving the pros and cons as you did. I have to wonder, though, if the family really was leaning towards circumcision anyway if all it took was a 5 minute convo to ‘convince’ them?
@Tiffany- I am sorry that you were offended, however, I stand by my statement. I believe that midwives are an asset to our community no matter where they practice. However, just as there are great doctors and not-so-great doctors, the same is true for midwives. It is midwives who have deviated from the midwives’ model of care that I consider medwives.
As for my clients’ decision - they were planning on leaving their son intact and wanted the midwife’s opinion. Using the words “dirty penises” and discussing “all of the men who she has had to see have their foreskins removed in their 30’s” as well as how painless the procedure is made my information seem inaccurate. When she quoted that 90% of American men are circumcised I was deeply disappointed in her misinformation. However, this is a very convincing argument. Not giving completely informed (and accurately informed) consent is a real problem here.
I think that there are medically minded midwives who don’t follow the midwifery model of care in all types of settings, though I do think many seek out hospital based practices. Just as there are physicians who are more midwifery model of care.
Tiffany,
If a midwife deviates from the midwives’ philosophy of care then she is not practicing midwifery.
From the website mymidwife.org from The American College of Nurse-Midwives they state: “Midwives listen to women, and always provide the information you need to make informed and educated decisions about your healthcare.” It sounds like this midwife did not fulfill her obligation to “always provide the information you need to make *informed and educated* decisions”.
If practicing in a certain hospital means that midwives are not able to practice true midwifery using the midwifery model, then they deserve to be called ‘medwives’. “Paying the bills” is no excuse to sacrifice your principles, and your title of “midwife”. If a midwife does not intend to follow the philosophies of a midwife, then she has no business using the title “midwife”. If women are treated in a way that goes against the midwives model of care by a person who calls herself “midwife”, she report her behavior to her states nursing board and then send a copy of the letter to The American Midwifery Certification Board (AMCB). Women choose midwives because they want to be treated with dignity and respect, and they expect to be treated in the framework of the midwifery model.
ugg, does she get a cut or what?