Thursday, November 10, 2011

Titles And The Work At Hand

             Spent a rather long day being a part of varies conversations surrounding why I became a Certified Nurse Midwife.  I felt like I had to tread lightly in discussing my reasoning, as to not diminish the importance of the work "Midwives" do in general,  despite my educational background versus those who have chosen a different one.  If your a Certified Nurse Midwife or a Licensed Practicing Midwife, or a Direct Entry Midwife, or a Registered Midwife, or a Lay Midwife, or a Certified Professional Midwife...this means you.  So many titles, when really we all "Are With Women" and we've all contributed to the advances in our professions.  This is a very difficult subject for me to discuss with this community of midwives right now.  I've found that my interactions with those who have variations in educational training to be very hostile, when really there should be none.  Attending this conference has been an eye opener for me, because somehow I am being viewed by "others" as being overly educated and medicalized because of my CNM training, and I'm also getting quizzical looks from women of different cultural back grounds because I'm Native American   It is all very disturbing to a woman and individual (minus the educational titles).  Despite the unsettling feeling I get while discussing my Native American views on women's healthcare and what their needs are, I feel like I'm constantly deflecting competency associations with educational training to those other then CNMs.  The minute I start to explain myself...and I shouldn't have to really, because automatically it becomes about why I feel my training should be held in higher regard.  When really, its not even about that nor did I ever say those words.  But some how..they automatically associate that with my CNM training.  This is what really turns me off from midwives who feel they need to "define" midwifery for "everyone" and if you don't fit into this box..your are not worthy to practice midwifery.  The interesting thing is I hear this from CNMs and CPMS, who are so used to defending their roles in women's health to physicians.  Let me tell you...I'm not going to play the game.
           I've always believed quality work will speak for itself and I've known amazing women from tribes and communities who have done amazing work for their communities without the title of MD, CNM, CPM..or PhD.  Which is why I have conflicting feelings sometimes on whether or not I should get my PhD.  Questions I ask myself..Do I need it to accomplish my goals?  What do I want to do with it?  Will it put me at the decision making tables that matter the most to my people?  Will it give me the ability to work autonomously?  Will it in hence my ability to help my tribe and the women in my community?  Education is a tool and allows for me to function in another world, the academic one.  Native Americans have already had to fight an up hill battle to maintain their "identities."  Why not use the education that is available to meet the many needs of our people.  We have the ability to make changes to the standards that have been set up without our input.  Our insight is valuable and needed, because right now the focus is on our "title" rather then focusing all our energy to providing culturally congruent care to women in our communities. Providing care that meets THEIR needs, not ours..
             In order for me to meet the needs of my people I had to get CNM training.  Native American women have many health issues, and when it comes to providing that kind of care, it has had to happen in the hospital.  Traditionally, home birth has selected out for women who are educated and healthy.  That is just the nature of the work, but I want this model of care to be available to Native American women.  I want them to be healthy and take active roles in their own health.  They deserve the option to birth in a birth center, in their home, in a hogan, in a hospital, but in a cultural way that meets THEIR needs.  I am committed to pushing this forward and I will get what ever training necessary to ensure that, that is what they get. Consulting with physicians and having positive collaborative relationships with them or them with us is vital to this process! Because right now... our women deserve more then what they are getting.

             Aside from conversations about educational training, I've also had some amazing conversations with the Six Nations Midwives...and you know what..THEY GET IT! And..they are Aboriginal Midwives..not CNM..not CPM.. They are able to access and use their traditional knowledge and birth practices to create an atmosphere that is un-like no other.  They are able to use traditional herbs for pregnancy, labor, and post-partum.  And no, these herbs can not be bought in a health food store.  They get what birth is about, they get why traditional knowledge needs to be included, and more so...they see it as a sacred ceremonial event that sets a life long foundation for the well being of the mother, baby, and the community.  They see it as a rebirth and realignment with our "Life Ways." Which historically, has been systematically dissected from tribes as a way to obliterate us as people.  I am in awe of these amazing women, as well as filled with gratitude.   They have been open and willing to share their knowledge with me, which is a great gift.  They see my dream for this birth center and I am happy to say, willing to help in anyway they can.  I've been fortunate to be invited back to learn about how they use their herbs, when they collect them, and how to prepare them.  I'm also going to make it a point to learn more about our traditional South West herbs that our healers have used in the past.  I am amazed at their ability to see my dream, but also to be willing to share their healing medicines with me.  For this...I am truly blessed...

                       Six Nations Birth Center, Ohsweken, Ontario

Translation of indigenous language for use in Birth

             All the babies born in 2011...this is one of many walls

Front desk as you enter the birth center ...person is called "House Mother"

Front desk..different view

Birth room 1 & Prenatal visit room

Family Kitchen

Hall Way
Gyn Room 

Front view of Birth Center

Midwife board room

Part of Family Room

Rest of Family Room

Private Counseling room for Couples

Services:  Just a list a few....
Post-partum doula:  who cares for the new mother & father over night, who also will make home visits to educate mom on newborn care, watch the baby so she can shower, and provide support up to 6 months. ( ALL within the traditional teaching of their tribe!)
Nutritionalist: educates new mothers on traditional foods to eat in pregnancy, in labor, and in the post partum period.  They will even go to their home and show them how to cook meals.
Full-scope midwifery care..well woman, menopause, sexual education..etc..

Programs They Offer Their Community
Traditional Medicine Work shops
Traditional Parenting education
Puberty education using traditional knowledge 
Called the Tsi Non:we Ionnakeratstha Ona: grahsta 
Or Degowadihsnye Program...translates.. (She Looks after Them)
Education, Awareness, and supportive services related to Fetal Alcohol Spectrum Disorder (FASD)
                                                         (Will be assessed for alcoholism during pregnancy)
Education on Child nutrition

     Yet, again I find myself in a unique situation, but I also feel blessed to have specific people in my life who have ALL different kinds of knowledge and come from diverse backgrounds.  Because it is from them I've learned the most from.  It is rare to find a community of colleagues and friends who share the same vision and despite what our educational training is, we are able to see our work as a collaborative effort by all of us.  One that requires all of our skills and knowledge.  CPM..MD..CNM..Midwife..Traditional Midwife..Aboriginal midwife....SISTER!....FRIEND! one person does this alone.

Here is to creating a foundation of trust and unity.


  1. Wow, I love what that birth center has to offer!

    I had a CNM for my last two babies (all 3 born at home, the first planned unassisted) and I definitely don't think she was somehow more "medical" because of that. In fact, I deeply appreciated the skills she had gained through both her CNM education and her 7 years as a high-risk L&D nurse before that. I'm much more confident in her ability to place IVs, intubate, etc than many direct-entry midwives because she's had so much experience in doing it over and over and over (not much with her current home birth clients, but of course a lot when she was a nurse). Anyway I have a lot of respect for the many different paths to becoming a midwife.

  2. Midwifery does attract all kinds of people with all kinds of experiences to draw from. Thank goodness>)