August 18, 2010
Volume 12, Issue 17
Midwifery Today E-News
“Midwives under Fire”
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In This Week’s Issue:

Quote of the Week

“You gain strength, courage and confidence by every experience in which you really stop to look fear in the face.”

Eleanor Roosevelt

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The Art of Midwifery

If a Midwife Faces Jail

Being in jail is the same for a midwife as being out of jail. You sit around and listen to women tell their birth stories.

Gloria Lemay
Excerpted from Sharing Midwifery Knowledge, Tricks of the Trade, Vol. IV
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Jan’s Corner

Midwives under Fire

We’ve had a period of relative calm in the North American midwifery community since 2002. In an issue of Midwifery Today E-News from July 2001 (, Sandra Stine, CNM, wrote about the history of midwives under fire:

“I am thinking about Yvonne Cryns, Nan Koehler, Abby Odam, the granny midwives and every other traditional birth attendant in this country who has been crucified by the AMA or another source,” Stine stated. “Wonderful, loving, competent midwives have been jailed, lost their homes, spent thousands of dollars defending themselves, or were placed under house arrest while serving families competently. The AMA (American Medical Association) has a track record of prosecuting midwives in almost every state!”

In July of 2002, Gloria Lemay was imprisoned for contempt of court in Canada. A few months later, Mennonite midwife Freida Miller was arrested and imprisoned for contempt of court in Ohio. Thanks to easy Internet access in 2002, the stories of these imprisonments—and of the events that built up to them—were relayed around the globe. Both women were mature adults and both went to prison knowing they had widespread support in the international community. They went to prison with their heads held high and their supporters worked behind the scenes, fundraising and researching to free them. Money and well wishes flowed in from all over the world. North American midwives had entered a new era.

While in prison, Lemay learned that she would be given an award for being “the woman in Canada who had made the biggest contribution to midwifery care in the year 2002.” (Women’s Voice Award). The story of her incarceration can be found at:

To read more about the trial and imprisonment of Freida Miller, visit

Lemay is in great company. There are midwives in more than one country who have gone to jail for serving mothers and babies in birth and usually on trumped-up charges. These maverick women serve those who are in jail with them who are pregnant or have babies. In Russia, jailed mothers keep their babies with them. On a recent visit to Russia we heard about a midwife, a mother of six who was jailed for nine months. I heard that she just took care of the mothers and babies who were in prison. I understand that she is out now, but her homebirth practice was essentially taken away from her. So sad for the mothers and babies she served for 17 years. Gloria cannot call herself a midwife and I wonder when the province of British Columbia stole that word. Midwife was a word long before BC became a province. I wonder when the same thing will happen in the US.

One of the reasons California was so keen to get a midwifery regulation law was that several homebirth midwives were jailed there. So there is being under fire and there is really being put to the test with actual bars that try to hold you back. (Midwives can never really be held back.) Others have been persecuted into stopping their practice or getting their CNM certification so they wouldn’t be persecuted in the same way. At least they can keep doing homebirths!

Perhaps we reached a turning point in 2002 in North America. Perhaps the imprisonment of these two midwives was the end of putting North American midwives behind bars. But the persecution of midwives continues in other areas. In 2010, the hot spot seems to be Australia. Many homebirth midwives have lost their licenses on that continent and there is a coroner’s inquest scheduled to investigate the death of an infant born at home in Adelaide, Australia. But we live in an era of instant communication. Thanks to online social networking sites like Facebook and Twitter, as well as basic e-mail, we can reach out to midwives even in distant lands and support them through these archaic investigations.

— by Jan Tritten and Gloria Lemay

Gloria Lemay is a lecturer, midwifery educator and traditional birth attendant in Vancouver, BC, Canada. She specializes in VBAC and waterbirth. She has served birthing women since 1976 and is an advisory board member of ICAN and the Canadian Doula Association. Gloria has three grown daughters and one teenage granddaughter. She wants her tombstone to read, “She spoke up for babies.”

Jan Tritten is the founder, editor-in-chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.

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A new study published in the July 2010 issue of the medical journal Obstetrics & Gynecology links induced labor with a greater risk of cesarean surgery.

The study, which looked at 7,804 first-time mothers giving birth in US birth centers showed that women who had their labors induced were twice as likely to have a c-section than those women whose labors started naturally.

“Labor induction is significantly associated with a cesarean delivery among nulliparous women at term for those with and without medical or obstetric complications,” the authors noted. “Reducing the use of elective labor induction may lead to decreased rates of cesarean delivery for a population.”

— Ehrenthal, D.B., X. Jiang and D.M. Strobino. 2010. Labor induction and the risk of a cesarean delivery among nulliparous women at term. Obstet Gynecol 116(1): 35–42.

Midwifery Today Short Video Contest Deadline Extended!

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Threats to Midwifery in Peru

Peru’s official health system discriminates against poor rural women, especially if they have an indigenous identity, as most Andean women do. The nature of this health system affects birthing women and traditional midwives in particular. This system practices and promotes institutionalized birth or delivery—that is, the Western model of medicalized birth. As a result, an ongoing underground campaign threatens traditional midwives. It is a kind of modern Witch Hunt, in which women who give birth at home with traditional midwives are fined. This has led to adverse consequences in women’s ability to control their bodies and to actively participate in the maintenance and treatment of their health, in their autonomy and in their cultural identity. …

In general, rural Andean women are discriminated against and mistreated by professional health workers at the local health posts and hospitals (based on their economic condition, gender and culture). In addition, traditional midwives are harassed and threatened if they continue with their practice. Most of the time, the health professionals (professional midwives, nurses, doctors and/or technicians) only speak Spanish; they don’t speak the local language—which is Quechua in the Andean areas—and aren’t interested in learning it. Perhaps most alarming is the fact that women who give birth at home with traditional midwives are fined by the health centers when they attempt to register their babies and get their birth certificates. If they don’t pay the fine (which most of them can’t afford) they don’t get the certificate, which violates their reproductive rights (right to choose where and with whom to give birth) and their baby’s international human right to identity. In addition, because a birth certificate is required in order to receive a variety of government services, including health care, these children suffer even further. …

In contrast to public health professionals, traditional midwives belong to the community and know their women best. As a result, supporting and strengthening community midwifery is the best strategy to improve maternal health, rather than focusing on campaigns to eradicate it and making all women give birth at the health centers. This strategy is urgent because in many Andean places now, traditional midwives are getting old and willing apprentices are afraid to learn and practice, in part because of the Ministry of Health’s harassment against traditional midwives. The younger women instead prefer to study obstetrics, risking loss of all this midwifery tradition and expertise.

The loss of traditional feminine medical knowledge—and consequently the dismantling of the community’s feminine social network to support women’s health—has a huge impact in the autonomy of women to control and to treat their bodies (and to know their bodies) because of the consequent total dependence on “professionals” and their medical system, which in many cases, isn’t even available in the community. Birth is one of the last cultural spheres where Andean cultural tradition remains almost intact, despite all the processes of Westernization that have influenced the gradual loss of many cultural features. Birth is a cultural sphere protected by women. Therefore, the changes occurring around birth in these areas have a great impact on Andean women’s autonomy, cultural identity and overall health. A satisfactory birth—in physical, emotional and socio-cultural terms—is pivotal for the successful reproduction of life in the Andes.

Cynthia Ingar
Excerpted from "Midwifery & Birthing: Women in Peru," Midwifery Today, Issue 85
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Web Site Update

Read these book reviews from Midwifery Today newly posted to our Web site:

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Question of the Week

Q: How does the threat of persecution affect your midwifery practice?

— Midwifery Today staff

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