Bridging the Gap: Cracks & Chasms
Editor’s note: This article first appeared in Midwifery Today, Issue 49, Spring 1999.
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Midwives are great bridge builders. We have many opportunities. There are so many gaps to bridge! Some are just shallow potholes, little bumps in pregnancy’s road—nausea, backache, heartburn, insomnia. We offer solace and suggest remedies, kindly ministrations to fill in and smooth out ruts in the prenatal path.
Many gaps are mere shadows, the difference between expectations and reality—“nobody told me I’d feel like this!” So we take time to explain many things—gently, with encouragement—sharing stories with happy endings, light-at-the-end-of-the-tunnel tales. Joining hands, we walk together, using experience and trust to guide us over the rough spots. Together we build upon knowledge and beliefs as our life-bearing companions learn and grow even more. They move through these major life changes gracefully at times, haltingly and with a struggle at various turns. We are there to lean on during times of discouragement, fatigue, confusion. It’s not always easy, but is generally a joyful and rewarding task.
I see other gaps as cracks. Caught early enough, while still small, these separations respond well to our special spackle—a mixture of wise words, generous praise and ready access to resources and information. Often, cracks emerge when the wishes of family members are highly discordant. She dreams of a candlelit, flower filled, hot-tub homebirth with just her husband and the midwife present; his vision involves a stainless-steel-bright, well staffed, high tech hospital, under the authority of a “real doctor” (as, incidentally, his mother feels is best). I enjoy these challenges because they always afford the opportunity for us to get to know each other better. I extend an open invitation to their friends and family members to call me with any questions they may have. I arrange meetings of the interested parties and encourage everyone to freely share their hopes and fears for this birth. By opening the lines of communication, we discover what’s really important and why, so we can craft a plan where everyone feels both safe and nurtured. Skeptical partners and parents express appreciation for the frank discussion, the opportunity to have their concerns addressed honestly and to know their input is welcome and valued. There are often some uncomfortable moments but in the end, we become a united team where mutual respect prevails.
Some gaps are downright chasms, huge gulfs that would require an exorbitantly expensive and lengthy feat of engineering to span. We can’t unite everything, nor should we. Certain chasms exist for a reason. The Grand Canyon is famous for its rugged beauty. To fill it in or mar it with construction of an overpass is unthinkable. Yet the logic of expediency might urge us to do just that. It is so easy to forget the lessons of history.
The problem is, each bridge also becomes an inroad. Consider ancient rainforests and their indigenous inhabitants. Outsiders were eager to broach the wilds to gain access. Why? For the sake of curiosity, easy commercial gain and ostensibly, to bring those poor primitive souls the fruits of modern medicine and technological advancement. Native societies, not always appreciating the ways in which they were already rich, were seduced by promises of prosperity. We know the sad outcome. Cultures and landscapes were degraded and languages lost; the old ways slipped away. Cultural homogenization occurred. Stripped of their resources, defeated, their knowledge dismissed, diverse peoples awkwardly integrated into an increasingly amorphous, dominant society. As antibiotics fail and cancer’s march continues, some search for those lost secrets. Too often, they find the healers have died off, their sacred places destroyed, necessary plants extinct and the wisdom forgotten.
Is our high-speed bridge from traditional birth practices leading us along the same path? We see acceptance and near-universal application of operative procedures—anesthesia, augmentation, instrumentation, cesarean, episiotomy—and women in fear of their own power, a scarred generation. While supervaluing the clinical aspects of the art, science and spirituality of birth care, something vital is being cast aside. Will it be too late when we go back looking for it?
Variety and choice are priceless treasures. Injured recently in an auto accident, I found a myriad of options for treatment. Chiropractors, medical doctors, physical therapists, homeopaths, radiologists, naturopaths, massage practitioners, osteopaths, acupuncturists, surgeons and more—all stood ready to offer their style of care. No one approach held all the answers. I made selections and coordinated my team according to my individual need and personal philosophy of healing. Someone else’s team may have been very different.
It is vital that we preserve the same range of choice in maternity services—honoring the many varieties of approach, practice, philosophy and vision held by those called to serve birthing women; acknowledging that women have their own visions and deserve the full right to realize them by choosing where, how and with whom they give birth. Rather than try to forge a limiting standard, we may more fruitfully seek to reinforce these individual freedoms, thereby finding strength in our wide professional diversity.
I ask, then, that a most important gap be bridged—the synaptic gap, the sparkling impulse of thought across our dancing neurons—to remember that “midwife” rightfully means all manner of different things to different people. May we treasure this kaleidoscopic banquet from which we have the opportunity to both offer and choose.