05.01.08 kulturnatib

Midwives

Since the birth of humanity human birthing has always been facilitated through a person who has a proven competence, experience and knowledge of the birthing process.

Even in the Biblical creation story, humanity itself is said to have been born into existence through the divine handiwork of a person in God.

In many societies and cultures, these persons occupied a position of stature although not all of them wielded power commensurate with such status. Almost all of them, especially those who attended to the births, were women.

When the practice of medicine and its allied fields became professionalized and increasingly technology mediated the practice of the facilitation of births also became professionalized in a medical doctor specializing in gynecology who now worked with other specialists, anesthesiologists and pediatricians, among others.

This is most widespread and most entrenched in the West or the advanced capitalist countries with the East or the mostly Third World playing a game of catch-up, despite a history of the practice of medicine several centuries ahead and advanced of the West.

In the West with every advance in the science and technology of birth a new or several specializations are likewise born and in the East their best specialists end up in the West resulting in a handicap that irreversibly skews the playing field.

The East cannot win this game. Even staying in the game is often a doubtful and much too costly proposition.

The costliness of this in the current practice of medicine has kept the traditional birth facilitators or the hilots alive in our country and with them the tradition of home births especially in the rural areas. Not only that, they have become specialists in their own right, as officially recognized midwives trained to be such like that of any profession.

Recently, as well, the traditional home birth have also now become mostly private birthing centers outside of hospitals and government health centers of which there are now several in the city.

But, even in the West, this costliness is also now recognized. Not so much the upfront cost of professional and other services or medication but in the hidden cost of the various dysfunctions that have come about with the very impersonal medical machine and their professional minders.

Here in Quebec, Canada, this recognition has meant the official recognition of the midwife who in French are called by a nobler name: sage femme, or, literally, wise woman. Now part of the government health system is a network of birthing houses or maisons de naissance.

I have not been to any birthing house in the city. I imagine it would compare favorably with the birthing houses here, give or take a few of the amenities that would expectedly differentiate one from an advanced country and another from the Third World.

Still, I expect there would be the same emphasis on natural birth and home birth is very much an option here subject to certain factors like accessibility for emergency personnel and equipment should that become necessary and breastfeeding post partum.

For my partner and I these were attractive options. We happily attended the preparatory and check-up sessions with our primary and secondary midwives together with other 'specialists' in relaxation exercises and massages, birthing, breastfeeding and others.

But when the time came, it did not come. The birthing house is not allowed to handle situations that would require surgery although it does have the basic emergency equipment that the midwives are fully trained to use.

We agreed with the primary midwife that the hospital was our only choice although a semi-natural birth assisted by epidural and chemically induced would still be tried. That didn't work either.

So, Ceasar had to be called in. But the midwife stayed with us the whole time, though not in the operating room but she facilitated our transfer and got in touch with the hospital baby delivery team, which was a no mean feat at 5.30 in the morning.

In the end, all was well. As they, indeed, continue to despite the inevitable and attendant challenges and sometimes even irritations of newborns with the continuing assistance and support of the midwives.