Last time you and I talked about death. I’m still shaken, in the happy sense of the word. Now let me reverse the curve of time, back to the very first breath, the one that sits just at the other end of the existential rubber band. Let’s talk about being born and giving birth.
Do you believe that we protect with the same fervor the place of birth, as this sacred space, too, in which the people involved should be able to find themselves in the same alignment with their deep integrity – let’s even dare to use the word “soul”?
It is with a certain anger, I admit, an anger that I only hope is rumbling and hot like a fire, and not destructive, that I rewrite this column that I have already written a thousand times. Already ten years ago, I wrote this letter in support of those who had shown me the path towards the true posture of support from which all caregivers should draw inspiration, if they claim to be in the slightest way a “humanization of care”. Ten years later, we are again faced with the need to defend, once again, their model of practice.
Already, last year, 10% of midwives had not renewed their license on the professional board, tired of not sleeping, being paid $1 per hour for their on-call hours, tired of face the reductive stereotypes that are still attached to them, tired of having to defend a mission which has so much impact on their way of life, in addition to having to hold a space which summons in itself its own requirement .
This year, with Bill 15, they have the impression of witnessing a historic step backwards and of receiving, in the face, once again, the contempt of a culture entirely placed under the dogma of the “techno-medical” paradigm. “. The intentions of this law are clear: “to place midwives under the hierarchy of a medical director and to submit their work to the evaluation of a professional council composed of a large majority of doctors, where they will always be in the minority. Midwives will lose the professional autonomy for which they have fought for almost half a century,” we can read in the open letter available on the website of the Movement for the Autonomy of Childbirth.
“A new exodus from the profession could well occur if this law is applied,” explains Sarah Landry, the coordinator of the Coalition for Midwifery, which brings together 15 community, feminist and/or union organizations engaged in the fight. for access to midwifery services. For her and the members she represents, behind a “trendy” speech invoking the breaking down of “silos” and the promotion of interdisciplinarity, the hospital-centric aims in terms of births of this bill are absolutely obvious.
In fact, usually, when we invoke interdisciplinarity, we generally avoid placing one of the disciplines above all the others. The cultures of care from medical practice and those from midwifery practice are embedded in radically different epistemological paradigms. However, it is a question here of reestablishing a medical hegemony, as well as a form of paternalism which never ceases to hiccup when it comes to the right of women to act on their own bodies in matters of reproduction, from the beginning to the end.
Let us remember — again — that midwives hold a four-year baccalaureate, based entirely on evidence-based data, that they are members of a professional order and that their framework of practice is approved and recommended by the World Health Organization. health.
Here, the debate does not invite division or to erase the collaborative efforts that a host of doctors demonstrate towards their midwife colleagues. There is already enough contempt surrounding these deeply intimate issues to fuel it. It simply has no place in this debate, which is only about offering and respecting a wide diversity of choices about the ways in which we give birth, here in our corner of the world.
Because giving birth goes beyond the simple delivery of a healthy baby, it also summons, first and foremost, something of the raw, radical, immoderate power of the woman, one wonders if it is not her who would shake the columns of the patriarchal temple too much, again?
To believe that powerful women, accompanied by other powerful women, is dangerous. It is necessary to reread again and again the doctoral thesis of Stéphanie St-Amant, who died in 2017, cut down at the age of 42 by a cancer that I know well from the inside. This entire activist, endowed with dazzling intelligence, provides solid and fundamental theoretical keys to understanding the extent to which the discourse around the natural act of birth has become socio-constructed over the centuries. In her thesis work, she deconstructs for us the history of obstetric practice, unraveling the semantic and practical thread that has gradually medicalized, from the beginning to the end of the continuum, the entire reproductive life of women.
“Thus we have observed that language tightens on the maternal body, a notch more with each decade, the deadly stigma of its failure and its dangerousness”, we read in the preface of this work written as a blow fist, in phase with the unique breath of this woman gone too quickly.
This column will also have been written in one breath, that of anger which has to say, again, things which should be common sense and, also, that of a woman who gave birth at home, yes, but above all that of a clinician who, in wishing to repair the living, has collected thousands of happy and traumatic birth stories and who, as a result, will never, no, tolerate a decline in the choices offered to people who have to experience this crucial moment of their existence.
Clinical psychologist, Nathalie Plaat is an author and teacher at the University of Sherbrooke.