June 6, 2014

The Midwife Debate

Written by Diane Fender, Girls' Globe blogger

This post originally appeared on Girls’ Globe’s website here. Reposted with permission.

The International Confederation of Midwives debate began at the 29th Triennial Congress in Durbin three years ago. This year, the debate centers on the topic of women’s choice and whether midwives base their care on listening to women. Today, midwives from around the world gathered to debate for and against women’s choice in midwifery practice. Each debate team was given two ten minute sections to state their arguments, offer rebuttal and three minutes to close.

The issue of women centered care is largely debated among midwives, health practitioners, organizations and individuals. The lively debate opened with the pro-women centered listening team. Judith McAra Cooper, Head of Midwifery at AUT University, argued that midwifery can not be anything else but centered on women. She states, “Whatever terms we use, women are at the heart of midwifery. Women are informed of their choices and supported with the choices they are able to make.”

Judith spoke passionately about the importance of women’s choice in midwifery practice. She coined women’s choices as the “Holy Grail” of midwifery. Judith argued for the importance of midwives supporting women to make a choices regarding their own bodies. She gave the example of midwives who have supported women during home births, even though they are not legal in many countries. Arguments also centered on the fact that midwives support women even when the appropriate resources are not available. Franka Caddee, supported the arguments and emphasized the intrinsic nature of midwives being women focused.

Jemima Dennis Antwi, Midwife from Ghana led the argument that midwifery practice is often not centered on women’s choice. Her determined and strong voice argued that political will, health infrastructure, physical and financial limitations and patriarchal systems are all challenges which impede women’s choice in midwifery care. She stated, “If politics and political will undermine women in their country: How can women have a choice?”

Jemima highlighted the importance of reaching out to the most vulnerable women, many of whom live in rural areas. These women often do not have any choice regarding their maternal health. Many of them do not have access to a skilled midwife. In addition, midwives are not supported at the government level to travel, live and sustain themselves in order to help these women. Jemima claims that this may not be the failure of the system rather than the midwife.

During the debate, Address Malata, Principal of Kamzu College of Nursing in Malawi, reinforced Jemima’s arguments. Address asked the vital question: “Where are the women in this room?” She emphasized the importance of hearing women’s perspective in the debate. In most countries decisions are made for women by their uncles, fathers, sisters in-law and others. Midwifery services can not focus on women’s choice because women simply lack choice, period.

The Audience’s Voice:

The strong debate concluded with the majority of the audience agreeing that midwifery is not women centered. The audience also agreed that all around the world, midwifery should be centered on women and their choices.