I was pretty excited when I first saw earlier this week that the New York Times had written about the increasing popularity and profile of midwives – until I actually read the article, that is.
It’s not that the article, “The Midwife as Status Symbol,” is wrong exactly. Yes, models like Christy Turlington and Gisele Bundchen used midwives. Yes, they are having something of a moment right now. And yes, the public perception of what midwives do and who they are for is changing. The problem is that the Times only presents a tiny piece of the story.
The article focuses on the popularity of midwives among one specific group of people: well-off, healthy women living in New York City. But aside from acknowledging a desire for a more natural birth and the fact that certain midwives are “status symbols,” the Times doesn’t really get into why someone would want to use a midwife in the first place, which seems like a pretty important thing to discuss.
In European countries like the Netherlands, for example, midwives are common and home births are not unusual. OB/GYNs are available for riskier patients but a normal healthy mother is likely to be cared for by a midwife throughout her pregnancy. C-section rates are lower and birth outcomes better; according to one recent report, European countries like Ireland, Italy, Bosnia and Herzegovina had the lowest maternal mortality rates in the world, while the United States ranked 41st.
Midwives are also licensed in some states – including in New York. The documentary The Business of Being Bornlooks at midwives operating in New York City in birth centers and in partnership with OB/GYNs. In other states like Kansas and Ohio, midwives are legal but unregulated, and in several states, including Alabama and North Carolina, they are illegal. Medical reimbursement for care by a midwife also varies by state and by insurance provider. If having a midwife is a “status symbol,” it’s at least in part because there are issues of access related to finances, insurance coverage and geography.
In Ontario, where I live, midwives are licensed and their care is covered as part of the provincial health care system for both home and hospital births, just as care by an OB/GYN is. The practitioners are in high demand here too, but not because women are competing for the midwife of the moment; it’s because their care is valued and available to anyone with an Ontario health card.
I personally have an OB/GYN but he was also supportive of my initial interest in using a midwife; having midwives as part of the health-care system here means less burden on OBs, allowing them to better focus on high-risk patients. As part of their embrace of midwives, Ontario’s government recently announced that they’ll build birthing centers in the province, which will hopefully cover some of the demand.
A midwife can be a great choice if you’re hoping for a non-medicated labor – research has shown that giving birth with a midwife results makes the use of interventions like labor induction less likely. But that’s not the only reason to use a midwife; plenty of women who have inductions, epidurals or c-sections have midwives, whether those interventions were planned in advance or came about as labor progressed. A friend of mine had a c-section for medical reasons, and her midwife was with her the entire time – in the OR, and afterward to help her start breastfeeding. It’s not hard to see why that kind of continuous, personalized care is appealing to many women.
Most articles in the NYT Styles section are fluff reporting on rather dubious trends, usually about something kind of silly that people with too much money are doing. That’s not that big of a deal when they’re talking about a hot fashion item, but I would hope that a matter of women’s health and medical care would get a slightly more serious and balanced treatment from the paper.