Birth workers


Homebirth midwives, doulas and childbirth educators like to refer to themselves as “birth workers.” I find it an apt description that betrays the focus of their work and the massive gulf between them and obstetricians.

Obstetricians are health care providers. Specifically, they provide healthcare for women throughout the reproductive years, including, but not limited to: well woman care, contraception, sexually transmitted disease treatment and prevention, pregnancy care, childbirth care, care for pregnancy and childbirth complications, gyncologic cancer prevention, diagnosis and treatment, and care during menopause.

Most obstetricians, in keeping with the ethics of any profession, provide health care regardless of the beliefs of the patient. Moreover, professional ethics requires providing care in keeping with the patient’s needs and values, and disregards the provider’s values and philosophies.

Homebirth midwives, doulas and childbirth educators are not healthcare providers. They evince little or no interest in the health of mothers or babies. They typically provide no care outside of pregnancy, and very little care within pregnancy. Their purpose is to create a very specific type of birth experience, regardless of whether that experience is compatible with the health and safety of their clients. Their purpose is create a birth experience that the provider will enjoy and that will validate the provider’s needs and preferences.

They are the childbirth equivalent of wedding planners with one very important caveat. They will only plan the wedding of their dreams, not the wedding of your dreams.

If the childbirth experience of your dreams happens to coincide with the childbirth of their dreams, they’ll help you. Otherwise, tough luck; you’re on your own. They enter the relationship with primary purpose of entertaining and validating themselves. They are invariably “birth junkies,” women who enjoy the process of birth, and they are “workers” because they want you to pay them for entertaining them, and validating their personal choices. Indeed, some birth workers are quite candid about their lack of interest in the baby.

“Birth workers” ignore the responsibilities of real professionals. They don’t bother with a real education; self-study and a few seminars all the educational and financial investment they are willing to make in their training. They created credentials for themselves without the input of anyone else. They reject oversight of any kind. They reject regulation. They refuse to carry insurance. In short, they begrudge anything that might interfere with their ability to enjoy themselves and profit from the experience.

To give them their due, however, we should acknowledge that although they are ignorant of childbirth, science and statistics, they are brilliant at public relations. Like tobacco companies, they have managed to convince a segment of the public that paying them for their inferior and deadly products is a matter of “freedom” and “human rights.” And like tobacco companies, they are willing to lie and obfuscate in the effort to keep the profits flowing.

Birth workers are an industry, an industry devoted to their own profit and entertainment. They are not healthcare providers and they are not professionals. If you are worried about the health and safety of your baby and yourself, you would hire a healthcare professional, like an obstetrician or certified nurse midwife (CNM), who has years of specialized education and training, and is governed by state regulation and professional ethics that place your well-being above their profit and their preferences.

If, on the other hand, you care more about your experience than about the health of your baby or yourself, feel free to waste your hard earned money on a “birth worker.” She’ll enjoy the experience and hopefully you and your baby will survive it.