Midwives and lactation professionals, stop abusing women and calling it empowerment


Imagine a gynecologist who performed hysterectomies on every women done with childbearing — whether women wanted them or not.

Regardless of the women’s complaint (be it vaginitis, sexually transmitted disease, fibroids, heavy menstrual bleeding or pelvic pain), he always recommended hysterectomy. If the woman involved opted for something else, a D&C for example, he would perform a hysterectomy anyway when she was under anesthesia.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Empowerment comes from giving a patient what SHE seeks, not what WE seek and certainly not what we think she OUGHT to seek.[/pullquote]

Now imagine that when called on it he claimed that he was entirely justified because he had empowered them.

They would not longer have fibroids, heavy periods or pelvic pain. As for the women who had vaginitis or sexually transmitted diseases, he had empowered them by making sure they would never get cervical or endometrial cancer.

I doubt any among us would fall for such self-justifying, self-aggrandizing nonsense.

We would recognize that empowerment, to the extent it can come from any medical provider, comes from giving the patient what SHE seeks, not what WE seek and certainly not what we think she OUGHT to seek. That’s not empowerment; that’s a violation of medical ethics.

So why do we let midwives and lactation professionals offer the same self-justifying, self-aggrandizing excuse for ignoring what patients want? Midwives claim that they are “empowering” women with campaigns to pressure women into unmedicated vaginal births, whether they want them or not. Lactation professionals insist they are “empowering” women by pressuring them to breastfeed, whether they want to or not.

Consider this self-serving, toxic nonsense offered by Rachel Reed, Midwife Thinking, approvingly quoting a student midwife:

As student midwives, we begin bright eyed and bushy tailed, with a passion for natural birth, for normal birth. We believe in the innate abilities of women, the knowing that she knows her body, her baby. That the woman is the expert and we trust in the seeming simplicity of this. Our university education aims to facilitate this passion, underpinned with feminist theory, enabling critical thinking, the use of evidence and the ability to learn how to apply clinical skill with heart and soul. Then, at some point, the on-the-ground practice begins. We set foot into the hospital. Here we fall into the deep chasm between theory and practice and experience the raw and visceral realities of the midwifery culture which exists at present. Where we thought we would be supporting women and the spectacular physiology of birth, we find the technocratic perspectives in full force. At every turn, in every space, be it antenatal, birth suite or postnatal, we view women being actively disempowered, intervened with and unsupported. Every damn day.

Not a single word about what women want, only what midwives believe women SHOULD want.

What if a woman DOESN’T want an unmedicated vaginal birth? She should be forced to have one anyway so she can be “empowered.”

But a woman is no more empowered by being denied an epidural or C-section than she is by being forced to have a hysterectomy she does not want.

Or this self-justifying nonsense from lactation professional Amy Brown:

Breastfeeding is not simply a logical choice based on some health benefit, but an urge, an instinct. And breastfeeding is useful to women, not just as a milk delivery system but as a convenience and means of mothering. Just as we quite enjoy having a sense of smell, women can enjoy breastfeeding. They can feel empowered, healed and calmed by it. And wanting that – expecting that – is fine.

But what about NOT wanting that, NOT enjoying it, NOT being able to breastfeed?

Formula milk can be life saving and some women may feel it works best for their family, but for others it can never replace the experience they hoped to have as a mother. They don’t want to simply give a bottle instead. Complications and stopping breastfeeding before a woman is ready can be a huge strain on maternal mental health. Women will grieve their loss – and should be allowed to.

She’s obviously disempowered and should be pressured to be empowered by breastfeeding so she won’t “grieve the loss.”

But a woman is no more empowered by being forced to breastfeed than by being forced to have a hysterectomy she does not want.

Who is being empowered in these situations? The professionals who insist that their skills offer empowerment.

Only gynecologists are empowered (and enriched) by forcing hysterectomies on women.

Only midwives are empowered (and improve their employment prospects) by withholding epidurals and demonizing C-sections.

Only lactation professionals are empowered (and enriched) by pressuring women to breastfeed.

A gynecologist who forces a woman into a hysterectomy is abusing her.

A midwife who forces a woman into an unmedicated vaginal birth is abusing her.

A lactation professional who forces a woman to breastfeed is abusing her.

No amount of empowerment blather changes these ugly realities.

Her baby, her body, HER choices and — regardless of who is or is not being empowered — nobody else’s business.