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Leadership

Cultural Misconceptions and the "Midwife" Brand

Communicators have long known that one of the most crucial ways to activate an idea in people's imaginations is to find a relevant way to discuss it and present it to them. I remember a colleague telling me that the makers of TiVo had him when they said, "Pause live television." That single concept made real what DVR technology had to offer him. As another colleague once said to me, much of what marketers do is create powerful metaphors that make a product, service, or brand immediately intelligible, to get at its heart and communicate its meaning efficiently.

It's especially frustrating when you see a brand or movement that should have that sort of immediate connection with people, yet something is lost in translation. And, today, I think there's a major disconnect from a branding and marketing perspective with what I would consider a key professional role in the world: the midwife.

The Business of Being BornIt wasn't that long ago that it was quite normal for children to be born at home, out of necessity more than anything else. Even a generation ago, one of my parents was born at home, and such occurrences weren't considered an oddity. Today, though, I'm amazed that "home birth" is considered some sort of activity for alternative lifestyles. What's more, midwives have seemingly been pushed to the fringes of our society more often than not.

The Business of Being Born points out the ways in which midwifery was demonized and questioned alongside the dawn of the modern delivery process, shown to be the purview of quacks and witch doctors rather than legitimate experts who know how to assist a mother through labor in a natural setting with few complications. The Business of Being Born is a polarizing film, I realize, but its points about the un-naturalization of the mid-wife profession that has happened in our country was hard to dispute.

Today, that concept of the mid-wife as being somehow unnatural or foreign has seeped so deeply into our way of thinking, it's amazing. When my wife and I were choosing a professional to consult with for our pregnancy, we were looking for someone whose offices were close to ours in New York City. We actually chose a mid-wife from our insurance list by accident. However, once we started going to her, we decided that we particularly liked the idea.

However, many friends and family demonstrated great concern. They were somewhat assuaged that we planned to deliver in a hospital and that our mid-wife consulted with a doctor in situations of any complication, but there was this feeling nevertheless that the only way my daughter would appear in the world would be through some sort of medical intervention—as if children weren't born before medical licensing boards came along.

Of the most surprise to me was that some family members in Kentucky seemed shocked and even concerned. As I said, it wasn't that long ago in these more rural areas where home births and experts who could assist in the community were the norm rather than the exception. Perhaps one reason the idea of a mid-wife seemed incomprehensible to some of our family and friends here in The Bluegrass State was because we really aren't that far removed from a time when travel was a concern, when people couldn't as easily make it to hospitals, and when mortality rates were higher because of those inefficiencies.

But, whatever the reason, the un-naturalness of the mid-wife seems to have formally taken hold. As I was thinking about the topic, I saw that there is no mid-wife available here in Bowling Green, where I live. The closest professional here in Kentucky would be a drive to Louisville. Meanwhile, many who prefer a mid-wife drive to Nashville instead.

The irony that only urban hubs now host mid-wives is massive. It's like only being able to get good barbecue or diner food in a city while small towns are now full of fast food chains, ironic of course because the city restaurants are based on what the small towns used to have. For midwifery, this has causes outside of the branding of the profession. For instance, medical malpractice insurance makes it very hard for a mid-wife to function in a rural area without a steady stream of expectant mothers to work with. But it seems that the largest issue of all has been a lack of demand and a belief now that the natural way to deliver a child is in the hands of a licensed physician.

The biggest hurdle to overcome is that many have painted midwifery in extremes: as only for parents who completely oppose medical intervention, almost as eschewing all that modern medicine and technology has given us. Yet, in our experience with Emma, my wife chose to take medication to help induce labor after being a week past her expected due date based on the counsel of our midwife and eventually also chose to have an epidural. But the midwife knew that our goal was to have a vaginal delivery and, despite constantly warning us that it might not happen and encouraging us not to rule out surgical intervention if there was no other way, she assisted alongside us for 18 hours. Once she arrived, she never left our side. She took naps by the nurse's station and didn't hover, but she had no other place to be. And knowing that made every step a little less nerve-wracking.

Many are battling these extreme notions of what a midwife is or does. Advocacy groups for midwives are quite active, and the rise of young mother movements amidst the growing influence of mommy blogger communities have given voice to pushing back against a culture of Cesarean sections, of excessive use of medical intervention, etc. But, to me, the battle will not be won until midwives can be positioned not as some new fringe "hippie-mother" movement but as a longstanding and natural part of the human experience, as part of rather than threat to the modern health care industry.

Sam Ford is Director of Digital Strategy for Peppercom, a PR agency, and a research affiliate with MIT's Convergence Culture Consortium. Ford was previously the Consortium's project manager and part of the team who launched the project in 2005. He has also worked as a professional journalist, winning a Kentucky Press Association award for his work. He also blogs for Peppercom's PepperDigital. Ford is co-editor of The Survival of Soap Opera with Abigail De Kosnik and C. Lee Harrington and co-author of the forthcoming book, Spreadable Media with Henry Jenkins and Joshua Green. Follow him on Twitter @Sam_Ford.