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O Midwife, Where Art Thou?: Experiencing the Plight of Midwifery Firsthand

Last October, I wrote a piece about the misconceptions surrounding the midwife brand, so to speak, in a culture where many have painted midwives either as a relic from a rural and unsophisticated past or else as a fringe hippy behavior.

Fast-forward to June 2011, and I find myself only three weeks away from daughter #2 (With the second baby, that might just equal "anytime.") and once again in the regular consultation of a midwifery practice. We did research once we learned we were expecting, and there was no midwife to be found here in Bowling Green, Ky. (Last time around, we were living in New York City.) The closest midwifery practices we could locate were up I-65 an hour-and-a-half to Louisville or down I-65 an hour or so to Nashville. So, Amanda and I make the trek now every week to Vanderbilt so that we can get the type of pre-natal consultation we prefer.

Since writing my first article here on Fast Company about the plight of the midwife brand, I've met a variety of smart women, all of whom are dedicated to "fighting the fight" to change perceptions about midwives in the U.S. There's The Foundation for the Advancement of Midwifery, for instance, a nonprofit dedicated to advancing education, research and public policy for increasing the availability of midwives in the U.S. And there's a particularly compelling project called Where's My Midwife?. The site tracks areas where midwives have been fired or driven out of practice to bring greater awareness to issues surrounding the marginalization of the profession.

Most eye-opening for me personally was hearing from some of the people who run The Frontier School of Midwifery and Family Nursing. It turns out that the particular irony of our plight in having the close care of a midwife here in Bowling Green, Kentucky, is that The Bluegrass State was actually the birthplace of the profession of midwifery in the U.S.. The Hyden, Ky.-based Frontier School is actually "the oldest and largest continually operating midwifery institution in the United States," according to Midwifery Today, launching in 1939.

In my previous piece, I wrote:

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.

It's particularly ironic that such an attitude has developed and a lack of access exists for us in the very state that actually first acknowledged this profession. The smart folks at the Frontier School are working to try and reverse that mindset, to help people understand why the availability of midwives only increases patient choice without encroaching on the expertise of obstetricians. However, they're working with meager budgets and, like many states, midwives in Kentucky are battling uphill in a regulatory environment that is less than fully hospitable to midwifery practices and a society that doesn't "get" what midwifery means outside of homebirth (if even that).

We were actually shocked that, only after months of talking to professionals in midwifery and researching the topic, did we discover options for midwifery for home birth in our area. In our case, we weren't interested in home birth, though, and the only option for having a midwife as my wife's primary care provider in a hospital is to drive to Vandy.

The midwifery profession has to come together to protect their brand from the misperceptions that surround it if they are going to be able to increase midwives' relevance and awareness and connect the many small, grassroots organizations doing work in this field. I'm excited by the possibility as to what happens when these various initiatives find ways to share resources and energy, even when their particular missions/focuses of advocacy are somewhat different. But it's no doubt an uphill battle.

In particular, midwives have to educate people that the overarching title actually houses a range of professions/types. For us, uninterested in home birth, the midwife was a crucial choice for my wife's care in labor because they are an advocate who sticks by a delivering mother's side from the moment she goes into labor until after the baby arrives. That level of attentiveness and a flexibility in adhering to my wife's desires as the patient, alongside the availability of obstetricians were any complications to arise, drove our choice to once again go to a midwifery practice...so much so that we were willing to drive an hour each way for every appointment.

We've been particularly proud these past few weeks that our midwives are a key part of a new TLC series, Baby's First Day, a series which demonstrates the role midwives play in the birthing experience of mothers in a hospital setting. But our second pregnancy experience only underscores for us the deep need for an ongoing education campaign as to how midwives are a crucial option to provide for women across the country and in a variety of settings.

Sam Ford is Director of Digital Strategy for Peppercom Strategic Communciations, a research affiliate with MIT's Convergence Culture Consortium, and an instructor with Western Kentucky University's Popular Culture Studies program. Ford was previously the MIT Consortium's project manager and part of the team who launched the project in 2005. He 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.