walkitout (walkitout) wrote,

_Mainstreaming Midwives_, edited by Robbie Davis-Floyd and Christine Barbara Johnson

Subtitled: The Politics of Change

It's almost 600 pages long. Each chapter has its own author(s), end notes, etc. It begins with an analysis of the two major midwifery organizations in the US. There's a state-by-state analysis of successful and as-yet unsuccessful attempts at licensing midwifery and the effects of the resulting regulation or lack thereof. The last chapters discuss how midwifery fits in with medical care in terms of transport and risking out, and the role of midwives who take on more than their community and/or regulatory system think they should. Scattered throughout, there's substantial discussion of the ideals held by the alternative birth movement and the direct-entry midwives who grew out of it and are possible as a result of it, and how those ideals problematize licensure.

First question: why am I reading this? No, I'm not going to become a midwife. But I really liked Robbie Davis-Floyd's _Birth as an American Rite of Passage_, so when this was published and popped up on my recommendeds at Amazon, I was predisposed to want it.

Second question: is there any earthly reason why someone who isn't interested in midwifery might read this? I think it's fairly obvious that if you are interested in midwifery (whether you want to become one, or whether you want to understand what's going on with them currently in the US or whatever), this book is going to be somewhere on your To Read shelf. But anyone else? I would argue yes. While in general the authors of the individual chapters are writing from an anthropological or ethnographic perspective, what they are writing about is public policy and how it happens (or doesn't happen). Since the public policy in question is not a partisan issue -- and since a lot of really interesting public policy similarly is not inherently partisan -- this slice of politics and policy at the state level over the last few decades is _really_ fascinating. I think there's a lot here of value to other people looking to effect change, whether in terms of health care in general, energy policy, family leave, long-term care, education, or whatever. (Highly polarized along party lines topics like gay marriage and abortion are substantially less comparable.)

This was a surprisingly fast read (2 days) considering its length, the number of authors (which can often seriously impede flow), the density of information, etc. Because the community under discussion is kinda not really pro-academic, even an academic analysis reflects the fun-loving, free-wheeling spiritual orientation of (some) midwifery (at least at times). That helps keep things moving. And there's a strong, underlying story line: the Turf War between nurse-midwifery and direct-entry midwifery, and the larger battle between midwives and medical trade groups like the AMA and their state level minions. And the most important struggle of all: to retrieve birth from the technocracy. They all continue, none entirely lost, and none of them far from certain in outcome.

If you are absolutely in favor of primary elective cesarean, this probably is Not Your Thing.

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