1. Get Real | Winter 2016 1
GET REALIgniting a consciously aware life Winter 2016
Issue 4
your rootsyour potentialyour vulnerability
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2. Deep Dives
Birthing Our Inner KnowldegeBy Melissa Pletscher-Nizinsky
78 Get Real | Winter 2016

3. Get Real | Winter 2016 79
Coming into the winter issue which focuses on
learning to prepare and the festival of birth/rebirth,
I started thinking about my own birth experiences. I
have three children ranging in age from twelve to four.
For each of these pregnancies and births, I chose to get
my obstetric care from a midwife. This is also where
I’ ve chosen to get my gynecological care when I am
not pregnant. For myself, this felt like a logical path to
take. I have always gravitated toward female health
care providers. Partially this is a result of being sexually
abused as a child. I have had little trust of men in general
throughout my life and was certainly not comfortable
enough to be as vulnerable as one needs to be in a health
care atmosphere with a male provider, particularly
when it came to gynecological and obstetric care. As a
woman, I also feel it is much easier for a female health
care provider to understand the physical, emotional
and mental workings of another female since they are
working with the same biological make up. This is not
to say by any means that male health care providers
do not know how to treat female patients. I currently
have two male providers on my medical team who are
both wonderful. That being said, I would still, given
the choice, choose a female health care provider over a
male in most circumstances and for gynecological and
obstetric care I can’t imagine not choosing a midwife.
I have been fortunate to have had uncomplicated,
“normal” pregnancies, labors and deliveries so I have
never had to face the possibility of not seeing my midwife
for care. Pregnancy and birth have always seemed like
For centuries, midwives were
the primary health care providers
for both women and men
within their communities.

4. 80 Get Real | Winter 2016
a normal event which my body was biologically made
for should I choose to use it for these purposes. I have
always viewed hospitals as a place to go when you are
sick or dying. Since I’ve never considered pregnancy an
illness and felt confident in my body doing what it was
biologically meant to do, I really did not want to have
my baby’s birth happen in a hospital. Unfortunately
(or fortunately as some friends and family would
see it, including my husband) the midwifery team I
had chosen for my care would not do home births. I
really liked both the midwives in this practice as well
as the female obstetrician who worked with them, and
therefore trusted that even though I would be giving
birth in a hospital setting rather
than in the comfort of my home, my
wishes and concerns would be met
and addressed. For the most part,
this was the case.
I was blessed with quick
and relatively “easy” labor and
deliveries. Labor and delivery are
NEVER easy. It’s a LOT of work to
bring a new human being into this
world. Having three unmedicated,
vaginal births, I can honestly say to
date giving birth is the most pain I
have ever been in. They don’t call it
“labor” for nothing and when that
baby’s head crowns there is nothing
to do but pay attention. So when
I say I had an “easy” labor and
delivery, I don’t want you getting the
idea that this was a jaunt through
the park while eating bonbons. It
was hard, difficult and often painful work but work
that I felt prepared for, both physically and mentally.
I’m not sure exactly why this was how I felt when so
many of the women I encountered along my journey
into motherhood felt so differently. Every woman
within my family who had children, delivered them in
a hospital setting under the care of a male obstetrician,
often highly medicated (and in the case of at least one
of my grandmothers, completely unconscious and
unaware she was even having twins until she awoke
much later and was handed two babies instead of one),
frequently without any familial support around and
often experienced complications of one sort or another
resulting in surgical intervention or loss. Considering
this, one would think my view of pregnancy and birth
would not be so positive in nature. I credit some of this
viewpoint to a mother who lifted me up and encouraged
me through every step of my life journey so far, even
when those steps weren’t necessarily the steps she would
have taken. I also credit this viewpoint as coming from
my unquenchable thirst for knowledge on just about
every topic I encounter. Pair these with my stubborn
nature to do things the way I want to rather than the
way society tells me to, and I guess we come closer to
the answer to that question.
As women, we are often taught to ignore our
intuition and core knowledge. This can be seen in
the history of midwifery. Historically, women have
always had other women in the community to turn to
for support, whether with reproductive health events
or societal/social issues. Midwife(English), sage-femme
(French), jordemor (Danish) or ljósmóðir (Icelandic) all
refer to women who have “been at the center of the
‘woman’s world’- the part of life and society that
women have some control over and from which men
tend to be excluded, including until recently, pregnancy
and birth.” (Wagner, 101) For centuries, midwives were

5. Get Real | Winter 2016 81
the primary health care providers for both women and
men within their communities. This was true of both
European communities as well as colonial communities
in North America. During the Middle Ages in Europe,
specifically during the Inquisition, midwives were often
victims of witch hunts. As stated on Gendercide Watch,
60,000 plus people were killed during these witch hunts,
80% of the victims were women and half of those
were midwives. (http://www.gendercide.org/case_
witchhunts.html)Theseaccusationsoftenstemmedfrom
the newly institutionalized medical field. At this time,
men were attempting to take over the heath care system
by requiring all health care providers to be university
educated with some sort of degree. Since education
in general and university-level education specifically
was denied to women at this time, this requirement
would effectively put local midwives and other female
health care providers out of business. Unfortunately
for the newly minted "educated" doctors, local people
were unwilling to trust these new health care providers
and continued to seek medical assistance from their
local midwives whom they had a trusted relationship
with. In order to remedy this situation, newly minted
doctors worked in conjunction with the church to level
accusations of witchcraft against these midwives. This
eliminated the midwife factor either because these
women were killed or there was enough distrust placed
around them that the local people were no longer
willing to risk going to midwives, thereby giving them
little choice but to seek healthcare from the university
educated doctors.
Much like in Europe, it was the professionalized
medical community which eventually pushed midwives
out of the medical field in the United States as well.
Although accusations of witchcraft were always a risk
in the American colonies and what would eventually
become the United States, up until the late 1800s and
early 1900s midwives were still an important aspect of
early colonial communities. Unlike Europe which had
been urbanized for centuries, America was a relatively
unsettled country (at least in the European colonists’
view).Initialcommunitiesweregenerallysmall,agrarian
based settlements surrounded by vast “unsettled” areas.
Because university trained doctors from Europe were
not often choosing to come to the colonies, midwives
were often the sole health care providers in colonial

6. 82 Get Real | Winter 2016
communities and greatly respected. “Midwives were
responsible for the care of almost all pregnant women
during the first 250 years of life in the colonies of
the United States.” (Rooks, 17) It wasn’t until the late
1700s and early 1800s when American medical schools
started to come into existence that midwives’ hold
on the healing professions started to slip. Even then,
midwives were still the primary health care providers for
women giving birth as well as for community members
in more rural societies where “educated” doctors
were unavailable and/or unaffordable. With the start
of the 1830s and ‘40s, male doctors began to make a
bid for taking over the obstetric field. Before this time,
birth was still considered within a woman's realm and
therefore untouchable by male doctors unless in cases
of difficult births. With the increase in professional
medical schools, doctors began to see obstetrics as a
money making field which they were losing out on due to
midwives. Rather than using accusations of witchcraft
like their European forefathers, doctors started to use
accusations of uncleanliness, lack of education and
practices based on superstition and old wives tales as
ways to sway people away from using midwives for their
obstetric needs. They also attempted to blame midwives
for high maternal and infant death rates, although
there have been studies to show that doctors had much
higher death rates due to overzealous use of various
interventions as well as unsanitary practices (such as
lack of hand washing between patients).
The switch from midwives to doctors happened
gradually starting with the upper classes until around the
1930s with the invention of sulfa based antibiotics which
greatly decreased maternal death rates. By this point
most states required midwives to be licensed, although

7. Get Real | Winter 2016 83
few provided adequate training Most midwives at this
historical juncture were immigrant women serving
immigrant or rural populations. Rooks states “By 1932
approximately 80 percent of all midwives practicing
in the United States were traditional birth attendants
living in the rural south.” (pg 50) It wasn’ t until the
1950s with the beginnings of the Natural Childbirth
and Breastfeeding Movements, and more so the ‘60s
and ‘70s, that the US started to see a returned increase
in obstetric care provided by midwives in the form of
Certified Nurse-Midwives.
Although the university trained doctors in the
United States did not use witchcraft accusations as a
means to eliminate competition from midwives, they
did use stereotypes and fear tactics, much like their
European counterparts centuries before. I do believe
that the male medical field was the main push behind
the removal of midwives from health care, but it is
important to remember that some of this shift came
from women themselves. During the beginnings of the
1900s when birth started to shift from midwife to doctor
based care, women of the upper class and eventually
the middle class began to demand more comfortable
and less painful births. This was often achieved
through administration of various drugs, particularly a
combination of morphine and scopolamine otherwise
known as "twilight sleep." This combination helped
reducepainandcausedlackof memoryof thechildbirth
process. These drugs could not be administered at home
and therefore required a hospital doctor based birth if a
woman chose this option. In addition, women were also
being advertised to more in journals and magazines,
encouraging them to choose doctor supervised, hospital
births for more comfortable and safer deliveries.
Currently, in most industrialized countries outside
of the United States and Canada, the majority of low-
risk births are attended by midwives. Why is it that in
our society, midwives are seen as less than both in their
knowledge and ability to care for women’s reproductive
needs? Why do we in the United States put trained
surgeons in the form of obstetricians in charge of a
natural process like birth? Dr. Marsden Wagner argues
in his book Born in the USA: How a Broken Maternity
System Must Be Fixed To Put Women and Children First, you
wouldn’t put surgeons in charge of other normal life
events, so why do we do that when it comes to birth? He
argues because obstetricians are trained surgeons, they
think like surgeons and unconsciously view birth as a
medical event. (pgs 20-21)
Judith Pence Rooks states in her book Midwifery and
Childbirth in America,
Whereas medicine focuses on the pathologic
potential of pregnancy and birth, midwifery
focuses on its normalcy and potential for health.
Pregnancy, childbirth, and breastfeeding are
normal bodily and family functions. That they
are susceptible to pathology does not negate
their essential normalcy and importance of the
non-medical aspects of these critical processes
and events in people's lives. (pg 2)
One detail we seem to overlook here in the United
States is the fact that midwifery and obstetrics are two
different professions. Although they do have overlapping
knowledge bases, essentially they are not one and the
same. Their philosophies around pregnancy and birth
are very different. “Midwives are not practicing from
the middle realm of obstetrics. They are practicing
midwifery.” (Rooks, pg. 6) In general, midwives focus
on pregnancy and birth as a natural process and one
which can be life-enhancing. They assist in the birthing
process and act as facilitators and support for the
birthing woman and her family/support system. They
are trained to identify problems and know what can go
wrong, but this is not their main focus.
Obstetricians, on the other hand, often view
pregnancy and birth as a medical condition, something
which happens to a woman rather than something
that women do. They generally focus on what can go
wrong with pregnancy and birth, and how to treat
those problems. They are trained to look for problems,
figure out treatments and generally focus on the science
without taking into consideration subjective experiences
Because university trained doctors from
Europe were not often choosing to come
to the colonies, midwives were often the
sole health care providers in colonial
communities and greatly respected

8. 84 Get Real | Winter 2016
that go along with all life events.
This is all not to discount obstetricians or argue that
they have no place in the birth process, but it is a call
for us to take a hard look at how we deal with this life
event which is a part of so many people’s lives. There
will always be a place for obstetricians in the birthing
process, it’s just a question of where that place is.
Should that place be with normal, low-risk pregnancies
and births, or should it be relegated to high-risk cases
where their expertise would be most beneficial? “When
we try to make women believe that they can’t give birth
without the help of men, machines, and hospitals, we
take away their confidence and their belief in their own
bodies - and with their confidence gone, any feelings of
power and autonomy also disappear.” (Wagner, pg 190)
Now of course, this story may not and probably
will not resonate with all women. Although I believe
my female body was created to gestate and birth new
humans, that does not mean I think as a woman this
is my sole role or even that I think it should be my role
at all. I chose to go down the path of motherhood
with open eyes, heart, mind and arms, but that was my
choice and may not be yours. Fundamentally though
this story of the stifling of women's voices in the
medical field, particularly in the realm of obstetrics and
gynecology, exhibits the continued denial of our inner
knowledge and intuitions of the workings of our bodies.
The medicalization of birth has caused women to lose
the trust we once had in ourselves and our abilities.
We often ignore what we know in favor of what we are
told. Where else in your life are you stifling your voice?
Where are you ignoring your inner knowledge? ~
Works Cited
Wagner, Marsden. Born in the USA: How a Broken
Maternity System Must Be Fixed To Put Women and Children
First. Berkeley: University of California Press, 2006.
Rooks, Judith Pence. Midwifery & Childbirth in America
Philadelphia: Temple University Press, 1997.

9. Get Real | Winter 2016 85
Books:
Witches, Midwives & Nurses: A History of
Women Healers by Barbara Ehrenreich and
Deirdre English
Reconceiving Midwifery edited by Ivy Lynn
Bourgeault, Cecilia Benoit and Robbie
Davis-Floyd
The Rhetoric of Midwifery: Gender,
Knowledge and Power by Mary M. Lay
Sisters on a Journey: Portrait of American
Midwives by Penfield Chester
Baby Catcher: Chronicles of a Modern
Midwife by Peggy Vincent
And check out this article about doctors,
nurses and other medical professionals who
are choosing to give birth at home:
h t t p : / / j e n n i f e r m a r g u l i s . n e t /
blog/2014/09/why-doctors-nurses-and-
other-medical-professionals-are-choosing-
to-birth-at-home/
American College of Nurse-Midwives
www.midwife.org
Midwives Alliance of North American
www.mana.org
Birthwise Midwifery School
www.birthwisemidwifery.edu
Want to know more? Check out these sources: