Rachel Stewart: Midwives - overworked, under-resourced and under-paid

As for midwives, who are overworked, under-resourced and under-paid, they're leaving the profession in droves. Photo / 123RF

Midwives. Who needs them?

Not me, that's for damn sure. Too late biologically for any of that birth carry on; too early for the responsibility and worry that comes with offspring. Not to mention the state of the planet. But, I digress.

Midwives are needed all right, and are in serious survival mode. Being hunted by both the medical establishment and packs of journos, joyful in their takedowns, is affecting their long-term viability.

Regarding the latter, I started paying attention to media coverage of midwifery. I noticed a constant theme; a tone that felt off somehow.

The words used to describe midwives are revealing. Editorials or features, usually written after a baby's birth has gone wrong or when they're asking for pay equity, are often peppered with gender-specific put downs.

Any counter-response from the Royal College of Midwives is similarly greeted by media with terms like "shrill" and "strident" or "trilling" rather than speaking, and "venomous" when criticised.

This use of this sexist rhetoric got me thinking. I'd never stopped to consider why it is that chunks of society appeared to display such a bias against midwifery. I mean, these are the specialists who're going to assist women to achieve one of the most amazing things they'll ever do. Why the snark?

My theory is there's a few dynamics going on.

The major reform of the 1990s saw obstetricians lose their exalted status as the one-stop shop of birthing services. The Nurses Act suddenly gave midwives autonomy for practice, giving expectant mothers an alternative maternity provider to the medical service.
Looking back, changing the legislation was hard-won, but relatively easy in the scheme of things.

Here, just like in the rest of the world, midwifery autonomy is constantly challenged as people - doctors, nurses and media - come to terms with the ability of a female-dominant profession to provide a safe service without medical supervision.

Suddenly there was a choice, just as there is today, about using a doctor or a midwife. Doctors were far from thrilled, and many dropped out of maternity work.

While the years have seen a mellowing, and inclusiveness now occurs more frequently, I strongly suspect midwifery is still experiencing a hangover from that era. Certainly, midwives (and new mothers) report experiencing hostility from the medical fraternity - all of which is adding to their qualms about their future.

The other iron in the fire, slowly heating, is the fact that midwives are completely underpaid. Is it sexism? You tell me.

So, what is it about women taking care of other women that is so challenging to the status quo?

Back in the early 90s, midwives started to be paid the same as the doctors had been for maternity and delivery care. More midwives subsequently entered the profession, the doctors racked off, and the pay rates have stagnated.

As with all female-dominated professions, you can kick the can down the road. Or just kick the gals in the guts. Which is essentially what low pay for incredibly important work is.

So, what is it about women taking care of other women that is so challenging to the status quo?

Is it about females having control over their own bodies that rankles so hard? Think anti-abortionists, Catholics against contraception, and weirdos who think that women invite rape by what they wear.

It feels at times like a witch hunt. There are numerous academic theses about this very contention. The disempowerment of women who practised healing or medicine has a long and tortuous history. Ask any self-respecting, self-taught midwife who went from village to village in the 16th century. If you could, but you'd need to cut her down first.

While I'm not suggesting we're still living in such times - although sometimes I've cause to wonder - the idea that women should have control over their lives is still difficult for some to fully accept.

Yet, here we are in the early 21st century, and American lawmakers are still obsessing over what rights women should have taken away from them.

This week an Oklahoma state representative described a child conceived because of incest or rape as being "beauty from the ashes" and "God's will". In other words, he's nuts.

Sure, that attitude is distinctly American but not entirely. There are deep-seated attitudes floating around here too. New Zealand misogynists just don't tend to articulate them. They operate on a different level; a quieter one. They still do damage though.

As for midwives, who are overworked, under-resourced and under-paid, they're leaving the profession in droves. Retention rates have gone from 15 years to about six years, and stress and burnout is greater than in any other profession.

I'm not suggesting they're above criticism. Not at all. I'm suggesting that we have a bit of a think about how we value women's work and women.

We could start by toning down the sexism and dialing up the appreciation. And the dollars.