Midwives, Mothers, and Power

When we use the services of a professional we voluntarily enter into a subservient relationship with that person. When it comes doctors, they wear a white coat, have a stethoscope slung around their necks and we are in their power. The doctor may be somewhat aware of this, and the need to “include the patient in decision making” but it takes more than that to alter the power dynamic. Usually the doctor believes strongly in his own power and that doesn’t help.  Despite malpractice suits held over their heads, physicians generally find it close to impossible to cede control totally to the owner of the body they are assigned to heal.

Midwives come to prenatal and birth care with a philosophy of woman-centered power and control. We usually wear our regular clothes, sit opposite our clients at the same height and discuss knowledge and options available concerning care. We try. But power is inescapable for those providing a service. We do have power.

I believe that much of our power lies not just in the knowledge and experience that we possess, but also in the relationship with our clients that we so treasure. We love what we do and we love our clients and their families. Ironically, this is dangerous! An inescapable outcome of love and caring is entanglement, psychological interdependence. “Well, so what?” you may ask. “Surely it’s good for a strong relationship to develop between midwife and client?” Certainly there are benefits for both in an interdependent relationship but the power of the midwife over her client is increased at the expense of the woman’s sense of self if she believes that her strength is in any way derived from the midwife. The less personal intimacy between midwife and client, the more powerful the woman emerges from the birth experience.

However, I do not believe that we midwives must remain distant, professionally objective and lacking empathy. I just don’t believe in that! (And it’s not possible). No, but somehow midwives must navigate the relationship to constantly move out of the way of women’s strength. I’m not sure I can explain what I mean better than that…. or whether it is possible, but it is certainly one of the great paradoxes and challenges for midwives: to recognize the dangers of the midwife-client relationship while building on its potential, and always trying to move out of the way.