My name is Stephanie, and I’m a midwife working in the urban United States. I provide full-scope midwifery care at two federally qualified health centers (FQHCs), working with incredible women and catching beautiful babies at an inner city hospital. I have recently graduated, and am experiencing my first year of practice. My prior education and profession focused on international work in both public health and clinical capacities. Since entering a clinical profession, I have come to believe that the parallels between under-served urban America and developing communities abroad are as important to recognize as the air we all breathe. The world is small, immense, beautiful, and vast.
I completed my midwifery “residency” at the same hospital where I am now employed, and remember how in my first moments of the residency, I felt completely overwhelmed. Overwhelmed is almost an understatement: I was pummeled off of what I previously had thought was a strong foundation of emotion and belief. The physical space itself contributes to the feeling of the space: the language barriers of the people seeking care and the geographical positioning of the facility create a sort of quiet place/pays/país of care; things happen, people don’t understand why, and it’s never discussed elsewhere. The unheard falling tree phenomenon. For both patients and providers, there’s a shoulder shrug of circumstances, a sort of “who knows” explanation of care. The pull in the gut of my stomach, echoed by other midwives in the practice, knows that there are some concerning things happening with maternity care in this setting as well as elsewhere. I sought, fought for, and accepted a job here because I believe that I currently have the gumption and drive to try and change the system from within. Naïve perhaps, but fired up.
It is striking, however, that this place is but a mere proxy for many others, micro though they all may feel, and macro in the sense of their additive factor to the political environment of women’s healthcare in this country, which is utterly entangled with the position of women here, there, and everywhere. And woman or not, feminist or not, the role of women in this country, as individuals, as contributors to society, as over half of the world’s population, remains a constant debate in a way that it just is not for men.
Similarly, in international settings, the experience is perhaps all the more intense given the circumstances of women’s inequality in family, communities, and state. Violence against women, in public, in maternity wards, in war, in domiciles, in law, in grey spaces where shoulder shrugs are rationales for care, should be named, named again, named yet again, and then yelled out loud. I, again, have this feeling that if it is not spoken of, it is almost like it did not happen.
One of my dearest friends, in listening to my emotional breakdown at the end of my integration experience, voiced what has been in my heart but I had never named. “Right now, there is nothing more important than caring women.” Feminism, reproductive choice, maternity care, queer and gender-spectrum care, empowerment, friendship, laughter, and love are vital components to how we all provide for each other, medical providers and co-humans alike.
There are some incredible voices in this realm, and I am humbled by their fluency and proficiency. I hope to advertise them, spread their words further, and perhaps add some thoughts to the mix. Miriam Perez’s passion on Radical Doula, Lola Mc.’s wit on The Hairpin, Margaret and Helen’s wisdom and broad view on their self-titled letter-blog, as well as anything from RH Reality Check and Childbirth Connection, I highly recommend. I look forward to interacting with whomever would like to comment, connect, challenge, and push my own thoughts further. Similarly, there is a selfish vein to this blog experience: to facilitate my need move some of the intensity of the work of midwifery away from my emotional core, to speak it and provide a few paces of space, to breathe deeply and then re-examine emotion-laden thoughts with a clear mind. I have a feeling others might be in need of a similar experience. Please join me.