When it comes to most everything, language and intent matter. When it comes to birth, that is even more clear. Currently a group of birth workers is attempting to place exclusive parameters around the way birth is discussed, while others are pushing back, hoping to keep things inclusive and intersectional.
The Midwives Alliance of North America is a well-known professional midwifery association that unites midwives across the country as well as educates and informs others about the midwifery model of care. It recently revised its Core Competencies, which, according to the organization, establishes “the essential knowledge, clinical skills and critical thinking necessary for entry-level practice for direct-entry midwifery in the United States.”
MANA revised these competencies in a very specific way. It realized that much of the language it used was female-centered. It has replaced instances of “woman” with “birthing patient” or “pregnant individual.”
What’s the problem, you may wonder? Aren’t women the only ones who give birth? Usually, but not always. What MANA did was make the language in its central documents inclusive of all people who give birth, including genderqueer people who may not identify as women, as well as trans men.
Health care can already be challenging for those who identify as genderqueer or trans. Doctors might not be accepting or understanding of the various health obstacles or needs these patients can have, and some providers may even ignore patients’ identities and treat them as part of a binary they do not fall into. So when health professionals make a point to take care of the language they use to include all people who may fall within there, it’s incredibly significant.
Yet this action by MANA caused a great deal of upset among a core group of midwives and others invested in birthing. In fact, an open letter was recently posted by Woman-Centered Midwifery, arguing against these changes, and was signed by many birth professionals, including noted midwife Ina May Gaskin. Their main gripe is that birth is an intimately female endeavor, biological at its root, and to divorce the language from that is a mistake. Yet they go on to then question medical treatments for trans youth and adults, and while they say they support the LGBTQ community, it doesn’t quite read like that, to be honest.
Another group of midwives and birth professionals has written its own open letter, this one in support of MANA’s changes. The midwifery group Birth for Every Body — an organization that in particular focuses on marginalized pregnant and birthing individuals — posted an open letter in response to the one Woman-Centered Midwifery wrote. Despite my affinity for Ina May Gaskin and all the important work she has done within the birthing community, it was this letter that truly spoke to me:
“We honor and uphold the right to self-determination and bodily autonomy for all people. We believe that as midwives, our purpose is to support parents and babies throughout the childbearing year, taking into account the unique physiological, psychological, and social well-being and needs of each client. […]We acknowledge the disproportionate effects of transphobia on those with other marginalized identities such as being a person of color, low-income or disabled. […]We assert that we can honor the power of the female body and at the same time extend this reverence to all people who are pregnant and giving birth, and that to do so is in full alignment with the heart of midwifery.”
I understand the desire to have birth language be female-centric, especially for older practitioners who most likely had to work hard to have women’s care be taken seriously. They understood the need and importance of fighting against the status quo for visibility and respect. If only they could see that the same thing is happening here.