Midwives: the Louboutin of birth experiences?

Washington City Paper published a story yesterday that left me feeling… uncomfortable. Left me thinking, thank God I didn’t go that route. Left me scowling the same way I scowl after too much time in Georgetown, watching ninety-pound co-eds tripping over 200 year old sidewalks in $300 stilettos. The article was about, of all things, midwives.

It’s a long article, and maybe it’s just the author’s snarky tone, equating a growing trend toward midwifery care and natural childbirth with wealth and style. If what this writer says is true, George Washington Hospital is raking in the big bucks with it’s highly exclusive midwifery practice run by saleswoman-slash-midwife Whitney Pinger. I want to believe this article is just dripping with the writer’s own biases. I really want to, because if that’s not the case, then GW Hospital’s midwifery program is a kind of ugly stepsister to the midwifery I believe in, and am employing for my home birth.

“In addition to promising to adhere to a set of diet and exercise guidelines that would please the most traditionalist doctor, the women in Pinger’s practice must be in excellent health and agree to hire a doula, a birth assistant whose services can run from $800 to $1,200 dollars in the Washington area.

It’s no surprise, then, that the group [attending an informational meeting at GW’s midwifery center] is largely composed of the highly educated and the professionally employed. Pinger says she sees lawyers, doctors, and even OB-GYNs. They are athletic women who have pushed their bodies before and will apply the same strength and endurance to preparing for labor.”

All midwives (and there are MANY more in the DC area than just the GW midwives featured in this article) will encourage a healthy diet and physical activity, and while midwifery care is intended for low-risk mothers, mentioning “excellent health” in one breath and implying that means gym-buffed bodies or endurance athletes is disingenuous. Additionally, implying that midwifery care is only for those who can afford a thousand-dollar doula and the costs of those gym-buffed bodies is not an accurate picture of midwifery care or natural childbirth. It’s not meant to be a luxury item packaged and sold to the type-A Washington professional woman – which is definitely a key theme of the Washington City Paper article.

I would encourage the author to look a little further in her exploration of the trends toward midwifery care and natural childbirth. Take, for example, the Family Health and Birth Center off Benning Road in Northeast DC. Their website explains:

“The Family Health and Birth Center (FHBC) is a full scope birth center providing prenatal, birth, postnatal, gynecological and primary health care to women and their families in NE Washington D.C. FHBC is a special place for pregnant women, children, and their families. We view pregnancy and childbirth as normal, healthy events. We promote wellness and confidence related to birth and parenting. We provide women with care that is respectful and also responsive to their individual needs. FHBC welcomes all women and their families, with a primary focus on residents of Wards 5, 6, 7 & 8. Our goal is to bring affordable, family-centered maternity, well-woman, and well-child care to all who need it. …Birth care is offered at two sites, at the freestanding birth center at our location and at Washington Hospital Center. The FHBC midwives provide labor support and management and catch babies at both locations. Volunteer Doulas are also available to assist women in labor at both sites.”

FHBC also offers a highly successful group prenatal session in which mothers in their third trimesters meet in groups to discuss common concerns, answer questions and gain support and confidence in their roles as parents. A similar program and Unity Health Care in my own Columbia Heights neighborhood was recently featured in an NPR series on Pregnancy, Birth and Parenting.

The author might also have looked at BirthCare, a freestanding (not hospital affiliated) birth center in Alexandria, whose midwives have been serving DC area mothers and babies since 1987. When I first moved to the DC area, I began seeing the BirthCare midwives annually for my GYN care. Though I interviewed other midwives in the area (there are numerous independent midwives in practice here) I found myself most comfortable with the midwives at BirthCare. Their modest center on King Street is their office where all prenatal visits are done, and they have two birthing rooms for families who want a birth in the center. They also attend homebirths, and their practice is about 50/50 home and center. When I visit, I see women older and younger than me, women richer and poorer, and from all over the metro area, from the far suburbs to right in the heart of DC like myself. Though there is a waiting list should you decide later in your pregnancy to come to the center, it’s nothing like what the City Paper writer describes at GW:

Besides health trends, one less quantifiable factor also helps explain Pinger’s lengthy waiting lists: It’s human nature to want something not everyone can have. With a small number of slots, Wisdom has “exclusivity cachet,” [John] Larsen [chair of the OB/GYN department at GW] says. He’s seen patients who wouldn’t be candidates try to re-describe their health history, making themselves sound healthier than they are. He’s seen influence peddling, women calling the executive offices of the university to ask if there are ways they can jump the waiting list—and never knows what he’ll hear when the phone rings.

“Tell a lawyer, lobbyist, or top-level bureaucrat she can’t have something and suddenly she’s hungry for it,” he said.

I still want to think it’s the author’s tone in this article that bothers me, and not the actual practice at GW, which I’ve heard positive things about in the past. Even the title of the piece, Real Midwives of D.C.,  is a snarky tip of the hat to the “Real Housewives” reality series showcasing shallow, overprivileged women spoiling themselves in front of the camera. That’s a far cry from midwifery and natural childbirth as I know it. And it’s a skewed picture – her article is about one midwife in one practice. Use of the plural is a stretch, Ms. Masterson, and I think you’ve misrepresented the majority of midwives and women seeking their services in D.C. and elsewhere.

I’m off to read some Ina May Gaskin and restore balance to the universe.

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12 responses to “Midwives: the Louboutin of birth experiences?

  • Sarah

    Really nice, thoughtful response. I no longer live in the DC area, but I did have my first child there and when I read this article I too thought that it was leaving out a lot of the other great midwifery work in the region. It sounds like Pinger is a great advocate for natural birth, but it is unfortunate that “elite” part of her clientele is what the article seems to focus on. I actually think the headline is a big part of the problem– this is actually a profile of one DC midwive, not the “real midwiveS” of DC.

  • DragonKat

    Thank you, Sarah. I agree with you – the article is playing up a segment of the GW clientele attempting to claim midwifery/natural birth is an elitist trend. While that may be partly true at GW, it’s not true city-wide and frankly I doubt it’s really accurate even at GW… There’s so much else I dislike in the tone of this article I really held back to keep my response focused.

  • Jenn Osen-Foss

    I stumbled across your blog from the citypaper article, and I liked it. I did BirthCare last spring for my midwife, and it was nice. Also, I don’t know if you remember me, but I used to work with you at CLPCS for a hot minute (I taught social studies there from 2007-2008). You can check out my blog recording my pregnancy and new parenthood experiences at: http://osen-fi.blogspot.com/

    • DragonKat

      Hi Jenn, Thanks for reading. And yes, I remember you! I hope you landed someplace great after CLPCS – that was an experience…

      I’m definitely going to visit your blog!

  • Letty

    I haven’t read the article, but if it sounds dripping with bias, it probably is. I heard a discussion/interview on NPR in recent months (Diane Rehm or Kojo, maybe?) which included local OBs and midwives and I think one of the doctors was from GW. He was talking about their midwife practice and birthing center. It sounded like a good program to me. Certainly didn’t get the impression it was exclusive.

    • DragonKat

      It was Kojo – and it was a really good discussion. One of the midwives in that discussion works in Charlottesville as partner to the midwife I worked with when I was assisting homebirths 10 years ago. I don’t recall hearing from the GW doc, but I was in the car at the time and didn’t get to hear the whole segment.

  • Hannah

    Dr. Larson is my OB, and during my session to confirm, he suggested I speak to “his” Midwives by stating the following: “The world of Midwifery is filled with witchcraft and rumors… but I’m associated with these midwives, and they’re excellent.” I was then instructed to call them to see if they would “approve” of me and add me to their list.

    So, this is about them approving of me? I thought this was supposed to be about making the MOTHER feel comfortable and supported. Now I have to compete with their expectations? My husband and I left there with a general feeling of McDonaldization, and little interest in calling a group of women who are set up to sit in judgement of whether or not I meet their standards. Like you say, there are plenty of midwives in the DC area, and this is just not the kind of care I was looking for.

    • DragonKat

      Witchcraft? Rumors?? What a weird and misguided introduction to midwives!

      I’m guessing in addition to that badly worded introduction, he also misworded what he meant by “approve” you – I would guess he meant that the midwives would need to assess if your pregnancy was normal (or in more medico-legal terms, “low-risk”). If you were likely to have complications you would probably not “be approved” to use the midwives. This is more about the restrictions they have to operate under to maintain compliance with the laws that allow them to practice at all. And in general, yes, midwife care is for low-risk, normal pregnancies.

      I have NO idea if the impression you were left with is an accurate impression of how the practice operates, but from your description, it does sound like the option of using the midwives was presented in a pretty back-assed way. Dr. Larson should spend some time in Europe.

    • DragonKat

      By the way, Hannah, thanks for visiting Woah Baby! I hope you’ll return!

  • Joanna

    Thanks for this post! The City Paper article freaked me out a little. I am still trying to decide whether to have children, but am certainly interested in midwifery if I do. However, I do not know what constitutes a “low risk” pregnancy. Can you recommend any information on this?

    • DragonKat

      Hi Joanna, I’m glad my response was helpful to you. I recently had an email from a couple in my childbirth class who had their baby with the GW midwives and were really happy, supported, etc and I think they too would not quite agree with the slant this article took. Also, as I pointed out, there are many other places to work with midwives in the city.

      “Low risk” is a bit fluid term but basically means that you begin your pregnancy without health issues known to complicate pregnancy and that during your pregnancy, you do not develop any conditions that could complicate pregnancy/birth/baby’s health. For example, if you had MS or a heart condition, you would be not be low-risk. Or if, during pregnancy, you developed very high blood pressure or some abnormality were discovered with the baby or placenta, you would cease to be low-risk. Midwives attend NORMAL pregnancy and birth. If your pregnancy has other factors to be managed, you need the oversight or care of an obstetrician. Make sense?

      Some great information on birth options can be found in the books: Ina May’s Guide to Childbirth (Ina May Gaskin) and Gentle Birth Choices (Barbara Harper). For some deeper information on birth options, research and outcomes, try something like The Thinking Woman’s Guide to a Better Birth (Henci Goer).

      • DragonKat

        Disclaimer – I am neither a midwife or a doctor. My background includes several years studying midwifery and apprenticing with home birth midwives about a decade ago. My father is a family practice physician. So my medical knowledge is not “official”. Gather lots of information and make wise decisions. 🙂

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