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Show 9 had to band together and create more professional standards and accountability and legislate practice to preserve the right to exist as a profession. The shift from art to profession has left some midwives to question weather the true spirit of midwifery is lost with conformity. Are we becoming just another medicalized, regulated profession? Finding a balance between professionalism and maintaining the spirit of the art of midwifery is an ongoing debate. LG: What are some of the cultural implications of our society that affect how you work? Tara: Because I work in a balance of supporting parents rights, maintaining a professional license and negotiating with sometimes hostile providers, it is difficult to practice what I truly believe all the time. Sometimes it is tempting to want to suggest an intervention to a parent because even though I know they are likely safe to continue with a planned homebirth, if I end up having to transport the situation, there are ramifications for going beyond the expected protocol as established by routine medical practice. In cases where it is clinically and evidence-based practice to allow a mother to choose to refuse transport, but standard procedures in a medical establishment would push a mother toward an intervention, then there must be documented evidence that a mother was given fullinformed consent, and that she refused to do the "wise" thing anyway. Litigation, malpractice and authoritative policies do not always lead to evidenced-based use of interventions. The result leads to secondary problems occurring from the over-use of interventions and providers pushing mothers to use them based on the safety of their reputation, license or fear of litigation over the best interest of the mother and her child. On the other hand, most of what I do is against the cultural norm, so I have had to develop very good reasoning, knowledge and the ability to defend how and why I do everything. I have been pushed into developing the ability to assert myself in almost any situation while building relationships with people who don't necessarily like me. I have had to develop a solid sense of who I am as a person, and this helps me to disregard the pressure to do everything according to protocol and find a way to defend my right to practice in the best interest of those I serve. LG: What are your hopes and fears for the future of midwifery? Tara: I hope that midwifery will continue to be on the rise, but I fear that the pressure to conform and be recognized as equals by medically established institutions will push midwives to lose their autonomy and to lose their edge on providing women with an alternative to being pushed into choices without fully-informed consent. I am obtaining a second degree as an MSW because I feel like there is a lot of work to be done in empowering women, educating providers and building bridges between two worlds so that there is less hostility and more incentive for midwives to keep their autonomy in practice. |