Category Archives: Laurie and Debbie’s blog

Choosing Midwives: Science Is Not Exclusively Male

Laurie and Debbie say:

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One of the many ways male hierarchies keep women’s skills at bay is by associating myths with women, and facts with men, magic with women and science with men. In this context, Therese Oneill detailed and informative essay at Jezebel on the tension between doctors/men and midwives/women tension helps reveal the persistent and culturally accepted myth which associates men, science, doctors and hospital births with cleanliness, safety, and infant survival.

There was nothing wrong in wanting those who attended birthing to be clean, educated and accountable, but the doctors were going for self-interested gatekeeping. Requiring official licensing was the first step in shoving women out of the field all together. You couldn’t get licensed from just an apprenticeship, which was the norm for midwifery. Official training and state licensure cost money, an expense passed on to clients. It undermined the centuries-old purpose of the midwife as an affordable option to assist births. Instead, went the parallel argument, physicians wanted the poor to give birth in charity hospitals—where tired, apathetic attendants and untold diseases and infections awaited them. …

[The 1906 study of 500 interviewed New York midwives, described in Oneill’s article] included only one, one, “West Indian Negress.” It seems unlikely that an urban population the size of New York had so few black mothers as to warrant only one midwife. It is possible that white midwives served black mothers, but highly unlikely in an era and place where ethnocentricity was king. It is more likely that black society, North and South, experienced far less interference from campaigns intended to improve society.

Women could, of course, go to medical school to become fully licensed obstetricians. But the number was minuscule clear into the 1980s. According to the Journal of the American Osteopathic Association, in the 1970s, only 9 percent of enrolled medical students in any field were women.

[Side note: Lots of factors kept women out of medical school. Debbie’s mother was admitted into medical school in the 1930s, defying quotas on both women and Jews. But her parents, who could easily afford it, refused to pay for it, reserving the money “to educate their two sons,” one of whom never went past high school. ]

But that changed, and it changed fast. According to The US National Library of Medicine, female residency in Obstetrics and Gynecology quadrupled from 1978 to the present. Women now account for 71.8 percent of OB/GYN residents….

It’s not just that there are more female obstetricians, either. Midwifery, far more sanitary and scientific than its ancient ancestor, is booming again after a near 200-year lag. The difference between the two is most salient in terms of their technical training: obstetricians have gone through medical school, are able to perform C-sections, suturing, circumcision, and are skilled in handling high-risk pregnancies. Midwives come in different flavors, but the majority are medically trained and licensed in all things related to normal pregnancy and birth.

None of this is new information to people who follow this kind of history. The persistent, deep belief that doctors are better than midwives is not just about pregnancy  and birth (so much of history is about men trying to figure out how they can own children!), but about how Western science was created and defended as a male domain. Science was developed (mostly) by men, promulgated (mostly) by men, and made available (almost exclusively) to men. Thus science became male, despite the fact that there are no “insert penis here” slots in any scientific test or accomplishment we’ve ever heard of.

In the last few decades, the presence of women in the sciences has shifted substantially (though we may be losing ground). In the same period,  the perception of science as male has shifted less.

If men “own” science, then whatever women do, by definition, isn’t science. That’s how you get to Teresa Oneill’s husband’s reaction:

“Yes! A midwife!” … “Because I was thinking to myself, ‘Who are we going to get to wave burning sage over your stomach and chant to Gaia while the baby dies?’ CLAP IF YOU BELIEVE!!”

While it seems very likely that some significant percentage of early midwives worked in filthy conditions, as Oneill points out, hospitals were filthy then also. Yet, the discussion implies men=science=clean and women=ignorance/magic=dirty.  We’d bet the rent that a good history of midwifery would point out many instances where midwives figured out sanitation and disinfection issues on their own, through experience and observation.

The association of women solely with magic and myth is one way that male culture uses its own myths to denigrate and trivialize those who work outside it. Let’s hope that this one remains dead for two centuries and more, while midwives continue to use science and intuition, caring and disinfectant to combat the risks of pregnancy and birth.

A RANT ABOUT LOWLINESS, POVERTY, AND HOUSEWORK

Lisa Freitag says:

In the May 18 issue of TIME Magazine, I read an interview with the new Prime Minister of India, the man whom everyone thinks will succeed in changing that country for the better, Narendra Modi.

I don’t have anything against Modi, really. I know nothing about him except what was in that TIME interview, but I need nonetheless write a rant about something he said. I know that his words are, perhaps, not entirely his fault. He was merely living up to a common myth, the Great American Dream of lifting oneself out of poverty.

The quote is pretty benign, taken in that light. Modi grew up in a small town steeped in poverty, and for that reason he has been inspired to make a commitment to helping the poor. Modi says, “I was born in a poor family. I used to sell tea in a railway coach as a child. My mother used to wash utensils and do lowly household work in the houses of others to earn a livelihood.” This quote is important enough that Modi actually uses it twice in the interview.

We are supposed to be very proud of this great man who raised himself from humble beginnings to a position of power. We are perhaps supposed to believe that, since he comes from there, he understands poverty well enough that he is the perfect person to do something about it. After all, he found a way out for himself, so must see the way open to others. As a solution to poverty, however, becoming the Prime Minister of India or, indeed, the President of the United States, is not a terribly viable option. Of the hundreds of thousands of poor tea sellers, only one can become Prime Minister.

I predict that he will not succeed in making even a dent in poverty. The reason is buried in his twice-quoted statement about his poor mother. He sees poverty as shameful. Or, more accurately, he sees the work done by his impoverished mother as shameful. We are to be impressed with him, because he has risen above the shame of poverty and is now in a position to raise others as well. He no longer has to sell tea, and presumably she no longer has to earn money in any way she can. Yet he has, seemingly, not thought about the nature of the work his mother did.

What awful thing did his mother do to earn a livelihood? She washed utensils, clearly a horrifying task! One has to wonder if Modi loads his undoubtedly top-of-the-line dishwasher himself, or if he considers the person who does it for him better or worse than his mother. She also did “lowly household work in the houses of others,” another thing generally acknowledged as being “below” most other professions, if it is considered a profession at all. Yet, I rather doubt Modi cleans his own bathroom. I have no idea what he thinks about the person who does, but I suspect that he does not notice her at all. He may not even realize that she exists. He is probably unaware of the size of the pittance she is being paid by the people who hired her for the task. But I have no doubt that Modi’s bathroom needs just as much cleaning as anyone else’s.

My problem, I think, is the vast set of assumptions behind the identification of household work as “lowly.” Yes, cleaning is boring, and dirty, and often hard on the knees. Does this automatically make it lowly? Carpet laying and plumbing are also dirty and hard on the knees. These professions are certainly beneath the Prime Minister, but I doubt Modi would refer to any of his constituents as a lowly plumber. Perhaps most plumbers in India are men, and only the knee-destroying, low-paid work done by women is considered lowly? Perhaps fixing bathroom leaks in India is more necessary than cleaning toilets? Or perhaps plumbing is not so lowly because it is not so terribly badly paid?

It is worth thinking about whether housework is lowly because it is low-paid, or low-paid because it is lowly. I think both of these aspects are true, and circle each other in a downward spiral that serves to keep people, particularly women, in poverty. The spiral may have started with the invisibility of women’s work, creating the impression among the rich and powerful that the world just cleans up after itself. Modi does not have to ask who will do this lowly work, after he pulls everyone out of poverty alongside himself, because he does not know that it must be done. Yet the work of washing Modi’s dishes, and cleaning Modi’s bathroom, will continue to be absolutely necessary.

The problem, perhaps, is not with the work itself, but with the lack of notice, respect, and payment given to the people who do that work. Modi will not be able to do anything substantial about poverty until he is able to recognize as essential the “lowly” work that his mother did, and that someone else must now do in her stead. As long as the essential work of the world is held to be without value, there must be people who have no option other than to do it for almost nothing, and who thus will stay poor.

If Modi truly wishes to do something about poverty, he should start with noticing the importance of the work his mother did, and stop thinking of it as lowly. He must, of course, work toward raising wages, but I think he will not succeed unless he also begins promoting such work as honorable. Getting paid more to do the dirty work is not enough, if the people doing that work are still seen as shamefully dirtied by doing it. The “lowly” aspect of his mother’s cleaning the houses of others was not just that it was badly paid, but that her son believes that it was beneath his notice.