As credentialing and certification becomes more commonplace in midwifery, there is also a renewed intrest in traditional midwifery, as well as a certain tension or animosity between supporters of each.  Tradition has been defined by Websters dictionary as “ the handing down of statements, customs, beliefs, etc. From generation to generation, especially by word of mouth” Profession is defined as “ following an occupation as means of a livlihood or for gain.

Pertaining to a profession, making a business of something” I would add it wishes to transmit ( profess) certain standards of knowledge. Both midwifery and prostitution have been purported to be “ the worlds oldest  profession” but I dont agree. I am not convinced that women have been selling thier  passions nor thier empathy since the beginings of time. I think the exploitation of both  came at later dates in our social evolution.

An interesting distinction between Traditional and Professional midwifery lies in the  Transmission of knowledge. Since by definition the traditional midwife is about passing down knowledge orally, and by apprenticeships, it must be very fluid. “Truths”,knowledge and techniques, must vary greatly on transmission.Like the childhood game of “telephone”, where someone whispers something in the next persons ear around a circle and everyone cracks up at how different the message is in the end, traditional midwifery is by nature, flexible, ecclectic, and subject to constant revision-dependant, in part, on the giver and reciever of the “knowledge”.Professionalism came in to assure standards and uniform safety practices. The price for this security is at times, autonomy, imagination, and improvisation.

There is a story about a Buddhist master who practiced a very deep and holy form of meditation , which he had learnd from a long line of masters. After a long series of initiations, his student was ready to master the same meditation. First, he found a wild dog from the village, chained him to a post, then sat down to meditate. An old woman walked by and asked “ Why do you chain that poor wild dog? “ who was, of course, restless and howling at his restraints. The pupil looked up and said “ It is what my Master did, and his master , and the master before that”. The old woman laughed. “The masters master was my grandfather, and he had a pesky dog who was always knocking him over and licking him during meditation, so he tied him to a post nearby. But you, young fool, seek out a bothersome dog merely to restrain him!”

So it is that when we eagerly come to sit at the feet of a traditional midwife, herparticular secrets may or may not have meaning to the context of our own work. We tend to romanticize or judge our traditional midwives, through the lens of our own cultural context. How could we not?

In the passing years, I have seen many  young women come down to Mexico seeking to experience traditional midwifery, with its promise of hands-on, more Spiritual, less technological approaches. Some come on internships from college, some are in between careers, some are simply curious. Many are later dissolutioned, angry or puzzled. “ I went to visit doña so and so but she didnt have many births. I ended up cleaning her house and following her around on her errands”… or, “ I went to observe in this or that place, but nothing much was happening…” or “ I went to a birth with Doña so and so but she used an I.V. and wore a surgical mask to a home birth. She wasnt very spiritual at all….”

We come from a consumer culture, and our educational system reinforces this:get “x” credits, “get” a degree, “get” so many births, etc. The traditional midwife lives at a different pace, and defines her knowledge by different standards.A traditional midwife is a community midwife. Her identity and job description isnt dependant on her schooling nor the number of births she has attended. She may spend more of her time doing massages ( sobadas) , weaving rugs, raising children, or tending her fields than births.

I have come to appreciate her rootedness in the community more as time has rooted me. I have lived nearly 30 years in my adoptive community, and were a college student to follow me around, they would be equally dissatisfied. I can imagine her saying : “ She saw this lady on the street and they chatted a few minutes and she suggested a remedy—she didnt even examine her lungs or take the case… then she talked to some guy on the phone and mixed up drops for psychcic protection-she didnt even see him, and then she did a prenatal and it lasted three hours and half the time they were philosophizing about the lady’s work and drinking tea in the garden-it took over an hour before they even went to the check-ups room” And this would be true.

But I helped the first woman through two pregnancies, births, a divorce, and her chronic asthma over the last ten years. The guy on the phone is the husband in a couple i helped through infertility, birth, a childhood death, and changes in housing and careers. The surface contacts may look sparse, but they are threads in a thickly woven tapestry that makes us community. The lady in the garden just moved to town, and is uncertain she will stay. We talked of the school she teaches at and where three of my children have attended over the years, about education, childrearing philosophies, and her situation past, present, and future. We talk not just as midwife and client, but woman to woman, for this is part of our tradition.

Our foriegn students come through for 6 weeks, 6 months. They are so open and eager to learn. It takes nine months to complete a pregnancy, and few are here long enough to ever feel the deepening and rising evolution of one pregnancy. They want to see Births. They want to learn tricks, and secrets.

At the recent MT conference in Oaxaca, I mentioned disliking the term : Alternative medicine because it connotates some sort of deviation from the norm. I prefer Origional medicine, because the caring, the improvising, the knowledge—whatever, we have always offered one another as mothers, as women. Professional midwifery ensures client-based care, standardized care, protocols and a degree of quality assurance for our clients. All of the terms are relevant in the context of  a consumer culture.  Professional midwives must answer to the consumer, and to other professionals. Traditional midwives must answer to the mothers, who are also their neighbors, their community. Most also answer to a Higher Power.

Professional midwives make sense in the cultural context they exist in.  They can move from one institution to another, one state to another, they are recognized for their credentials. They answer to a community of their peers, not their community of origin. The mothers, “informed consumers” can count on thier knowledge. Now, enter the Doula. The word is of ancient Greek origins, but the Professionist relatively new. A student of mine asked me, “What, exactly, is a doula, what does she do?” I replied how she is with a woman before, during, and after her birth, offering emotional support, information, footrubs, etc. How important she is postpartum,  helping the family with the organizing, cooking, children, giving energy  and support for breastfeeding, advice, etc.  Just then my 16 year old daughter came in the room and said “But mom, is’nt that what  you always did as the midwife? Whats the point?”

The point is, as America becomes more fragmented and specialized, what was once   (and still is, in “traditional midwifery”) considered normal care has now been compartmentalized into a new Profession. So where does that place the Midwife? As “professional” she attends the birth, does her prenatals and post-partum visits, is  responsible for the technical and bio-medical aspects??Maybe our modern professionals are too busy to sit around for several days “hanging out”. Maybe their shifts are for 24, or 48 hours. Maybe its against the rules. I dont know. So maybe the doula is the modern bridge between the professional and traditional forms of midwifery. Maybe she is not only not redundant, but maybe she is critical in maintaining some sense of continuity with the traditional meaning of midwife as “with woman”. Learning traditional midwifery cannot be understood on a time line, or through protocols. Nor is it a fascinating compendium of “tricks”. It cannot be understood, perhaps, even by others pasing through for less than the time it takes to gestate a pregnancy.

For the same reasons that it seems a “lost art”, that we seek to regain as we mourn its passing, I feel it will never dissapear. For wherever a woman plants her spirit and says: “Im with you” even in the subtleties where “nothing is happening”, a tradition is carried on.