Gender inequality and oppression is a pervasive feature of human cultures and societies across the world and this is reflected in women’s reproductive health with unacceptably high maternal mortality rates in low-income countries and excessive rates of intervention in childbirth in high-income countries.
Midwifery, a profession whose raison d’etre is to be ‘with women’ with an explicit focus on maximising their reproductive health, has been slow to engage with a gendered analysis of these effects.
There has also been a reluctance to utilise a feminist lens in addressing midwifery policy, practice and research.
In the article, Why midwives should be feminists, which appears in the June 2015 issue of MIDIRS Midwifery Digest, the authors argue for change, so that feminist values and gender equality become central to all midwifery endeavours. A short extract follows.
Why midwives should be feminists by Denis Walsh, Monica Christianson, Mary Stewart
Nearly 4000 midwives from all over the world attended the International Confederation of Midwives 30th Triennial Congress in Prague, 2014 and were exposed to an incredibly varied programme centred on midwifery and childbirth. Yet within the printed programme, the phrase ‘gender equality’ was hardly mentioned and the word ‘feminism’ never. This irony was made all the more striking by a massive electronic advertisement thrown onto one of the walls of the Congress centre of a topless woman covering her breasts in a provocative pose. The image was part of a loop of advertisements that confronted every delegate as they approached the building. Many midwives, women and men, would have found this offensive in any context, let alone at an international conference of midwifery. Yet this explicit objectification of women on the outer wall and in broader society was not critiqued in the formal programme for the conference inside.
There was an absence of a language and vocabulary to frame any presentation or debate through a gender or feminist lens. In this paper, we develop an argument that calls for a comprehensive recasting of childbirth and midwifery issues through a feminist lens and language. This is imperative, we will argue, if the layers of oppression, injustice and the factors that undermine women’s agency in both low-income and high-income countries are to be exposed and challenged at their source. This is not to diminish in any way the multiple initiatives happening all over the world at a macro and micro level to improve childbearing women’s lives, but to make the link to institutionalised gender inequality beyond childbirth at virtually every level of society and across cultures. By raising a ‘feminist consciousness’ (Green 1979) in this way, to borrow a phrase from second wave feminism, we believe the profession of midwifery will be more effective in challenging and overturning injustices in childbirth wherever and whenever they occur.
Midwifery and feminist waves
It is axiomatic to point out that pregnancy and childbirth is only done by women and that midwifery is an overwhelmingly female profession. We state this at the beginning to make the obvious point that these are heavily gendered domains and therefore a gender lens through which to view them would not be unexpected or surprising. Yet the absence of this lens is striking in the published works of midwives in the vast majority of education, practice and research topics. For example, since 1985 in Midwifery journal, only 18 papers have the word ‘feminist’ or ‘feminism’ in the title, abstract or as a key word.
Similarly, the British Journal of Midwifery has six papers with these words in the title stretching right back to 1994. A Google Scholar search for the words ‘feminist’ and ‘midwifery’ in a book or journal paper title resulted in just 25 hits spanning several decades of publishing. Whilst the subject of feminism and the maternity services may have been raised in more specialised academic journals, it is notable that this discussion is largely absent from the professional journals that are most likely to be read by practising midwives. We can only speculate as to why this is the case. Our experience with teaching gender perspectives with undergraduate and postgraduate midwifery students is that many have internalised negative stereotypes about feminists from second wave feminism. Research in this area suggests that while women may express feminists values, many do not publicly identify themselves as feminist because they believe others, in particular men, will have negative views of them (Roy et al 2007). Typically these stereotypes include characteristics like being anti-male, stubborn, angry and egotistical (Twenge & Zucker 1999). There is some recent evidence that generation Y (born between1980s and early 2000s) may no longer hold thesestereotypes and are more willing to self-identify as a feminist, for example the ‘I am a feminist because…’ campaign (Tumblr 2013) which started on college campuses in the USA in 2013 before spreading to a number of UK university campuses.
The struggle for gender equality began with first wave feminism fighting for the end of slavery and for women’s suffrage covering the period from 1830 to 1930 (Walters 2005). The second wave can be traced from the 1960s to the early 1980s and addressed equal opportunities, anti-discrimination policies and reproductive rights (Evans 1995). Third generation feminists arose in the early 1990s and foregrounded differences between women, giving voice to marginalised groups within the broader constituency of women. It was also responding to the perceived failures of the second wave to roll out the gains in political and economic freedoms far beyond universal suffrage to representation at the highest level of politics, business and the professions. Third wave feminists also challenged binaries like male/female, deconstructing gender stereotypes, making space for men to be feminists too (Gillis et al 2007). The third wave morphed into the fourth wave from the early 2000s, especially in the UK, giving rise to a myriad of groups addressing a range of issues like sexist behaviours, objectification of women, gender violence and persistent economic inequality. The fourth wave is distinguished by the harnessing of the internet for debate and dissemination purposes (Cochrane 2013). These waves of feminism in broader society are reflected in the childbirth realm by women’s struggles over the past 50 years for birthing autonomy (Edwards 2005), by resistance to the ongoing medicalization of childbirth across the world (Johanson et al 2002) and by the historically conflictual relationship between midwives and obstetricians (Donnison 1988). Competition for control over the terrain of childbirth remains an enduring feature of the maternity care landscape.
The full article can be found in MIDIRS Midwifery Digest, June 2015. To receive regular delivery of our quarterly journal visit
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