Global Midwifery

of Women’s Health and Women’s Rights

I’m reviewing the semester’s lectures today.  I need to take my final exam a week early to head for Kenya so I need to start getting ready. Honestly, I’d start getting ready anyway–it is just who I am.

One of the lectures was on the topics of medical abortion and sterilization. Midwives need to be ready and able to counsel women on the full range of women’s health issues so I need to know my research even if I am not the practitioner performing a procedure. Only, midwives in some areas do have the legal right to provide some medical abortion services – generally the induced abortion from medications rather than the surgical procedures. I’m not sure how I feel about that yet.

On the one hand is my image of midwives as protectors of  women, doing what is needed to help a woman adjust well to her new parenting roll.  Abortion doesn’t fit that image for me. Not because I do not see midwives as full scope health providers, but because abortion represents the exact opposite of that image for me. For many women abortion was not a part of their reproductive plan, and is a last resort because this a world that does not support a woman in her adjustment to the parenting roll unless she meets very specific criteria.

She better have completed her education; have a stable and reliable partner; have an adequate and steady income; not be too old; breastfeed but only at home where no one is offended; and she should go back to her well paying job with appropriate day care plans as quickly as possible and not add to the rolls of the various social programs designed to help the poor.  I don’t subscribe to the perfect “timing” as the only pregnancy that counts. I tend to be a person who supports a woman’s right to believe her baby is worthwhile even if society has decided her baby is a mistake.

I think I can get over my issues and prescribe the medications if a woman wanted them. I have to do that with so many things working in birth and my guess is eventually you just become numb to some things. But I don’t know that I want to become numb to the pain it causes a woman to be told society doesn’t value her baby because she is too poor. Too poor, really?

Yep.  Check out the statistics on abortion at the Guttmacher Institute. Here is a quote:

Three-fourths of women cite concern for or responsibility to other individuals; three-fourths say they cannot afford a child; three-fourths say that having a baby would interfere with work, school or the ability to care for dependents;

But it doesn’t stop there.  54% of women having an abortion had been using a contraceptive method when becoming pregnant – with large numbers using their selected method inconstantly (which means they were not properly educated on how to use the method). These were women who were trying to prevent the pregnancy, but didn’t have good information or good options.

Of the 46% who were not using contraceptive, only 26% had “unexpected” sex (which means about 12% of abortions). The rest did not have a reliable contraceptive method for reasons that I read as “poor education from medical practitioners” because the women had concerns about contraception (but were obviously not helped to find a method that would work for them), or believed they were low risk for pregnancy (either poorly educated about how pregnancy happens or a specific condition they had).

So I see abortion as a symptom of society devaluing women and mothering, and I hate treating a symptom instead of the problem.



Jennifer Vanderlaan (Author)