Dr. Maulana Karenga, professor of Africana Studies at California State University in Long Beach, CA, answered his call in 1966 to spiritually midwife the resilience and the multiplicities of strength embedded within the marginalized African-American living in the United States of America. The byproduct of his engagement, Kwanzaa, is an African American and Pan-African holiday celebrated throughout the African Diaspora and the world.1 The principles that govern the expression of Kwanzaa can be likened to Chanukah (Hanukkah), a Jewish festival marking the Jewish Temple rededication with the kindling of eight (8) lights from December 25th through January 2nd. Within Kwanzaa, there are seven (7) principles (the Nguzo Saba in Swahili) “which contribute to building and reinforcing family, community and culture among African American people as well as Africans throughout the world.”2 Fashioned by Dr. Karenga to be building blocks that reinforce and empower, “the Nguzo Saba stands at the heart of the origin and meaning for Kwanzaa.”3
To pave a bridge along a path not easily traveled by the majority, the minority (or the marginalized) in given societies have proven to be embedded with a resilience mandated for those who do not just survive, rather thrive. The second Swahili principle, Kujichagulia (Self-Determination), celebrates “the journey to define, name, create and speak for oneself” and African peoples collectively.4 The standard of learning the principal philosophy and communal sacrament of Kwanzaa formed a construct from which I answer another call to yet another marginalized people – certified professional midwives.
The notion that a woman is the definer and thus carrier of life is a staple within most societies and throughout dispensational engagement. Yet, midwifery (at its core) revolutionized familial preferences and professional prestige to provide a common denominator for anyone seeking to promulgate: I have a right to define, name, create and speak for myself; and so do we all! By God’s design, I have yielded to the construct that bridges Dr. Karenga’s sacrament of Kwanzaa for African peoples with those who, like Peter Chamberlen, answer the call to midwifery and advocacy to midwife a movement that leads to the establishment of organizations purposed to empower the certified professional midwife (Singingtree, 2010, p. 240).
There is something greater than ourselves that compels male counterparts to engage and advocate territories silently deemed FWO: For Women Only. In secrecy, Dr. Chamberlen invented and utilized obstetric forceps in his practice (Singingtree, 2010, p. 240). Upon the demise of his grandson, the invention was discovered and utilized by other maternal caregivers to foster vaginal births in women with contracted pelvises (Singingtree, 2010, p. 244-245). Whether “for professional advancement and personal gain”, or just an act of communal professional disobedience amidst surmounting disdain concerning further medical advancement, byway of midwifery, Dr. Chamberlen and Madame Le Boursier Du Courdray (the notable French midwife who designed teaching aids to assist in demonstration exercises regarding delivery and fetal positions) had to embody the second principle of the Nguzo Saba — Kujichagulia (Singingtree, 2010, p. 235). Upon Dr. Chamberlen exercising his right to Kujichagulia, there was a surge in the medical and social acceptance of male physicians in birth. A world, void of his legacy, would be one that would alter the lives of those with whom I currently engage in our ministierial midwifery agency.
Today, the journey of the midwife is similar to the experiences shared by Dr. Chamberlen and Madame Le Bousier Du Courdray and their contemporaries such as Daphne Singingtree, CPM and Holly Powell Kennedy, CNM. Although technology has advanced, universal standards within the general midwifery community evidences divides concerning accreditation and federal legalization. This is representative in the two (2) aforementioned distinctions. For some, Singingtree is not deemed learned-enough, liability-free enough, disciplined-enough, trained-enough, or even equal to Kennedy. Singingtree is considered a Certified Professional Midwife, who by her own admonition chose “a path of careful planning and responsibility” (Singingtree, 2010, p. 165). Moreover, a chosen lifestyle, philosophy and a path of service (Singingtree, 2010, p. 154).
In our present American society, the boundaries of civil liberties and the security of inalienable rights provided to us by the United States Constitution are being tested and tried. Nevertheless, the fundamentals of our right to choose a health care facility, insurance company and maternal care provider is one that is becoming more and more strained and challenging. In the strides taken by midwifery organizations to produce standards such as the MMC and the Core Competencies for Basic Midwifery Practice, a listing of principles compiled by MANA on October 3rd, 1994, these standards can be reckoned to the first Midwives’ Act of 1902. (Singingtree, 2010, p. 282). This legislature created “a licensing board and standards for professional midwives (Singingtree, 2010, p. 282). Similarly to the late nineteenth (19th) century and early twentieth (20th) century, there is a divide, not just among advocates for maternal care equality versus advocates of maternal care status quo, but internal divides that posture midwife against midwife: friend against friend. As a result of the Midwives’ Act of 1902, Singingtree revealed that the role of the handywoman (a female domesticated worker by day who is a midwife by season and a caregiver of the dead by night), traditional birth attendant (an individual who served as a midwife trained by other midwives in the community of maternal care progenitors), and the emerging professional midwife (an individual entering into the maternal care arena with limited or no prior experience) experienced tension much like the that of CPM and the CNM of today (Singingtree, 2010, p. 286).
Kennedy, in her means to do a comparative study of midwifery of old and midwifery of modern age, proposed, “Midwives should be seen as ‘instruments’ of care just as valuable than instruments of technology” (Kennedy, 2002, p. 1759-1760). With the consideration that both Singingtree and Kennedy recognize that the core of their servicing relies upon collaborative relationships within and within out the midwifery model of care giving, each has been called to a specific vein within the midwifery care model. As a CPM, Singingtree and her aspiring midwives are governed by the same principles as Kennedy and her aspiring nurse midwives. If so, what is the tension all about? For some, the response is simple, while others would render a response that is quite enveloped. I proffer that the same outside influences governing most shifts in social conscience and how each individual views himself or herself within community, sets the stage for the care givers of that community to question themselves and their path to forge identity within that same community. Although the scope of a midwife’s role has been redefined and re-evaluated, it is the role of the midwife to discern what tools s/he has been called to use in practice. For the CPM, tools are yielded to a care model resting on birth as a sacrament in the life of every childbearing woman. This contrasts, the CNM who upholds that same reverence for the woman, her womb and her offspring; however, is inclined to merge her/his medical model of care with the core midwifery training.
In today’s maternity care system, there are indemnification concerns for the CPM not always shared with the CNM. Present liability concerns become even more disconcerting, when frustrated by regulations that re-draft and re-adopt professional benchmarks that regard regulatory measures to protect other care givers from lost wages paramount than the drafting and adoption of legislation that demands thorough evaluation of individual care givers. The CPM certification process drafted by MANA is another way in which the CPM choice, within midwifery, is given an opportunity to “equal” the opponents of such strides within local and federal government (Singingtree, 2010, p. 370-374). MANA established guidelines and requirements to protect the consumer, while still allowing the self-taught midwife to practice. Concerning liability, informed consent documents provide a defense against probable liability and/or malpractice suits. Singingtree (2010) stated, “Malpractice is determined by what is considered the standard of care in any given community” (Singingtree, 2010, p. 384). Singingtree (2010) further proposed that an essential component to the art of midwifery is being able to balance the standard of care instilled in the medical model with intuition and respect for the natural birth process and parents’ choices (Singingtree, 2010, p. 398).
While there is frustration, there is also a looming potential for the certified professional midwife. States that are on the forefront of this civil liberty and human right issue concerning maternity care, are becoming distant educators for states yet to amend or pass legislation in favor of the CPM or midwives in general. Within my home state of Georgia, CPMs such as Debbie Pulley meet diligently with the Midwifery Task Force of the Georgia Division of Public Health. The due diligence of such CPMs, for the causes and rights of certified professional midwives, and those yet to become a CPM, is a testament to Kujichagulia. Pulley‘s honesty, as cited during a November 2008 meeting, reveals how her ability to listen (and not judge) her fellow caregivers (CNMs) made the difference. Pulley (2008) stated, “I made a wrong statement … I said that most CNMs don’t deliver in homes because they are afraid of prosecution… I spoke with my CNM colleagues and they explained that CNMs don’t deliver in homes because it does not pay” (GDPH, 2008, p. 2).
Women have the right to choose a male CNM. Women have the right to call-out the prejudice regarding gender inequality within the midwifery profession. Women have the right to choose natural healing measures, after life-changing medical procedures contributing to an improbable expectancy. Women have the right to exercise Kujichagulia. Women have rights, women should enforce their rights.
I have read journeys that incorporated loss and gain, advocacy, midwifery, education, and callings. Yet, within the wisdom well of this training center for destiny midwives (DMs) fullfiling divine destiny, we aspire to be CPMs (in iure) and DMs (in spiritu). On the cusp of change, we anticipate being historically embraced and rejected, for midwifery chose us (Singingtree, 2010, p. 143; 154). The initial midwife and creator of all, God, elected us.
Throughout the United States of America and the world, CPMs continue to answer their call to service. The principle of Kujichagulia is still relevant today, as it was in 1966, regardless of gender, race or creed. I have found that one’s origin of frustrated marginalization is the birthplace of Kujichagulia (self-determination): the very essence that equips one to become humanity’s servant on display – each day, by choice. Consequently, while on the road to define, name, create and speak for oneself, a CPM continues to experience the one tangible right purposed in it all: the right to be a CPM.
1 The National Association of Kawaida Organizations. (2008). Kwanzaa: a Celebration of Family, Community and Culture. Retrieved from http://www.officialkwanzawebsite.org/karengabio.shtml
2-3 The National Association of Kawaida Organizations. (2008). Kwanzaa: a Celebration of Family, Community and Culture. Retrieved from http://www.officialkwanzawebsite.org/7principles.shtml
4 The National Association of Kawaida Organizations. (2008). Kwanzaa: a Celebration of Family, Community and Culture. Retrieved from http://www.officialkwanzawebsite.org/nguzosaba.shtml
5 Citizens for Midwifery. (2011). Background about the Midwives Model of Care: About the Definition. In Midwives model of care brochure. Retrieved from http://cfmidwifery.org/mmoc/brochure_text.aspx
6 Georgia Division of Public Health. (2008). Midwifery Task Force: Meeting Minutes. Retrieved from http://gamidwife.com/pdf/MTF102308.pdf
7 Kennedy, HP. The midwife as an “instrument” of care. American Journal of Public Health. 2002; 92: 1759-1760.
8 Singingtree, Daphne. (2010). Birthsong midwifery workbook (6th ed.). Eugene, Oregon: Eagletree Press