December, 2012
To the Assistant to the Attorney General of Arizona
Director of the Arizona Dept. of Health
Arizona Office of Special License-Midwife Licensing

And to all the women that are concerned about their birthing options….

Two years ago, I served a wonderful, passionate, loving woman whose dream it was to birth at home after a cesarean years ago. She was amazing and strong and healthy, and so was her baby. She did not achieve her vaginal birth at home, but to no one’s detriment or fault. She and her baby were never threatened, and the outcome, although not what she desired, was favorable. To this day, I am not one bit regretful that I chose to stand by her. Her options in our rural area were to birth alone, or to agree to an elective cesarean at the local hospital. No woman should be forced into that choice. Her body, her baby, her choice to make. Birth at home with a midwife, even for a VBAC woman, is supported by evidence.

She had every right to be cared for and supported in her choice, and unlike many other midwives, I chose to not lie about it. I chose to not pretend I was unaware she had had a cesarean birth. What I chose was truth, and the truth really does set one free. Telling the truth and standing up for her and my beliefs was the best thing I have ever done. I do not regret one moment of it. After two years of being pursued by the State of Arizona for doing absolutely nothing except supporting a woman that no one would–I realize the real truth.

The real truth is that birth cannot be controlled. Women cannot be controlled, although you may try. Birth is not medical and it is not a medical event. It is not the duty of any state to determine how, where, why or with whom a woman births. It is not the business of the government to know women’s personal histories, their birth stories or anything else. Forcing a subpoena on me for client’s charts was not effective; you threatened me to get to them, and all to please a doctor. I have never, ever had a complaint filed against me by a client or her partner or her family. I have given compassionate, respectful, competent, research-based, motherbaby focused midwifery care. Let it be known that the ONLY complaints against me while licensed were from two doctors in the same rural hospital who are against and threatened by home births.

(In addition, a peer review of five experienced midwives in Arizona agreed. They deemed that my care on the three occasions that produced “complaints” from local doctors was every bit responsible, appropriate and even conservative. Shame on you, Arizona, for not having a peer component to your licensing “board”. Shame on you for ever making licensing involuntary. And as we all know, Arizona is only one of four states that licenses midwives and does not allow VBACs at home with midwives. This does not support current research.)

It is sad, but expected, that the “department” of licensing in Arizona chose to not investigate these complaints before threatening me with my license. They took the words of doctors, filed over the internet, above and beyond one of their licensees and any of my clients. It doesn’t add up, really, because there are Licensed Midwives I know of (illegally) attending VBACs, and to my knowledge, no other midwife has been harassed or disciplined (other than a Licensed Midwife being fined several years ago for attending a VBAC) by the “department” for what is “prohibited care” (this also includes twins and multiples). Midwives in this State have, do and will attend these women. I may never know the “whys” or “hows” I was pigeonholed, and I have made peace with that. I know enough to know that the dealings of the last two years have been unprofessional and revealing. They have confirmed my realization that birth is not the business of anyone that has not created the baby. And that licensing does not protect women, babies…or midwives.

Arizona has an archaic, conservative attitude that is hurting mothers and babies. This need for control, for perceived “safety” of moms and babies has been detrimental to a woman’s choice, and to true midwifery care. The Department of Health and the licensing office have no idea what it means to be a midwife. They have no idea what it is to have a baby, or to hire a midwife, or what makes normal birth “safe”. I am saddened that the word “midwife “in Arizona has come to mean “medical care provider”, and that the use of drugs and interventions is part of “normal” birth at home. The irony is, unbeknownst to you, these drugs and interventions create birth that is NOT safe at home. You have created the exact threat you think is being avoided. You’ve spent the last two years and lots of government money pursuing me, but you are barking up the wrong tree. My hope is that the women will eventually realize how severely their birthing rights have been limited; and because birth is a human rights issue more will begin to challenge the status quo.

I am a birth attendant. My loyalty is to women that choose me to serve them, and you can never take that away. Owning the term “Midwife” is ridiculous; however, please remove the title, “Licensed Midwife” from my name, and accept my request to take it back. I am purposefully not renewing my license, and will not be practicing midwifery in Arizona any longer. The women of Sedona no longer have the option of local home birth with an experienced birth attendant.

Thank you for helping me find my truth in birth. I started my career as a licensed midwife thinking that I made birth safer, or that I controlled it somehow. An arrogant attitude that many midwives hold. I now know I couldn’t have gotten it more wrong. I serve women, I guide them as they take back their births. Thank you for helping me find this truth; my truth in birth. I could not have done it without you.

“I found goodness in the place that I once believed to be evil; and found evil in the place that I once always knew to be good! The truth is so far separated from where I thought it existed. It can be such a wild, unbound journey: the journey from the illusion into the truth. Some people take that journey, but more people don’t.”
― C. JoyBell C.

With many blessings,

Maryn Leister
Former Arizona Licensed Midwife #159