Rejecting Licensure and Finding Your Own Self Worth | Indie Birth


Rejecting Licensure and Finding Your Own Self Worth

March 13, 2021

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We're Maryn + Margo

We are mamas and birth workers who decided to do birth differently– and bring others along with us. We are kind, fun to work with, and great at (lovingly) calling people on their bullshit. With 12 children and 18 years of midwifery between us, we’ve learned a thing or two along the way, and Indie Birth is our space to share it all with you.


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The Student Midwife Primer

An edited transcript from one of Margo’s Live Youtube Sessions

Talking about Midwifery Skills, Persecution, Licensing, Emotional Work and More!

You can watch the video here, or read all the good stuff below.

Something that came up during the weekend, last weekend — which honestly comes up every time we do a skills workshop, and every time that we really have more than a surface level discussion with a group of student midwives — is this feeling like we can’t.

Student midwives, midwives, birth workers feel like they can’t do something because of rules, regulations, other midwives, essentially fear that they are going to get in trouble from some outside authority.

That came up a couple times over the course of this Skills Workshop weekend and it’s come up other workshops as well. I shared a story about this really lovely student of ours who came from Sweden a few years ago, and whose husband is a doctor. She essentially told us, “My husband was just shocked that we were going to practice IV skills on each other. He thought that that was a really bad idea. It’s too advanced.”

And I like to share this story with people practicing now because the story—the end of the story is that she placed an IV on her first try (like most of our students do).

And she was like, “I can’t wait to tell him that I did this, and that it was not hard. And this is not advanced. And women are more than capable of doing this.”

So where was I going with that? I guess to bring up we often have women say, “I don’t know where to get IV supplies, or I can’t. If I got caught with this, I’d be in trouble.” And so it really brings a lot to the surface when we actually start getting into the nitty gritty of – How do you want to show up to births?

Not everybody has to bring all of this stuff. I don’t necessarily bring all the stuff that I teach at the skills workshop!

The point of the skills workshop is to explore and build our skill set. That doesn’t mean we have to use all of this all the time in every context. It doesn’t mean we always have to have these things in our bag. It’s to build our capacity and to build our own self worth in this world of birth work knowing we are valuable in the birth space.

So inevitably, this bubbles up. Like, “Oh, I’m not allowed to carry Pitocin. Or I’m not allowed to do this.”

And so we had a really good come to Jesus talk and explored the idea more at the end of the day that we really have to stop giving our power away.

And this is not to say I think everybody should go out and do “illegal” things, like I’m not necessarily encouraging you to do that. But I’m also not discouraging from doing whatever feels like it is in service of your highest self and in service of the women that you’re working with.

I definitely identify myself as an activist. I think that it’s really interesting if we study the way that social justice movements work and how big, large scale social change happens.

And it doesn’t happen with everybody playing by the rules. And it doesn’t happen when we let our voices and our skill sets be silenced because other people have told us what we can and can’t do.

I have talked about this other places, so I won’t wax on about it. But it’s—for me, it’s been baby steps. And, again, this might look different in different contexts. And the amount of boldness I can put forth changes depending on the moon phase and where I am in my cycle, ha!

But the more that I’ve stepped into this and the more I’ve kind of unraveled the ties that bind us, this feeling of, “Oh, I’m only allowed in this box because this is the box they gave me,” the more I’ve gotten outside of that the more I can see. The more I can just see how ridiculous it all is.

If I know how to do something—why would I let someone tell me I can’t?

If somebody is trained in CPR and they see somebody on the street who needs CPR, they’re going to do it, right? There’s this societal understanding that the person who knows the most about how to help the person on the street should help that person. And they’re not going to get in trouble for practicing medicine even though they’re friggin’ saving a person’s life possibly.

Same if there was a major emergency, or a natural disaster or a political upheaval. In those circumstances, literally no one is going to care about the piece of paper the State gave you, they will just be grateful as hell to have a competent midwife at their disposal!

So at a basic level, our society understands this. But then we get into this super micromanagey place, which is patriarchy, capitalism, nationalism, colonialism.

Mostly it’s capitalism trying to control what we can do to make money, and patriarchy trying to control what we can do as women helping other women during birth which is one of the most pivotal moments of a woman’s life, and the State trying to control us because without that, it loses its power.

It just becomes so crystal clear. And the more we can pull it all apart to see it for what it is, the stronger we become.

So I was at a place years ago where I did feel nervous about calling myself a midwife even though I had good training, even though I had many—I had the blessing of many midwives including medicalish midwives. Everyone from Maryn, who I obviously respect so deeply and was my primary preceptor, to a nurse midwife. So I’ve had the gamut of midwives I’ve worked with who have all been like, “Yeah. You’re competent. You’re ready to do this.” And even after that, I still was not sure coming from a place of being not certified and not licensed. But I did it anyways after attending 50+ births and studying for 5 years, so it wasn’t like I could even remotely be accused of being underprepared. And I was just radically transparent with the women in my community.

And little by little, I’ve really built that sense of worth up to the point where I could be anywhere in the world and would feel comfortable telling people I’m a midwife.

Like me stepping over a line that’s made up —these borders—if I step into Canada where I’m not recognized as a midwife, does that mean I’m not a midwife anymore? Since when do we hinge our identity on the pieces of paper that we’ve purchased from someone else?

So I think ultimately it’s all just really interesting. If it wasn’t interesting, I wouldn’t keep thinking about it and talking about it and doing this work. So I hope you think this is interesting too and will continue to explore those ideas on your own or perhaps in our new “pay what you can” course The Beginner’s Guide to Radical Midwifery.

And so we’ve talked about the political stuff, but it’s really interesting to start talking about it now in a more focused way around—okay. But what are the emotions underneath? And what are sort of the limiting beliefs that are keeping us from really rising up around the world as midwives and saying, “You can’t get rid of us. We’re here. We have this knowledge. There is no way to get rid of us.” They’ve tried, and they can’t.

And so yeah. I think it’s all just really, really exciting. It feels like there’s a lot of this revolutionary sort of spirit at the moment and—yeah. Bold is a word that I keep coming back to. And I’m really excited to be actively helping people who want to be birth workers in their communities really step into this.

And I guess that’s where all of this is coming from is we’ve seen a lot of people who are smart and capable and they get the training and then they just aren’t sure how to become visible and put themselves out there.

So a song that we played at the end of the workshop that I’ve been listening to a lot over the last few months is called Open Doors by Trevor Hall because it feels like it just goes with this whole theme so well. This theme of how do we move beyond this fear of persecution is really what it is into doing something really important and needed for our communities.

The lyrics are, “All of my doors are open. Got a full moon in that sky. I’m leaving that darkness broken. Blowing smoke rings out my mind. Calling on all that’s wild. Pages have been turned. Going to reach into my fire. Going to let that old way burn.” And then this is my favorite part. “I ain’t afraid of shining. I ain’t afraid of love. I’m going to stop denying. This time I won’t run.”

And then I do like this part too.

“It’s all in perfect timing. I’m crushing all my doubt. Step into warrior status. All things come back around. I’m pulling back my arrow. I’m shooting for the soul. Standing strong like mountain, I’m coming home.”

So I was listening to it, I think, the night before the workshop and though, “Oh my gosh. This is what I need to share with these women who are here for the skills workshop who are facing these questions and coming against some of these obstacles, which are really internal obstacles.”

Yes. There is the external. And yes, that’s something that we should spend time on, but we have to figure it out internally first. And then we can come up with some really cool, creative ideas to deal with the outside.

So something that came up was, in a particular state right now, they’re, again, pushing for licensure. And it’s like, “Okay. Well, instead of being like oh no. They’re going to come get me, and I’m scared. And I’m angry,” being like, “Okay. What do I believe? And what do I think is the best way forward? And what is the solution?” And maybe it’s not just you. Maybe you are networking and working on this with others. We don’t have to do it alone.

But just one idea I threw out was like, “Well, why don’t we figure out a GoFundMe, some fundraising, whatever, and send a copy of this book Making Midwives Legal to every midwife in that state,” with a handwritten note saying, “This is how I truly feel. Here is what I see being the possibility of a different way. Can we have a conversation about this instead of this just being this ahhhh. Victimy kind of place,” which we all find ourselves in from time to time. Cool.

Okay. Freedom Seeker says, “Then what is your opinion about licensure?” I mean we have so much stuff for you to check out if you are new to us. My first recommendation would be to read our book, Indie Birth: A Story of Radical Birth Love which is also included in our Beginner’s Guide to Radical Midwifery. My second recommendation would be to listen to the new podcast Maryn just put out this week on PMAs. And then there is also, again, my total anarchist self, who is going to say just frigging do it. I mean you should get trained. And ideally, a good long apprenticeship alongside some didactic learning. And it takes a couple years typically. And once you’re ready, our recommendation whether you have a license or not is to just really embed yourself in your community and be of service and of value to them.

So for me, that looks like teaching and networking and being here for people who need support during the childbearing year. So sometimes I get texts and phone calls and emails about people who have had a miscarriage, for example. And just need someone to bounce ideas off of maybe if they’re trying to get pregnant or people who had a really shitty birth and want to process it. I’m just here. And I’m available. And by being here and available and VISIBLE and teaching cool classes, no one cares about a license.

So that’s what we teach. That’s what we talk about. I’d be happy to talk more. We do consultations and we also do VIP days where we spend the whole day unraveling the emotional and inner belief stuff, PLUS the logistical, branding, visibility, marketing, and client generation stuff. Email if you want to hook that up.

[read another comment in the chat] Right. The moms don’t care. But the states do.

But what? So what? I don’t know— what’s the point? They might hunt you down, but they probably won’t.

This is what I’ve been talking about this whole time – we have this fear of persecution, which, in actuality, isn’t often what happens.

And there is also the truth of the matter which is that maybe what needs to happen is we need women to be willing to put themselves on the line, and it doesn’t have to be you.

But if we want things to change we have to top giving our choice and power over to a system that wants to destroy us.

And a license doesn’t protect you either honestly. So you can read all about that in our book. You must deal with your fear. Because if you’re fearful of being hunted down and you have a license, you’re probably going to get hunted down even with your license is the truth. So that is true.

Also, if moms don’t care and they want to support you, this is where the revolution comes from. The revolution does not come from us all playing by the rules that oppress us.

And so my opinion is if you don’t believe in licensure, either don’t have a license or don’t be a midwife. Find something else to do! There’s a million jobs we could do.

It’s just like the mask stuff right now – people that are willing to just put on the mask even though they don’t believe in it just to continue living their lives instead of speaking up. If someone goes into a store without one on, all of a sudden, every other person is saying, “Oh, we don’t have to wear one?” And the person who is not wearing one says, “I don’t know. I’m just not gonna.” And it emboldens other people to start thinking for themselves and living their truth.

So the more we can do that, the better. And that might not be your role, and that’s ok. I’m talking to the people that this resonates with. The more women we can speak to and reach who are the right people and who are ready to be bold and start saying the madness has to stop.

Why do we think that we get to regulate who someone can have at their birth? I mean it all just completely falls apart, right?

Something I also come back to a lot of times is, “What is midwifery?”. What I do is not what a lot of other midwives do. So when you actually try to define what midwifery is and figure out what a person would be allowed and not allowed to do even under some of these state rules, it falls apart. A good example is with Gloria Lemay in Canada. And you can read about this other places. But she was told she could not practice midwifery anymore. And I hope I do this story justice here from memory, but she said, “Then tell me what I’m not allowed to do.” They said, “You can’t do vaginal exams.” So she said, “Fine. I won’t do vaginal exams then.” I could go to births without doing vaginal exams. That’s fine. Also how would anyone ever know if I gave someone a vaginal exam in their own home, right? It all just starts to fall apart – it’s like the emperor has no clothes.

Danielle asked, “Wondering how you began to work through that fear. Resources. I know it’s a massive topic but something I’m struggling with.” Yeah. I mean our courses through the Indie Birth Midwifery School! That’s what they are. They’re not just how to be a midwife. They are comprehensive in that they also help people work from A to Z through all the things that we’ve seen come up as we’ve educated people over the years, if that makes sense.
So I’m reading a book right now. We’re always learning and adding tools and resources. But I’m reading a book right now about limiting beliefs and common obstacles that people create for themselves. And so I’m probably going to be creating some more content actually for both the Birth Warrior Project and the Indie Birth Midwifery School. But either taking our educational stuff or being part of some of our programs and doing some live coaching with us, I think is a really great way to move forward. I know that sounds like I’m telling you to just buy our stuff. But honestly, this is what we specialize in. And we’re some of the only people in the world talking about these issues in this way. Lauren says, “As a previous student, I will testify their courses do just that.” Thank you so much, Lauren!

Danielle said, “That’s definitely what started this journey. Loving 13 Moons.” Awesome. I’m so glad you’re enjoying that which is still a pay what you are able option for people who are watching, if you are interested.

Comprehensive birth education. Pay what you can. But yeah. How to work through it is, like you said—it’s a big topic. But the biggest thing is to sit with it. What are you actually afraid of? And then I was going to segue a little bit into some more of the desire map kind of debrief from yesterday. Figuring out how you do want to feel. And I know for me, if I had a license, I would not feel how I want to feel. I would feel restricted. And I would feel—let’s see. How would I feel? This is a fun exercise. If I had a license here in Minnesota, I would feel restricted. Like it totally makes me feel sick. It would make me feel—honestly, it would make me feel ashamed. I would feel—let’s see. Displeased, disgruntled, irritated. And maybe I could talk about this. I am able to do birth certificates here in Minnesota. But even that right now is making me feel some of these ways too. I’d feel contempt. And just disgusted and repulsed. A lot of aversions, so those are all under the aversion category (on the Non-Violent Communication Sheet). I’d be pining and yearning for a different way. I’d be envious and jealous of the midwives who are figuring out how to do it without a license. I’d also feel really just unhappy. It would not feel how I wanted it to feel is what I’m saying. It would not—I would not be meeting my strong need for autonomy.

And so if I felt—I’ve always said this. If I felt like I had to get a license, if tomorrow I all of a sudden was like, “You know what? I’m too scared. Or this is too stressful,” or all of a sudden that fear came back of being hunted down, if that came back and was not something I could manage, then I would either get a different job or, I’ve said, I’d go to school and become an obstetrician.

My first birth I attended was ten years ago. And I came into this knowing I never wanted a license, which I’m so grateful for. It is also super unique and sort of weird. I was 21 when I went to my first birth. Is that right? Yeah. Yeah. I was 21, about to turn 22. Just a baby.

But because of my sort of really solid inner compass and understanding of my own politics, which are based on my needs — all of our politics are based in our needs—nonviolent communication again for the win — I need that sense of autonomy. And I need room for creativity. And that’s what we talked about in our book, if you haven’t read it.
And so the way for us to all collectively move forward towards something better—and that’s what we all want. We want something better for ourselves, for our kids, for the world. The way to do that is to be authentic and to be honest. And so that’s what it comes down to for me. And I totally was not planning on launching into a licensure lecture. But thank you for your questions. It’s so helpful.

So for me, the licensure conversation comes back to honesty. And for me, it’s dishonest because if I signed a piece of paper saying that I would follow rules around being a midwife I would be lying.

There is no world in which I am capable of following the rules if a woman looks at me and says, “I’m outside of those rules. Will you still help me?” My answer would not always be yes. It is not always yes as an unlicensed midwife. But I would want that choice to be mine, not because I had signed a piece of paper. Does that make sense?

And I wouldn’t—there’s no way I would be able to follow those rules. And I go back often when — I’ve had occasional people during interviews ask me where that comes from. Where my beliefs around this all come from. And I often tell them my own stories. So I’ve had two full term babies. Both pregnancies I fell outside of the scope of what a licensed midwife was allowed to do. Not just in pregnancy but also during the birth with my first birth. So we counted it up. I counted how many rules a licensed midwife would have broken in doing what I wanted for my birth, and it was over ten. I would have broken over ten rules because of how long the birth was and the order in which things happened and the blood pressure and the this and the that. And all of it, right? I was pushing for a billion years. I was outside of the scope of what the state of Arizona thought a licensed midwife should be allowed to do.

And so if I had been working with a licensed midwife, they would have either had to break the rules or abandon me.

I have an article on this called Go Risk Yourself. I wrote that after reading in a Facebook group this thread about what would you do if your client was refusing transport to the hospital. And that would have been me if I had been working with a licensed midwife who wasn’t willing to break the rules.

And every student midwife in this group was like, “Well, you’ve got to just call 9-1-1 on them.” Gross! That article is also in our new course that we’re—that we’re putting out very soon. The new mini course. The Beginner’s Guide to Radical Midwifery.

We have this new mini course coming out called The Beginner’s Guide to Radical Midwifery.

We also have a full super radical doula training called The Doula Academy for anyone who wants to become a doula.

And we have a pathway for people who want to become midwives via our Indie Birth Midwifery School.

So we’ve got it all. We’ve got it all for you. There’s just endless resources, tons of articles, tons of podcast episodes. Let’s do this!

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  1. Jess says:

    Excellent message. This is exactly what I needed to hear. <3

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Meet the duo behind Indie Birth

We are mamas and birth workers who decided to do birth differently– and bring others along with us. We are kind, fun to work with, and great at (lovingly) calling people on their bullshit when necessary. With 11 children and 16 years of midwifery between us, we’ve learned a thing or two along the way, and Indie Birth is our space to share it all with you.

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