Male Midwives

Hello – My name is Danny and I am about to start a 18 month BSc Midwifery course. I would like to know if anybody has worked with any male midwives in the UK. If so was there any problem with a male midwife attending any births?


I have recently been mentoring a male student midwife, also on an 18 month BSc Midwifery Course. Initially, I think, his problems were more with being accepted by us midwives than by the women for whom we care. Mentoring him has been an eye-opening experience for me. He had had some problems with attending births, but we both now agree that this was more to do with the way in which he was introduced to women by midwives than by him being a male. We now introduce ourselves as ‘hi, I’m Dianne and I will be the midwife caring for you, this is **** who works with me. He is a student midwife working under my supervision and mentorship, is this OK?’ We have not yet had a problem. I had anticipated some problems with partners. However, to the contrary, most of them have been relieved to have another male in the room, and seem to find his presence comforting!

Dianne


I was originally assigned a male midwife when I booked for a home birth with our local community midwives. Although the man I saw seemed very progressive and enthusiastic, I just didn’t feel right about having a male midwife, and asked to be transferred to a team with no male members. Part of the reason I wanted midwife care rather than obstetrician care was that I wanted to be looked after by women.

I have always had some doubts about the motives of men who chose obstetrics as a career – did they want to show these ‘silly women’ how it was done? Did they think it was about time a man sorted things out? Did they want to be able to tell women what to do, when the women weren’t in a position to argue? I am sure that many male obstetricians have the best of motives, but still I worried – and some of the same concerns apply to male midwives. I understand that probably most male midwives have wonderful motives, but still these issues worried me.

When I asked to be transferred to another group, the male midwife I saw was obviously pissed off, and acted peeved. I assured him it was nothing to do with him personally. He said ‘Well, if you go into labour and there are only male community midwives on duty, you’ll just have to go into hospital’, which was TOTALLY out of order; I said I would rather give birth attended by Atilla the Hun and his smelly henchmen, than go into hospital. I thought his comment was not constructive or helpful, especially as after a few moments thought he said that actually I could simply be transferred to an all-female team so that I could be guaranteed a female midwife!

Danny, I wish you all the best with your course – but please, if you meet a troublesome case like me, don’t take it personally! Incidentally, I have since spoken to anumber of women who have told me that they greatly preferred having male midwives, and that in our area the male midwives tend to be very progressive and one in particular is considered an excellent breastfeeding advisor – maybe because he has so little personal emotional baggage on the subject.


I read the above response with interest. I expect that you will have to deal with similar attitudes from other women too. I am not a midwife but I am a mother. I have two children and would like to have more. None of the midwives who attended me were male, but if they had been it wouldn’t have bothered me at all.

I can understand it if a woman refuses a male midwife because she wants to be attended by someone who has experienced childbirth first hand, but that would presumably exclude some female midwives too. In my mind, there is no difference between refusing a midwife because they are Black, Asian to refusing you because you are a man. Surely that is sexual discrimination, isn’t it?

The most important thing for me is that the person who delivers my baby is reassuring, confident and has the necessary training and expertise to look after me and my baby properly.

Out of interest, my husband felt he would have benefited from a male midwife when I had my children. He felt that he missed out and didn’t fully understand all of what was happening. He thinks that a male midwife would possibly be able to explain the whole thing to him in a language he understood and that female midwives take certain knowledge for granted during labour.

I have to say that I found some of the comments about the possible motives of male obstetricians and midwives quite alarming. She appears to be inferring that they have chosen their profession because they can enjoy a feeling of power over `silly women’ or think that, as men, they can show us how to give birth ‘properly’.

At a time when pregnant women and new parents are fighting for equal rights in the workplace and to be judged on our merits rather than our biology, we should be applying these attitudes to male midwives.

Kathy


Well, Danny asked for opinions and I gave mine honestly. Kathy appears horrified, so I’d better explain myself more fully. I did not mean that I question the motives of ALL male obstetricians. I said “I am sure that many male obstetricians have the best of motives”. Please note that I also acknowledged that many women *prefer* male midwives.

In my mind, there is no difference between refusing a midwife because they are Black, Asian to refusing you because you are a man. Surely that is sexual discrimination isn’t it?

Yes, it is sexual discrimination, but it has nothing at all to do with race discrimination. The two are entirely different matters. “Discrimination” simply means finding the differences between different things, and in this sense is taken to mean acting on them as well – eg we ‘discriminate’ between apples and oranges, good and bad, whatever. Not all ‘discrimination’ is bad. Believing that there are some differences between men and women is not necessarily bad; blocking someone’s career, or severely limiting their opportunties, might be.

There is widespread recognition of the fact that some people feel more comfortable with medical carers of a particular sex. The midwife/client or doctor/patient relationship is not like going into a shop and being served by someone. It’s intensely personal, and in recognition of that fact, healthcare providers often make the choice explicit. When I signed up at my GPs surgery, I was asked if I would prefer a female doctor, and told that even if I registered with a male doctor, I was welcome at any time to make an appointment with a female doctor for specific matters. This was not at my prompting – it was standard practice. When I was given my first appointment with the male community midwife, I was told by the Supervisor of Midwives’ office (who called to give me appointment details) that I did not need to see a male midwife at any point if I was uncomfortable with that – again, I had not asked.

– Just a few reasons a woman might not want a male midwife: religion (what if strange men are not supposed to see you naked?), culture, extreme embarassment, past history of physical, sexual or emotional abuse, in or outside or relationships, or just not wanting a man messing with her vagina.

You may think that some of these reasons are better than others – but who decides which reasons are good ones? Surely far better just to let a woman decide whether she wants a male midwife or not.

– I would prefer to be cared for by someone who has experienced childbirth herself, but if not, at least someone who can understand what it’s like to have a rough internal (and after cervical surgery, I’ve had plenty of those. I’ve also read articles by male obstetricians stating that there is no need to use local anaesthetics in cervical surgery, as women cannot feel anything in the cervix!!!!).

– One thing I hope for in a midwife is the ability to empathise, to understand what my emotional state is. A woman is better placed to do this, having a more similar brain structure and hormone balance to me than a man does. There is plenty of evidence that the difference between the sexes is not just down to nurture, if anyone still has doubts over this – eg some interesting studies show significant differences in emotional response and behaviour of female humans and animals who have prenatal exposure to testosterone. If your gender affects things as basic as your emotional and psychological response to any circumstance, then in certain situations such differences in response could be important. I celebrate the differences between the sexes, but those differences do mean that some jobs are better suited to women or men. Perhaps if I was a man with erectile dysfunction, I might prefer to be seen by another man who could appreciate the complicated psychological and physical interactions better than a woman who could never experience it.

– Like many women, I find it easier to develop close and trusting friendships with women than with men. I didn’t expect my midwife to become a friend for life, but during labour I wanted to feel like she was a trusted friend *right then*; for me, that was easier because she was a woman.

– Histories of midwifery usually note that male involvement is a fairly recent phenomenon, starting to become widespread first with the Chamberlain brothers and their forceps, and then booming in this century. I wanted a traditional midwife who would be ‘with woman’; I had hoped for someone who would ‘mother’ me during labour if necessary.

– We often hear talk about the psychosexual aspect of childbirth, and as a first-time mother not knowing how these matters might affect labour, I did not want to take the risk of sexual thoughts or worries about how someone was touching me, occurring during labour. I have been surprised and sometimes a little ashamed of thoughts I’ve had during internal exams. OK, if you’re going to have someone poking around and doing a bloody uncomfortable internal, it might as well be a good-looking bloke; amusing perhaps during a smear test, but maybe disturbing or distracting in labour.

– Michel Odent says in ‘Birth Reborn’ :

“It is not mere coincidence that in all traditional societies, women in labor are assisted not by men, but by other women who have had children themselves….”

“It is very important that midwives be women… Labor, birth and breastfeeding are in part sexual events, and the gender of those people present must be taken into account. The contact between the birth attendant and the woman in labor can be exceedingly intimate and intense. A woman in labor is in an espceially vulnerable physical and emotional state, apt to become dependent on her birth attendant, at least for a while. The sexual overtones that might accompany such contact with a male attendant could hamper the woman in labor in acting as openly and spontaneously as whe would like, or afterwards might even make her feel ashamed of what she has revealed about herself”

However, Odent does not rule out male midwives altogether: “Of course, it’s not that simple. for all the importance of gender, the essential quality a birth attendant – male or female – must have is the ability to help a woman feel secure and at ease” [Birth Reborn, 2nd edition, p43-45]

– We often hear how other psychological factors can affect the progress of labour – such as women whose labour slows when an attendant they don’t get on with comes into the room, or when their partner seems uncomfortable. I was not going to take the risk of this happening because of something entirely avoidable, ie having a male midwife when I was not comfortable with that.

– My husband was very, very uncomfortable with the idea of having a male midwife, and I was if anything more worried about *him* being tense during the labour than me. Like many men, he feels that certain tensions often arise between men in situations like this, and he did not want to risk feeling that the midwife was bossing him around, or trying to prove a point, or whatever. Not that he thought this was likely, of course, but it is possible.

– You may be aware that there are exceptions to the laws on sexual discrimination, to reflect the fact that this is quite a different matter from race discrimination. There are special provisions for having employees of one sex only in certain circumstances where it is considered appropriate to the job, and the most common example is in medical fields where, eg, it is usual practice to offer women the option of seeing a female nurse/midwife/Dr where possible. For example, I understand that a GP practice would be able to advertise for a *female* practice nurse to run family planning clinics, although these matters are subject to continual change.

– Sexual discrimination laws apply to the employer, not to the customer; as a patient or consumer you are free not to use someone’s services for any reason you want. Discrimination legislation aims to stop people being disadvantaged by their employer’s actions, not to stop individuals having choice in the question of who treats them. You may not agree with their choices, but that is not an argument against peoplehaving the choice.

>I have to say that I found some of the comments about the possible >motives of male obstetricians and midwives quite alarming. She appears to be >inferring that they have chosen their profession because they can enjoy a feeling of >power over `silly women’ or think that, as men, they can show us how to give birth >’properly’.

What I am doing is hypothesizing that these motives may apply to some obstetricians, and I make no apology for that. Plenty of other people have said it. Many obstetricians are no doubt wonderful people with the best of motives, but read through a few AIMS journals and you’ll find plenty of quotes from obstetricians which might make you question their motives.

For example, these quotes were featured on the cover of AIMS Journal, winter 1996/7 ‘Home Birth – How Far Have We Come?’:

Psychiatrists do not as yet agree on precisely what it is the disturbed woman seeks in ‘natural childbirth’. some say it is proof of femininity; others, oddly enough, say that it is power or psychic masculinity they are after” – Dr Waldo Fielding, 1962, and his modern counterpart: “Any man whose wife wanted to stay at home to have her baby should put a headstall or harness on her and drag her or bully her to the hospital” Consultant obstetrician Donal O Suilleabhain, 1996

Those are just examples that I have to hand – many women’s experiences support the inference that their obstetrician thought women, or at least women who questioned him, were ‘silly’ etc..

As I said before, very best of luck to Danny; my reason for posting was to try to explain why some women will not want a male midwife, and to urge Danny not to take it personally if this happens.


I’ve read with interest the replies from two mothers (above) – you couldn’t get views so vastly differing, could you! Everybody is entitled to their opinions and, perhaps, this is the crux of the whole matter. We are in this business (I hope) in order to give women the best possible care and, in doing so, we have to treat their opinions with respect. If you take this is your guiding principle then I’m sure you won’t go far wrong.

Once again, good luck

Dianne


Thank you for your replies.

My background or my interest in midwifery stems from my family. Having five sisters, who are all midwives, and a mother who has been practicing midwifery for some 30 years. Midwifery and the care of women in pregnancy, has been so much a part of my life. As you can imagine when going home on family occasions, discussions relating to midwifery get very heated. Opinions about men in midwifery range from very positive to scepticism.

My mother’s position is very encouraging. She thinks men should be allowed to practice, but the choice of midwife should always be the woman’s choice, and if she does not want a man, then this should be respected. She also points out that this is a perfect time for the male midwife to reflect not only on his practice, but also on the woman’s freedom of choice.

With freedom of choice being the basic philosophy underlying midwifery practice, I personally would not feel affended by a woman not wanting me to attend herIn fact I would go as far as to say that she had made a choice based on her own personal needs.

I would like to finish by responding to what Dianne described, when mentoring her student. It makes a refreshing change to see communication between student and mentor ( some bad experiances from my general traning ). I only hope that this course I’am about to embark on provides support and freedom to communicate for both the student and mentor.

Danny


I have worked with a male midwife who is brilliant. All the midwives at my unit think the world of him; most women are happy to have a male midwife. We have a high asian and jewish population and therefore he does not care for many of these. Good luck – I’m sure you will do well.

Celina


My name is Kelly, I am a Hospital based midwife, here in England. I just wanted to reply to your letter to say “go for it”. I feel that as long as the folk who work in Midwifery feel that they are truly there to help and support women, and feel a calling to do this work, and it is a calling, or you won’t be any good at it…..then, go for it!!!!!

I am currently working with a male student, and he has been fantastic. He is truly “with woman” and the women he looks after have no qualms about him being involved with their care. Nor do the partners for the most part. He does have a few refuse, but only a very few. The male partners seem to appreciate another male in the room,and he relates to them at a male level. Yes, I feel there is such a thing, not being sexist….

In all, I enjoy working with him…and very quickly have forgotten about the fact that he is male. As long as a student is keen, loving to women, appreciates the awsome, challenging, rewarding job (vocation) of being a midwife, well, they are winning as far as I am concerned. I have seen a few too many female student midwives who lack the empathy and desire to learn that he has.

Kelly


The only men I can countenance as midwives are those who are openly gay. That way their orientation doesn’t call anything into question when providing intimate physical care of another man’s partner. I know that still doesn’t address all those lesbian midwives, BUT most of the women we see are practising heterosexuals and wouldn’t be interested even if the midwife was. But professionally speaking, that should never enter into the midwife’s equation.


Birthday Boys: an article about male midwives in the Guardian Unlimited.

Comments:

This has done me a world of good – i am back on track – ready to continue with the course I am destined for …. – I cant tell if i will be any good at all – only time will tell – but I must give it my best …. I might come close to being satisfactory in which case I will feel justified in following my instinct !

Ian


When I had my baby I was asked if a student could attend the birth. I said yes, and the midwife asked me if I still minded as he was a man. It was his last day on the labour ward and he was yet to see a birth. No-one else had allowed him into the room. I said yes, although I was unsure. He was marvellous, very supportive, and an asset. I could not believe that this was his last day and I was the only person who had allowed him in to see a birth.

He cried when Emma was born, he helped tidy up, and he held my baby, Wonderful man and I hope he makes a superb midwife. And he gave me a cuddle afterwards. Just asked my husband, and he remembers him, and said he was wonderful too.

Sue


I’m afraid that I am one of the women who would not be comfortable with a male midwife. I know a few women who have been attended by male midwives and felt that they, and their husbands, had a better relationship with them than they might otherwise have had – we all know people who get on better with either men, or women, and in labour, when you’re feeling vulnerable, maybe some women feel more comfortable with a man than with a woman.

There are some elements of my preference that I could rationalise – I’d noted that generally women were more gentle about internals etc.. than men! Smaller hands and an understanding of what it feels like, both help.

However, there are other elements that I could not rationalise. It was just about personal preference and what I felt comfortable with. I find it generally easier to ‘bond’ with women, and I was not prepared to take the risk of some deep-seated worries affecting my mental state, and perhaps my physical progress, while in labour. It was too important to risk. I have some sympathy with the thoughts of Michel Odent on this matter. If there’s someone who you’re not comfortable with in your birth environment, it could trigger a ‘fight or flight’ reaction. If you’re comfortable with a particular male midwife then this is unlikely to be a problem.

What it came down to, for me, was that you can try to rationalise all you like about living in modern times and believing in sex equality, but you cannot change your emotional response to a situation – and that was what worried me. I couldn’t change how I felt. I therefore had to find midwives who I would feel comfortable with, no matter what primitive state my brain was reverting to.

I think that male midwives could be perfect for some women, and should certainly be encouraged in their studies – but no mother should be made to feel guilty for not wanting a man to attend her.

Angela


Prior to training as a midwife, when I was having my own children, I felt a definite objection. I knew, that for me, I needed to be surrounded by women during childbirth, barely noticing my own husband, and by number 3, not really caring whether he was there or not.

But since training as a midwife, I have met so many uncaring, brutish, bitches I have had to concede that gender is not necessarily the most important aspect!

I still harbour some misgivings – for instance in the ‘Birthday Boys’ article, the lovely John actually ends up being requested by women. What a novelty to tell your friends – ‘my midwife was a man’. I know many wonderful female midwives – but women daren’t ask for them a second time around – that just wouldn’t be fair!

I have also met quiet a few male midwives – yes, they have all been very nice people. But some strange feeling lingers, of discomfort. I don’t know what it is – but it’s there.

Lynn


We have two male midwives at our unit. One is now lecturing at uni, the other in clinical practice. I know that the man in question is extremely sensitive to women, an excellent practitioner and has never complained and totally understands when a woman declines to be cared for by him, which, in practice is extremely rare.

Let’s not forget that women are perfectly within their rights to refuse care from any m/w for any reason at all, race, religion and colour aside.

I don’t think it’s prejudiced to refuse a midwife of a different race, just as I don’t think it’s sexist to refuse a male Midwife.

Interestingly here in New Zealand we have a similar situation where we have a shortage of Maori midwives. Maori woman don’t feel comfortable being attended by pakeha ( European) Midwives and want there own. Is that racist? I don’t think it is, culture is important to people, and never more so at birth. Jewish woman I believe can not be touched by their husbands during labour, or during bleeding, they need midwives who are sensitive to that belief and culture. I’m not saying the midwife needs to be Jewish, but a Jewish woman is going to feel more comfortable with a Jewish Midwife than a Jamaican one, be it right or not. Our Maori have protocol surrounding their birth and some will only feel that another Maori Midwife will be sensitive to this.

We need to feel comfortable with our attendants, and if there is a subconscious barrier, be it sex, race, or philosophy, the process will be hindered.

Andrea


As a single parent finding myself pregnant for the third time whilst living in New Mexico, I deliberately chose a lay midwifery practice that had a male and a female midwife. I also surrounded myself with women friends for the pregnancy, birth and postnatal period. I have thought about this over the intervening 15 years, during which time I have become a midwife myself. What made me chose this option? I think that I needed a little male energy and he was a wonderful, sensitive caring man.

However, I never felt totally at ease about it and I still have slight reservations about male midwives. It was ok antenatally although he did try and persuade me to have the foetal heart heard via sonicaid when I had expressly stated that I only wanted it heard via a pinard.(no, I did not give in).

There was no problem during the birth, which was wonderful and just how I planned, having had 2 previous induced, pethidine-drugged hospital labours. I gave birth at home, totally unmedicated, surrounded by my children, 2 women friends and both the midwives to a 10lbs 4ozs baby boy – intact perineum, physiological 3rd stage, true knot in the cord!

Postnatally, however, I felt totally ill at ease being visited by him, and felt unable to tell him exactly how I was feeling. This was nothing to do with him, he was the most pc guy you could ever meet, but it was to do with the whole male/female thing.

Since then, I have always had mixed feelings about male midwives. In our unit, we have a wonderful one who the women love and who all the midwives get on well with ( why is it that gifts to female mws are always chocs and the male ones get alcohol??) but I still have reservations about the whole power thing and the women not really being able to open up to them as they would to a woman.

Dillian


AH updated 10 September 2000

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