Chapter 2


Proactive Strategies for Midwives and Their Clients

Susan Hodges, President, Citizens for Midwifery

If you are being investigated or have just been arrested and you want to put the information in this book to work, you probably will want to quickly gather as much support around you as you can find. Under those circumstances, starting "from scratch" to develop a knowledgeable and effective network of past and present clients and friends can be daunting. Having an informed network of clients and other advocates already in place would be very helpful.

You can help your clients become midwifery advocates long before you have any legal challenges. By doing so you will not only be better prepared for such challenges, you will also be developing a group of people who have some understanding about maternity care issues and the Midwives Model of Care*, and who understand that they have important roles to play in keeping midwifery alive and improving childbirth in this country.

Your clients—women and families—are essential for midwifery advocacy. Consumers can speak very effectively as midwifery advocates in the political/legislative arena. We can talk to our friends, teach and make presentations in schools, colleges, community events and to state agencies and legislators, speak to the media, write letters and raise money. We also bring different perspectives, skills and experiences that energize others and contribute ideas and strategies for midwifery advocacy. Also, among your clients may be individuals with connections to people in the press, government, local universities, etc. that could be very helpful.

You may not realize that as a midwife you play a critical role in whether or not your clients become activists for midwifery. I can say from my own personal experience that my midwife was key to my development as an advocate. In general, midwifery advocates do not just appear out of thin air. They evolve, with help and nurturing from their midwives and from other contacts. Midwives can be instrumental in this process, by bringing the political aspects of childbirth to their clients' attention, putting them in touch with other activists, and providing opportunities and encouragement for their clients to help even in small ways with advocacy efforts and projects. Many home birth midwifery clients begin with just wanting to get this kind of care for themselves, for any of a variety of reasons. Many midwifery clients may have no idea what is going on, especially if they live in a state or area where home birth is common and midwives are easy to find. They may not even realize that you may be going out on a legal limb when you provide care for them. Gaining these understandings is a first step towards advocacy for many midwifery clients, and you are the best person to help them take that step. With your help, your clients can evolve into people who understand both the impact of birth practices on babies and families, and the need for everyone to have access to out-of-hospital birth and the Midwives Model of Care.

In general, people (i.e.: your clients) need information that persuades them that midwifery is an important cause, they need ongoing information and encouragement, and they need to get something out of it. Organizations that have worked with volunteers have figured out that volunteers, at any level, are giving of their time and energy and they need non-monetary "compensation" or they will eventually quit, because no one keeps giving and giving without getting anything back. This kind of compensation includes friendships, feeling appreciated and valued, learning new skills, getting a sense of accomplishment and having a good time while volunteering. In other words, it is worth while to keep these factors in mind if you would like your clients to keep on being active over a period of time, to "be there" for you the way you were there for them.

Here are some specific things that you can do to help nurture your clients into active advocates—"consumers" who understand how important they are to the "cause" and who will be there for you in the future:

Will you get all your clients to be active advocates? Probably not, although almost every one can carry out at least a small act (sending a born at home birth announcement to a legislator, for example). You may find it helpful to start by identifying one or more potential activists/leaders among your clientele and bringing that person along with some opportunities to be involved. A potential activist might be someone who already is a leader in other areas of their life, or someone that you notice is evolving from "I want to have a midwife" to "this is so great, so important, every mother should know about this and have access to a midwife." You can acknowledge this woman's experience or interest, then ask if they would like to help you get others interested, and offer some opportunities – help with a potluck or meeting, talk with a class, or something else. Envision the future and plant some ideas. Guide and encourage – people generally like enough direction that they feel confident they are "doing it right" but enough freedom to be creative or at least contribute their own ideas. Even if someone can't do a lot, they may have really good ideas and know others who would like to be involved. Projects and actions don't have to be big – they can be small and local ("bite-sized" activism) —but they can be oriented around your advocacy strategy.

"But I don't have time to talk to my clients about politics and advocacy." I hear this often. But consider that neither you nor your clients can afford for you to omit this kind of information from your prenatal care and postnatal visits. By the time you need that client network for support, it will be virtually "too late." And your clients will be shortchanged if you have not helped them understand the threats to midwifery nationwide and worldwide, even if everything is OK where you practice.

Citizens for Midwifery, the only national consumer-based organization promoting the Midwives Model of Care, wants to make it easy for you to reach your clients and get them involved. They have made a postcard you can include in client packets; your client can send in the postcard for a free issue of the informative CfM News. You can sign up your clients with Citizens for Midwifery and a state or local midwifery advocacy group for a reduced rate. There are fact sheets useful for public education events. CfM also has free packets of grassroots organizing tips and public education ideas. However, it is still crucial that you also speak with your clients directly about the politics of maternity care; introducing them to Citizens for Midwifery is a great way to start.

Invest some time and energy now into nurturing your clients into an informed network, and you will have knowledgeable and loyal friends all ready to help should you find yourself facing legal charges.

During May 1996, representatives of the Midwives Alliance of North America (MANA), the North American Registry of Midwives (NARM), the Midwifery Education Accreditation Council (MEAC) and Citizens for Midwifery (CfM) worked together to put into words a brief description of the kind of care we are working for -- a definition that all the groups could use consistently in communicating with health care decision makers. As of 2001 the title became the "Midwives Model of Care." Citizens for Midwifery developed and publishes the widely used "Midwives Model of Care" brochure to describe in more detail what can be expected from this kind of care. Unlike the phrase "midwifery model of care," which means different things to different people, the phrase "Midwives Model of Care" has a consistent and specific meaning. The Midwives Model of Care may be practiced in or out of the hospital by midwives, nurse-midwives, or physicians, although at this time it is rare to find this kind of care in hospitals. The phrase and definition are copyrighted but may be reproduced in their entirety without having to get any permission. Find more information, the definition, and the text of the brochure at the CfM web site.

The Midwives Model of Care Definition

The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes.

The Midwives Model of Care includes:

The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.

Copyright (c) 1996-2004, Midwifery Task Force, Inc., All Rights Reserved.

Almost Everything Midwifery Activists Need To Know About Working With The Media

Edited by Katherine Prown, Ph.D.

The information below, unless otherwise noted, is based on The Strategic Press Information Network's (SPIN) Media Tutorials and is adapted to refer to the specific needs of midwifery activists.

Learning to work with the media is probably one of the most effective ways that midwifery advocates can educate the public about the Midwives Model of Care, the benefits of out-of-hospital birth, and the injustices involved in using the court system to regulate midwifery. The first part of this section is intended for activists and organizations that wish to draw positive media attention to midwifery issues in their state or local community before a legal crisis involving a midwife emerges. It's important to note, however, that the information in this section applies as well to activists forced to launch a media campaign because of a trial or other legal crisis. More specific information on writing letters-to-the-editor, issuing press releases, and developing sound bite messages to promote during a trial situation is also included below.


The first step in learning to work with the media is to identify the message you want to promote to the public.

The Midwives Alliance of North America (MANA), Citizens for Midwifery (CfM), and other national midwifery organizations have worked together to develop the core messages that will prove most useful in bringing positive media attention to midwifery and homebirth:

For more information on the Midwives Model of Care, refer reporters to the CfM web site.

Each news and human interest-story you promote, or pitch to the local media should include these two messages. Be sure when speaking to reporters to refer often to the Midwives Model of Care.

NOTE: Avoid using the word "choice" when referring to maternity care issues since many people associate it with the debate on abortion. Always use the word "options" instead.


Before you approach reporters with an idea for a story, you need to consider the basic question, what is unique about your issue? What are the news hooks? To really grab a reporter's attention, a story must be newsworthy. The upside to the relative lack of media attention that midwifery issues have attracted is that there is still plenty of room to come up with literally hundreds of potential human interest and news stories to pitch to the media, all of which can be used to promote the Midwives Model of Care.

Use this list of news hooks to help you think of angles that can help you score press coverage and raise public awareness of the need for a broader access to the Midwives Model of Care.


Working with the media to promote positive messages about midwifery is, essentially, a public relations campaign. And all public relations efforts must target a specific audience. Who are you trying to reach? Depending on the particular midwifery-related story from the many possibilities included above that you've decided to pitch, you may wind up with several targets or with one specific audience. The targeted audience will help determine the scope of your media plan. Give your audience some thought before embarking on a media campaign. This is good strategic planning.

Midwifery activists often make the mistake of assuming their message is of interest only to a small group of people or, worse, only to conservatives or to liberals. It's crucial to remember that midwifery care and homebirth are bi-partisan causes involving issues that are of interest to a wide range of audiences including:

  1. Lawmakers, particularly in states with an active legislative agenda
  2. Voters
  3. Opinion-makers
  4. Community leaders
  5. Women
  6. Young people, particularly young women who haven't yet had their first baby
  7. People of faith
  8. People of color
  9. Liberals
  10. Conservatives
  11. Libertarians
  12. Others


In his book, Making the News: A Guide for Nonprofits and Activists, Jason Salzman quotes a reporter from a major daily whose sentiments are probably echoed by journalists everywhere: "A lot of what gets covered depends on personal relationships at the paper."

Here are some simple, basic pointers that will help you start out on the right foot as you begin to work with reporters. Remember these tips as you begin your media work.

Who To Call? Avoid the scattershot approach.

When pitching stories or responding to coverage, it is important to remember your first line of contact is always with the individual reporter. Target specific reporters. Do a brief search of the paper's archives to determine which reporters have covered women's health or maternity care issues. When you call, refer to their prior work and suggest how it might relate to the story you're pitching to them.

If the reporter you call is not interested or on another beat, ask who you can speak to instead. At the very least, target reporters in the relevant section of the paper. Pick a section based on how you are framing the news and call the appropriate reporter. If you must make a cold call, ask the general assignment editor or producer who you should contact, then call that reporter.

If you pitch more than one reporter at the same media outlet, let each reporter know that the other has been pitched. That way no one is caught by surprise.

Even if the story has potential in different departments—"Lifestyle," "Business" or "Metro"—always start with your key reporter contacts. If you do not have key contacts, cold-call a couple of reporters or general assignment editors and ask who would be interested.


Pitching means "selling" your news story to a reporter or editor. It typically is done over the phone, although reporters can be pitched in person at briefings or while they are covering other events.

Often, you will have no more than a few minutes to convince the person that you have news. Here are some tried and true rules to bear in mind while your fingers do the walking and your mouth does the pitching.



The majority of the information in this packet is offered to help you proactively reach out to reporters. But the sad reality is that midwifery supporters often find ourselves in a position where we need to respond to negative, biased and inaccurate media coverage. Here are some tips for managing damage control:

Call the reporter
When you have a concern with a story call the reporter first to discuss it. Don't accuse them of bias but assume their errors are honest mistakes—a result of deadline pressures, an understaffed newsroom or inaccurate information.

If there are factual inaccuracies, reporters will generally appreciate the correction. If you are repeatedly shut out of the news, ask why.

If the reporter is uncooperative, call his/her editor. But tread carefully! Do not call an editor or producer to complain about a story if you haven't already taken your concerns to the reporter who wrote the story.

What if the facts are wrong? Who should I call?
If a reporter makes a mistake or misquotes you in an article, always speak directly to that reporter—not his or her editor. Only as a last resort do you escalate. Your focus primarily should be on reporters and possibly those editors immediately above them. But if direct conversations with the reporter have not been productive, then it's time to move up the food chain to their editor or producer.

How do I respond to a reporter who appears hostile to midwifery and homebirth issues?
Unfortunately, midwifery activists will encounter reporters whose stories are consistently slanted, inaccurate or downright hostile. What does your organization do when you've got a less-than-friendly reporter on your hands? What do you do with a reporter who has made up her mind, to the exclusion of any contrary information about your organization or your issue?

Here are some tips to help your organization design a step-by-step course of action to improve your relationship with the difficult reporter described above:


Monitoring coverage of your organization and of coverage of midwifery issues in general is one of the most important elements of a well-executed media strategy. It helps you determine which issues have established media appeal and which need further promotion. Check the list of resources at the end of this section for online sources that will help you track coverage of midwifery in the news.


Be prepared to invest sufficient time in putting together a database of the media outlets and reporters you wish to target with your news. Here are some tips to remember as you begin your media contact research:

Responding To Media Coverage Of A Midwifery Investigation, Trial, Or Crisis

Edited By Katherine Prown, Ph.D.

Ideally, every state Friends of Midwives organization should have a proactive plan in place to work with the media to promote positive messages about midwifery care before a crisis emerges. For more on planning a media campaign please see the expanded version of "Almost Everything Midwifery Activists Need to Know About Working With the Media.

Unfortunately, midwifery activists rarely have the opportunity to work proactively with the media and more often than not find themselves forced to respond defensively to negative coverage of an investigation or trial. Below are some tips to keep in mind about strategies and messages you'll want to use in this situation.


When faced with the onslaught of negative media coverage that invariably accompanies an investigation or trial, midwives and activists often assume a defeatist attitude. How can we ever hope to tell the other sides of the story when all the press is interested in are stories about dead babies and reckless midwives? While the sad reality remains that many reporters prefer to frame the issues involved in a sensationalized and one-sided manner, getting the other side of the story aired isn't as difficult as many people assume. Letters-to-the-editor are both the most widely read section of most newspapers and the most accommodating forum for the average person to express their opinions.

While writing letters-to-the-editor is an important component of any proactive media campaign, it's an absolutely essential component of responding to negative coverage of midwifery investigations and trials. Numbers, persistence, and format are the keys. If you send enough letters often enough, they will get published, particularly if they conform to the appropriate format (more on that below).

The first step in getting your letters published is organizing. This is where e-lists can become very effective advocacy tools, allowing you to share sample letters and ideas, post addresses, and determine a system for making sure you maintain a steady flow of letters until you begin to see results.

Next you should make sure everyone involved in your letter-writing campaign understands some of the basic ground rules:


Press releases are another useful tool for inserting positive messages about midwifery into local coverage and, more importantly, for establishing your organization as the source for comments and quotes on issues related to homebirth and midwifery care.

If you have followed the steps above to cultivating relationships with local reporters and editors, you should have no trouble getting key information from your press release included in media coverage of a case. If, on the other hand, sending out a press release about a case or investigation will be your organization's first contact with local reporters, be sure to follow the steps outlined above for developing positive relationships with the media.

REMEMBER: NEVER, under any circumstances, refer to the specifics of a case against a midwife. Always stick to the simple, core messages and stay positive.

The following tips are from Dr. Randall Hansen's Guide to Writing Successful Press Releases.

The workhorse of your relationship with the media will be the press release, a one-page document you write and send to the press to alert them to or respond to important news issues. Press release writers must think like a reporter. Media releases must follow journalistic style in order to be given any kind of consideration. How do you accomplish this task? Here's a basic guideline:


Media events are an effective means of turning a negative event such as a trial into a forum for promoting positive messages. Many people assume that rallies or demonstrations leave too much of a negative impression on the public, but the fact is that if they're properly organized and staged, demonstrations can be a very powerful forum for raising public awareness about an issue.

Any time you stage a media event, be sure first to find ways of visualizing your news: no picture, no image. No image, no television, no photographers. No television, no thousands if not millions of audience members seeing your message. Television in particular needs pictures. So instead of just presenting talking heads in suits, behind podiums, beneath bad fluorescent lights, in boring office suites, create photo ops for your news.

Stage the photo op with the message in mind. Visualize how everything will come together and look in tonight's TV news or tomorrow's paper. How will the viewer get the one key message that drives home your point? Find the one visual metaphor that communicates the message. Think about your news hooks! All of the elements that make your story newsworthy should be considered as you design your photo op.

Build your event carefully so photographers don't have an opportunity to capture an image you'd rather not see on the front page of tomorrow's paper. Think about the pictures that help tell your story, then build that picture, thinking through all the details, including:

Your location should be appropriate, convenient, and should help tell your story. Be mindful of camera angles, the direction of the sun and the effect on lighting at outdoor events. Do not make camera people shoot directly in to the sun. Also, does the backdrop "read" in your picture? In other words, can you make sense of it? Examples of possible locations include: parks, libraries, courthouses, local midwifery offices, the home of a family, churches, rec rooms etc. If you're using a public space, make sure you have applied for and received the necessary permits, and always be sure that whatever location you use can accommodate participants and reporters comfortably.

The messenger is as important as the message. Think about your spokespeople and the other key players at your event. Are all the right people represented? Will members of your target audience see people who they will find credible when they see your story on the six o'clock news? Will they see people who look like them?

Typical speakers at your event might include:

  1. A key organization representative, like your Executive Director or a board member
  2. A person who represents the human interest inherent in your story, such as the child of a midwife on trial (yes, at times you need to engage in a little exploitation to get media attention)
  3. A local politician, ally or public official
  4. An expert, such as a scientist, economist or lawyer who can present the "raw facts" of your issue

Consider gathering families that have used midwifery care together with their children. Children/families can provide an excellent photo op. You can easily create t-shirts that are eye catching with phrases such as: "Born at home" or "Homebirth rocks" on them for the children to wear.

What are the visual elements and gimmicks that flesh out your story? It might be a costume, a toy, a cardboard cut out or some symbol of your issue. The perfect prop is often the crowning glory of your photo op. Consider artistic props, such as midwife and mother sculptures, artistic paintings or drawings of nursing or laboring mothers, photos that would be appropriate for the general public to view blown up and framed or banners with catchy phrases on the wall. If you are staging a protest, find someone skilled to assist artistically with the signs to be carried. Give careful consideration to what phrases to include on signs. Some examples include "born at home" for children to carry, "My child/ren were born at home", "support your local midwife", etc.

Sound Bites
What you are saying at your event is, of course, as important as what your event looks like, so be sure that your sound bite is consistent with your theme and communicates a consistent message. Does your visual metaphor hinge on a common phrase or cliché? Put it to work in your sound bite! For more information on sound bites see the quick reference guide to sound bites at the end of this section.

Midwives Supporting Midwives

Melissa Smith-Tourville, Community Midwife

Modern day midwives by our very nature, tend to be rebels. We buck against the established order of obstetrics by suggesting that birthing women are strong, courageous and capable. We tend to trust the cycle of life and death. Nonetheless, we live in a world that insists on placing blame when life emerges into death before expected. The sting of this reality is never more painful than when the other end of the blaming voice lies with your sister midwives. And yet it is understandable that midwives in the community would have questions. Let's face it, our basic survival instincts leave us with no choice but to examine what others around us have done in order to create or avoid their resulting consequences. The goal is to find the balance between learning and blaming when we are faced with the knowledge of a midwife under investigation. With that in mind, I offer the following suggestions. They were gained through listening, observing, experiencing and learning.


The first response to the news that a sister midwife is under investigation is always "what happened" and "what could have been done differently?" We want the details. We want to comfort ourselves with the "I wouldn't have done that's." We want to pinpoint the differences in our styles of practice. We want to believe that it couldn't happen to us. If the midwife under fire happens to be our friend we naturally feel defensive. If she is someone we don't know or never cared for, we want to exalt ourselves above her skill level. We naturally look over our backs to make sure that we are not at risk. In the midst of these natural reactions how can we extend support? My first and foremost suggestion is expect nothing from the midwife as she goes through the investigation process. Be gentle with her if she seems detached, explosive or ambivalent towards your kindness. Her immediate internal response to being threatened is fear. This fear leads to utilizing her flight or fight instinct. While this instinct is in use people tend to lash out. They snap, even at those who are behind them or they avoid even those who care. This can result in those around them feeling upset that gratitude is not shown for their effort. Remember that they are in survival mode. They are focused on protecting themselves and their family from harm. They are unable to focus on those around them. Extend your support anyway. There are several ways in which you can extend that support.


Combined with everything suggested above there are some basic tips for supporting a sister midwife if she actually goes to trial. The single most stressful thing a midwife under investigation can hear is that charges are being filed. Yet when it happens we must come together as a community and support her. In my experience there are a few core issues that prevent midwives from coming forward in support.

First, they often feel afraid that their visibility in court will risk them being next. This is a reasonable concern and should be considered by each midwife in the community. If it is determined that showing up in court is too risky for a sister midwife, it is important that she express her support and desire to be there to the midwife on trial. Silence can leave the midwife on trial feeling unsupported. Sending a card or note letting her know why you are unable to physically be there is a valuable way of expressing your support. Sometimes midwives from neighboring states are better able to stand on her behalf because their laws are more favorable and there is therefore, less risk to them. If you do not feel safe attending, contact midwives from safer neighboring states and ask them to be in attendance. Do your part to extend your support.

Second, personal issues between the two midwives often rise to the surface when a midwife needs support. There is never a more important time to let the past go than when a midwife is on trial. Disagreements, struggles and arguments can be resolved later. She needs your presence in that courtroom. Midwifery needs your presence in that courtroom! If she drives you crazy, show up anyway! When you have been wronged, practice forgiveness. Extend your hand to heal the past.

And third, from what you heard of the circumstances, you disagree with her management and don't want anyone to think you would have acted in the same manner. The reality is that for every midwife who takes a stand that something is dangerous and irresponsible there are three other midwives that would say something she does is dangerous and irresponsible. We practice differently. We recognize this. Standards of care differ from one area to another. Midwifery is an art not a science. It is the art of being ‘with woman'. What that looks like for each midwife and woman is very different. And sometimes we even make decisions that we later regret. But at no time do we, as midwives, intend to cause harm. And it is with that in mind that I believe every midwife on trial for a midwifery related "offense" deserves the support of her sister midwives. Without that support we remain fragmented and divided. Division prevents us from accomplishing our goals. Support does not equal agreement. You can have a vastly differing opinion of how to handle a situation and still stand beside those you differ with. United we stand, divided we fall.

Utilize your strengths. Everyone is good at something. If you are a good public speaker, then speak. If you are good writer, then write. If you are a gifted organizer, then organize meetings. If you are skilled at rallying, then rally the troops. If you are an artist, use your skills to make flyers & banners. If you are gifted at caring for children, offer to do childcare for courtroom attendees. And so on. If you are unsure where your talents would best serve the midwife on trial, ask people who know you. Many women are committed mothers of small children and feel that they would not be capable of extending much support. In my experience, this is not true. During the trial mothers can come with their children and rotate between the childcare room and the courtroom. Women can creatively arrange to care for one another's children so that everyone can participate in supporting the midwife on trial.

Call and email supporters to update them and remind them about court dates. Take a few minutes of your time to let your clients, friends and sister midwives know that they are needed in the courtroom. Sometimes a simple phone call or email will encourage them to leave their comfort zone and show up. Remind them that the issue affects them directly. Once the trial begins it is essential that people show up for court. Our presence in the courtroom reminds the public, the court and/or the jury that midwifery is important to us. The issue is usually bigger than supporting this one midwife. Yes, she is on trial but make no mistake about it, the profession that we hold so dear is also on trial. Regardless of the circumstances that led her into court we have a responsibility to attach a face and a voice to midwifery. We do that by being a presence there and by talking to the media.


Not everyone feels able to speak to the media. Those who feel able should and those who don't should try to avoid it. These tips are equally important for those who do not want to talk to the media but find themselves with a camera in their face anyway. And be prepared, because this can happen at a trial.

Organize sound bites. Get together with others that are attending the trial and determine what two or three statements should be given to the media as sound bites, each time they are approached. Keep it short. Sound bites such as; "The family is in support of their midwife. This trial is an unnecessary expense for the people of the State of _________________." Or "Women have the right to choose to give birth at home. Charging their midwife with a crime will put them at risk of being unattended when they desire to have a midwife present." Or "The United States is 27th in the world in infant mortality. The majority of countries ranking at the top use midwives as the primary caregivers of pregnant women." Or "The parents in this case fully support their midwife. Criminal Court is not the appropriate avenue for justice in cases like these. If the parents had an issue with the care they received, they could bring a civil suit against their midwife. However the parents do not have an issue so the state should not create one." For more suggestions for sound bites see the quick reference guide to sound bites at the end of this section.

Never address the specifics of the case. Reporters are masters at diverting you from the point you want to make to the point they want made. You must become a master at ignoring their questions and redirecting them to where you want them to go. When you stick to the same three sound bites repeatedly the words will flow after repeating them over and over. You should never address the specifics of a case with the media. You were not there. And if you were, you are bound by confidentiality. Either way, avoid talking to the media about the details of the situation at hand. To discuss the specifics opens the door for your words to be misconstrued and used against the midwife on trial. The most important thing for you to remember, when speaking with the media is that you must be in control of the interview. If you feel that you are losing control of the interview, simply finish your sentence and end with "thank you" and walk away.

Find one or two favorable reporters to do lengthy interviews with. There are always midwifery supporters in the crowd. The trick is to find them and allow them to do the interviews with you. Note that I said, "Allow them." Always stay in control of the interview. For a lengthy interview in print, you can ask them for their edited copy before it goes to print. This ensures minimal misquoting.

Do the interview on your terms, in a space that feels comfortable to you. On the spot lengthy interviews should only be done by those well versed in dealing with the media. If you feel that it would benefit the cause and the midwife on trial for you to do a lengthy interview, set one up. Make arrangements to meet with the reporter somewhere that you feel comfortable, will not be distracted and can focus on your main points in the interview. Consider the atmosphere carefully, as it could influence their opinion of you.

Approach clients that you consider well spoken to join you for a lengthy interview. Often times we have clients that would be a shining example of the types of people who choose to birth with midwives. If you have agreed to a lengthy interview with a reporter, try to include a client in the interview that could speak well to the issue.

Coach Clients and other midwives who may be approached by the media. Give information to people that may be approached by the media about what to say, when to say it and which reporters are known for being friendly. Speak with authority and confidence. The voice you use to speak with the media should be confident about the topic you are addressing. If at any point during the trial you are feeling less confident than usual, avoid the media. You are speaking on behalf of midwifery and there is a certain responsibility to carry yourself as a professional.

Know your statistics, know your subject. Do not speak to anything that you do not know the answer to. If a question is asked of you that you are unsure of, say so. You can answer simply "I cannot speak to that issue but..." and move on to the topic that you want to address. Do not quote statistics that are questionable. Do your best to know the source of your stats should you be asked. Always be honest. Do not exaggerate or speak in assumptions. Note: the Citizens for Midwifery website has several printable fact sheets with reliable statistical information (references included), that may be useful when dealing with the media.

Remember that what you say on film could be clipped and taken out of context. You may be intending to make one point but if you take too long to make it you may say something that could be taken out of context. Sticking to sound bites is always your safest bet. Accept that when you are quoted in print it is often not what you said. This is never truer than when you find yourself in the barrage of media frenzy. Use caution when speaking to a reporter. Unless you are prepared to do a lengthy interview, always keep it short. Stop an interview if your emotions get worked up. If at any time during an interview, you begin to feel upset and are at risk of appearing unstable, end the interview. If you are doing a lengthy interview on film politely say that you appreciate them doing the interview but you need to end it now. If you are speaking briefly to a reporter on film, finish your sentence and say "thank you," confidently, and walk away. If you are speaking to a reporter whose piece will be in print, politely let them know that you appreciate their time but you have nothing further to offer. Avoid hostility at all costs. Do not use hostile political statements. Do not use hostile tactics to get your point across. Do not wear hostile clothing on film (such as t-shirts with hostile political statements on them). This only serves to make us appear on the outer fringes of society, rather than stable adults making safe decisions in childbirth.


Knowing your community is under fire can initiate a whirlwind of emotions. Watching a sister midwife go through an investigation and/or trial is bound to bring up areas of fear for you. The trick is to feel your feelings and work through them. Some of the emotions likely to arise are fear, anger, criticism, disdain, sorrow, depression, denial and guilt. Face each emotion as it arises. Do not refuse to feel. Shutting down the feelings can lead to painful consequences. Give yourself permission to feel and work through your emotions. Touch it, talk about it and focus on gaining control over what you can. There are some things we have control over and some things that we don't. Figuring out the difference is one of life's greatest challenges.

One of the problems facing a midwife supporter is that we need to communicate about our feelings and determine which ones are irrational and which ones need us to take action. But communicating can leave us or the midwife under investigation vulnerable. Some of our feelings may not shed a positive light on the situation. So what can we do? Choose one or two trustworthy friends to communicate with. Of utmost importance is that these friends have demonstrated the ability to not share details with others. Personally, I use the "do they tell me about other people's lives" test. I trust friends with private details of my life and feelings only if they have never shared details of other people's lives with me. Once a person has passed this test I would make certain that they are sensitive to the issues closely connected to midwifery. If they are trustworthy but tend to believe that babies should be born in hospitals with doctors, you are not likely to find solid support. If you have no one in your life that would qualify, consider a supportive therapist. Sharing your feelings is critical to healing.

I remember clearly the emotions that I experienced as a supporting midwife. I can remember feeling very guilty that I was so upset when I wasn't the one that was under fire. I remember feeling angry that the state had so much power. I remember feeling alone in my sense of despair. I chose a trustworthy midwife friend in another state to call and talk to, as I processed my feelings. She was detached from the situation because we lived so far apart. She had proven trustworthy for many years. She supported me as I supported my midwife friend through her trial. She acted very much like a doula during a birth. She was in a supportive role, rather than a lead role. I cannot imagine what it would have been like to not have someone to process through my feelings with.

Take breaks. In the midst of being an activist it is easy to forget that taking a break will not bring the cause down. Refueling is an important part of carrying the torch. Be gentle with yourself. Set limits. Know yourself. Know your needs. Allow yourself to be supported. Allow yourself to decline a request for help. Keep your life in balance. Give when you can, receive when you have need. Know that your feelings are shared. I remember wondering if anyone else was feeling overwhelmed by the stress of being in a supportive role. I remember wondering if anyone else felt the isolation I was feeling. I remember being afraid to admit that I wasn't as strong as I appeared. When I finally shared these feelings with a couple of allied supporters, I was met with relief that they weren't the only ones feeling them! Day after day we met at the courtroom with the goal of showing our support. Each day we left feeling drained and unable to do it another day. And yet we motivated ourselves out of bed the next morning to do it again. The midwife on trial is not the only one experiencing the agony of exhaustion during a trial. Each one of us carries a piece of the stress with us. Nonetheless, I can honestly tell you that I would not trade a day of it. I feel proud that I take my personal commitment to raising my voice seriously. And in the end, the women that I finally opened up to remain today as some of my dearest friends. We bonded during a very stressful time. That bond has lasted for years.


Time and time again I have heard midwives complain that when needed, their former clients are often nowhere to be found. Once their babies are born they assume that we can take it from here and their assistance is no longer needed. They are occupied and busy and don't consider how important they are to us. Families that choose midwifery care must understand how critical their support is. This begins taking place long before an investigation begins. One of the best ways to keep your clients up to date on midwifery issues is to include a two year paid membership to a midwifery consumer based organization with their fee. An organization that actively sends out updates about your state to their members is ideal. This will keep them up to date for two years and encourage them to stay active in the cause when they are needed. The most common mistake made by midwives in "a-legal" states is to leave out the detail that though their state may not currently be prosecuting midwives that could change at any time. To suggest that an "a-legal" state is safe for midwives to practice is simply a mistake. The bigger picture leaves us aware that at any given time the tide can turn. Preparing your clients for that in advance will increase the likelihood of having their support if you ever need it.

Beyond the things that can be done before a crisis hits there are ways to rally supporters together during a crisis. Utilize the phone and email. Keep people informed. Emailing is the fastest way to inform a large number of people at one time of what's happening. Make sure you have a spot for email addresses on your initial intake form. However, email is not as personal and some people don't check theirs very often. When the information you need to get to people is pressing or urgent, use the phone.

Create a calling tree. For urgent matters the phone is clearly more reliable. Ask your clients permission to be included in the calling tree. Set up one main caller for every five people that need to be called. You will then only need to call the main callers. Connect people who are already friends, if at all possible, when assigning connections. When you have run out of friendships to connect, choose people who have common interests. As a last resort assign connections that might not naturally form. Keep a master list of who is calling whom so that if a main caller is out of town, you can make their phone calls for them. If this is too much for you to do on your own, assign one person (possibly an apprentice) that you can contact with urgent information to disseminate. This person should be easily accessible. A person that carries a cell phone or pager at all times is ideal.

Have a potluck, picnic or homebirth reunion. Sending out an invitation to a potluck, picnic or homebirth reunion will often draw clients that might not be active otherwise. Being with other families and hearing about what is going on politically will often inspire action. Create a comfortable environment for your clients to learn about the current events.

Call your sister midwives together. Picking up the phone and calling every midwife in your community can go a long way in rallying their support. In my experience people will feel more connected to the situation if someone calls them and lets them know they are needed. Sharing with them how important their presence is will leave them feeling like a valued part of the midwifery community. Plan a gathering for midwives. Not everyone will participate but some will. Organize, organize, organize. Be prepared. Organize political meetings, organize social gatherings, organize workshops, organize connectedness. If your sister midwives presence is needed for a trial, call on them. People will often respond to heartfelt requests for involvement. Midwives who are reminded that their presence makes a statement to the court about how important this issue is will often show up.

Assign jobs to people. Don't try to do everything yourself. Delegate anything that can be delegated. Offer people the opportunity to get involved. Choose tasks that are well suited to their talents. Show your gratitude when people step up to the plate. Every time a client or sister midwife performs a task or shows up for an event, take the time to thank them. After a crisis is over, plan a potluck or picnic as a thank you for those who showed support. Stay connected. When all is said and done don't forget to stay in contact with those that you stood beside. The connections you made will hold you through your years of practice. We need one another.


You've heard the details. The source of the information was reliable. There is no chance that you would have accepted this woman as a client in the first place. Under those circumstances, you would have promptly transferred the woman out of your care. Given that situation, you would have transported the woman to a hospital immediately. You know you would have done it differently. You don't think, you know. Now what? What will people think of you if you stand tall along side this midwife? How can you extend support and not appear as though you agree with how the situation was handled? And more importantly, should you? These are important questions, which I will attempt to answer.

Many years ago I had a conversation with a midwife who clearly represented the majority of midwives in her community. They strongly believed that a senior midwife in their community was dangerous and had to be stopped. During that conversation I expressed my compassion for the many thousands of clients that had been served by this midwife, and now no longer had her in their community. I expressed the pain that I felt inside, imagining how it must feel as a midwife to train several midwives in your community and then have them stand against you, suggesting that you are dangerous. The most compelling point that this midwife made was "What were we supposed to do? We were concerned for the women she serves." By the time we had this conversation my answer was irrelevant. The senior midwife, who had tirelessly served her community for years, was already serving time. She was taken from her family, her community and her clients and put in prison. If it had mattered, what I would have expressed to her was that we must support women in their choice of care providers. Support them; by recognizing that they are capable of seeking out a midwife that they feel can be trusted. Give them the credit they deserve. Expect them to listen to their instincts and hold them accountable for their choices. Do not assume that a woman has chosen a "dangerous" midwife and just doesn‘t know it. Assume that a woman has chosen a midwife that she feels comfortable with and trusts is best to meet her needs. Trust women not to hire a midwife that is dangerous. Trust them to educate themselves and not be ‘led' astray. Women who choose midwifery care, especially homebirthing women, know that the choice they are making is outside the "norm". They understand that they have a responsibility to collect adequate recommendations from within the community to make an informed decision about their care provider. They must be held accountable for this choice. If their choice turns out to be the wrong one, they will make different choices in the future. We cannot rescue women from their choices in childbirth. We can give them the information and we can support them in the process of making their decisions but ultimately we must let them make those decisions. If we don't, we take away their power. When all is said and done, it is the parents who must take responsibility for deciding which midwife can best meet their needs. If we leave the decision in their hands we are empowering them to take back their birthing experiences. We are empowering them to own their decisions. We are honoring their capability. We are removing the idea that we know better than they, what is good for them. We are focused on empowering, rather than directing them. We are treating them differently than they are treated by mainstream medical professionals. We are giving them what they have asked from us... respect.

Allowing women to take responsibility for the care providers they choose is an important preface to the assertion that midwives should support one another. Because as long as we are convinced that we know what is best, our egos will leave us unable to support a sister midwife when she faces a crisis.

First, let's establish what I mean when I use the word "support." Webster's defines support as "to promote the interests or cause of." This is an appropriate definition for my point. I am asserting that to ‘support' a midwife under fire is to "promote the interests and cause" of midwifery at large. Not everyone agrees with this assertion but I will attempt, through the course of this section to delineate the importance of providing this support.

Homebirth midwifery is unpopular in the United States. It is considered by the general population to be archaic. Most homebirth advocates strongly hold to the idea that changing this fact will afford women safer childbirth experiences in the United States. I agree. However, I am realistic. I understand that we are unlikely to make significant headway in changing this in my lifetime. So in the meantime, I seek to dispel the myths about midwives, every chance I get. One of the myths that need dispelling is that midwives are dangerous. I encountered this myth many times during the course of my own pregnancies. In fact, my grandmother gave birth at home three times with the midwife in her close-knit community in rural Tennessee. She even returned, after moving away, to give birth to her youngest child in her mother's home so that she could be assisted by the midwife she knew and loved. Her midwife was an important part of her life. They shared a community together. Their children played together, they cared deeply for one another. My mother and uncles have fond memories of this woman. Growing up, I heard of her often. Despite my grandmother having such a beautiful experience, when I told her that I would be giving birth at home with a midwife, she expressed that she was concerned that it was dangerous. This conversation with my Grandmother illustrated to me how, in just a generation of primarily hospital born babies, we have turned the tide from trusting midwives to believing that they are dangerous.

The general public, whether we like it or not, believes what they are told by the media. You can hardly make it through the average American town without seeing a billboard that says "Such and Such Hospital- where babies come from." Our society has been programmed to believe that doctors "deliver" babies. When a midwife comes under investigation, everyone from the regulating body for nurses to the District Attorney, from the media to the general public assumes that she must be guilty of something because she shouldn't exist in the first place. In my experience, the general public must be educated to understand that people from all walks of life, all economic standings and all types of personalities choose to birth at home with midwives. The best way to make that statement is for the midwives and their clients to directly address this issue. We can best accomplish this during a legal crisis by standing tall alongside a sister midwife that is being investigated or charged with a crime. We attach a face to midwifery by being present. The general public can look to us to balance out what is being said about our profession. I believe that whether we like it or not, every time a midwife is put on trial, midwifery stands trial along with her. Our silence or ambivalence leads the public to believe that no one cares. They are left assuming that no one really chooses to have their babies at home with midwives anymore so why would it matter if this midwife is sent to jail. We must magnify our cause in the midst of a legal crisis. We must draw attention to the thousands of responsible parents that choose to give birth at home with midwives every year. When we stand by silently and allow them to take one of us down, we must be clear that they will continue until they have all of us. To the contrary, when we stand united, despite our differences and style of practice, we show the public that midwifery is important to us. We indicate by raising our voice that we will stand up and be counted. We demand our right as women to have midwives serving women in every state in this country. We speak to the myths about people that choose midwife attended homebirths.

Fear is a blinding force. Living with fear can lead us to do things that we would never do in its absence. Midwives have lived in fear for centuries. Historically, we have overcome incredible odds to survive as a recognized profession. But the reality is that we have been given reason to fear. When a midwife is under fire, her community has no choice but to feel it. I have heard more than one midwife complain about the choice her sister midwife made which risked the entire community. These feelings from the community often lead to them being outcast. Midwives have expressed that they don't want to be associated with a midwife who practices in a way that they would never practice. So they stay silent during an investigation or a trial and hope to not be associated with the midwife under fire. This solution has always been a curious one to me. It is assumed that the general public will be inclined to make a distinction between the midwife that practices one way and the midwife that practices another. In reality we are all clumped together, whether we like it or not. If a midwife does something with which the majority of midwives in the community disagree and as a result they stay silent or work to bring her down, it is only a matter of time before the entire profession goes too. There are, after all, so few of us. We have more enemies than allies. When we become our own worst enemy- who will stand on our behalf? The majority of American doctors believe that the very act of assisting a woman in childbirth at home is dangerous. Every single one of us, as midwives, has someone that imagines that what we do is dangerous. Being the type of midwife that works hard to stay within the current OB standard of care does not exempt you from that fact. It merely aligns you with the majority of other midwives. In the end, if you don't speak on behalf of your profession, who will? Can we afford to leave it in the hands of the media, ACOG or those who seek to close us down? No, we can't. I propose that when we find ourselves faced with a sister midwife under fire and we are certain we would not have done what she did, we stand tall in support of midwifery and women's rights. We do not have to speak to our feelings about her actions or inactions publicly. We can stand tall in our belief that there is a midwife for every mother.


I have been accused of suggesting that midwives should function under a "code of silence" whenever a legal crisis comes into play. In truth, I believe that in order to preserve our profession from being viewed as a fragmented, disassembled group of individuals, we need to avoid addressing the specifics of a case publicly.

When a midwife, police officer, doctor, military personnel or any other professional comes under attack by the media it is presumed by the majority of the public (unfortunately) that they are being given accurate information. Anyone who has ever dealt with the media knows that a dramatic spin is always put on a story. Frankly, there is often little but a grain of truth in the first place. Trials are held in the media by prosecutors because potential jurors are out there watching, listening and often trusting what they hear. The accused is typically warned by their lawyers that they should not speak until the trial, to prevent the prosecution from gleaning insight into their defense. This invariably puts them in a position where they are being lied about to the public with no opportunity to defend themselves. And if a midwife is forced to plea-bargain because she cannot afford to go to trial, she then looks guilty and can never redeem her reputation. On top of all of this, she is often shunned by her community of midwives because they "wouldn't have done what she did." It is tragic.

Let's face it, whether we like it or not when one of us gets thrown into the eyes of the public, it puts us all into the eyes of the public. If we don't stand tall and insist that we are a united front then we are to blame when they have taken down every last one of our sisters and then they come for us. Let us not forget the powerful words of Berlin Pastor Martin Niemoeller, in the face of Hitler's despotism, "When they came for the Jews I said nothing for I was not a Jew; when they came for the unionists I said nothing for I was not a unionist; when they came for the Catholics I said nothing for I was not a Catholic, and when they came for me there was no one left to speak!"

If I am honest, I can admit that when I hear a negative story within the media about one person within a certain profession acting irresponsibly, it does make me wince a little and wonder if things like this go on all the time and I am just naive. It leads me to question the entire profession. If the story was followed up by people within that profession making comments like "I would never have done that" or "I think we need to enact laws to prevent this" I might assume that these individuals had some insight into the situation and it must in fact, go on all the time. This would lead me to giving the media claims more credence. Silence in the above mentioned professions is not meant to imply agreement. It is meant to imply respect for the profession. Privately when a police officer, doctor or military personnel makes an error that plummets the entire profession into a negative light, I guarantee you that their colleagues have plenty of opinions! Publicly, it would be irresponsible to make their profession as a whole look bad by making loose comments. What is responsible is stating that they believe in the importance of what they do. This reminds us, the general public, that their profession is important. It balances out the barrage of media attention to the contrary.

I do understand that as a midwife the natural internal reaction of defense is to say "don't look at me; I would never do what they did!" But the fact is that not having been there, not having full knowledge of the situation, understanding that information always gets skewed in the media and knowing that we could be next, should lead us to careful use of words, both spoken and written when a sister midwife is under fire.

It is my position that to preserve our profession and its reputation, even if I disagreed wholeheartedly with the conduct of a sister midwife, I would stand tall in my support of midwifery. I believe that when we are united we can change the direction of the windfall of accusations against all of us. The reality is that when a midwife is in attendance during a birth she never intends for a baby or mother to be harmed. Her goal is always a healthy baby and mother. (And I have never seen one exception to this rule) I always remind myself of this when I hear a story that jars the "wow, I wouldn't have done that" thought in my head. I can understand why we, the "public" would have a difficult time comprehending the professional need to not speak out against colleagues who have made a poor decision. But I also know that within our own profession, without restraint of negative comment, we stand to lose our right to birth our babies where we choose and with whom we choose, as well as our right to assist women in birth. The risk we take when we publicly make midwives sound irresponsible is that when one of us goes down the rest could quickly follow. Therefore we should do our best to prevent even one of us from going down. If we can't work together for the sake of our cause and set aside our differences why on earth would we expect anyone else to? Sometimes ego becomes more important than the greater good of all. And often it is ego that leaves us wanting to insist that we are not like whoever it is under attack.

Lest I be misunderstood, I am in no way suggesting that it is responsible to cover for a colleague that has intentionally harmed someone. In the case of violence, discrimination or intention to do harm, blowing the whistle is essential. I am suggesting that a midwife serving a family, by being in attendance at the birth of a baby, which resulted in an investigation would not qualify as someone needing the whistle blown on them.

Each one of us is essential in preserving our profession--even the sister midwife with whose practice other midwives strongly disagree. I view us working together as the hands that support midwifery. When we cut off one finger at a time, we eventually end up with a hand that no longer functions. I would like to believe that our willingness to serve women in this profession is the tie that binds us. The more we bite and snap at one another the looser this tie becomes until eventually it unravels and we have no profession at all. We must be reminded that clients have a right to make the choices that they make. It is irrelevant whether it would be our choice or not. In life people make all sorts of choices that I disagree with, but I recognize their right to make them. I can assure you that no loving parent that has chosen a midwife to assist them at home intends harm to come to their baby. And it is with that in mind that I believe parents and the midwives they choose should be supported, without public humiliation for the choices they made that may differ from our own. We make the difference by showing support. And not one of us is exempt from scrutiny, no matter what guidelines we practice under.


As soon as I blissfully glided from being just a client to being an apprentice I realized that midwives are often not very kind to one another. It seemed as though everywhere I turned there was a story of why one midwife simply could not get along with another. It became painfully obvious to me that we are our own worst enemy. The attitudes thrown about resembled junior high drama. The great majority of the midwives who expressed problems with one another could date them back to the stone ages. And yet, few were willing to make the effort that it took to stop the madness and work their problems out. Many of the issues had to do with practice differences. It is nearly impossible to find two midwives that agree on every detail of how care should be provided to women and their babies. It is our egos that leave us certain that our way is superior. We presume we know the best way and criticize when our peers don't follow our lead. The most common place that this example is seen is in the senior midwife/former apprentice relationship. A young midwife moves into her own place in the midwifery world. Her senior midwife has worked hard to teach her everything she knows. When she begins taking her own clients she implements all the things that she can now do differently. This is a disruption in the relationship between the two midwives. It is very similar to the adjustment necessary for a parent of a newly adult child. The relationship must change. If it is not found to be flexible, it will break. Story after story of midwives who do not get along involve completed apprenticeships or apprenticeships that have gone awry. The other common example that I have seen is the midwifery partnership relationship. Two midwives worked together for a time and then after a difference of opinion or style of practice decide to split. When they split there is no attempt at resolution. They attempt to convince others in the community that they are right and the other is wrong. Years will go by wherein women will not speak to one another or worse yet speak poorly of one another publicly. The energy that is put out into the community is negative. Instead of midwives proving themselves the trustworthy wise women that we are depended on to be, we prove to be backbiting, unforgiving, angry women. This fact leaves observers convinced that we are unstable. Creating a midwifery community involves working through dysfunction. Doing this involves communication. How can we facilitate communication amongst women who won't speak to one another? We keep trying. We never give up. We reach out to those who dislike us. We forgive those who have wronged us. We offer a helping hand to those who distrust us. We take responsibility and quit waiting for others to.

I believe that midwives can work together. This begins long before a legal crisis hits in our communities. It involves learning to set aside our egos. It involves letting go of the camps in your community and working together for the good of the cause. The argument has been made that an individual cannot start this alone, but I disagree. One person coordinating a gathering of midwives and apprentices can be a stepping-stone to healing a divided community. If no one shows up, you try again. We each have a responsibility to try. A phone call expressing to a sister midwife that she is an important part of the community, can go a long way towards reuniting the collective group. Forgiveness is a high call. Learning to let go of past grudges is a challenge. Taming our giant egos is essential. If we never learn to work together, we must remember that we risk not surviving alone. We cannot wait for the other party to step up to the plate. We have to call upon our higher selves and reach out first. The power of a unified group of oppressed people can never be underestimated. Together, we can change the world we live in.


Eventually things will settle down (though I can hear the hysterical laughter of the midwives in Illinois who have hoped that for years). When they do you will be able to relax... briefly. After your period of relaxation is complete remember that there are still states in which midwifery is engaged in a heated battle. Remember to contribute as you can to legal defense funds. Encourage clients to do the same. Continue to be active in your local, statewide and national midwifery organizations. Use the spoken and written word to pass your vision of unity to the next generation of midwives. Live by example. Continue to gather with the midwives in your community. Periodically, check in with the midwife who was under fire, especially if she is unable to practice now. Remember that she is an important part of the community. Do not abandon her. It can take years to recover from the financial and emotion stress of a legal battle. Keep the ball of forgiveness rolling. When you are faced with a situation that hurts you, forgive. When you feel your ego rising to enormous proportions, check yourself. When you hear a second hand story that leaves you saying, "wow, I wouldn't have done that," remind yourself that details are not always accurate. When you know the situation first hand and you strongly disagree with how it was managed, pause and reflect on the reality that someone feels the same way about something that you've done. Be gentle with yourself and your sister midwives. Work to continue the healing in your community. Celebrate every victory and grieve every loss... together. Keep your community alive with love, gratitude, forgiveness and celebration. Never, never, never, never give up.


I consider it my life work as a midwife to bridge the gap and bring midwives together. I was blessed to be trained by three midwives who, though exhausted from years of watching midwives fight against one another, believed in my dream. I believed that we could bring the midwives in our community together, learn from one another and create a supportive environment. We set up meetings, we organized workshops, we planned events, and we shared meals together. I was, at the time, a starry eyed student. I was certain that if someone would just step up to the plate we would find ourselves working together as one unit, for one cause. Before I moved from the area, I saw the dream come to fruition. We had regular gatherings of CNMs, DEMs, LMs, doulas and supportive members of the community. I was blessed to observe midwives come together who had avoided one another for years. This was accomplished by midwives being willing to take that first step. I implore you to start with step one today. Organize, plan and wait. If your first attempt leaves you discouraged, give it another shot. Keep trying until you see results in your community. Together, we can combine forces to create a supportive environment. Alone we lack the power.


Melissa Smith-Tourville, Community Midwife

Fundraising can be enjoyable, if some basic guidelines are followed. People enjoy getting together for events that are centered around issues that are important to them and focus on their personal interests. The trick is to remind them that midwifery is important to them and one of their personal interests. Below you will find some suggestions for getting people involved.



The best way to guarantee that midwives can practice freely in all fifty states is to organize. The strategies listed below are aimed at consumers and midwives in legal and a/illegal states who want to do everything they can to make sure American families enjoy full access to the Midwives Model of Care.

Organize Your Community Before a Crisis Starts (For more information, please refer to "Planning Ahead: Your Clients Are a Valuable Resource")

Learn to Work Proactively With the Media (For more information, please refer to Almost Everything Midwifery Activists Need to Know About Working With the Media and A Quick Reference Guide to Working with the Media)

Develop a Plan of Action in the Event of a Crisis

When a Midwife is Arrested (For more information, please refer to Midwives Supporting Midwives)


  1. Designate one or two spokespeople to serve as media contacts.
  2. Ideally, at least one of your designated media contacts should be a former client who can make personal statements about her positive experiences with the midwife in question.
  3. Notify the midwife's attorney, the family involved, and anyone who may be contacted by the press that they should refer reporters to your media contacts.
  4. Make sure everyone understands that only designated media contacts should talk to the press.
  5. Prepare a list of three to five talking points ahead of time and repeat them as often as possible.
  6. Make sure your media contacts understand that they should always keep their notes and list of talking points in front of them during interviews. And they should practice, practice, practice beforehand!
  7. It's important for your media contacts to think of themselves as politicians: instead of answering questions directly, use them as an opportunity to respond with a statement from your list of talking points.
  8. Remind your media contacts that a reporter can't print anything they don't say. The focus should always be on repeating your talking points.
  9. Prepare in advance for uncomfortable or difficult to answer questions with responses such as "That's a question the jury (or the appropriate authorities) will have to answer. The real issue here is (insert talking point here)" or "I don't know, but what I can tell you is that (insert talking point here)."
  10. Make sure everyone understands that under no circumstances should anyone offer opinions about the midwife's conduct at the birth or about the particular details of a case.
  11. Unless the midwife in question is not a CPM, always refer to her and other midwives as "Certified Professional Midwives."
  12. Refer to an "out of hospital" birth rather than a homebirth.
  13. In situations where the family remains supportive of the midwife in question, work with them to prepare a statement to make to the press such as, "Our family is very disturbed that charges have been filed against (name of midwife), who acted professionally and responsibly when she attended our birth. We fully support (midwife) and hope that the charges against her are dropped immediately."


  1. Always begin by making positive statements about the Midwives Model of Care and Certified Professional Midwives. See description in the "Identify your Message" section above. For more information on the Midwives Model of Care, refer reporters to and
  2. We need to stop clogging the court system with expensive prosecutions of midwives and start finding ways to give the families of this state better access to the Midwives Model of Care and out-of-hospital birth options. The Midwives Model of Care, which recognizes that pregnancy and birth are normal life processes, has been proven to reduce the incidence of birth injury, trauma and cesarean section.
  3. The cost of prosecuting one midwife is greater than the cost of providing all families in the state with better access to Certified Professional Midwives and the Midwives Model of Care. The Midwives Model of Care has been proven to reduce the incidence of birth injury, trauma and cesarean section.
  4. If we had a million-dollar trial for every doctor who lost a baby, the state would be bankrupt. It's time to regulate Certified Professional Midwives in the same way we regulate every other healthcare professional.
  5. As a taxpayer I'm offended to see the state spend millions of dollars regulating Certified Professional Midwives through criminal prosecution when we could be spending much less money integrating them into the existing healthcare system. The Midwives Model of Care not only has been proven to reduce the incidence of birth injury, trauma and cesarean section but also to help contain the outrageously high costs of maternity care.
  6. Using the courts to regulate healthcare professionals is an expensive, inefficient, and useless waste of taxpayer dollars.
  7. Our (city, community, state, school system) is in financial crisis. The last thing we need to be doing is wasting valuable tax dollars on an expensive prosecution that the family in this case doesn't even want.
  8. Regulation through prosecution is not the answer.
  9. Regulation through prosecution is both ineffective and costly.
  10. It's a shame to see the state spending all of this money using the courts to regulate healthcare professionals when right here in (name of locale or region) we have (insert local crime story here). Demand for midwives and out-of-hospital maternity care is increasing every year. The best way to serve the families of this state is by making sure they have access to the healthcare providers of their choice. Prosecuting Certified Professional Midwives is not the answer--integrating them into the healthcare system is.
  11. The state won't discipline doctors and won't stop harassing midwives—how does this serve the families of (name of state)? (Name of midwife) has enjoyed an unprecedented outpouring of support. The people of this state have spoken, and they want the charges against her dropped.
  12. Medical mistakes are the third leading cause of death in this country. Instead of focusing on disciplining incompetent doctors, the state is wasting huge amounts of money prosecuting a midwife in a case where the family doesn't want to bring charges and popular support for dropping the charges has been unprecedented.
  13. Why is the state spending such extravagant amounts of money investigating the death of a single infant in a case where the parents do not hold the care provider responsible when there hasn't been one cent spent investigating the deaths of the (number) infants that died in local hospitals that same year?


Monitoring coverage of midwifery issues in general is one of the most important elements of a well-executed media strategy. It helps you determine which issues have established media appeal and which need further promotion.

Probably the simplest, cheapest way to track online coverage of midwifery and maternity care issues is to run regular searches at the following sites: is a free service that allows you to search for Internet news stories. is the web's first news-only search engine. features information from over 5,400 journals, books, magazines, databases and newswires. Searching is free, but there is a fee to view articles. offers free TV lists on their site.

A number of commercial sites will, for a fee, send your press release to their contact lists. While they do cost a little money, these can be great quick-distribution methods for organizations that do not maintain in-house media lists. Here are a few to check out: has a web friendly distribution format. is specifically for public policy news, and has very reasonable state-by-state distribution rates. offers press release writing, targeted media lists and press release distribution. has long been a leader in press release distribution via wire.
In addition to press release distribution, will send your photos to key editors and reporters.

Here's a list of organizations that provide assistance to non-profits seeking to increase their presence on the Web: is the largest nonprofit computer assistance organization in the country. is an online resource for activists who want to integrate the web into their organizing and community outreach efforts.

The following sites offer helpful ideas to drive traffic to your Web site. lists useful links for online advertising.
Outrider offers traffic building services, which is an index of the best free places to list your Web site.

One way to increase your media presence is to register your key spokespeople at these sites that connect you with journalists seeking sources for stories. All are fee for service sites. a service of PR Newswire, is a collaborative of information officers linked by Internet to give journalists free, convenient access to expert sources. provides directories of experts. is the Yearbook of Experts, Authorities & Spokespersons online.

The following sites offer further information about working with the media: is an online media tutorial created especially for nonprofits by Internet News Bureau and Tracy Schmidt Consulting. offers an excellent series of articles on media access tips and tools for activists. has resources and services for not-for-profit companies and other community-serving agencies as well as information on promoting your not-for-profit organization online and marketing your Web site. offers step-by step strategic tutorial to lead you through the considerations that should go into building your web site. also offers a number of useful tips and suggestions to help you build your site and use it to support your PR efforts.

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