What is Really Behind the “Woman-Centred Midwifery” Letter

A few days ago, I wrote a blog post attempting to claim a middle ground between gender inclusivity and feminism in the midwifery community. I am a gay, transgender man, and I am a feminist. A vicious response by a lead midwife from the group Woman-Centred Midwifery was posted and then deleted later in the day. Have no fear, I obtained a screen capture of it so we can all read it and discuss.

Here’s a quick synopsis of the issue: The Midwives Alliance of North America (MANA) formerly referred to clients as "women" and "mothers," but in 2014 changed some (but not all) language in its core competencies document to refer to "pregnant people" and "birthing individuals." On August 20^th, a dissenting group of midwives calling themselves "Woman-Centred Midwifery" wrote a letter to MANA protesting the “erasure” of the word “woman” from the documents.

I proposed that organizations like MANA can and should continue to use the words “woman” and “mother” in addition to gender neutral terms like “all birthing people” or “people of all genders.” There can be respect for women’s struggles against patriarchy and inclusivity of transgender, genderqueer and intersex individuals at the same time.

In response, Mary Lou Singleton, the first signatory on the Open Letter to MANA, wrote a comment on my blog post that is the most bizarre and hostile piece of misinformation I’ve ever seen. Her opinion about transgender people is made abundantly clear by her use of terms such as "medical mutilation" and "gender industrial complex."

But there's still more. Ms. Singleton asserts, "Male-to-trans billionaires pour millions and millions of dollars into promoting transgenderism, while simultaneously funding horrific anti-woman politicians and initiatives." Yes, it is true that there is one trans billionaire in the world. She doesn’t represent all trans people, who in general face high rates of poverty and are frequently victims of violence. I love a good conspiracy theory as much as the next person, but painting one of our society’s most oppressed groups as the oppressors is not only far-fetched, it contributes further to the transphobia and discrimination we already encounter.

Ms. Singleton continues: “transgenderism reinforces the patriarchal caste system but being gay challenges it... The erasure of biological sex and the legal codification of sex-role stereotypes as the sole definition of male and female is the patriarchy's wet dream. ” What about individuals like myself who are both transgender AND gay? What about transgender women who are lesbians? And, let’s remember the topic at hand - midwifery care during pregnancy, birth and post partum. I can say from personal experience that being a guy with a beard, a low voice and a pregnant belly does not constitute conforming to sex-role stereotypes in our society. Nursing a baby while sporting facial hair does not constitute conforming to sex-role stereotypes in our society.

As the first signatory on the Open Letter to MANA, I assume that Ms. Singleton must have a good deal to do with the motivation behind it. I fear that we have now seen the true colours of this particular “woman-centred midwifery” group - hateful yet utterly confused.  I hope that others who signed will carefully consider the implications and will withdraw their support of such a brutal ideology.

Many thanks to Sion Jesse for providing this screen capture:

Yonifest 2014!

I'm thrilled that Yonifest is nearly here! For those who don't know, it is a radical birth conference, taking place in a small town in the stunning Quebec countryside. I will be speaking, along with the likes of Ina May Gaskin and Michel Odent!

I'm particularly excited to attend because I'm 27 weeks pregnant myself - perfect timing for me to be surrounded by birthy energy, take in new information and inspiration, share what I can, and then return home to focus on my own powerful journey. I haven't attended Yonifest before, but it seems to have a special community vibe. People camp in tents at the festival site, bringing their families along as they wish.

The middle of a pregnancy is a significant time to lead a workshop for midwives, doulas and other birth workers. Much of what I share will stem from my personal experience as a trans guy about to have his second child. Like, how I had trouble getting into obstetrical triage at the hospital a few weeks ago when my midwife wanted me to have a particular issue looked at. Or the time when it took 20 minutes to convince the clerk at a medical supply store that I did, indeed, need compression stockings for pregnancy.

In my workshop I'll be teaching participants how to communicate effectively with trans* clients and how to be a good ally. We'll talk about gender dysphoria and pregnancy, lactation after top surgery, and inducing lactation in trans* women, among other topics.

Workshop date and time: SATURDAY, AUGUST 2nd, 3:30pm.

Looking forward to seeing some familiar faces and meeting new ones!

Birth and Death: Helping a Toddler Say Goodbye

I've learned a lot in the last few days. Our family knew already for a few weeks that a tough time was looming ahead of us. Our dog was diagnosed with stomach cancer and wasn't responding well to medications. After a difficult, painful weekend, I arranged for a veterinarian to come to our home to euthanize her.

I had asked my vet what she thought we should do with Jacob, now 19 months, during this process. She recommended that her assistant take him into a different room, and told me that when I talked to him about our beloved Quinoa, I should try not to cry because it could make him fear death. Well, I knew right away that this wouldn't be possible for me to accomplish.

Quinoa was a sweet, gentle soul who taught me about good parenting, including cuddling, co-sleeping, and patience. Oh, the patience that this dog had! She taught Jacob the importance of being kind (she would get up and calmly walk away if he wasn't), sharing food with others (she was always polite but she did have a way of letting him know when she deserved a piece of his bread or a morsel of his egg) and catching snowballs (he hated snow this season until he saw Quinoa playing in it about two weeks ago). There was no way I wasn't going to cry over parting with her.

As Quinoa's final days approached, Ian and I both realized that Jacob would be most upset if he saw me having such intense emotions but was separated from me. He had to be there with us. When the time came, Ian cradled Quinoa's head in his lap, and I put my lips to her ear and told her all about the car rides she would enjoy and the cheese she'd love to eat again. Jacob stood quietly between us and watched, one small hand on my back and the other holding my shirt sleeve.

We stayed with Quinoa for many hours after she died. I washed off the urine that she had released at the moment of her passing, and we took turns grooming her still soft and shiny coat. Jacob found an old bottle of her ear drops and tried to administer them. We went over every single part of her body - we felt every lump and bump, noted which of her toes were white and which black, remarked on the beautiful, warm orange colouring on the underside of her tail and the details in her clear, blue eye. We felt her body become cooler, and then stiff. Spending this time with her body helped each of us to celebrate her life and accept her transition. Jacob looked at her and asked me, "Owee?" I told him, no, not anymore. He responded, "Oh."

I remembered that we deeply need to do many of these tasks with our newborns, too, in order to meet them, celebrate their birth, and establish bonding and breastfeeding. When new parents are free from medical interference, they examine every tiny bit of their babies, touching them everywhere, even smelling and licking them. This is what we require as mammals and humans. We and our loved ones, both those we are welcoming and those we are wishing farewell, deserve this time and space together to try to come to terms with the mystery of consciousness. Too frequently, babies are whisked away and bathed by nurses, and bodies of loved ones are "touched up" and cleaned by professionals instead of those who knew them best.

Everywhere I go, I think of Quinoa. I look around for her, but she's not lying under the painting of Everest on the wall, or by the window, or at the front or back door, or on our bed. I regret that Jacob is not at an age where he will remember her, but we'll tell him stories and show him photos of his dear friend. He may have a sense that death is something that happens, and through which we hold each other, in the midst of our tears.

Guest Post: My Doula's Story

The midwives unwittingly hung my IV from our Medicine Buddha.

The following is the written story of my baby's birth, presented to me by my incredible doula. I have edited minimally for clarity and length, but these are her words. To me, this story feels like a most wonderful gift of a unique perspective. I was especially amazed to see the words "without consent" in my doula's telling of events. At the time, I had a sense that I did not want certain procedures to be performed and I have ever since blamed myself for "allowing" them and "not being clear enough." I would like to thank my doula for being a powerful witness.


​Trevor felt the first rushes of labour on Sunday evening before heading with Ian to dinner at their friends' house. They kept the excitement a secret for the time being. On arrival home later that night, relieved to be able to labour openly, they continued to witness transformation as the magic of birth took flight.


Trevor rushed frequently throughout the night and attempted to sleep but felt restless. Cleaning the kitchen satisfied an early labour ritual for a few hours with baby as an active participant. The rushes started to come closer together and Trevor found comfort in a hot shower and his loving partner Ian. Together they recited the sacred incantation Om as they moved deeper into their birth journey and ultimately the path to becoming parents.

​Trevor slept for an hour and then had breakfast. He and Ian watched Grey’s Anatomy, pausing for each rush - the show proved to be a great distraction. At this point Trevor felt labour was manageable. Rushes were short in length, however Trevor could no longer talk through them. The labouring family went to the Forks for river gazing and stopped in at a pet store for a few rushes.

On April 12th, 2011 at midnight, I was honoured with an invitation to join the sacred birth nest. Ian began to set up the birth pool and gather supplies. Trevor’s rushes came more frequently and were more intense. I arrived to their safe and loving birth space and watched as Trevor focused inward, using deep slow yoga breath to move through each rush.

At 1:45 am Trevor entered the birth pool for the first time with Ian cocooned in the hammock next to him. Trevor leaned over the tub to work through each rush, supported with loving touch and kisses from Ian. Hot water and frozen grapes brought much joy to this hard working man.

At 3 am Trevor’s labour became deeper and birth sounds grew louder. Ian held Trevor over the tub and they kissed deeply during each rush. Trevor and Ian shared the story with me of how they first met and soon after Trevor began to sleep deeply between rushes. The word OPEN made its way into Trevor’s birth ritual, followed by a deep enjoyment of sorbet. The rushes became more intense, at times overlapping.

At 5am Trevor and Ian were ready to welcome another doula, Krystal, into their birth nest. “How will I be able to do this?” Trevor asked. The birth circle attempted to add more hot water to the pool and instead sprayed the entire room as well as each other. Laughter, water and tea revived us and reminded Trevor that he could continue. Trevor began to make louder, deeper birth sounds and felt intense sensations in his pelvis. Trevor and Ian discussed whether it was time to invite the midwives. With careful consideration it was decided that Ian would made the call.

The first midwife Leslie arrived at 8 am. Trevor and baby passed all the vital tests and Trevor vomited. The birth circle headed upstairs to settle back into the birth nest. Trevor squatted on the floor during rushes and rested on the birth ball in between. Rushes started to feel different, shorter with longer rest time. Trevor shared his concern of a stalled labour and questioned whether it was caused by the arrival of the midwife? The daylight? Trevor and Ian had a shower together to refocus and reconnect. Krystal took Quinoa for a walk and Alexa the second midwife arrived.

At 10:30 am Trevor decided it was time to return to his happy place (the birth pool). Ian attempted to rest and snored in sequence with Trevor’s labour mantra, which induced healing laughter but unfortunately woke Ian. Trevor breathed deeply and squatted in the pool during rushes. He could feel his pelvis opening. At this point Leslie found the fetal heart tones to be a bit high and asked that Trevor be helped out of the pool quickly to bring his body temperature down.

Trevor was open to trying every suggestion offered. Hot tea, hip opening yoga poses, leg massages, more Sorbet, lunges, stair walking and finally a shower. Back in the birth nest Ian assisted Trevor into a hanging position between rushes. Trevor started to feel more pressure and baby movements and decided finally to return to the comforting waters of the birth pool. Once again, Leslie found the fetal heart tones to be slightly above normal (164). Hydration, cool cloths and removal from the tub were requested to help bring his temperature down. Trevor squatted with Ian during rushes. Half an hour later, fetal heart tones lowered to 150 and Trevor returned to the tub, tête-à-tête with Ian, breathing deeply as one.

At this point the midwives took me aside to discuss their concerns: Group B Strep, length of labour, Trevor’s energy level, Trevor’s request for no internal exams and ultimately how they could communicate these concerns with Trevor. After an attempt to calm their concerns and bring trust to their practice, I returned to the birth room and asked Ian to give it a shot. Frustration was building, fueled by the midwives' lack of trust in birth and respect for informed choice.

Trevor and Ian decided to go for a walk to process how to move forward with their midwives present. They called a supportive friend and had a good cry. They returned to their home to request of their guests rest and privacy. Krystal and I served dinner in bed to the labouring couple. Despite the request for privacy, the midwives continued to interrupt to monitor.

At 9pm Trevor decided to consent to an internal exam in order to satisfy the midwives. They confessed they wanted to know how far along Trevor’s labour had progressed so that they could decide to stay or leave. Trevor’s cervix had dilated 6-7 cm and so they would stay. The midwives suggested baby’s position was preventing descent and further dilation. Once again Trevor tried everything to move things along. Aromatherapy, stair walking, acupressure, yoga poses and finally an epic head stand.

​“I welcome these sensations and I’m opening. I’m opening. I’m opening.” Smells of clary sage and peppermint filled the air as Trevor recited his birth mantra.

At 1 am on April 13th Trevor requested sterile water injections to relieve his back discomfort and they worked. Ian took the opportunity for rest. A few hours later Leslie suggested a second internal exam and artificial rupture of membranes to move things along. A discussion took place in the birth room regarding the pro’s and con’s of AROM at this point. Trevor requested a discussion with Ian before proceeding. I went to wake Ian to bring him into the conversation.

While waking Ian, Leslie found the fetal heart tones to be a bit high. Trevor was removed from the pool promptly and Leslie named dehydration as a possible cause. Leslie and Trevor entered the bedroom and an internal exam began without consent. The intended discussion between Trevor and Ian had not yet taken place. Leslie ruptured Trevor’s membranes during the internal exam without consent. Trevor’s cervix had dilated 8 cm, his fluids were clear, baby was positioned at -2 station with an asynclitic head tilt. Trevor felt the intensity of his membranes rupturing, started to feel pushing sensations and headed back to the safety and comfort of the water.

After an hour and a half of hard work, the midwives found fetal heart tones to be high and Trevor was once again removed from the pool to cool down. At 5 am Trevor and Ian moved to the bedroom to labour in bed together and Quinoa joined them. Trevor felt nauseous and the midwives suggested an IV to help with hydration and to regulate fetal heart tones. The IV was hooked up with a direct line to the medicine Buddha painting hanging on their wall.

At 7:45 am Trevor returned to the birth pool. Moments later fetal heart tones were found once again to be high and Trevor was removed from the tub to birth next to the pool.

Trevor pushed with strength and determination and at 8:23 am baby Jacob was born.

​Trevor and Ian immediately fell in love with Jacob and time stopped. Their house filled with midwives, cleaning, organizing and replacing the exhausted with the rested. Trevor's placenta took its time coming out and an alarm bell was set off. Thankfully a transfer was avoided due to the work of two new midwives. Trevor was finally given space to start his breastfeeding journey while being cared for by an intuitive and supportive midwife, Ian and Quinoa. And so begins another story...

​It is an honour to have been invited to witness this most amazing experience in the lives of Trevor and Ian. Trevor, you have reminded me of the courage and strength of body, mind and spirit that is required to give birth to a baby. Ian, you have reminded me of the importance of love, support and trust in this process. It was with humility and awe that I witnessed your birth. Thank you for this opportunity.

With love,

your doula and friend.