Seattle midwife Debra O'Conner, who has been featured in previous postings, is under investigation again. She was a doula (a birth assistant) — not the midwife — for a birth that involved the death of an infant. While the mother is bravely taking full responsibility for what happened, the midwives in town have decided to turn O'Conner in. I'm glad she has a good lawyer.

I hope Cindra Thompson does, too.

Thompson is a friend of O'Conner and a fellow midwife. They were both present at Kenzo's birth in 2002. Smart and soft-spoken, Thompson is also a busy mother of four. She has recently run into problems with her malpractice company and is trying to raise legal fees to defend her practice.

If there's anyone in the Seattle area interested in donating items for a yard sale in early April to help Thompson's cause, send us an email or post a comment below, and we'll get in touch.

What we know about pregnancy and childbirth today were largely shaped by the medicalization of birth, following the anti-midwife campaign. Pregnant women, the physicians insisted, were best served by the professional care of obstetricians because childbirth is fraught with risks and dangers that require intervention. Only a very small minority of women were able to give birth naturally and trouble-free, they said. Well, the public ate that up hook, line and sinker. By the late 1960s, midwife-assisted births dropped to an all-time low of under 1%.

When I was born at a Manila hospital in 1965, my mother was so drugged out she could barely recall what had happened. Years later she told me that the only thing she remembered before the painkillers kicked in was how much she had wanted to squat. Her instincts were correct; squatting, which yields to gravity, is one of the most natural birthing positions. But she was overruled in what must have been a common situation back then. You could say ours was a generation practically born to drugged-out mothers in hospitals across the country. I was extracted with forceps; perhaps you were too.

For years, that was how I pictured my own childbirth — at a hospital with drugs. How else was I supposed to give birth? Towards the end of the birth class I attended with my husband, the childbirth educator Elena de Karplus told us that if we should have to literally run into a birth center with the baby's head emerging between our legs or if we ended up giving birth in the car on the way to the hospital, then we should consider ourselves very lucky. "That should be your goal," she said triumphantly. We all thought she was crazy.

It turned out that she was right. And the good news is, the midwifery model of care has been making a small but steady comeback since the 1970s thanks to the hard work of a few dedicated midwives, supportive obstetricians and innovative natural-birth techniques imported from Europe, notably Lamaze. Hospital births still account for 99% of all US births, but today 10% are assisted by midwives. Homebirths account for about 1% of midwife-assisted births.

Also, the rate of episiotomies has been dropping, more babies are being breastfed for longer periods, and the medical establishment is beginning to acknowledge the benefits of midwife-assisted births. These small but significant accomplishments are still dwarfed by the enormous amount of work that requires immediate attention.

Midwives have been around since time immemorial. They appear in the Bible and in Shakespeare’s literature. They have been the main providers of maternity care throughout the history of mankind. In most cultures today, a laboring woman can still count on the presence of a skilled midwife.

Labor and childbirth in the U.S. weren’t any different. Though its history is tumultuous, “midwifery was seen as a respectable profession, even warranting priority on ferry boats to the Colony of Massachusetts,” says a website for the Parkland School of Nurse Midwives.

Unfortunately, that would change.

Between the years 1915 and 1940, midwife-assisted births plummeted from about 50% to 10-15%. The drop has been attributed to a number of historical developments; among them were World War I and advances in science and medicine.

But that wasn't all. From around 1910, the US government and the medical establishment began waging a vigorous public campaign against midwives in a nationwide offensive to medicalize the birth industry. Midwives were called filthy and ignorant, and blamed for the country's birth-related fatalities. Other tactics included public PR, where physicians touted the safety and ease of births handled by obstetricians.

“The strategy to abolish the profession of midwifery (as practiced by midwives) was multifaceted and included a legal, legislative and public education approach described as ‘elevating the public conscience,’” writes California midwife Faith Gibson.

On her website, Gibson shares excerpts from documents she uncovered after she was arrested and charged with the illegal practice of midwifery, among other things, even though she was a state-certified midwife. The charges were later dismissed.

My nonagenarian great aunt is a ball of fire. Toshi-oba (aunt Toshi) has strong and sensitive hands, a hearty laugh and an earthy demeanor. Nobody suspects that this four-foot-tall woman was the recipient of a cultural award from the late Emperor Showa for her outstanding work as a midwife in the rural community where she served.

Toshi-oba is retired now. But I bet in a pinch, like many a midwife who has come before and after her, she would rush to the side of a woman laboring at home.

A good thing too, that Toshi-oba lives in Japan. If she were to venture into a home to assist in a birth in the U.S. today, where midwives and the medical establishment are locked in a sort of obstetrical turf war, she would be walking into a legal minefield — regardless of the outcome of the birth.

From California to New York, midwives are being harrassed with lawsuits and legislation aimed at limiting their scope of activities or their right to practice, especially if they are not working within the parameters set by the medical community. Many have called the midwives' plight a "witch hunt" after the 17th century persecution of women believed to be witches. In fact, midwives were among those who were "charged" as witches and murdered.

The website Wears the Baby carries an interview with legendary U.S. midwife Ina May Gaskin:

“Some midwives have been charged with felons after births which turned out well. There is a California case in which a CNM (certified nurse midwife) was charged — taken from her home in handcuffs and chained to a wall for four hours — after a birth, a good outcome, that took place in her birth center when she was out of the country.”

Here in Seattle, certified nurse midwife Debra O'Conner, who specializes in out-of-hospital births, is appealing charges of negligence levied against her on the basis that her case was not judged by her peers. The case against her was initiated by a hospital midwife, which many out-of-hospital midwives argue is midwifery by name but basically medical profession by practice.

I recently received an email from Setsuko Yamamura, the head midwife of Tokyo's Aqua Birth House. She wrote me that the birth house, which she founded, was publishing a book to celebrate its 10th anniversary. Would we mind if she included our birth experience in the book? We'd be honored, I replied, and emailed back a Japanese translation of the comments my husband left in the birth house's log book eight years ago when Kimi was born.

As I translated my husband's words, my mind traveled back to that April day in 1997. I recalled the scent of lavender Yamada (she went by her maiden name in those days) sprinkled over my shirt; the drawn curtains; the sound of the drizzling rain; the look on my quiet husband's exhausted face; and how time seemed to have stopped as I writhed in the dark, still hours of the late afternoon.

These are among my fondest, most cherished memories of my life. And if it weren't for a series of disappointing encounters and events, I wouldn't have them.

When I first met Yamada in the winter of 1997, I was six months pregnant, scared and lonely. I had been seeing an obstetrician, but after a few visits I knew this was not where I wanted to deliver. After scolding me for gaining too much weight, he told me all the things that could go wrong if I weren't careful. My paranoia eventually grew to the point where I began to fear that my baby was dead. So, when I heard about Yamada and her birth center, my husband and I promptly made an appointment to meet her.