Violence, the Human Experience, and Midwifery

Sarah Proechel, Midwife International Clinical Director, reflects on the state of violence in the world today including its presence in birth, and explores its roots as deeply embedded in the human experiences of shame and vulnerability. She offers the role of the midwife as an opportunity to transform violence at the source, holding the space for a more peaceful world to be born.

In my year working as a midwife in Guatemala, I became acutely aware of the role of violence in everyday life and how deeply it affects birth.  Since then, my quest has intensified to understand violence and its relationship to midwifery and to learn effective ways for addressing it. When I use the word violence I am speaking of the use of force or aggression to control, punish, or impose one’s will on another or on nature.  This is distinct from the use of force as a means to protect.

A woman is experiencing violence when she is coerced into medical procedures that can do more harm than good such as an induction or a cesarean, and is then shamed or threatened if she dares question her doctor. When a newborn is separated from his mother at birth, or her umbilical cord is cut before she receives the full return of her own blood from the placenta, or when he is strapped to a metal table and the most sensitive part of his sex organ is cut off without the benefit of anesthesia, he or she is experiencing violence as an introduction to life.

These types of violence are so pervasive in Western society that they actually appear normal.  It has become so prevalent, in fact, that a term has been created to describe it – “obstetrical violence.”  For me, the perennial questions are “why?” and “what can be done about it?”. I am left searching for answers that make sense.

The roots of violence

If we are to address violence, we must go to the source.  I do not want violence.  My way of dealing with my distaste for violence has always been to avoid it, wherever possible.  I became a midwife in order to promote peace in the world.  I have been relating to violence as if it were the enemy of peace. Yet I now sense myself opening to a clearer vision: one that embraces the whole of the human experience, with violence as a teacher.

What does violence have to teach us about the experience of being human?  Someone who is acting violently is someone who has temporarily lost touch with their own humanity.  On the contrary, we say that someone who acts out of love and care is someone who acts from the heart. In our hearts we experience our human vulnerability – our emotions and our needs for love, care, connection, meaning, and contribution, among other non-material things.  Those feelings and needs are real and they are at the “heart” of what makes us human.

I have just finished reading a book called “Violence:  Our Deadly Epidemic and its Causes,” by James Gilligan. Gilligan worked for 15 years in the Massachusetts prison system as its chief psychologist.  There he became engrossed in determining what makes people act violently.  First, he discovered that every act of violence is an attempt to create justice, to right a wrong.  Second, no matter what the cause might appear to be on the surface, at the very root of it, there is always the experience of shame, and in particular, shame about one’s vulnerability.  In other words, shame for feeling, loving, and caring, or for wanting love and care – shame over the core experience of being human.  He found that when a person’s shame, whether they are aware of it or not, gets to a point that is intolerable to them, anything can provoke them to become violent to others or themselves. They will risk their life and liberty in order to defend any modicum of dignity they possibly can.

When I think of the people in my life who have acted violently, including myself, and I look all the way through to the level of shame, my heart opens with an understanding and a desire to stop the cycle, out of caring and compassion, rather than anger or indignation. This is where I can already see that change is possible.

Humanity is at a crossroads.  Violence against humans and against the Earth, which is our life-blood, is reaching a fever pitch.  I have been a pacifist all my life and yet at least part of me has embodied that value by condemning violence as wrong.  Yet it is that very kind of thinking, right versus wrong or good versus evil, that is what has led individuals and nations to fight violence with more violence to the point where we are so engulfed in our own delusions that we are on the verge of exterminating ourselves.

What if we instead saw violence as a disease resulting from an intolerable degree of shame?  Would we not then treat the shame instead of trying to kill the violence?  And what is shame, anyway?  And where does is come from? Shame over one’s humanity is essentially a belief that there is something fundamentally wrong with oneself.  In this state, one’s natural vulnerability to both love and the possibility of being hurt is defended to the extreme, for to touch that vulnerability is to touch the shame about being human.  How do we prevent shame?  And how do we heal it once it has taken hold of a person?

Hope for a nonviolent world

If we are to escape the vicious cycle of violence we must break the cycle of violence starting with ourselves, and by changing the way we treat those closest to us and those who are just beginning life on this planet. As Suzanne Arms put it,

 “If we hope to create a non-violent world where respect and kindness replace fear and hatred, we must begin with how we treat each other at the beginning of life.  For that is where our deepest patterns are set.  From these roots grow fear and alienation or love and trust.”

I deeply believe this, and I am beginning to see an even bigger picture…

If we hope to create a non-violent world we must also understand the roots of the violence that already exist and be willing to walk into the heart of the issue in order to transform it.  In midwifery this means that every time we encounter violence, or the conditions that are likely to create violence, either within the family, in our culture or in the dominant medical system, we have an opportunity to transform violence at the source.

How to do this, in service to birthing women and incoming souls, is a question I would like to explore over the coming years in my work in Guatemala as Clinical Director of our new midwifery school, Ixchel-Atitlán. I have many more questions than answers.  Some questions I have are,

• If shame is at the root of all violence, then how does this translate for obstetrical violence?
• Are medical workers simply acting out their discomfort with the extreme vulnerability of childbirth? How does the medical system reinforce this?
• What kind of strategies can be developed to address the violence individually and systemically without anger, blame, and more shame?

One avenue we will be pursuing is to work directly with the health system to create new ways for midwives and other medical personnel to relate to each other, with respect as the bottom line.  This is part of our “leadership and collaboration” program.  This program is the subject of a future blog post, so stay tuned.

As a midwife, I know first hand the power that birth has to heal and transform a woman, and to connect all who are present with our core humanity.  Rarely do I witness a birth in which I am not brought to tears.  I also know that midwives do not work in isolation.  We, of necessity, work within the family, the medical system, and the culture as a whole.  We also work within a national and global context.

Midwifery is about holding the space for something new to emerge that we know is there but simply has not yet been born.  We stand firm on both sides of the threshold, as a witness, in faith that what we envision will eventually come to pass.  In this case, I want to believe it is possible to reclaim the experience of being fully human, by dissolving shame, embracing my human vulnerability, and being willing to help others who are lost to find their way home.

Sarah Proechel, Co-Founder & Guatemala Clinical Director, is a Certified Professional Midwife from the United States. Sarah discovered her passion for birth at the age of 12 when she was present during her older sister’s birth process. Her midwifery education has included formal study at Seattle midwifery School, Maternidad La Luz, and the MMA Midwifery Studies course as well as two home birth apprenticeships, international internships in Costa Rica, Nicaragua, and Jamaica, and original research on midwifery in Guatemala. She has had a private home birth practice in western Massachusetts since 2005. Sarah was a 2010-2011 Fulbright fellow. Her project, a cultural exchange with traditional midwives in San Marcos La Laguna, Guatemala, evolved into what is now Midwife International and Ixchel-Atitlán: Escuela Intercultural de Comadronas. Sarah holds a bachelor’s degree from Goddard College in Health Arts and Sciences with a focus on Mayan midwifery and herbal medicine and is currently enrolled in a Master of Midwifery program at Midwives College of Utah. She is author of Voices of Maya Midwives: Oral Histories of Practicing Midwives from the Mam Region of Guatemala, Lulu press, 2005.