Protecting Midwifery Rights – The Final Frontier of Women’s Autonomy
- Brainz Magazine
- Oct 14
- 7 min read
Anne Wallen is a respected figure in women’s health with over 30 years of experience and is a leading voice on global change in maternity care, particularly for those at greatest risk.
Midwifery represents the heart of women’s autonomy, yet increasing restrictions threaten this essential profession. This article examines how defending midwifery rights safeguards the freedom to birth safely, naturally, and with dignity, highlighting the evidence, global practices, and moral imperatives behind empowering midwives worldwide.
“It is vital to understand that midwifery is the final frontier for women’s rights. Without midwifery, we lose essential frontline workers for every kind of women’s health care, and we throw away any hope of increasing bodily autonomy rights and protections.” – Anne Wallen, Director of MaternityWise International
These words ring more urgent today than ever before. Across the United States and the world, the decline of midwifery access and the tightening of restrictions on home birth represent not just a professional crisis but a moral one. When the voices and hands of midwives are silenced, when women are told their bodies are not trustworthy, when birth is treated as pathology instead of physiology, we lose something sacred, the right to give life without surrendering ownership of it.
Midwifery stands at the intersection of freedom and care. It is not an alternative medicine fad or a nostalgic return to the past. It is an evidence-based, deeply relational, and time-honoured model of health care that honours the natural rhythms of the human body. When midwifery rights are under siege, so too is every woman’s right to choose how, where, and with whom she gives birth, whether it is at a hospital, birth centre, home, or under a tree somewhere, with a physician or any type of midwife (CPM, CM, LM, CNM, or DEM), or no one at all. It is her right to choose during this powerful, sacred, and intimately private event.
The right to birth autonomously
Traditional midwifery care is built on a foundation of respect for the birthing body, for informed choice, and for the natural process of labour. Restrictive laws that demand physician oversight or prohibit midwives from providing skilled home birth attendance rob women of genuine options. They reinforce a medical monopoly that too often prioritises control over connection.
Midwives are not assistants to doctors. They are independent, highly trained professionals skilled in normal physiological birth, early risk detection, and holistic postpartum care. Their autonomy is what allows them to hold space, to listen longer, to intervene less, and to honour the instinctive power of the birthing person. In many places around the world, we find obstetricians as adjunct care professionals, almost like assistants to the midwives, in that referrals are made for additional care as the midwife deems necessary because she is overseeing maternal care and not the other way around.
The erosion of that autonomy is not just a professional issue, it is a human rights violation. As the World Health Organization affirms, “Every woman has the right to the highest attainable standard of health, which includes the right to respectful maternity care.” When midwives are disempowered, birthing people lose advocates who protect that right.
The evidence speaks: Home birth is safe when supported
Despite fear-based rhetoric, the data consistently show that planned home birth for low-risk pregnancies, attended by qualified midwives, is safe and often leads to better outcomes in terms of interventions, satisfaction, and overall well-being.
A 2019 meta-analysis in The Lancet’s EClinicalMedicine found that planned home births had 30% fewer caesareans, 50% fewer episiotomies, and lower rates of postpartum haemorrhage compared to hospital births, without an increase in perinatal mortality among low-risk women in high-income countries with integrated systems.[1]
The British Medical Journal’s 2011 Birthplace in England study also found no difference in neonatal outcomes for multiparous women choosing home birth and significantly fewer medical interventions overall.[2]
In North America, the Midwives Alliance of North America (MANA) Statistics Project, the largest dataset of planned home births, reported that **89% of mothers who planned home birth had spontaneous vaginal deliveries, and 87% avoided epidural anaesthesia.[3]
These numbers are not accidents. They reflect what happens when we allow birth to unfold in its natural rhythm. Birth must be supported, not managed.
Physiological women's birth is not fragile
One of the greatest misconceptions about childbirth is that it is inherently dangerous. But birth itself is not the threat, fear and interference are. The hormonal symphony of oxytocin, endorphins, and catecholamines works best when undisturbed. The natural cascade of labour relies on safety, privacy, and trust, which are the very conditions midwives excel at creating.
Home birth supports that physiology. Familiar surroundings calm the nervous system at a deep, subconscious level, reducing stress hormones that can stall or complicate labour. When a woman feels safe, her body opens. When she feels watched, pressured, or doubted, labour can shut down.
The beloved Michel Odent, the pioneering French obstetrician and natural birth advocate who recently passed, famously wrote:
“To change the world, we must first change the way babies are being born.”
Supporting home birth and midwifery autonomy is not just about individual comfort. It is about rebalancing our entire cultural relationship with the female body. It is about trusting life again, trusting mothers, and trusting women.
Integration, not isolation: The path to safer systems
Critics of home birth often cite rare emergencies as justification for restriction, but that logic is backward. True safety does not come from banning home birth, it comes from integrating it.
In countries like the Netherlands, where home birth is normalised and midwives are fully integrated into the national health system, about 13–20% of births still occur at home, and maternal and infant outcomes rival or exceed those in hospital-heavy nations.[4]
In contrast, U.S. midwives often face fragmented relationships with hospitals, punitive transfer protocols, or legal ambiguity. This fractured system endangers families far more than home birth itself. When collaboration replaces competition, outcomes improve.
A study in Reproductive Health (2023) found that people receiving community-based midwifery care had five times higher odds of experiencing respectful treatment and five times greater decision-making autonomy than those who gave birth in hospitals.[5] That is not just patient satisfaction, that is human dignity in statistically recognisable form.
When midwives thrive, communities thrive
Midwifery is not a luxury, it is a public health investment. Studies show that states with midwifery-friendly laws have better birth outcomes, lower cesarean rates, and higher breastfeeding rates.[6]
Yet in many regions, midwives still face systemic barriers, lack of insurance reimbursement, regulatory hostility, and professional exclusion. These barriers do not protect safety. What they do protect, however, is the profit-driven hierarchy.
Every time a midwife is forced out of practice, a community loses access to compassionate, personalized care. Every time a home birth is criminalized, another woman’s right to choose her care is stolen.
Supporting midwifery autonomy is not about ideology, it is about equity. It ensures that low-income families, rural mothers, and marginalized communities can access care that honours their values, culture, and dignity.
Home birth as a normative option, not a radical one
Home birth is not a rebellion, it is a reclamation. Babies were always born at home, and only in the last 100 years has it become a medicalized, profitable event. The goal is not to make everyone birth at home, of course. But what are we doing if we are not providing legitimate options for safety? The goal is to make home birth a supported, normalized choice within a balanced system.
This means:
Legal protection for all midwives to attend home births without physician gatekeeping.
Insurance coverage on par with hospital births to remove economic discrimination.
Seamless transfer systems where collaboration, not punishment, governs care.
Public education that tells the truth, that birth at home, for many, is not reckless but responsible.
When families have genuine choice, when midwives can practice freely, and when hospitals respect, not dominate, the continuum of maternity care, the system becomes safer for everyone.
Reclaiming birth as a human right
Birth is not a medical event. It is a human, spiritual, and biological experience that deserves reverence, not regulation. The right to birth freely, supported by skilled, autonomous midwives, is inseparable from the right to bodily autonomy itself. The World Health Organization has stated that midwives could prevent 83% of all maternal and newborn deaths globally if fully integrated into care systems.[7] Yet in many U.S. states, midwives must fight just to practice legally.
This contradiction reveals a deeper cultural wound. We claim to value life, yet distrust the very process that brings it forth. Reclaiming birth means reclaiming trust in women, in physiology, in the power of life itself. It means acknowledging that safety is not created by control but by respect. It means remembering that autonomy and compassion are not opposites, but allies.
A vision for the future
Imagine a maternity system where:
Midwives are fully autonomous and respected as essential primary care providers.
Home birth and birth centre options are accessible, reimbursed, and celebrated.
Transfers between settings are collaborative and seamless.
Every birthing person feels seen, heard, and empowered, not managed or doubted.
In that world, birth is no longer a crisis to be controlled, but a rite of passage to be supported. That is not a utopia, it is a reachable goal when we choose trust and respect over fear.
Conclusion: The frontier we must defend
Midwifery is more than a profession, it is a promise that we will not let fear, bureaucracy, or profit strip away the sacred right to birth in safety and sovereignty. Protecting midwifery rights means protecting women’s rights. It means preserving the lineage of wisdom-carriers who remind us that birth works. It means choosing compassion over control, trust over fear, and freedom over conformity.
Home birth, midwifery autonomy, and bodily sovereignty are not luxuries. They are the foundation of justice, equity, and humanity. And as long as midwives stand at the threshold of birth, we have a chance to make the future world a more peaceful place. I want that for my children and grandchildren, don’t you?
Anne Wallen, Director and Founder of MaternityWise Intl
Anne Wallen is a respected figure in women’s health with over 30 years of experience and is a leading voice on global change in maternity care, particularly for those at greatest risk. She continues to educate and empower birth professionals in more than 20 countries, contribute to a variety of curriculums, and shape the future of maternal health through her impactful role as a speaker and mentor. Anne is the Director and co-founder of MaternityWise International, and her legacy lies in inspiring generational changes around and elevating women's healthcare worldwide.
References:
[1] de Jonge et al., EClinicalMedicine / The Lancet, 2019
[2] Birthplace in England Collaborative Group, BMJ, 2011
[3] Cheyney et al., Journal of Midwifery & Women’s Health, 2014
[4] Offerhaus et al., Midwifery, 2015
[5] Vedam et al., Reproductive Health Journal, 2023
[6] George Mason University School of Public Health, 2016
[7] World Health Organization, State of the World’s Midwifery Report, 2021
