Male Midwives: A Case of Gender Bias?

Equal opportunities and sexism are familiar concerns for women in the workplace. But what about the challenges faced by male midwives?

Very little has been written about the difficulties that men can face working in a female-dominated profession, yet it’s a topic that deserves open and honest discussion.

Is it just gender bias and societal attitudes that are stopping more men from training as midwives?

Or is there more to it than this?

Changing Attitudes

Before the 17th century, the birthing process was an all-woman affair.

Babies arrived attended by female friends, family members, and a female midwife. Men, even husbands and doctors, were not allowed to be part of the proceedings (Morton 2016).

Historically, men only attended childbirth to help with difficult labours and emergencies. But around 1750, male surgeons and physicians began to promote their role in normal births.

They questioned women’s reliance on tradition and experience and emphasised the value of anatomical study and technical training with forceps (Fores 2020).

Resistance to male midwives has a deep historical background and it wasn’t until the Sex Discrimination Act of 1975 that men in the UK were finally allowed to enter training.

Interestingly it seems that it was midwives themselves who opposed the idea of male colleagues and in 1951 the RCM (Royal College of Midwives) fought back against proposed legislative changes that would allow male midwives. Their reasons were clear:

• Midwives give intimate care and most of the public, as well as women giving birth, would not accept this care from a male midwife.
• The depth of intimate care required for psychological support during a woman’s pregnancy is best given by another female.
• The very fact that a midwife is a woman is vital in her function.

Ultimately, The Royal College of Midwives defined midwifery as a relationship between pregnant women and female midwives, assuming that women would feel more comfortable attended by another woman (Jones 2017).

The RCM did eventually realise the part men had to play in the midwifery profession, and in 1982 they recommended that midwifery training should be open to male applicants.

Today, many years later, male midwives are still surrounded by controversy and as Jones (2017) reflects, to a large extent, men working in midwifery is still a taboo subject, reflected by constrained discussion and out of date references.

Why Aren’t There More Male Midwives?

There’s no question that male doctors are an accepted presence in the birthing room, but as Morton (2016) suggests, male midwives still tend to encounter suspicion from expectant mothers as well as female colleagues.

So, just how many male midwives are there? Jones (2017) estimates that in the UK men make up a mere 0.4% of the workforce. Similarly, in Australia the percentage of male midwives remains very small and depending on the state or territory is between 1 to 2.7 percent (Pittman and Fitzgerald 2011).

Gender Labelling and Sex Discrimination

It’s been suggested that there should be no such thing as a ‘male midwife’.

In the view of McEwan (2014), it makes no more sense than speaking of a 'female lawyer' or 'male doctor'.

Indeed, gender labelling within health care has been recognised as discriminating against men, essentially suggesting that although they are part of the same professional group, they are different because of their sex.

That said, sexual discrimination laws apply only to the employer, not to the customer, so the labouring woman must always be offered the choice of a female midwife.

Some Women Prefer Male Midwives

It’s widely recognised and accepted that some people feel more comfortable with medical carers of a particular sex.

The midwife-woman or doctor-patient relationship is intensely personal, and in recognition of that fact, healthcare providers often make the choice explicit.

However, Jones (2017) reports on studies that suggest many women who were cared for by male midwives described them as gentle, calm, sympathetic and more understanding than some female midwives.

They go on to suggest that while some women said they would prefer to be cared for by a man, 10% of women actually requested a male midwife.

It’s becoming clear that male midwives have a role to play in midwifery and are a valuable asset to the profession (Jones 2017). For many women however, the thought of being attended by a male midwife can be disturbing, even frightening.

Reasons for Refusing a Male Midwife

Aside from embarrassment, some women have other concerns about being attended to by a man. For example:

• Religious or cultural concerns about being seen naked by any man other than their husband.
• Past history of physical, sexual or emotional abuse.

Pilkenton and Schorn (2008) also suggest that the woman’s partner may feel intimidated or jealous of the bond between her and the male midwife and that this might cause stressful relationships in the delivery room.

Conversely, rather than feeling jealous or intimidated, some husbands and partners expressed relief at having another man in the room.

Perhaps this is because a male midwife may be viewed as more relatable to the husband. Male midwives may also showcase a quality of gentleness that impacts how fathers view their role in the context of the new family. In other words, rather than being problematic, some qualities of being male were viewed as distinct advantages.

There’s Still a Long Way To Go

Deltsidou (2017) reports on the findings of a recent pilot study showing that male midwives, because of their gender, continue to face problems with their colleagues and other health care professionals throughout their professional life, confirming that the stereotype of the traditionally female midwife is still firmly in place.

It’s a controversial view that is fuelled by the work of Dr Michelle Odent, who insists that men, including husbands, should stay out of the birthing room (Campbell 2009).

Why?

Because in Odent’s view, labour, birth and breastfeeding are in part sexual events, and the gender of those people present must be taken into account.

For example, it’s suggested that the sexual overtones that might accompany such contact with a male attendant could hamper the woman in labour in acting as openly and spontaneously as she would like, or may later make her feel ashamed of what she has revealed about herself (Association of Radical Midwives 2000).

Even though midwifery is a profession with ancient roots it continues to adapt and evolve.

The question is, will male midwives continue to be a part of this evolutionary process? It’s often said that evolution can be mistaken for revolution in the early stages of the change process.

Could the same be said of male midwives perhaps?

Will it take a revolution to increase their numbers in the midwifery profession?

Pilkenton and Schorn (2008) suggest that it will be a shame if male midwives remain in the minority as the midwifery community will be stronger when all voices, including those of men, are heard as one.

Perhaps they are right.

References

• Association of Radical Midwives 2000, Male Midwives, [online], viewed 20 February 2020, https://www.midwifery.org.uk/articles/male-midwives/
• Campbell, D 2009, Men Should 'Stay Away From Childbirth', [online] The Guardian, viewed 24 February 2020, https://www.theguardian.com/lifeandstyle/2009/oct/18/men-birth-labour-baby
• Deltsidou, A 2017, Characteristics of Men who Choose to Study Midwifery and Their Experiences From the Midwifery Practice: A Pilot Study, Epitheorese Klinikes Farmakologias kai Farmakokinetikes, [online] 35, viewed 20 February 2020 https://www.researchgate.net/publication/316944007_Characteristics_of_men_who_choose_to_study_midwifery_and_their_experiences_from_the_midwifery_practice_A_pilot_study/citation/download
• Fores, S 2020, Man-Midwifery Dissected, [online] The British Library, viewed 20 February 2020, https://www.bl.uk/collection-items/man-midwifery-dissected-by-samuel-w-fores
• Jones, D 2017, Male midwives: How Men Are Changing the Rules | Totaljobs, [online] Totaljobs, viewed 20 February 2020, https://www.totaljobs.com/insidejob/male-midwives-men-changing-rules/
• McEwan, T 2014, There Is No Such Thing As a Male Midwife!, Essentially MIDIRS, [online] 5, viewed 20 February 2020, URL
• Morton, E 2016, How Man-Midwives Armed With Rusty Forceps Shook Up Obstetrics, [online] Atlas Obscura, viewed 20 February 2020, https://www.atlasobscura.com/articles/how-man-midwives-armed-with-rusty-forceps-shook-up-obstetrics
• Pilkenton, D and Schorn, M 2008, Midwifery: A Career for Men in Nursing, [online] Men in Nursing, viewed 20 February 2020, https://nursing.vanderbilt.edu/msn/pdf/nmw_midwiferyformen.pdf
• Pittman, E and Fitzgerald, L 2011, The Campaigns for Men to Become Midwives in the 1970s, Health and History, [online] 13(2), p.158, viewed 20 February 2020, https://www.jstor.org/stable/10.5401/healthhist.13.2.0158?seq=1