I come before you very humbly because I believe many of us feel this tension every single day in our work. We feel the divide within midwifery. We feel the pressure to choose a side.
On one end of the spectrum, there are midwives who are often labeled “medwives.” Midwives who are seen as too clinical, too evidence-based, too medicalized.
And on the other end, there are midwives who identify as traditional midwives or birth keepers, who are often viewed as too spiritual, too intuitive, or somehow disconnected from science.
And what I have noticed is that there seems to be very little room for us to meet in the middle.
Both sides can clearly identify the flaws in the other. But what I would offer tonight is that maybe both sides are only seeing one part of what midwifery truly is.
One side may be holding tightly to the science. The other side may be holding tightly to the humanity and soul of birth. But true midwifery has always required both.
And I believe that middle space—the place where science and soul coexist—is being neglected.
Physiological Midwifery
I want to offer a term tonight: physiological midwifery. Not simply physiological birth. Not just the physiology of labor.
But physiological midwifery—the act of the midwife itself.
Because just like we say the body knows how to birth, I believe our bodies also know how we are meant to midwife. There is something inside of many of us that recognizes when care feels aligned and when it does not.
When we are forced into these rigid boxes—medical or traditional, evidence-based or intuitive—many of us feel that tension in our bodies. We know instinctively that something about those binaries does not feel right.
Because birth itself is not binary.
Every birth is different. Every family is different. Every mother is different. And therefore, every act of midwifery may need something different too.
Physiological midwifery is the understanding that the midwife must remain responsive, adaptable, observant, skilled, intuitive, and deeply human.
And I would define it this way:
Physiological midwifery is a practice where the midwife integrates both scientific knowledge and ancestral wisdom, standing against rigid binaries and centering justice, equity, and the full humanity of every birthing person.
That is the middle I am talking about tonight.
Why The Middle Matters
So why does this matter? Because I believe this divide is hurting all of us.
It hurts midwives. It hurts students. It hurts organizations. And most importantly, it hurts families.
When we spend all of our energy trying to determine who belongs in which category, we lose focus on the people standing directly in front of us.
The laboring mother. The birthing person. The partner. The baby entering this world.
We cannot fully care for people if we are constantly defending ourselves against one another.
And the truth is, many of our clients do not need us to choose between science and soul. They need both.
They need someone who can recognize an emergency.
And they need someone who can recognize fear in someone’s eyes.
They need someone who understands physiology. And they need someone who can sit quietly in sacredness without disrupting it. Families deserve care that sees them as full human beings.
And when we divide ourselves into extremes, we limit the fullness of what midwifery can offer.
The Larger Systems Behind The Divide
I also believe we have to be honest about the systems underneath these divisions. Many of these rigid binaries are rooted in systems that force people into categories in order to control, rank, and separate them.
And yes, I believe white supremacy culture plays a role in that. Because white supremacy depends on hierarchy. It depends on purity. It depends on proving who is right and who is legitimate.
And midwifery has not escaped that.
We ask one another constantly:
Are you medical enough? Are you traditional enough? Are you evidence-based enough? Are you radical enough? But what if the future of midwifery is not found in purity politics? What if the future is found in integration? Because in many parts of the world, midwifery is not treated as a battle between science and tradition.
In many cultures, midwives are allowed to hold both. Clinical skill and ancestral wisdom.
Education and intuition.
Safety and sacredness.
The science and the soul coexist.
And I believe that is where the true power of midwifery lives.
The Ask
So my ask tonight is simple. I am asking us to stop neglecting the middle. I am asking us to become curious about one another instead of defensive. I am asking us to stop reducing one another into labels and begin recognizing the shared heart underneath all of this work.
Because regardless of our pathways, our credentials, or our philosophies, most of us entered this work for the same reason:
To care for people. To protect birth. To walk families safely through transformation.
Imagine what could happen if we stood together as one united profession instead of fragmented groups fighting for legitimacy. Imagine what could happen if our collective energy went toward improving outcomes, increasing access, supporting families, protecting physiological birth, and preserving the humanity of this work. The middle is neglected. But the middle is also where healing happens.
Why This Matters to Me
And I want to be honest about why this matters so deeply to me personally.
Because every moment we spend divided from one another is a moment we are pulled away from the actual work.
And for me, the work is clear.
The work is creating more Black midwives. The work is eliminating disparities. The work is protecting Black mothers and Black babies.
And I cannot ignore the reality that Black women, during some of the darkest periods of history in this country, survived childbirth at higher rates than they do today.
At a time when Black people were considered worth less than cattle, sheep, pigs, and goats, Black women were still surviving birth better than they are now.
That should stop every single one of us in our tracks.
Because that means something is deeply broken.
And while we debate labels, legitimacy, and who belongs in what category, families are still dying. Communities are still suffering. Midwives are still burning out.
We do not have time to keep neglecting the middle when people are asking us to help save lives.
For me, physiological midwifery is not just philosophy. It is survival. It is liberation. It is the belief that we can build a model of care that is both deeply skilled and deeply human.
And I believe that is the work we are being called toward together.
Conclusion
So tonight, I want to leave you with this:
Birth is not one-dimensional. And midwifery should not be either.
Physiological midwifery is not simply a technique or philosophy. It is the embodiment of balance. It is the willingness to hold knowledge and humanity together at the same time.
And maybe that is what our profession is being called into right now, not greater division, but greater integration.
Because when we neglect the middle, we lose each other.
But when we protect the middle, we protect the future of midwifery itself.