Founding the Seattle Midwifery School
Members of the Birth Collective brainstormed over how to build a school, noting it was going to be “a long and difficult project to launch.” They needed to think about the nuts and bolts — curriculum, staffing, and fundraising — along with philosophy and vision. In this excerpt from Coming Home: How Midwives Changed Birth, author Wendy Kline explores the founding of the Seattle Midwifery School.
Members of the Birth Collective brainstormed over how to build a school, noting it was going to be “a long and difficult project to launch.” They needed to think about the nuts and bolts — curriculum, staffing, and fundraising — along with philosophy and vision. Given their politics, how could they ensure that their pathway to licensure did not replicate the very system they were fighting against? “We had studied and discussed the issue of professional licensing quite a bit, considering it historically to be a mechanism of cooptation by the medical establishment,” they explained. “We envision a school that not only offers fine technical training, but does it with the right orientation of non-interference in birth and respect for the process. We want the school to promote non-hierarchy and avoid the many negative traits of professional medicine.” Deciding they were up for the task, they incorporated the Seattle Midwifery School in May of 1978.
Their intention was to create a program similar to existing nurse-midwifery programs, minus the nursing requirement.
Mansfield focused on developing curriculum and trying to “drum up teachers.” Among them were Durlin Hickok, the obstetrician portrayed in the SMS skit at Pike Place Market, and Katherine Camacho Carr, a certified nurse-midwife who had just opened a birth center in Seattle. Both volunteered to teach them free of charge. Susan Anemone worked on grant writing, and the others did “a little bit of everything.”
Their intention was to create a program similar to existing nurse-midwifery programs, minus the nursing requirement. In order to do so, they had to convince Department of Licensing director Roz Woodhouse that the school would fill an existing need. With that in mind, they solicited letters of support from certified nurse-midwives who had reviewed their curriculum proposal. CNM Katherine Camacho Carr noted the “great interest in the Seattle area and throughout the Northwest for the development of a school of midwifery,” as well as a “need for non-physician birth attendants . . . consumers are calling for their services.” Another CNM, Elaine Schurmann, believed the proposed curriculum to be a “comprehensive program of study” and noted her willingness to accept Seattle Midwifery students and serve as preceptor, as well as provide lectures on nursing and midwifery. “The need of more qualified practitioners is evident.” Rosemary Mann, director of the Nurse-Midwifery Education program at the University of California, San Francisco, noted that the concept of midwifery training without the prerequisite of professional nursing was of “great interest” to her. “I am convinced that the effort to identify those nursing skills inherent in midwifery with the goal of encompassing those skills in a Midwifery Curriculum is worth investigating,” she wrote. She expressed her support and satisfaction with the curriculum developed by the SMS. Given the sometimes antagonistic relations between lay and nurse midwives, and conflicts over professional organization, it is significant that the SMS was able to gain the support of these notable CNMs.
Between the time of incorporation (May 1978) and the March 1979 proposal, over 150 women had reportedly contacted SMS “from across the nation requesting to be admitted.”
The feedback from health professionals through letters of support undoubtedly strengthened the resulting program. In their “Proposal to Fund a Midwifery Training Program at the Seattle Midwifery School” submitted in March of 1979, SMS founders also stressed the growing need for non-nurse midwives in Washington State as well as nationwide. During their time at Fremont, they operated with a “full case load at all times,” serving 300 women but turning away an equal number that they could not accommodate. By 1979, there was only one physician left in the Seattle area still offering home birth services. Clearly, as Gloyd had pointed out, there was a demand for skilled attendants, as more consumers opted to give birth out of the hospital and fewer physicians were willing to serve them.
At the same time, the interest in obtaining midwifery training was on the rise. Between the time of incorporation (May 1978) and the March 1979 proposal, over 150 women had reportedly contacted SMS “from across the nation requesting to be admitted.” Its founders believed this was due at least in part to the severely limited opportunities nationwide. There were only eighteen nurse-midwifery programs in the United States, and these were “exclusively hospital-birth oriented,” admitting only experienced registered nurses. There were no formal schools to train non-nurse midwives, although three non-nurse groups (in Minnesota, Arizona, and Texas) offered some training. “Our intention is to fill some gaps in maternity care today by providing competent, experienced birth attendants,” they declared. “There is a missing link between health care in the communities and health care in the hospitals. We hope our project will help bridge that gap.”
SMS founders initially developed a two-year, fourteen-month program (to comply with the vaguely worded 1917 law). In their first year, students would take didactic courses (such as anatomy and physiology), receive clinical training under the supervision of licensed clinical faculty at the Midwifery School Birth Service, and assist at home births. Their second year would be more “intensely clinical,” as students would rotate through clinical training sites, spending twenty-four weeks in out-of-hospital birth services outside of the school, followed by twelve weeks at the Midwifery School Birth Service as primary midwife.
Wendy Kline is professor and Dema G. Seelye Chair in the History of Medicine in the Department of History at Purdue University. She is the author of Building a Better Race: Gender, Sexuality, and Eugenics from the Turn of the Century to the Baby Boom and Bodies of Knowledge: Sexuality, Reproduction, and Women’s Health in the Second Wave.
