They worked their way to the far corner of the hall, where Beckie had just arrived. She was discussing the news with some of the other members.
“. . . on parliamentary grounds,” Beckie was saying. “The bill originally was referred to the Medical Practices Committee, as the only reasonable place for such a bill to start. I think we should argue that the substitute motion must be sent to that committee before it can come out on the floor.”
“But that’s just the point,” someone else argued. “Glanvil will accept the idea of them both being sent back to committee. That’s what she wants.”
“Both?” Beckie asked. “Why both? One bill came out of committee, and the other didn’t. Let the one that did come to the floor for discussion and a vote, and let the other go to committee.”
“But that would make the Glanvil motion moot. I don’t think we can get away with it.”
Maggie turned around and looked at the slowly filling room. She hated politicking. She hated talk of “getting away with it,” and “sneaking it by,” “tricking someone into looking like a fool,” and all of that depressingly irrelevant garbage. And she hated the way Beckie rose to it, and blossomed, as if the maneuvering were her one true love. Turning back to the group, Beckie caught her eye.
“I told you we were only halfway home. Do you have any feel for how it’ll go?”
Maggie frowned. “How the hell should I know? All I know is that Glanvil is dead wrong, and it’s crazy for her even to be suggesting such a stupid move.”
Beckie smiled delightedly, and crossed over to give Maggie a hug. “Ah,” she said, “my favorite little anarchist!”
Maggie pulled away in irritation. “(A) I’m two inches taller than you; (B) I’m ten years older than you; and (C) I’m not an anarchist. But neither am I a politician. Strange as it might seem in this group, I’m a midwife, and that’s what I like being!”
Beckie frowned. “Well, if you don’t get a little political quick, you might not be a midwife for long! Glanvil is serious about this thing, and she’d be delighted to get all of us drummed out of the Association.”
“But being in the Association isn’t the same as being licensed. So even getting kicked out wouldn’t make any difference, Beckie.”
“Except that we aren’t in here as solidly as we’d like to think. Maggie, you’ve forgotten Somers’s threat that the A.M.A. would take action against us if we passed this resolution.”
“Come on, Beckie, we agreed two weeks ago that they wouldn’t have the nerve.”
“But that was if the whole organization approved it,” Beckie countered. “I agree that they’re not willing to take on the whole California Midwives Association, but it a group of us is kicked out for refusal to follow what the C.M.A. officially calls ‘good medical practice,’ then I think the A.M.A. would swarm down on us as a bunch of radical troublemakers. Plus,” she continued, “with no group of our own, we’d lack the means of fighting such an attack.”
“Well,” Maggie said, “then we’d just have to form our own group, split off from them, rather than get kicked out. But I still don’t think that they’d try to revoke our licenses.”
Beckie looked at her, startled, “That’s it! A splinter group. We can at least use that as an out if we get trounced in the vote.” She hugged Maggie. “I take back everything I said. Underneath that calm exterior lurks a scheming politician.”
From the front of the room the sound of a gavel reached back to them. “Come on,” Beckie said, taking Maggie’s arm. “Let’s sit down. There’ll be a break before the big vote, and we can try to organize some sort of orderly retreat if it becomes necessary. Not,” she added, “that I’ve given up the fight yet.”
The meeting started slowly, for there was a lot of old business to be dealt with. It was 9:30 before the report of the Medical Practices Committee was presented. Amy, who was chairperson of the committee, presented the report, and ended by officially entering the motion. “By a vote of fourteen to five, the committee approved a resolution that the C.M.A. recommend that its members refrain from the use of intrauterine fetal monitors, except in circumstances where it is the opinion of the member that either the mother or the child is at risk. Therefore, I would like now to introduce such a resolution.”
The motion was entered and seconded, then opened for discussion. Apparently by prearrangement, the chair called immediately on Susan Glanvil, “Madam Chairman,” she began, “it is my belief and, I am sure, that of a vast number of the midwives present, that the motion is an abomination. Not only is it an attempt to impose a specific political ideology on the midwives of this Association, but it requires this membership to reject one of the most valuable advances in obstetrical practice in the last fifty years. Rather than the senseless rejection of this practice, it would seem more reasonable, more forward-looking, for this Association to embrace this practice. Rather than accept the nihilism of this small group of agitators we should stand behind the advances of the medical profession. For these reasons I would like to introduce a substitute motion, which states that ‘The California Midwives Association recommends to its members that they make use of intrauterine fetal monitors except in circumstances where specific medical reasons indicate that such use would be dangerous to the mother or child,’ and I so move.” With a flourish, she sat down.
The chair nodded to Glanvil and turned to the audience. “I will accept a second to the motion—”
“Objection!” Beckie was on her feet. “Point of order, Madam Chair.”
With some irritation, the chair recognized Beckie.
“Madam Chair,” she began, “I have two objections. First, this motion is not a substitute motion, but a separate motion, which may be brought up after, and only after, the motion currently on the floor has been passed on. Secondly, this motion should not be allowed to enter directly onto the floor, but should first be referred to the Medical Practices Committee of the Association. If Ms. Glanvil, who is a member of that committee, has chosen to have this motion entered as an official minority report of that committee, it would then be appropriate for it to enter onto the floor directly after the current motion. But Ms. Glanvil did not so choose, and I therefore ask the chair to rule that this motion be referred to the Medical Practices Committee for consideration.”
Maggie was dazed. She hardly understood a word of what Beckie had said. Her mind drifted as the meeting went into a technical, parliamentary argument. The California Midwives Association will turn into another A.M.A., she thought to herself, if Beckie and Glanvil keep fighting.
Suddenly she realized that the fight was an important one; she remembered that Ann, who seemed to be recovering, had been treated with a recipe lost for three hundred years because modern medicine had no place for it.
Maggie turned to Beckie, but she was whispering to the person on her other side.
Maggie’s mind drifted to Ann again and Tuesday’s X-ray scans. She was terrified that the remission would turn out to be a fantasy, that the tumors would show clearly. She realized now that this fear had prevented her seriously considering the implications of a cure. Although a cure obviously had been her goal, Maggie had never seriously thought much beyond Ann’s case. And she hadn’t told anyone about it yet, not even Beckie. She turned to Beckie, suddenly excited. But as she did, a general commotion rose in the hall.
“Dammit!” Beckie muttered, getting to her feet.
“What?” Maggie asked. Everyone seemed to be getting up and talking to people around them. “What happened?” she insisted. “I wasn’t paying attention.”
“Well, you better start paying attention,” Beckie growled. “Didn’t you even vote?”
Maggie shoot her head. “What happened?”
“Jesus Christ! You’re unbelievable,” Backie exclaimed. She started pushing Maggie out toward the aisle. “Glanvil’s motion has been ruled a legitimate substitute motion, and been seconded. After this break we’ll be arguing her motion, not ours, and if hers passes, that’s it for
us. Fetal monitors for all.”
Maggie stopped before reaching the aisle and turned to Beckie. “Do you think it might pass?”
Beckie shoved her forward again. “If you had been awake, you would have known that about two-thirds of the votes said that it should be allowed as a substitute motion, and that’s a hell of a lot of votes. Come on, we’ve got to find Amy and talk about your splinter group.”
“Mine?” Maggie asked. “What splinter group?”
“Come on! We don’t have that much time.”
Ten minutes of frantic conversations followed, none of which Maggie paid much attention to. She found herself dragged back and forth across the hall as Beckie cornered one woman after another to drum up support for a walkout. Why can’t they all just leave us alone, Maggie wondered, unsure just who “they” and “us” were.
Finally, the gavel pounded again. Beckie looked incredibly defiant as she charged back to her place, for once leaving Maggie to follow along at her own pace. The debate began just as she reached her seat and continued interminably.
Eventually the chairperson recognized Glanvil for a final summation. The hall was silent as she rose to her feet. Slowly, dramatically, she turned a full circle, so that she could see the entire hall. “Madam Chairman, members of the California Midwives Association: we have reached the most critical point in our short history tonight. The practice of midwifery, until just recently illegal throughout this nation, has reached a point from which it must now decide either to move forward or move backward, to embrace the advances in obstetrics and midwifery that science has produced or to turn our backs on them and reject them, just because, if you will, they are new and scientific. I fear,” and here her voice began to rise, “that whether we know it or not, whether we want to or not, we must, by the very nature of our decision, also decide tonight whether we are to build midwifery into a more legitimate and respectable profession, or if we are to destroy it, destroy its legitimacy and respectability, and even, I fear, its legality.
“We all know the fight that we had to receive legal status, we all know the opposition that the established medical profession raised to our certification, and we all know that this opposition and resentment has not disappeared following our legalization. That opposition would not hesitate to destroy our legal standing at the first opportunity. If we now choose to take a formal position in opposition to a standard obstetrical practice, one accepted by the vast majority of obstetricians, then not only are we giving them grounds for renewing their attack on us, but, in fact, we are challenging them to do so. And this is not a challenge that they will pass up. I promise you.
“In fact, we have done even worse than this. By having the Medical Practices Committee pass favorably on this motion, by having this motion come before this body at this meeting, we have already initiated this renewed attack. Even if we were to defeat the Medical Practices Committee’s motion, they might still attack our credentials. And this is why we must approve the substitute motion. Only by firmly stating that we accept, and believe in the use of the fetal monitor, can we prevent our own demise as midwives,
“I have not talked here about the value of the fetal monitor, or the lives saved, about the added information gained from this wondrous machine. Others have discussed this over the last hour. And those reasons should be more than sufficient to gain your support for the substitute motion. But I wanted to bring up the matter of our continued professional existence before the vote, because I want you all to be aware that your vote might determine whether, six months from now, you will still be midwives.” Finished, she sat immediately.
Beckie leaped to her feet. “Madam Chair?”
The chair turned to her. “I’m afraid those were the concluding remarks, and the floor is no longer open to debate.”
“But Madam Chair,” Beckie persisted. “Ms. Glanvil has brought up an entirely new argument in her concluding remarks, and I feel it is only fair that a reply be permited.”
The chairperson frowned, and then shrugged. “Oh, go ahead. But you have three minutes. If you run over, I’ll cut you off. And after she finishes,” the chair said, facing the rest of the audience, “absolutely no one else is going to speak.” She nodded to Beckie.
Beckie turned around to face the bulk of the membership and then back toward the chair, trying to marshal her thoughts. “Look,” she finally began, “I don’t have anything fancy to say, but what Glanvil just said is nonsense. It’s preposterous to think that at this time there is any way that the A.M.A. or any other group can stop us from practicing midwifery. Who else is going to do it? Doctors certainly aren’t going to take the time required to deliver children at home. They could never make their hundred thousand a year that way. And if they started delivering them in hospitals again, they’d lose their shirts in malpractice suits, and they know it. As it is, it’s only in cases of great risk to the mother or child that they’ll agree to let us bring a mother into the hospital.
“But there’s another point, If we buckle under to the demands—in this case the alleged demands—of the A.M.A., and give up our freedom to have our own independent opinions on the best way to conduct our business as midwives, we will end up repeating all of the horrendous errors of the medical profession. When male doctors first began to wrench the practice of childbirth away from midwives, they brought with them the diseases and infections of the hospitals, and the rates of fetal and maternal deaths skyrocketed. That was hundreds of years ago, but now they have repeated that history, and once again their practice of childbirth brings with it such a tragic price that they have conceded that practice back to us, the midwives. It will do women and children no good if we become little doctorettes, mimicking the procedures and policies of the A.M.A. It is only by maintaining our independence that we can properly serve the women of this state.
“So Susan Glanvil wants us all to use the fetal monitor, so that we can be like little doctorettes. And what has been the effect of this usage in the past? You all know the answer to that. The use of fetal monitors has led to a tripling of the rate of Caesarian sections with no perceptible benefit—with no reduction in the infant mortality rate! More surgery for the obstetricians in the hospitals, and, since the rise of the superstrains of bacteria, more fetal and maternal infections. It has been suggested that if we vote to avoid the willy-nilly use of the fetal monitor we will be turning the clock back hundreds of years. But I say to you that if we vote to mimic the behavior of the A.M.A., we will bring upon our patients the disease and death that we have always strived to prevent.” She stopped, and looked around the audience, unsure what more to say. Unable to come up with anything, she finished with, “I cannot urge you strongly enough to vote against this despicable resolution.”
“And that finishes all debate,” the chair announced, rising from her seat. “The secretary will now read the motion on the floor.”
The secretary read the motion.
“Very well,” said the chair, “you have heard the motion. All in favor, signify by raising your right hands . . .” In just a few moments votes aye and nay had been counted.
“The result of the balloting,” announced the chair, “Is two hundred and fourteen votes in favor of the motion, one hundred and eighty-seven against. The motion is approved.”
As applause broke out from the audience, someone in the front shouted, “No!” Heads turned as Amy leaped up onto her chair. “This decision is a farce!” she shouted. “You have let fear replace reason, and you have allowed that fear to harm your abilities to act as responsible midwives!” Her face was red with anger. “Well, I for one cannot, and will not stand by you while you destroy all that we have struggled for!” So saying, she jumped down from her chair, pushed her way through to the aisle, and stomped from the hall.
Beckie was on her feet, pulling Maggie up by the arm. “Come on, that’s our cue.” She shoved Maggie toward the aisle.
Looking around, Maggie realized that an impressive number of others were doing the same, close
to a third by the looks of it.
“It’s working,” Beckie said with delight. “We’ve pulled enough to form that splinter group of yours, Maggie. You’ve saved the day!”
Chapter Nine
THE next half-hour was a total mystery to her. In all, 135 women had walked out of the meeting, and, to Maggie, it seemed to be a victory celebration despite their loss. Finally, Beckie stood on an overturned wastepaper basket and called for quiet. Thirty seconds passed before the lobby grew calm. “Listen, everyone,” she shouted, “there’s a lot of work to do, and some of it needs to be done quickly, so we’re going to meet Monday evening at 7:30. That’s in just three days. Call either the Santa Cruz clinic or the Haight-Ashbury clinic on Monday, and they’ll tell you where it’s going to be. So congratulations, everybody, and think up a good name for us before you come on Monday.” Cheers rose from the group and Beckie waved as she climbed down.
Beckie came up to Maggie. “Can I catch a ride back to Santa Cruz with you? Peggy’s decided to stay in the city tonight.”
Maggie shrugged, but then smiled. “Sure, happy to have you. Besides, I’ve got something I’d like to talk to you about.”
“Fine. I’d just like fifteen minutes to tie up some loose ends.” With that, she disappeared back into the crowd.
Over an hour passed before they even got out the Medical Center door, and Beckie was running on a mile a minute about their new group, which she started calling the Natural Midwives Association. “Someone suggested calling it the California Midwives Society, but then we’re just copying the C.M.A., and the point is that we’re not just another C.M.A., we’re different.”
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