Your friends and neighbors: Midwife Tara Workman Tulley

Who are the people in your neighborhood? You’d be very surprised. And in this new Q&A interview series, The V is bringing their thoughts and opinions directly to you in order to satiate curiosities you didn’t even know you had.

Due to intrigued response to our issue on homeopathic medicine, Loraine Glueck-Gholdston brings us an interview with local midwife Tara Workman Tulley.

Tara Workman Tulley is a local midwife, boxer, marathon runner, mother and wife. She has delivered over 300 babies and recently returned from summiting Mount Kilimanjaro in Tanzania, Africa.

LG: Can you talk a little about your life, your family and your hobbies? How are they affected by your career as a midwife?

Tara: Hobbies? Running, boxing. … I like extreme sports because they push me and are empowering. I also am a Social Work student and hope to combine the midwifery model of care to address other areas of women’s health issues.

I became a midwife because it was the first time in my life that I felt empowered. I had a very emotionally and physically difficult first birth, but I had a very patient and understanding midwife. It took me several more years to work through issues that had left me believing the societal lies of body-perfection, performance expectations and why being female was a good thing in our culture. But my first birth started something in me that is still going. It was difficult, and I was supported in working through it and being allowed to find my own path through birth.

It was my first positive identification with the divine feminine. Since that time I have not only developed a career in midwifery but have studied and advocated for societal change in pressures to conform to a certain body size and type, finding an identity within the self instead of one that is measured and judged by cultural expectations and false-perceptions, healing from trauma and pain through positive body experiences and pushing myself to expand in areas I never would have thought to try before.

I have expanded into social work to address some of these issues and personally enjoy the challenge of extreme sports and competition as a form of testing and increasing my limits. I haven’t found an end to my limits yet, so I just keep expanding.

LG: What are the greatest challenges you face?

Tara: The greatest challenge in the field of midwifery is maintaining autonomy while also facing the ramifications of going against a patriarchal standard of maternity care established by modern obstetrics and the American Medical Association. Despite large scale efforts to collect and support the midwifery model of care and direct-entry midwifery as both cost-effective and safe in maternal and infant health, The American Congress of Obstetricians and Gynecologists and the AMA continue to attempt to twist the political arm by pulling faulty research and authoritative rhetoric to discredit midwifery care.

The World Health Organization and many nations with well-developed health care systems support the midwifery model of care and show better outcomes in both maternal and infant mortality and non-surgical methods of delivery.

Women are beginning to demand choices denied to them in traditional medical birth settings as they become more educated about their bodies and the effects of surgical and interventive birth methods. The demand for midwives and out-of-hospital births is on the rise, and the political backlash of the AMA and ACOG are extreme and rely on the credibility of authoritative words enjoyed in the past. However, the information age has increased consumer awareness, and more women are demanding choices in decisions surrounding their children and bodies.

When I started as a midwife there were fewer questions about whether midwifery was legal, what the ramifications were for legislating practice, and the value of autonomy and traditional care was more important than credibility. The political climate has changed dramatically, and midwives across the country have had to band together and create more professional standards and accountability and legislate practice to preserve the right to exist as a profession.

The shift from art to profession has left some midwives to question weather the true spirit of midwifery is lost with conformity. Are we becoming just another medicalized, regulated profession? Finding a balance between professionalism and maintaining the spirit of the art of midwifery is an ongoing debate.

LG: What are some of the cultural implications of our society that affect how you work?

Tara: Because I work in a balance of supporting parents rights, maintaining a professional license and negotiating with sometimes hostile providers, it is difficult to practice what I truly believe all the time. Sometimes it is tempting to want to suggest an intervention to a parent because even though I know they are likely safe to continue with a planned homebirth, if I end up having to transport the situation, there are ramifications for going beyond the expected protocol as established by routine medical practice.

In cases where it is clinically and evidence-based practice to allow a mother to choose to refuse transport, but standard procedures in a medical establishment would push a mother toward an intervention, then there must be documented evidence that a mother was given full-informed consent, and that she refused to do the “wise” thing anyway. Litigation, malpractice and authoritative policies do not always lead to evidenced-based use of interventions. The result leads to secondary problems occurring from the over-use of interventions and providers pushing mothers to use them based on the safety of their reputation, license or fear of litigation over the best interest of the mother and her child.

On the other hand, most of what I do is against the cultural norm, so I have had to develop very good reasoning, knowledge and the ability to defend how and why I do everything. I have been pushed into developing the ability to assert myself in almost any situation while building relationships with people who don’t necessarily like me. I have had to develop a solid sense of who I am as a person, and this helps me to disregard the pressure to do everything according to protocol and find a way to defend my right to practice in the best interest of those I serve.

LG: What are your hopes and fears for the future of midwifery?

Tara: I hope that midwifery will continue to be on the rise, but I fear that the pressure to conform and be recognized as equals by medically established institutions will push midwives to lose their autonomy and to lose their edge on providing women with an alternative to being pushed into choices without fully-informed consent.

I am obtaining a second degree as an MSW because I feel like there is a lot of work to be done in empowering women, educating providers and building bridges between two worlds so that there is less hostility and more incentive for midwives to keep their autonomy in practice.