Lately there has been much discussion in my area regarding hands-on Midwifery versus hands-off Midwifery. There has been accusations that a hands-off Midwife is more dangerous than even a scheduled cesarean. However, this seems to be a diversion tactic amongst the Midwives here who believe that it is okay to control a woman's birth, and not let her know that it is the intention to do so, until the woman is at her most vulnerable.
I am a hands-off Midwife, and proud of it. I do not do unnecessary vaginal exams (and yes - an exam upon arrival and an exam when mom says she feels like pushing *ARE* unnecessary!), I won't induce labor at home unless there is a reason that would necessitate a hospital induction if labor didn't begin in x amount of time, I don't tell women how/where/with whom they can birth, and I don't tell women how/when to start pushing. Women are quite intelligent, believe it or not. Dr. Michel Odent and Dr. Sarah Buckley have written extensively about instinctual birth being the most optimal for women. I firmly believe that labor and birth happen in the best way possible when a woman is not directed, controlled, or interrupted.
The confusion surrounding this also lies in the same accusation that hands-off Midwifery is dangerous. It is assumed that a hands-off Midwife is hands-off no matter what. That apparently we hands-off Midwives (aka, "Instinctual Birth" supporters) would sit in the corner and twiddle our thumbs if a labor were abnormal, or if complications should arise with mom or baby. Quite the contrary. We are very well trained in handling complications - but the catch is that by not interfering with a woman in labor, we also do not *cause* complications to arise.
This is a blog post by The Mandala Mom that fits this so appropriately, from the standpoint of the consumer. From the standpoint of a woman and mother who has had both a hands-on Midwife, and then intuitive births. From the standpoint of a woman who has seen first hand how a hands-off Midwife supports a woman during labor and birth.
Bulls in the China Shop: Hands-On Midwifery Versus Instinctive Birth