Leadership, Traditional Midwifery, and Structure Without Hierarchy

This week’s portfolio prompt asks us to reflect on Indigenous cultures, traditional midwifery, and “wise women” models of leadership. The Lao Tzu quote, “Lead so the mother is helped, yet still free and in charge,” feels deeply connected to midwifery and to the leadership project we are developing through the SweetGrass Wellness Collective. 

For me, this quote is about reducing hierarchy. Leadership is not supposed to mean taking over, becoming the center, or deciding what someone else needs without them. In birth, the mother or birthing person remains the center. The midwife may bring knowledge, skill, presence, and guidance, but the goal is not to control the experience. The goal is to help create conditions where the birthing person’s power can be felt, trusted, and exercised. 

Chamberlain, Fergie, Sinclair, and Asmar (2016) describe traditional midwifery and “wise women” models of leadership as grounded in empowerment, ethical practice, emotional attunement, mentoring, and responsiveness. What stood out to me is that this type of leadership does not depend on formal authority. It comes through accountability, trust, relationship, humility, lived experience, and recognition by the community. This challenges Western leadership models that often prioritize titles, credentials, hierarchy, or institutional power. 

This connects directly to SweetGrass. I do not want to build a top-down organization. Yes, I want SweetGrass to have structure, but not become rigid; accountability, but not punitive; growth, but not disconnection from community care. The Collective needs a membership process, Advisory Council, Shared Agreements, a Code of Conduct, Membership Handbook, Grievance Protocol, feedback forms, community surveys, and clear roles. Without structure, community care can become confusing and unsustainable. But structure should help hold the work, not control the people. 

I have often said that if it were legally possible, SweetGrass would have a council of grandmothers. Instead, we have an Advisory Council. That distinction matters to me because the Advisory Council is not meant to function as a corporate board. It is meant to hold wisdom, accountability, cultural memory, community voice, and relational guidance. In many ways, it is my attempt to create a structure that honors the role elders, aunties, grandmothers, and wise women have always played in community care, while still working within the legal and organizational systems available to us. 

The MCH Leadership Competencies also helped me think about the relationship between formal leadership training and community-based knowledge. The competencies name skills such as self-reflection, ethics, communication, conflict resolution, honoring lived experience, mentoring, team building, systems thinking, and policy. These are important, but traditional midwives, aunties, grandmothers, birthworkers, and community caregivers have practiced many of these skills for generations through relationship, observation, cultural protocol, storytelling, deep listening, and collective responsibility. 

This made me reflect on how often institutions recognize knowledge only after it has been translated into professional language, competency frameworks, trainings, or credentials. The MCH competencies are useful because they give language to important leadership skills, but traditional midwifery reminds me that these skills are not new. They have always existed in community. 

For SweetGrass, this means building structure without erasing community wisdom. The handbook, advisory council, shared agreements, grievance process, birth fund guidelines, and feedback forms should not make institutional knowledge more important than lived experience. Instead, they should protect and organize the wisdom already present in the community. 

This reflection also challenged me personally. I care deeply and can sometimes feel responsible for holding everything. But midwifery leadership asks me to build containers instead of carrying all the water myself. It asks me to trust the collective, share responsibility, and create conditions where people can participate, contribute, rest, speak, disagree, repair, and grow. 

To “lead so the mother is helped, yet still free and in charge” means building systems that protect choice, dignity, and self-determination. It means reducing hierarchy wherever possible. It means remembering that the goal is not for the leader to be seen as powerful, but for the community to become more powerful together. 

References 

Chamberlain, C., Fergie, D., Sinclair, A., & Asmar, C. (2016). Traditional midwifery or “wise women” models of leadership: Learning from Indigenous cultures. Leadership, 12(3), 346–363. https://doi.org/10.1177/1742715015608426 

MCH Navigator. (n.d.). Maternal and child health leadership