I believe that birth is a deeply moving rite of passage in which care providers work with and create space for a woman to claim her own power. Midwifery is both feminist praxis and a distinctly pro-choice activity. When I worked at Planned Parenthood, I labored daily to give women choices. My days were filled by providing information to teens about birth control choices, opportunities to engage in safer sex, ways to avoid and end abusive relationships, options for terminating a pregnancy, and encouraging a healthy interest in the workings of their own bodies. Midwifery, and by extension homebirth, is an uncompromising expression of a woman’s right to reproductive choice. Women need a wide range of choices when it comes to all aspects of their reproductive health. The choice my mother made to have a CNM in a hospital was an important one. It is equally important, if not more so, to protect and ensure the choice for women to give birth outside of a hospital.
Of the many problems with the traditional American medical system, one of the most insidious is that its hierarchical, top-down power structure perpetuates the sexism, racism, classism, and heterocentrism that underlie many aspects of American society. Homebirth and direct-entry midwifery subverts this hierarchical power structure, resulting in an experience of the midwife as holding power-with, instead of power-over, the laboring woman. Direct entry midwifery has incredible potential to transform the way that marginalized women experience healthcare. The act of serving another woman during birth as an equal turns on its head the pervasive idea that teenagers, women of color, poor women, lesbians, and women with disabilities are somehow less whole, less worthy, or are separate from and therefore different than their care providers.
Birth is an incredible and powerful rite of passage. When birthing women are skillfully and sensitively supported physically and emotionally, they often discover a wellspring of inner strength and self-confidence as they learn to trust themselves and their bodies. Direct-entry midwives must work to keep and expand homebirth and freestanding birth centers as valid and accessible choices for all women. These are especially important options for marginalized women because they combat the dehumanization perpetuated by the traditional medical system.