Rachel Maddow on Racial Disparities in Infant Mortality

This is a story about what happens when extreme right politics get in the way of saving lives, specifically for birthing parents and their babies. Rachel Maddow tackles the racial disparities that cause the infant mortality rate in Mississippi to be worse than that of Sri Lanka and Botswana. The national infant mortality rate is atrocious at 6.8 deaths per 1000 live births. And the rate in Mississippi is a heart-stopping 10.6 per 1000 live births. (for 2005-2007 as recorded by the CDC). Maddow interviews Dr. Carl Reddix, an OB/GYN that was just ousted from the Mississippi board of health for apparently being too pro-abortion for the new right-wing players in the government (who are apparently to the right even of Haley Barbour, the right wing anti-abortion former governor of Mississippi who appointed Dr. Reddix to the board originally).

The problem? Dr. Reddix agreed to back up a clinic that provides abortions. As in, if something goes wrong during a procedure and they have to transport to a better equipped hospital, Dr. Reddix agreed to provide care for the patient. I would have thought that even people who are staunchly pro-life would be for a very well-qualified doctor providing life-saving care to patients experiencing a complication from an abortion. We might disagree about whether abortion is ok, moral, or should be legal. Surely we don’t disagree about whether we should provide care to an adult in medical need, regardless of their choices.



What to Wear as a Butch Midwife

So, what do you wear as a butch midwife? I’m still trying to figure that out. One answer I’ve come up with is this dapper gentleman to my right. What is more at the heart of midwifery than knitting? I could knit myself this handsome vest (already planned as my next big project), fit right in with midwifery and still be my beautiful butch self, right?

One of the main problems I have with dressing as a butch midwife is that I understand formal/business casual menswear. I also understand casual menswear. What I don’t understand is that very fine line between the very casual and the more formal that most midwives walk and how that translates into butchwear for me. I can’t just wear polos every day, and sweater vests are fantastic but completely unrealistic for the Austin heat. Add to the mix that I’m 5’2″ means that most men’s clothing does not fit very well and I’ve gotten myself into a real pickle (most men’s shorts look like poorly tailored capri pants on me, for example).

I have some growing to do for sure, part of which is discovering my own aesthetic. While I think that not knowing what to wear says more about my lack of education than the challenges of being a butch midwife, the fact remains that I could use an education. Do you, gentle reader, have any ideas for me, tips, suggestions, or places to explore?


Butch Midwife

What does it mean to be a butch midwife? I personally know a few lesbian midwives (and know of many more), but none of the lesbian midwives I’ve spoken with are openly and outwardly butch in appearance currently even if they are out to their clients as queer. I know transmasculine midwives and student midwives who dress masculinely, but no cisgender butches. Granted, I’m still pretty green in the midwifery world and I certainly don’t know everyone, but I’m guessing if there are other butch midwives, we are a pretty rare breed.

Note: I focus in this post on midwifery because, well, that’s where my brain is these days. However, I know there are many butch and gender non-comforming birth workers out there. One great example is Miriam Zoila Perez who continues to do the birth work world proud as a butch/genderqueer doula.

I identify (most days) as a soft butch and as a dyke. It’s an identity I have taken years to come to and one that is still evolving. I have figured out what that identity looks like in most of my life, but when it comes to midwifery it’s all still a bit of a mystery to me.

I have spoken to most of the queer midwives I know about what it is like to be practicing as a queer midwife, their particular challenges and joys in the process, and sought advice for myself when I finally begin to practice as a bona fide midwife with my own clients. What I haven’t been able to suss, though, is how do you dress and present as a butch midwife? More importantly, how do I want to dress and present as a butch midwife?

Just in time for this post, dapperQ has begun a series on fashion in the workplace. Seems like this issue has been on other people’s minds recently as well. Jody Mousseau kicks off the series with her own story of coming into her butch identity and what that meant for her in the workplace:

As an adult tomboy/soft butch, changing my fashion in my private (i.e. non-work) life to one incorporating the men’s clothes that I feel comfortable in was no problem.  However, I initially had my reservations about taking this mode of changing fashion into the workplace. My primary concern was, “how will people react?”  I had been dressing a certain way for years, and although I was uncomfortable dressing in somewhat feminine clothing almost the entire time, this very public transition in the workplace was difficult.  But the process began.

However, dressing for midwifery is a bit more nuanced than business casual in an office. I more or less get how to dress butchly in an office setting (if I may be so bold as to invent words here). With midwifery, though, people wear everything from flowing purple caftans to mini skirts to just plain jeans and a (often birth/midwifery-related) t-shirt. Most midwives I know dress less formally than business casual.  This is for some a calculated move to help put clients at ease mixed with the knowledge that practical clothing is important when you can get called to a birth at any moment.

Another challenge, perhaps the main challenge for me, is the history of midwifery as (straight, gender-conforming) women’s profession. It’s hard enough being out as queer as a midwife and how that affects your client base and who is willing to hire you, but try being masculine of center midwife and the game just got that much harder. (And don’t even get me started on how difficult it is to be trans and doing birth work, that’s a whole different story for another day.) Clients who might be able to stomach a lesbian midwife may not be willing to embrace one who dresses in men’s clothing. Or maybe not, I don’t know yet. Maybe any client who is comfortable with a queer midwife doesn’t mind if she is also butch. Maybe all of this worry is for nothing. Who knows? That’s part of the point – I can’t know until I actually try, in part because I don’t know any other butch midwives who could share their experience.

It’s nice and lovely to tell someone to be yourself and dress how you feel, but what about when it affects your bottom line, your ability to feed yourself and your family, even your ability to work in your chosen profession? For me personally, it means thinking very carefully about where I choose to move to join or set up a practice (and thank goodness I have that flexibility of geographical location, many midwives are not so lucky). It also means doing some more soul searching about my identity and presentation and how that fits into midwifery for me personally, making sure that however I choose to present feels genuine to me and helps me feel confident and professional.

Stay tuned for my upcoming post trying to suss out what one actually wears as a butch midwife.

The Whiteness of Homebirth

USA Today published an article this week about the 20% rise in homebirths between 2004 and 2008. What struck me most, though, was not the fact that homebirth has been on the rise, but that USA Today focused in so much on the racial disparities amongst women choosing (and in many places having access to) homebirth. I feel like it’s something I am constantly talking about and working towards remedying. It’s a bit surprising and surreal to see this angle of the story picked up by the mainstream press.

Fewer than 1% of U.S. births occur at home. But the proportion is clearly going up, study by researchers at the Centers for Disease Control and Prevention found. The new figures are for 2004 to 2008. Home births had been declining from 1990 to 2004.

The increase was driven by white women — 1 in 98 had their babies at home in 2008, the most recent year for which the statistics were available.

Only about 1 in 357 black women give birth at home, and just 1 in 500 Hispanic women do.

“I think there’s more of a natural birth subculture going on with white women — an interest in a low-intervention birth in a familiar setting,” said the lead author, Marian MacDorman of the CDC’s National Center for Health Statistics.

For all races combined, about 1 in 143 births were at home in 2008, up from 1 in 179 in 2004.

Read the whole article here: Home births up 20%, driven by natural birth subculture – USATODAY.com.

My hope in all of this is that those statistics are changing, that midwives and clients are working together to change the face and make up of people who choose and can access homebirth. I feel really pleased to be working in a practice right now that is incredibly diverse as homebirth midwifery practices go. I’ve been here just over a month and I’ve met clients from nearly every racial background, lesbian clients, clients of many different nationalities and countries of origin. Interracial relationships are commonplace in this practice and our clients are all over the board in terms of class background. This practice has a thriving community in their midst and the midwives work very hard to ensure that this community continues to grow and develop as clients meet each other, network, become friends, and help each other through pregnancy and early motherhood.

Is everything perfect? Certainly not. We have a long way to go in Austin in terms of increasing diversity, especially amongst birth workers. And I definitely know that I am fortunate to be working for one of the most diverse practices in town. But it’s made me start to think long and hard about where I want to practice in the future. It’s helpful that Austin itself is a diverse locale and the sort of place where homebirth is a popular and accepted choice. Working with this practice and here in Austin makes me question on a deep level whether I’m willing to work long-term as a midwife in a less-diverse locale where there is less opportunity to co-create this beautiful, rich and diverse birthing community. Northern New England and central Texas and vastly different places and it shows in the practices I have been involved with. There is a palpable difference from a practitioner standpoint. And while I know that the individual practitioner has a profound effect on how diverse, inclusive, and accessible their practice is, so does the locale.

Deadly Delivery Update for 2011

Did you see that Amnesty International updated their publication Deadly Delivery? Things continue to not look very good. The US now ranks 50th instead of 41st in terms of worldwide maternal mortality. We continue to fail women of color and women living in low-income areas. And, for the 13th year in a row, our rates of cesarean birth have risen and now are at an all time high of 32.9% (as of 2009). Fully one third of all babies in the US are born via surgical incision instead of the time-tested vaginal route.

Da Midwif at Midwives of Color gives a poignant overview here.

Access Intimacy: The Missing Link (via Leaving Evidence)

Mia Mingus gives a name to a set of experiences in my life that I didn’t know could have a name. This is a beautiful, brave, and painfully honest piece about Mingus’ experiences with access intimacy. She says it much better than I ever could – make sure you make time for yourself to read her blog post and soak up her eloquent words.

Access Intimacy: The Missing Link There are many ways to describe intimacy.  For example, there’s physical intimacy, emotional intimacy, intellectual, political, familial or sexual intimacy.  But, as a physically disabled woman, there is another kind of intimacy I have been struggling to name and describe, what I have been calling “access intimacy.” I have begun using the term loosely and am still realizing different aspects of it.  This is in no way a complete describing of it, … Read More

via Leaving Evidence

Catching Our Babies: Open Arms and Michelle Sarju

There should be a beautiful and stunning film right here to start this post off. For some reason, I cannot get the video to embed properly. Watch it here instead.

I grew up in western Washington and lived in Seattle for a year. I definitely have mixed feelings about the birth scene in the Seattle area, but this film highlights what I think is absolutely working there.

A beautiful piece about serving women of color and low income women in Seattle. The doula service featured in this film, Open Arms, is pretty incredible. Run primarily by women of color, as you can see in the film, Open Arms provides doula services to any woman who desires a doula, basically. As far as I understand, they use grants to pay their doulas when individual clients cannot which really is a win-win situation for everyone involved. It’s a model I highly respect, think is working well, and would love to see replicated  many, many times across the country.

Michelle Sarju is also worth a mention in her own right. She currently works for Open Arms and I don’t know if she does much midwifery work anymore. She has been a tireless advocate for women of color in the midwifery scene in Seattle. A former Seattle Midwifery School (SMS) student, she has shown up time and time again as a voice advocating for better and more inclusive midwifery education, better treatment for students of color at SMS (now Bastyr), and a staunch supporter of a fundamental change in the midwifery culture and education in Seattle – one that embraces anti-oppression work at its core. Michelle Sarju has worked hard and long in what has been largely an uphill battle. It is really fantastic to see her shining in this beautiful and well-made film.

HT to Christy Tashjian for sharing this film in her blog.