Midwifery Care is Revolutionary

 

“Deciding that you’re going to have a baby with a midwife makes you a revolutionary. Just that decision alone. You have decided that you are not going to be a passive voyeur in the journey of pregnancy and of birth. That you are, as I tell my clients, deciding that you’re going to drive this car. You will invite other people to be in the car with you. Your midwife and your birth team will be sitting next to you with a map. When you decide that you’re going to have a baby with a midwife, you decide that you’re going to participate in the decisions that are made during your pregnancy.”

Inspiring and stirring words by Claudia Booker from the short film Midwives Address Health Disparities.

“It’s Not Acceptable”: Midwives Address Health Disparities

This.

“It’s not acceptable that African American women, regardless of their educational and economic background, still have a four times greater chance of dying in the childbearing year than their white counterparts… It’s not acceptable that three to four times more Native American and African American babies die than their infant white counterparts.”

This is how the incredible Geradine Simkins opens this new film in MANA’s new I Am A Midwife series. I love this short film. None of these midwives are beating around the bush here. They give you the facts and make it clear just how serious of a problem racial inequality is for maternal and infant mortality. This film features some of the most brilliant CPMs today working on reproductive justice within a midwifery context including not only Geradine Simkins, but also Katsi Cook, Claudia Booker, Umm Salaamah Abdullah-Zaimah, Tamara Taitt, and Arizona’s own Marinah Farrell. I can’t even tell you how honored I am to be joining a community of midwives that includes these women. I feel like they and other midwives and birth professionals like them have been laying and continue to lay the groundwork and foundation that will allow these crucial changes to take place and transform maternity care as we know it in this country.

To that end, I leave you with this quote by Tamara Taitt:

“I feel like health disparities is really the battle ground on which midwifery will be proven to be the gold standard.”

 

Once Upon a Time in Western Washington

Hello! It’s been a long time, nice to see you here again. I realize I haven’t posted since, well, I left Austin. There are a whole lot of reasons for not the least of which were adjusting to a new state/new midwife/new clients/etc. as well as healing emotionally for the reasons I left my preceptorship in Austin so abruptly. I’m working through it all and have several posts planned to touch on those subjects.

In the meantime, I thought I’d tell you a story. It is a story about a bizarre convergence of events, touching on mysterious Pagan ways and midwifery. It begins in the usual way, like so:

Once upon a time, a young baby dyke was growing up in the woods of a placed called western Washington. She made friends with a Very Tall Family. This Very Tall Family was so tall, in fact, that they did outlandish things like keep their microwave on top of the refrigerator where the shortish baby dyke could not reach without standing on a stool. The Very Tall Family loved to go backpacking, and the mother in this family talked frequently about how she used to go backpacking with her former best friend, Teddy. The baby dyke heard lots of stories about her escapades and adventures backpacking with Teddy and though she never met the woman, felt like she kind of knew her anyway.

Skip ahead a few years, and the baby dyke finds herself attending a women’s gathering called Longdance. The mother and daughter from the Very Tall Family go, and apparently Teddy used to go too. She learned all sorts of wonderful things, including songs like We Are Sisters On a JourneyShe thought these are purely Pagan chants and delighted in teaching them to her circle mates in her college Pagan/Wiccan Collective.

Fast-forward several years later when the baby dyke (not such a baby dyke anymore, btw) decides to become a midwife (called to be a midwife, really, in an undeniable way. But that’s a tale for another place and another time). She travels a great distance to a far away land called Maine to attend midwifery school. There, she learns about MANA and how it was formed, and also about a woman named Teddy Charvet who was instrumental in founding the Seattle Midwifery School and was the first president of MANA. And then she had an epiphany that this Teddy Charvet was the same Teddy Charvet who used to go hiking with the mother of the Very Tall Family all those years ago (who, btw, now goes by Therese and still loves being in the forest). And she found out that We Are Sisters on a Journey is not just a Pagan song, but a beloved song for MANA as well. In fact it was sung at the very first MANA gathering brought, I like to imagine, directly to MANA by Teddy herself from the bosom of the women’s Pagan circles that later formed Longdance.

And it is in this roundabout way that I feel like I have always, somehow, had a connection to the rebirthing of midwifery in the US and the creation of MANA, although I didn’t realize it until very recently. Curious, no? It does seem strange to me that I’ve seemed to narrowly avoid meeting this woman my entire life.

Recent Race and Birth Posts

So, funny how this small project of mine called school has taken over my life. I have a few blog posts in the works, but I have been noticing how quiet Bloody Show has been lately. It makes me a little sad. So until I get a few moments to finish the posts I have started, here’s a little light reading for the meantime. Over at The Unecessarean, there’s a lively discussion going on:

My philosophy of midwifery

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.

My Journey to Midwifery

Over the next few days, I will be publishing several essays and shorter bits about my journey to midwifery. The application process for Birthwise gave me lots of time and space to think deeply and write about my philosophy of birth, the reason I am drawn to a career in midwifery, and what I think a midwife should look like. Enjoy!

I come from a family transformed by the act of birth. My mother gave birth to my sister and me in a hospital with a CNM. I grew up listening to her recount her birthing experiences: how she and my father wrote their birth plans carefully, how she refused medication and interventions, and how this was the greatest gift she felt she could give us. Listening to my mother, it is impossible not to be struck by the deep pride and self-reliance in her voice. These stories contrast sharply with those of my grandmother who gave birth to six babies in the 1950s and 1960s and does not remember a single birth because she was forced to undergo twilight sleep. The first time that my grandmother experienced birth consciously was when she was present at my birth. Observing my birth transformed my grandmother. The opportunity to observe my birth first-hand seemed to make up for her own stolen memories. She was awestruck by a sense of the miraculous and cherishes the memories of my birth to this day. I grew up knowing about the strong birthing women in my family and being told explicitly that my body was built to be able to give birth despite what doctors might tell me.

Women’s health has always been a deep interest of mine and I took every opportunity to study it while attending Mount Holyoke College. I majored in cultural anthropology and chose to earn the Five-College Certificate in Culture, Health, and Science instead of a traditional minor. During one summer, I interned with the education department of Planned Parenthood of Western Washington (now Planned Parenthood of the Great Northwest) and returned to continue my work at Planned Parenthood as their Teen Clinic Coordinator upon graduation.

My introduction to the world of homebirth and direct-entry midwifery was a rather fortuitous one. Each time I visited my academic advisor, I passed a bulletin board filled postings of health-related job opportunities and post-graduate programs. I frequently found myself lingering to pore over the midwifery school listings. One day, I came across an advertisement for a CAPPA labor doula course and signed up with building excitement. The first day of class my eyes were opened to a whole world of birth taking place outside of hospital settings that I had not known existed. As I learned and practiced my doula skills I began to understand birth as a normal, non-medical part of life. Safeguarding the option to labor and give birth in one’s own home or at a freestanding birth center became as critically important to me as protecting my mother’s choice to give birth in a hospital birthing suite under the care of a CNM.

Hello Midwifery Student!

I was just accepted as a student at the Birthwise Midwifery School in Bridgton, Maine. Midwifery here I come! I am so excited to start learning (well, learning formally at least), getting messy, and beginning to do hands-on work. It feels like I have just taken one more important step down the path to an incredible journey.

Pregnancy and Power

I recently read independent historian Rickie Solinger’s book Pregnancy and Power: A Short History of Reproductive Politics in America. Solinger’s central argument is that women are not accorded full personhood and cannot be fully participatory members in a society where they are not allowed to manage their own reproductive lives, a premise with which I fully agree.

Solinger’s narrative about abortion was especially eye-opening for me. She argues that abortion today is far more heavily regulated and oppressive than it was pre Roe v. Wade when abortion was outright illegal.  It floored me to read Solinger’s account of the ease with which both women (read: middle class, White women) and doctors circumvented the law to procure the medical procedures they needed. General practitioners who performed abortions were hailed for performing a necessary service. There was no harassment of individual women terminating pregnancies and little organized public outcry, even from the religious right.

Working at Planned Parenthood straight out of college, I was constantly made aware of the perilous state that abortion rights are in today. My first day at work, I was shown around the building, shown which glass was bulletproof, where the panic button was, and what to do in the case of a clinic shooting or bombing. Several times a week, we had protesters lining the streets with ugly signs and shouting uglier slogans at anyone entering the clinic. Despite the FACE act, they repeatedly tried to follow women into our parking lot or physically block their access, at which point we called the police. They took photos of everyone who worked at the clinic and I would not  be surprised if my face was on an anti-abortion site somewhere. Working in an abortion clinic today can feel like a warzone.

Pregnancy, abortion, and motherhood have heavily shaped our ideas of race, class and gender in the US. One of the most engaging aspects about this book is the Solinger breaks down the reproductive realities of women throughout time by race and class. She portrays state-legitimized motherhood, and therefore the right not to reproduce, as a class and race-based privilege. Her narratives of the reproductive lives of White middle class, White poor, African American (both pre and post slavery), Native American, and Chinese women fill a glaring gap in many of our reproductive histories.

Regarding abortions pre-Roe, it was much easier for middle class White women and women of color to obtain care than it was for poor White women. Middle class White women could afford to purchase privacy and competent medical care. In a racist, pro-eugenics era, policy makers all but encouraged women of color to have abortions so as not to produce more “inferior” children. Plus, the lives of women of color were valued less than those of middle-class White women so if these women received substandard care, the government did not spend time searching out incompetent care providers. This was of course completely unconscionable, but the effect was still that women of color had an easier time procuring abortions than poor White women.

 

For poor White women, their ability to access abortion was tied up in their race and gender. There was no question that middle class and upper class White women were White. If they transgressed the strict boundaries of their gender by not carrying a pregnancy to term, it did not call their whiteness into question. However, poor White women existed in a boundary zone, especially if they were immigrants from countries not always seen as White – Ireland, Italy, eastern Europe, etc. Solinger describes how socioeconomic class was/is inherently tied up in our ideas of race. By virtue of being low class, poor White women were seen as in danger of becoming Black. The way to rectify this unthinkable circumstance was to strictly police and enforce gender norms, one of which was bearing and raising White children who would become productive White citizens. It was poor White women who were arrested and tried in the courts if they were discovered to have received an abortion. It was poor White women who were jailed and fined for such acts. Of course middle and upper class White women were having abortions as well, but they were not transgressing race boundaries and so were allowed to do so by and large without interference.

 

As time marches on, class and race still have great effects on our ideas of who is and can be a mother, what makes a “good” mother, which mothers deserve to mother their children, and what children are worthy of being raised in “good” homes. Just look at our racialized and gendered stereotypes of the welfare system, which parents can choose to stay home and mother their children, which children get adopted, and which children wind up in the foster care system. As responsible citizens, we need to actively question and combat racialized and gendered ideas of pregnancy and power where we find it in order to create a world where all women are equal and full citizens with autonomy and agency.