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Home birth in the NYTimes, minus class analysis

An article from this weekend’s NYTimes chronicles the rising trend in home births in NYC. It partially credits the recent Ricki Lake documentary, The Business of Being Born.

The article does a good job of addressing the different challenges for women giving birth in their NYC apartments. It takes about space concerns, neighbor issues, clean up and hospital transfers. The article is also accompanied by a slideshow of photos from various home births.

What the article doesn’t address is the huge class divide in these types of births. I, as a doula and general advocate of midwives and out of hospital births, am a huge supporter of home births. I think they are better for moms and babies who have low-risk pregnancies. I think moms feel more comfortable and are away from the stress and pressure of a hospital. She is on her own time line, no questions asked.

But the huge drawback to promoting home birth is that it is primarily an option for upper middle class women. Not everyone has a home that is safe to birth in. This could be because of family circumstances, overcrowding, lack of support from partners or simply lack of adequate space. There are also obvious financial barriers since most insurance companies won’t cover home births.

It’s unfortunate that an article about birth in NYC didn’t address this issue at all, seeing as it is such a diverse city, in terms of both class and race.

Also, once again an article about women’s health is marginalized, this one was placed in the Home and Garden section. At least it wasn’t in Fashion and Style this time.

Cross-posted at Feministing

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2 Responses to Home birth in the NYTimes, minus class analysis

  1. Lara Miller says:

    Your post brings up such a critical point in this movement: homebirth is a great choice for low-risk women who consider their homes a comfortable and safe environment, but for many women their circumstances may not permit this. This is why birth centers are critical in the spectrum maternity care services. Being able to offer a home-like environment in a professional and safe center (that accepts many insurances and medicaid) is the missing piece in the home vs. hospital conversation.

  2. a doula says:

    Not everyone has a home that is safe to birth in. This could be because of family circumstances, overcrowding, lack of support from partners or simply lack of adequate space.

    i don’t think what you speak of above is class related. it sort of sounds like you’re suggesting poor women have to deal more with certain things that i don’t think follows — like an abusive or difficult family circumstance at home, or an unsupportive partner — those things i do not feel are class-dependent. alot of women won’t have a homebirth even if they want one, b/c husband is against it.

    space need not necessarily be an issue . people need to vamoose if a woman is having a baby, and usually (in my experience at births as a doula and/or friend sometimes) they will. i’ve been to homebirths in tiny homes or apartments with many children and animals and various relatives around. usually at a certain point most of the other family members leave, at least for awhile, or at he very least they get out of the room the woman is birthing in. they instinctively give her space. and anyways, if that is what the woman is used to, its her home and the amount of space she is used to.

    also, i attended my friends birth at a TINY army hospital room! there was barely room for me in there, just one support person, squished to the wall. the hospital staff had to squeeze in to attend to her, there was barely room for their equipment. additionally hospital births are generally very crowded with all manner of medical staff in and out — they can feel quite clautrophobic no matter their size. i dont think they are better than homebirths in the “space”/room regard. though, i have known a few overwhelmed moms who say they want to birth at a hospital b/c it’s like a vacation for them, with people bringing you meals and such…however being woken every 2 hours thru the night by hospital staff checking you and baby doesnt sound like a vacation to me. that’s what they do in the hospital.

    i think its really overstating it to say homebirth is basically only an option for uppermiddle class women. it depends on what state you are in-there are actually several insurance that will cover midwife and homebirth if you are low risk. (maybe not in ny? but in my state.)

    it also depends what sort of homebirth you’re talking about, what sort of midwife (lay or licensed)– i had a lay midwife friend who often would get maybe 50 dollars for delivering a babe, and doing prenatal. (that is a nother story …not a good thing for the midwife.)

    i have known several truly low income (not middle class) women who had a homebirth paid for by insurance thru a parent or partner. it depends on her circumstances, her risk factors, etc. and some low income women have truly fabulous insurance coverage that covers home births!
    i have been a homebirth doula for an upper middle class woman who wanted a vbac (and got one). in that case, definitely, money helped. no woman who wants a vbac rich or poor will be covered by insurance — the woman i helped was upper middle class and so could pay out of pocket for her midwife.

    also state-wise …you have to look at what the state is and what the woman is used to as far as birth goes. in ny i guess most poor women would probably just think “time to go to the hospital.”
    but, some poor women, in the south , in certain areas (rural basically), see home birth as normal, and they just go to the midwife and call the midwife when in labor.

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