If you’ve been following the tumblr meme of sites that use photos of Ryan Gosling with “Hey girl” sayings, it’s excitably reached the birth activist world.
Homebirth Ryan Gosling shows us all sorts of approving statements about homebirth from America’s heart throb. One part poking fun at the birth activist community and one part legitimate support for homebirth, it’s worth checking out.
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Posted by radicaldoula
Last week, the CDC released data proving what those of us in the birth activist community have noticed for years: home birth is on the rise. They evaluated home birth numbers from 1990-2009.
After a decline from 1990 to 2004, the percentage of U.S. births that occurred at home increased by 29%, from 0.56% of births in 2004 to 0.72% in 2009.
There are many reasons for this increase, from Ricki Lake and the Business of Being Born, to studies that show serious problems with our maternal and fetal mortality rate. Also midwifery is on the rise, and CPMs have been successfully pushing for recognition at the state level.
To those of us who support the midwifery model of care and believe that leaving the hospital setting is a good idea for many low-risk births, this is great news. It’s also still disappointing that the overall percentage is so low–less than 1% of all births! Although when you look at it on a state level, there are places (like Montana and Oregon) where the rates are double the national average.
But, as we’ve come to expect, when you examine these numbers based on race and ethnicity, the picture is very different:
For non-Hispanic white women, home births increased by 36%, from 0.80% in 2004 to 1.09% in 2009. About 1 in every 90 births for non-Hispanic white women is now a home birth. Home births are less common among women of other racial or ethnic groups.
About 90% of the total increase in home births from 2004 to 2009 was due to the increase among non-Hispanic white women.
The chart above shows just how dramatic the disparity is. I addressed some of my thoughts about what’s behind this gap in this post, which generated some good discussion in the comment thread.
I think we’ll see that racial gap diminish when midwifery advocates include people of color in their work. When more midwives and doulas of color are leading these initiatives, and also when public funding for out-of-hospital birth care is addressed.
The other disparity that the CDC study points out is a geographic one, which may also mirror the racial disparities:
The percentage of home births was generally higher in the northwestern and lower in the southeastern United States.
This Northern/Southern disparity is true for many health outcomes, and can probably be attributed to demographic differences, as well as a political climate that more favors midwifery and out of hospital birth in the Northwest. It’s clear we need more strong midwifery advocates in the South–and that would also be a place where it would make sense for people of color to take the helm.
We know that a shift as radical as bringing maternity back out of the hospital is going to take decades. It was a decades-long, well-funded campaign that brought birth into the purview of doctors and hospitals to begin with. The good news is we are moving in the right direction, but if we leave women of color behind, we’re not going to achieve the wide-spread culture shift we’re working towards.
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Posted by radicaldoula
Right as 2011 was wrapping up two articles were posted about home birth and midwifery revivals in communities of color. Having written about the question of race in the home birth movement back in 2009 for RH Reality Check in these two articles, I’m excited when new outlets pick up the story. There is much movement in this arena, and also much more than can be done to make sure US midwifery is accessible to people of color.
In New America Media, Valeria Fernandez writes about efforts to revive Mexican midwifery in Arizona:
Marinah Valenzuela Farrell is one of only a few licensed midwives in Arizona. Though it isn’t a profitable venture, helping mothers bring their newborn children into this world is for Farrell a calling deeply rooted in her native Mexican tradition.
“It is really hard to be a midwife,” said the 41-year-old. “You don’t sleep, and you don’t make money. People think you’re crazy because you’re doing homebirths.”
A majority of Farrell’s clients are middle class and white, though as a Latina she aims to make midwifery accessible to low-income women in dire need of prenatal services but too afraid to seek them out in a state virulently hostile to undocumented immigrants.
“I think they don’t know that we exist,” she said. “I think the more the community knows that there’s a midwife who will come and visit them at home and do a homebirth… [attitudes] will change and shift.”
I spoke to the author while she was working on the piece, and a quote of mine is included toward the end.
In The Grio, Chika Oduah writes about black women and home birth. The article includes a video, which is a good primer of the issues at hand with home birth. It also references my Colorlines article about the possible connection between maternal health in communities of color and access to midwifery care.
What is clear from the research about this issue is that women of color are less likely to receive midwifery care, and that disparity is larger than the population numbers would suggest. I think this dynamic is complicated by global sociopolitical historical factors. For example I experienced resistance from Latina immigrant women to midwifery care because of the stigma toward parteras (midwives) in their home countries. In many places in Latin America, midwives and home birth are seen as the option used by women who can’t afford to go to hospital for birth–basically an option only for those who have no other option.
That creates class and race stigma on home birth and midwifery care.
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Posted by radicaldoula
Update: It failed! Big victory for health and autonomy. Also proof that even those with more moderate or conservative politics are skeptical of such far reaching legislation. The fight is far from over though, as these efforts are bound to continue.
It’s a scary time for women’s health and autonomy. The political movement to limit access to abortion, as well as pregnant people’s rights to make decisions about their bodies and medical choices, is stronger than ever.
In the absence of any strategies to address the actual problems plaguing our economy (unemployment, for example) the ultra right wing in control of many of our state governments (and the House of Reps too) have decided to focus instead on debilitating budget cuts and bills that damage women and pregnant people’s health and human rights.
As I’ve said over and over on this blog–bills that limit access to abortion also limit the choices of pregnant people who want to parent. NAPW has a video explaining exactly what is at stake with Prop 26:
Irin Carmon, reporting for Salon, wrote about how this initiative would limit access to even birth control. These efforts are serious, and want to turn back the clock on reproductive health almost fifty years. All of these extreme efforts are poised to take judicial challenges all the way to the Supreme Court.
The vote on the initiative could go either way, which is even more frightening. Polling shows voters split evenly.
If you’re in Mississippi, please make it out to the polls tomorrow and vote NO on 26. This is serious.
2 Comments | abortion, activism, birth | Permalink
Posted by radicaldoula
California Governor Brown vetoed a bill yesterday that would have limited the use of restraints on pregnant incarcerated women during transport. A ban on using restraints during labor already exists. The bill passed the legislature with overwhelming support, and likely received a veto because the California State Sheriff’s Association decided to push heavily against the bill.
From the Governor’s veto message:
At first blush, I was inclined to sign this bill because it certainly seems inapprpriate to shackle a pregnant inmate unless absolutely necessary. Hovwever, the language of this measure goes too far, prhohibiting no only hsackling, but also the use of handcuffs or restraints of any kind except under ill-defined circumstances.
Let’s be clear. Inmates, whether pregnant or not, need to be transported in a manner that is safe for them and others. The restrictive criteria set forth in this bill go beyond what is necessary to protect the health and dignity or pregnant inmates and will only serve to sow confusion and invite lawsuits.
This is really disappointing news, and further proof that the health and safety of pregnant incarcerated women is not a priority. The fact that he attempted to say that the use of handcuffs or restraints could actually be needed to “be transported in a manner that is safe for them” is appalling.
In my article for Colorlines last week, I talked to Marianne Bullock, a prison doula and co-founder of the Prison Birth Project. She had this to say about the danger of restraints during transport:
Marianne Bullock, cofounder of the Massachusetts-based Prison Birth Project, offers an anecdote from across the country illustrating why shackling during transport is an acute problem. As a doula who has been working within a Springfield prison for the last four years, Bullock and the other members of the Prison Birth Project see exactly how incarcerated pregnant women are treated. Even though their facility doesn’t shackle women during childbirth, shackles are still used during transport, especially postpartum. Bullock recounts one woman that she supported during labor who ended up with a full episiotomy (an incision to widen the vaginal opening) to deal with her baby’s shoulder dystocia.
“Twenty-four hours later she was shackled foot-to-foot and walked out of the hospital,” she remembered. “It’s so dangerous to have a woman walking shackled, with who knows how many stitches.”
Congrats to everyone in California for such an impressive push getting this bill through, and here is to hoping that it gets through next time.
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Posted by radicaldoula
In my latest article for Colorlines Magazine, I write about the efforts to prevent prisons and jails (and detention centers) from shackling incarcerated pregnant women. What inspired me to write about this issue, which has been covered pretty extensively by the progressive media in the past, were Rebecca Brodie’s plans to shackle herself during her own birth as a protest of the practice. From the article:
Rebecca Brodie sits in her suburban Massachusetts home, talking on the phone with me while her family member sits nearby, filming the interview. The oldest female correctional facility in the United States, MCI-Framingham, is just a short eight-minute drive away. “When I conceived my third child earlier this year, it really hit home for me because everywhere I go I pass the prison,” Brodie explained. “I have all these choices and opportunities: who do I want in the room with me, do I want a water birth, or a home birth? Obviously the incarcerated women can’t make these choices.”
The proximity of the women’s prison and Brodie’s pro-bono legal work with incarcerated women is what inspired the protest she’s planning for December, when her third child is born. If all goes according to plan, she’ll be laboring and delivering her baby in metal restraints that restrict her arms and legs. She’s planning to simulate the same conditions that many incarcerated pregnant women face when delivering in state prisons and jails, including some of the women housed at the prison right by her home.
I’m still not sure what I think about Brodie’s plans. It’s an extreme form of protest, one that involves much spectacle (and a documentary to boot). But what it was clear everyone I talked to cares about the most is bringing attention to this horrific practice in hopes of ending it.
Only 14 states specifically ban the practice, and even those states don’t necessarily ban the use of shackles during transport. Governor Brown in California has a bill waiting on his desk for signature that would ban the practice during transport as well. The more work I do in the field of social justice the more I believe that the practices of our criminal justice system are some of the most dire issues we face today. We incarcerate more people than any other country in the world, and the treatment of people on the inside brings up many, many human rights questions.
I’m glad I was able to talk to one of the founders of volunteer doula program that I seriously admire, Marianne Bullock from the Prison Birth Project, for this article. Marianne and the other PBP folks work at a prison in Massachusetts, trying to address the myriad challenges moms on the inside face, including shackling.
Read the full article here.
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Posted by radicaldoula
I used to write a lot more about celebrities and birth (hello Caroline in the City post from 2007!) but have since gotten sidetracked with other things.
But this was too good not to post! Erykah Badu, who has been a doula for years, is now training to become a midwife.
This is was the best part:
Badu, who provides all of her services for free, has since become a spokeswoman for the International Center for Traditional Childbearing and she is now aiming to get her professional certification so she can open birthing centres in inner cities in the future.
She reveals patients call her “Erykah Badoula” and insists “nothing gives me more pleasure” than assisting in anaesthesia-free births.
Erykah Badoula! Love it.
Via Toronto Sun
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Posted by radicaldoula
Yay!
The New York Times reported that although home births still represent a small majority of overall deliveries, by the 2008 numbers they are up 20% since 2004. I’m sure we will see an even bigger increase once we get 2011 numbers.
This demonstrates that people are really getting the message that there are safe and viable alternatives to hospital birth.
You can share your home birth story in their comments section.
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Posted by radicaldoula
I often use the example of bowel movements when talking about why it makes little sense that women are forced to labor on their backs. Imagine taking a s–t lying down?! I say for emphasis. (Gravity, of course, is the missing element).
Well this new short film from the folks at the Future of Birth demonstrates how that analogy goes even further.
“Failure to progress” is one of the more common reasons cited for c-sections. It’s a vague diagnosis, and one based on a time table for birth that is overly standardized and limited. Pressure to progress, coupled with hospital environments that don’t encourage relaxation (think lots of staff in and out, harsh lights and machinery) can have serious impacts on the labor itself.
I’ve seen this first hand with women whose labor is progressing fine at home, but once they get to the hospital, survive the intake process and are settled into a room, stop having contractions altogether. What follows is usually lots of interventions and often a c-section.
We need to challenge these practices and highlight how they themselves interrupt the flow and progression of birth.
I had the unique pleasure of interviewing midwife and birth activist Ina May Gaskin (via email) for my latest Colorlines feature.
Ina May graciously allowed me to post the full text of our interview since only a few snippets made it into the Colorlines piece. She had a lot of wisdom about this issue (not surprisingly!). It really is worth the read–Ina May displays a really comprehensive understanding of the issues facing women of color when it comes to out-of-hospital birth care.
Here’s Ina May:
RD: You mention briefly in Birth Matters that when obstetricians were trying to bring birth to the hospital (and learn how to care for birth), one doctor in Chicago paid immigrant women to give birth there. I’ve also understood that initially, particularly black women weren’t allowed access to hospital birth because of segregation/racism and class issues as well.
IM: That’s true. In general, low-income women in urban areas were initially brought into hospitals so that doctors in training could practice on them. That how they “paid” for their care.
RD: Can you tell me a little more about the history of particularly women of color in the US when it came to birthing in the hospital? Did they have a different experience than white women in terms of when they made the transition from home birth to hospital birth?
IM: Yes. For the most part, women of color who lived in the rural south didn’t go into the hospital until the 1970s and 80s. Alabama, Mississippi, Arkansas, Florida, and Georgia still had midwives who assisted women giving birth at home right through the 1970s. When doctors could count on Medicaid reimbursement for the first time, that situation quickly changed, and the midwives who were so needed before were forced to retire. Farther north, the pattern was somewhat different, because midwifery was outlawed in many states. Everyone was pushed into the hospital when this happened, regardless of the color of their skin. Women of color and poor white women were both used as teaching material in the teaching hospitals throughout the country. For this reason, the shift from home birth to hospital birth took place much earlier among urban women of color than it did for those in rural areas of the south.
5 Comments | birth, midwives, racism | Permalink
Posted by radicaldoula
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