While Canada is frequently touted as our more progressive and liberal neighbor to the north, things are not perfect for childbirth there either. The Society of Obstetricians and Gynecologists of Canada reports that more than 1 in 4 deliveries in Canada are c-sections.

“While the individual risk for a woman having a C-section is very small, the rising rate is certainly a concern,” society president Dr. Guylaine Lefebvre said in a release.

“We fear that there may be an emerging trend towards more scheduled childbirth and routine intervention. We need to be sure that C-sections are not driven by convenience, that interventions are medically indicated and that the safety of a woman and her baby are the driving factors in these decisions.

Between 1993 and 2006, Canada’s C-section rate grew to 26.3 per cent of all deliveries from 17.6 per cent. The increase is attributed an increase in the number of obese mothers, in which more pregnancy complications necessitating a C-section can arise, and older maternal ages.

Canada’s rate is still behind our 1 in 3 rate, but may not be far behind. They are also more supportive of midwives and out-of-hospital births.

Check out RH Reality Check on Monday for my feature on the myth of the elective c-section.

Thanks to Derek for the link!

From the ACLU’s blog, the Blog of Rights Symposium. Thanks to Nancy Goldstein for inviting to participate! In a related vein, I was recently on NPR’s Here and Now with Robin Young also talking about gay marriage. This was particularly fun, as it was me and a log cabin republican. You can listen to the show here, the segment begins five minutes in.

It’s official. Same sex couples can get married in California, as of 5 p.m. PST on Monday. While most people in the GLBT community are celebrating the decision, my excitement was rather muted. While I am touched by the stories of couples getting married after 50 years together, I know that marriage isn’t my golden ticket. Marriage isn’t my golden ticket unless I’m lucky enough (or even want) a long-term monogamous partnership. It isn’t my golden ticket unless I have a job or a partner with healthcare benefits. It isn’t my golden ticket unless I have an inheritance to worry about, or a pension to be concerned with.

Mattilda Bernstein Sycamore, a radical activist and writer has been one very vocal voice of dissent. From her piece at Alternet:

Gay marriage does nothing to address fundamental problems of inequality. What is needed is universal access to basic necessities like housing, health care, food, and the benefits now obtained through citizenship (like the right to stay in this country). Legalized gay marriage means only that certain people in a specific type of long-term, monogamous relationship sanctioned by a state contract might be able to access benefits. While marriage could confer inclusion under a spouse’s health-care policy, it does nothing to provide such a policy. Marriage might ensure hospital visitation rights, but not for anyone without a spouse. Marriage may allow for inheritance rights between spouses, but what if there is nothing to inherit?

While I would not go as far as Mattilda to say that I oppose the CA marriage decision, I agree with her that a movement so focused on marriage is not a movement that represents my activism and interests. She also makes the important point that marriage is not a cure-all. So many problems exist in our society that deserve our attention and it’s upsetting to me to see the majority of the resources of our movement being allocated to marriage-only fights. Social benefits should not only be afforded to those who enter into long-term romantic partnerships. I said as much on a recent segment of NPR’s Here and Now.

Thankfully there are groups and activists who are working for a broader vision of what marriage equality might look like. Queers for Economic Justice put out a Beyond Marriage statement in 2006, with pages of important sign-ons in support of their principles:

The current debate over marriage, same-sex and otherwise, ignores the needs and desires of so many in a nation where household diversity is the demographic norm. We seek to…diversify and democratize partnership and household recognition. We advocate the expansion of existing legal statuses, social services and benefits to support the needs of all our households.

As a queer Latina working in the reproductive justice movement, my vision of social justice focuses on putting the needs of the most marginalized members of our community at the center of our organizing. The current marriage-focused movement fails to do this. Issues like universal health care, immigration reform, comprehensive sex education, ending gender-based discrimination and violence are central to my activism and I would love to see a queer movement that reflected these values as well.

Unfortunately, this is not surprising.

Maternity care is a multi-billion dollar industry in the United States,” said Steff Hedenkamp, Communications Coordinator for The Big Push for Midwives. “So it’s no surprise to see the AMA join the American College of Obstetricians and Gynecologists in its ongoing fight to corner the market and ensure that the only midwives able to practice legally are hospital-based midwives forced to practice under physician control. I will say, though, that I’m shocked to learn that the AMA is taking this turf battle to the next level by setting the stage for outlawing home birth itself—a direct attack on those families who choose home birth, who could be subject to criminal prosecution if the AMA has its way.

The Big Push for Midwives has released this story (the above text is from their press release). What people tend to forget is that the American Medical Association is a professional association, not a scientific or medical (and therefore unbiased) organization.

It’s hard to see this as anything other a business ploy to further dominate (and secure) their place in the market. With how expensive childbirth is, it’s a lucrative market.  This mode of business-oriented thinking has dominated the attempt to push out midwives since the beginning of obstetrics. What’s missing here? Perhaps what is best for the mother? Just a thought.

I posted about this on feministing already, but I wanted to share my excitement with RD readers! A fabulous feminist sex shop is opening up in Brooklyn this week! Check it out online or in person. I’m been a big fan of this place for years and have serious fantasies about working there (or another feminist sex shop) someday.

I posted about this yesterday over at Feministing, and I wanted to link here in case you didn’t see it. There was some really good conversation in the comments, be sure to check it out.

An exerpt:

The American Psychiatric Association appointed members at the beginning of May to the Committee on Sexual and Gender Identity Disorders for the revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).

This committee will be reexamining the DSM-V, which is the manual of mental disorders that controls the diagnosis and treatment of gender and sexual difference. It was a big deal when homosexuality was declassified as a disorder, and some queer and trans activists are calling for gender identity dysphoria to be similarly declassified.

Since then, lots of people have been expressing their concern about two particular appointments: Ray Blanchard and Kenneth Zucker (who has been appointed as chair).

From Rea Carey, Acting Executive Director, National Gay and Lesbian Task Force

We are very concerned about these appointments. Kenneth Zucker and Ray Blanchard are clearly out of step with the occurring shift in how doctors and other health professionals think about transgender people and gender variance. It is extremely disappointing and disturbing that the APA appears to be failing in keeping up with the times when it comes to serving the needs of transgender adults and gender-variant children.

Read the rest of the post over at Feministing.

The event that I helped to organize was an apparent success! We had a good turn out, a got quite a few birthday wishes and we hopefully made good money for the DC Abortion Fund. Jill Morrison, from the National Women’s Law Center graciously put her comments into a blog post. She’s great. She spoke about the connections between abortion rights and birthing rights, and really brought it home with her discussion of two court cases (she is a lawyer, after all).

I am thrilled that the DC Abortion Fund is hosting an event to celebrate a book that enhances women’s ability to make pregnancy and birthing decisions.  Let’s face it, some don’t think that abortion supporters can be all rah-rah about the childbirth thing, but we really are. But this isn’t just because we think pregnant women are incredibly gorgeous and we’re the first in line to coochie-coo. It’s because we share common goals with those who support a woman’s pregnancy and birthing choices. Sometimes it is really difficult to make the connection between abortion, pregnancy and birth, but I think one case really brings home the point.

Read the full post here.

I finally did what I’ve been meaning to do for a long time now, I’ve edited the Radical Doula??? page. I’m going to repost it here, so you can all read my new description of what this blog is all about. Things haven’t changed radically, but I’ve tweaked a few things here and there to reflect the way I talk about what it means to be a radical doula (particularly from a personal perspective). The new page is after the jump!

I’ve also updated and expanded my blog roll. I decided I wanted something more comprehensive and that actually reflects what blogs I am reading on a frequent basis. (Thanks Google Reader!) You can see that I now have broken it up into categories (look to your right!). I will try to keep it updated, but bare with me. Also, if you have a blog you think I would want to read, email it to me or link to it in the comments! I promise I will check it out, and maybe you will even make it to my google reader.

It’s been more than a year (16 months almost!) since I started this blog. I decided it was time to revisit this page, and edit it to reflect my changing philosophy. Unsurprisingly, not a lot has changed since I wrote this page originally, but I wanted to make a few tweaks. As much as I cringed when I read this again, it’s a testament to the fact that our politics are frequently changing and developing.

So what the heck is a radical doula anyway? Good question. The answer to which is much of the reason I decided to start this blog. If you want to know more about how I started using the term, read this post.

But on to the more pressing issue at hand: what the hell am I talking about? Here are a few reasons why I identify as radical doula: (btw, I used to have a list of categories I identified with here, but that always made me cringe. Especially when it was read back to me! So here is something a little different)

1) I’m a doula who is pro-choice. Thanks to Lynn Paltrow at NAPW, I realized that not everyone in the birth community agrees with me on this. Read more about the connections here and here.

2) I’m a doula who is queer, and identifies as gender non-conforming or genderqueer. The birth world is dominated by women, many of whom don’t share my beliefs about gender construction and who use essentializing language when talking about birth and gender. I try to push those boundaries, and also think about how queer parents are affected by these issues in different ways.

3) I’m a doula and I’m Latina. My parents are Cuban immigrants, and being part of an immigrant community in the US is important to me. I also try to use my bilingualism and cultural competency to work with Latina women and think about how their needs might be different.

What I have come to realize is that this collection of politics/identities/ideas is kind of a surprising thing for other people who identify with some of these and not others. For example: some queer people and gender non-conformists might think its odd that I choose to work with women in labor (many of whom are straight and very female-identified). Other doulas would take issue with the fact that I am also an abortion rights advocate–quite a number of them are staunchly anti-choice. Same for the abortion advocates, many of them think birth activists are all earth-mama midwives who are super against them if they want an epidural. And the contradictions go on.

So came the impetus to begin this blog, as a space to bring many of these issues together, highlighting the connections and the contradictions.

Being a radical doula is also about wanting to expand doula services to women of many backgrounds. Unfortunately today the majority of women who receive doula care are women with resources, support and education about birth options. I call myself a radical doula because I want to dedicate my time to working with women who might not have access to these services otherwise. How do I think radical doulas can do this? By providing their services at a low cost or free (through volunteer programs) and also reaching out to immigrant communities, young women, women of color and incarcerated women. You can check out my Kick-Ass Radical Doula section to see how some doulas are doing this.

As I said last year, these defintions will continue to evolve, as this blog and my ideas do. Maybe this will be a yearly exercise, to reflect the changing philosophy behind radical doula. Thanks for being part of this ride with me! Special thanks to all you doulas, midwives and birth activists who also identify with radical doula. The best part of having this blog has been connecting with you all, and I hope that more of you will email me (radicaldoula@gmail.com) so I can share your stories as well.

Last updated May 30, 2008

While many of us spend a lot of time fighting against anti-abortion legislation, crazy lawmakers and their ballot initiatives, there is a whole other group of people pro-actively working to ensure women’s access to abortion–by providing them.

Last week I was at the National Coalition of Abortion Providers Conference (talking about abortion doulas) and Dr. Susan Wicklund spoke about her new book. Dr. Wicklund is an abortion provider living in Montana, and has written a touching memoir of her life as a provider. She lives in Bozeman, MT currently and wants to open up a new clinic (in an area with few options for women) but has run into a lot of hurdles. Building owners who won’t lease to her under pressure from anti-choice people mainly.

So to help Dr. Wicklund some of the attendees of the conference opened a paypal account in her name, to help her open her clinic (possibly by buying a building). Want to chip in? Email supportsuewicklund@gmail.com and ask for information about how to donate!

Cross-posted at Feministing

Hi everyone! I’m on a two week vacation (from my day job at least), in Seattle and San Fransisco. Hopefully it will give me some time to catch up on blogging, and make some much needed changes here at Radical Doula! Stay tuned for an overhaul of my blog roll, as well as my Radical Doula?!?! page revisited.

I’ve had this article in my drafts for a while, and while it’s a piece from last year that ran at Alternet.org I wanted to highlight it anyway.

In The Disturbing Truth About Doctors and Your Medical Safety Atul Gawande discusses the spread of disease in hospitals, partially caused by providers not washing their hands enough.

Each year, according to the U.S. Centers for Disease Control, two million Americans acquire an infection while they are in the hospital. Ninety thousand die of that infection. The hardest part of the infection-control team’s job, Yokoe says, is not coping with the variety of contagions they encounter or the panic that sometimes occurs among patients and staff. Instead, their greatest difficulty is getting clinicians like me to do the one thing that consistently halts the spread of infections: wash our hands.

Those of you who know anything about the history of obstetrics in the United States are probably familiar with puerperal fever, which was a major cause of death of pregnant women when birth was first brought into the hospital. (Side note: this is a great thing to bring up as a counter to the “but so many women used to die in childbirth before hospitals argument”) Basically, doctors at the time didn’t understand bacteria and how disease was spread. They also believed that hand washing wasn’t necessary for gentlemen. This meant that doctors went from birthing mother to birthing mother without washing their hands or using gloves, and passed infections between them.

Gawande touches on this in the piece:

This is, embarrassingly, nothing new: In 1847, at the age of twenty-eight, the Viennese obstetrician Ignac Semmelweis famously deduced that, by not washing their hands consistently or well enough, doctors were themselves to blame for childbed fever. Childbed fever, also known as puerperal fever, was the leading cause of maternal death in childbirth in the era before antibiotics (and before the recognition that germs are the agents of infectious disease). Out of three thousand mothers who delivered babies at the hospital where Semmelweis worked, six hundred or more died of the disease each year — a horrifying 20 percent maternal death rate. Of mothers delivering at home, only 1 percent died.

While issues of gentility and knowledge of disease spread are no longer to blame for these infections being passed in hospitals, getting hospital staff to wash their hands is still a huge challenge.

Our hospital’s statistics show what studies everywhere else have shown — that we doctors and nurses wash our hands one-third to one-half as often as we are supposed to.

Gawande further explains the challenges around getting providers to comply with hand washing standards, including time constraints, understaffing and skin irritation caused by too frequent washing. Add to that the fact that it is almost impossible to rid the skin of bacteria effectively and you’ve got a not-so-comforting equation.

What’s my point in sharing this? To me it’s just further evidence of why most childbirths should be kept out of hospitals. Why should women and newborns be exposed to possible infections and other hospital related ailments? I’d argue that we might have been better off at home. Hospitals are for sick people, and pregnant and birthing women are not sick. Let’s keep combating the “hospitals are the safest place for birth” myth.