More good news on the midwifery front, this time from Wyoming!
A bill was signed into law there on March 5th, legalizing the practice of Certified Professional Midwives. CPMs are midwives that are trained to practice in homes or birth centers. They are an essential player in out of hospital birth access.
Yay Wyoming!
According to the Big Push, Nevada is now the only state in Western US that does not allow CPMs to practice.
Great news from Mississippi. The bill that had passed the House there and was headed to the Senate was defeated.
Woot!
For background on the bill go here, and thanks to everyone who took action.
Basically, the bill that has passed the Mississippi State House would outlaw the practice of any midwives that aren’t nurses.
There are many ways to learn midwifery, including the excellent programs completed by CPMs, which include traditional schooling as well as apprenticeship.
We need MORE midwives in this country, not less.
If you live in Mississippi, the Big Push for Midwives has details about what you can do to stop this bill from passing.
I’m speaking at a great event next week in NYC, at Barnard College. If you are in NYC, you should check it out.
It’s a panel with Mary and Lauren, the two other co-founders of the Doula Project (and current coordinators!) as well as Aishia Domingue from the Brooklyn Young Mother’s Collective. It’s going to be an interesting conversation.
Reproductive Justice in Action
Aisha Domingue, Mary Mahoney, Lauren Mitchell, and Miriam Pérez
Panel Discussion:
Wednesday, 3/3, 6:30 pm
Sulzberger Parlor, 3rd Floor Barnard HallThis panel will feature a group of reproductive justice activists and birth doulas who work across the spectrum of pregnancy, birth, and women’s health, connecting the traditional reproductive rights movement with new social justice activism that considers the complete physical, political, and economic well-being of girls and women. Birth doulas, as trained sources of physical, emotional, and educational support, work to empower women and support their reproductive choices. How does childbirth fit into the discussion around reproductive rights, a discussion that is often based around access to abortion and contraception? How can the reproductive justice framework help us consider institutional barriers, such as racism and poverty, that have limited women’s empowerment and decision-making when it comes to their reproductive health?
I’m also speaking at a couple of other places in the next few weeks, including Smith College, University of Iowa and University of Minnesota. Check out the details here, and if you’re interested in bringing me to speak email me.
My newest article is up at RH Reality Check. This time I took on a topic I knew very little about. What I discovered is that surrogacy is extremely complicated–morally, ethically and legally. It’s also not being worked on by very many reproductive justice organizations, and should really get more of our attention. It is the concern of some right-wing conservatives though, and they are having an influence on how surrogacy court cases are playing out.
Surrogacy is a complicated subject, to say the least. It involves many of the issues central to reproductive justice—bodily autonomy, a woman’s right to abortion, definitions of parenthood, and custody of children. It’s also an option increasingly relied upon by gay couples—usually gay men—to create families. It invariably brings up concerns about racial and economic justice when the majority of surrogates are low-income and many are women of color. It’s an issue on which few reproductive rights and justice groups are currently working but one that deserves our close attention.
A recent and closely-watched ruling on surrogacy by New Jersey Superior Court Judge Francis Schultz contributed to the hazy patchwork of court cases and legal precedence that guides how surrogacy is now dealt with in the United States.
The U.S. is one of the few countries worldwide to have neither federal laws nor federal legal precedent restricting surrogacy, making the ease of surrogacy arrangments relatively attractive for couples who can not bear children. But the landscape is mixed. Some states’ laws and legal precedence completely contradict those of other states. What has resulted is an entirely unregulated surrogacy industry, with the majority of activity occurring in the few extremely permissive states.
Go check out the rest here.
Just wanted to post a quick link to a great interview with doula and director of the film Orgasmic Birth: The Best Kept Secret, Debra Pascali-Bonaro.
It doesn’t get much more radical than the idea of orgasmic birth.
Read the interview at Stand and Deliver, check out their website, and you can even pre-order the book written the film creators.
A new investigative report released by California Watch reports that maternal mortality rates in California have seen a spike in recent years, almost tripling in the last ten years.
To me, there is one clear cause of this kind of increase, and that’s the c-section rate, which according to California Watch have increased 50% in the same decade in CA.
The World Health Organization recommends a c-section rate of about 10%. We currently have a national average of 30%. In some hospitals it’s as high as 90%.
C-sections are major abdominal surgery. There are risks involved, and with so many c-sections, you’re going to start having deaths as a result.
We need less c-sections. Period.
The other thing this report revealed was that there was significant increase in maternal mortality among non-Hispanic whites, a group traditionally excluded from maternal mortality and low infant birth weights. Well again, this is probably because of the c-section rates, which might even be higher among this group than women of color.
The idea that increases in technology use could actually harm women, rather than help them, is impossible to believe for the OB-GYN community:
When researchers unveiled their initial findings to a conference of the American College of Obstetricians and Gynecologists in 2007, there were gasps from the audience, according to participants at the San Diego event. The idea that California was moving backward even in an era of high-tech birthing was implausible to some.
This is exactly the point. Overusing technology it’s just as harmful as under-utilizing it. The bottom line is that OB-GYNs are trained as surgeons, and their dominance of maternity care is proof of that–they are performing more and more surgeries than ever.
We need practitioners who are trained to care for women birthing without technology, namely midwives. Technology has a role, but it should be the exception not the rule. And let’s be clear here. It’s not just c-sections that are to blame. It’s also increasing induction rates, epidurals and other medical interventions that disrupt the process and are more likely to cause interventions.
“For every maternal death, there are 10 near misses; for every near miss, there are 10 severe morbidity cases (such as hysterectomy, hemorrhage, or infection), and for every severe morbidity case, there is another 10 morbidity cases related to childbirth,” Camacho wrote in an e-mail.
There is a great article up at RH Reality Check, written by Mary Mahoney, one of the founders of The Doula Project. I’ve written about the NYC-based Doula Project before, and am honored to have been one of the founders.
All the credit for what the project has become goes to co-founders Mary and Lauren, who took some very early stage ideas about providing doula care to folks having abortions and turned it into this amazing project which supports people throughout all stages of reproductive life, including abortion, fetal anomalies, miscarriages, adoption and birth.
I think this project takes doula care to its natural end–we’re there to support pregnant folks, through any and all decisions.
The Doula Project has served over 500 pregnant people since the fall of 2008, guided by the mission of providing free compassionate care and emotional, physical and informational support to people facing birth, abortion, fetal anomaly, or miscarriage. The foundation of our project is built on meeting pregnant people where they are, something I’ve taken with me from working four years in the reproductive justice movement. This connects to our belief that pregnant people should be trusted to make the choices that are best for them and that their experiences and the memories of those experiences should be honored.
Doulas hold a unique position in health care as non-medical lay people who are there solely for the pregnant person. The birth doula movement has certainly grown over the past few years, and innovative and radical projects have expanded care for pregnant people who might otherwise not receive it, such as young mothers and women in prison. During this time, The Doula Project has been building on a new model of doula care: one that supports pregnant people having abortions and choosing adoption.
Read the whole article here and check out the Doula Project here.
UPDATE: There is another great article about the Doula Project in the Brooklyn Link.
UPDATE (Jan 13): Via the ACLU’s blog posted at RH Reality Check and Feministing, the State of Florida yesterday argued that forcing Burton to bed rest was just maintaining the “status quo.” Ugh.
Via a press release from the ACLU (which I can’t find on their website), a woman who was forced via court order to hospital confinement during her pregnancy’s case was heard yesterday in a Florida court.
Samantha Burton who was confined to a hospital bed, against her will, after disagreeing with her doctor’s recommendations for treating pregnancy complications last year.
In March 2009, the Circuit Court of Leon County ordered Ms. Burton – a pregnant mother of two – to be indefinitely confined to Tallahassee Memorial Hospital and forced to undergo any and all medical treatments deemed necessary to save her fetus. After three days of state-compelled hospitalization, Ms. Burton miscarried and was released from the hospital.
In August 2009, Ms. Burton asked the court to overturn the lower court’s decision to compel her to undergo medical treatment, stating that her rights had been violated.
It’s pretty scary stuff when a court can force you into hospitalization based on the idea that they are protecting your fetus.
Jill at Unnecessarean wrote about this case in August. In her post, she explains that Burton actually had a forced c-section during the time of her hospitalization, which is when they realized that she had miscarried. The statement above doesn’t include that fact, but it’s in the brief filed by the ACLU.
The language the court used is pretty damn scary:
At the State’s request, the Circuit Court, Leon County, ordered Ms. Burton to be indefinitely confined, which had her pregnancy gone to term would have been up to fifteen weeks, to Tallahassee Memorial Hospital and to submit, against her will, to any and all medical treatments, restrictions to bed rest, and other interventions, including cesarean section delivery, that in the words of the court, “the unborn child’s attending physician,” deemed necessary to “preserve the life and health of Samantha Burton’s unborn child.”
I’ll update when I hear about the results of the case.
Thanks to Lynn Paltrow for the heads up
There is an article in the UK newspaper the Telegraph, about Sheila Kitzinger, and her thoughts about a new UK plan to ensure all women have choice when it comes to where they give birth. From a US perspective, the plan is pretty radical. The choice includes home birth, a birth center attended by midwives and a traditional hospital setting.
Kitzinger supports the plan, but criticizes the language of choice:
“Choice comes from the language of advertising – it is what happens in supermarkets,” she said. “The idea is one of free choice but in fact the products at eye level are displayed to have the greatest impact on the consumer; it is the same with maternity.”
“Childbirth experts are often blamed for raising women’s expectations but I think you have to look further. I think the problem is a consumerist agenda. We are geared up to competition, to test everything; nowadays, we see birth as a performance,” she said.
Sound familiar to anyone?
Reproductive justice activists have long critiqued the reproductive rights movement for using the consumer based “choice” framework. They argue that not everyone has the same “choice” largely due to social and economic factors.
Moving from choice to justice has been a way to move the reproductive rights framework to a broader philosophy that incorporates the reality that many women do not have a choice–and their socio-economic situation, their race, their religion, etc don’t allow them to make these decisions.
One of the reasons “choice” is so popular, though, is that it removes judgment. If I say I am pro-choice, I’m not saying I like abortion or promote it, but that I value the right of every individual to decide. Same thing with birth. If the UK government supports every woman having a choice, they are not saying that homebirth is good, or hospital birth bad, but that every person should be able to decide.
But “choice” still ignores that there are factors that influence us, often that we don’t have control over. Those factors could be doctor’s opinions, family pressures, economic circumstances, access issues, cultural barriers. This is another place where the reproductive justice and birth activist movements find commonality–“choice” isn’t working too well for either movement.
Reproductive rights folks have latched onto “justice” as a frame instead. Reproductive justice works toward a world where all people have the resources and support they need to make decisions about family creation. I think birth activism fits neatly into that framework, which is part of the reason I write about how these issues overlap.
Radical Doula 