Why Ina May is not my hero

I was in a conversation yesterday that reminded me of this. There’s so much cultural appropriation in the birth worker world.

Rocking the Birth Dogma Boat

Again, because history left unaddressed becomes the present:

There’s a lot of mythology to midwifery, and not just in sense of herbal medicine and holding the space, though those stereotypes are present, too.  Most of our mythology involves our history, and I am about to attack one of our giants, Ina May Gaskin. Ina May is a poster grandmother, if not a poster child, a white hippy who founded a back to the land commune in Tennessee in the 1970s, The Farm.  Ina May began doing births for the women of the farm, with very little training, teaching herself midwifery by reading obstetrics textbooks, and opening a birth center that women flocked to, avoiding the more restrictive hospital conditions of the day.  Ina May is often credited with founding, or at least re-discovering U.S. midwifery, but the truth is that midwifery was here all along, it just was not White.

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Reproductive Justice

Rights versus Justice

I’m sad this article didn’t come across my digital desk until just now because it is a brilliant piece that calls out structural racism within the reproductive rights movement, takes a hard swing at the criminalization of pregnancy, and asks some serious questions about the motives of a movement that frames family planning and birth control as social goods only if they ally with political priorities of those pushing the agenda. 

In this article, Dr. Dorothy Roberts, Reproductive Justice Scholar, Professor at UPenn, and author of Killing the Black Body: Race, Reproductive, and the Meaning of Liberty, gives a great introduction to Reproductive Justice.  (If you’ve got the time, Roberts’ article has a link to best-selling author Katha Pollitt’s rebuttal, which offers some good points about reproductive rights movement).

Roberts outlines many of the underlying difference between reproductive rights and reproductive justice.  For many, rights and justice sound the same. But often, as Roberts points out, when platforms call for extending rights, the value of those rights is only measured by how much they are worth to other people (e.g. birth control is good because it saves money on welfare, etc).  This market value conception of rights is especially damaging for historically marginalized and persecuted groups.  If you do not have the resources to access a “choice” then you don’t have a choice.  And the commodification of these rights limits their availability to anyone not accessing them for the “right” reasons. It is here when the notion of reproductive rights as we understand them, fail to produce justice. 

When the richest country in the world has the worst maternal mortality rates of any industrialized nation, and those health disparities are more likely to be fatal to black women (all women of color are at higher risk, but black women bear much more of the burden), the liberal notion of individual rights is not enough.  It is not an individual problem that could be solved with more access to particular goods and services, reproductive injustice is a wide-scale socially and politically constructed problem that requires a wide-scale politically and socially conscious solution.

Looking through the reproductive justice frame takes in the whole field, while reproductive rights takes a specific chunk and works to repair it.  Ultimately the two movements have similar goals and should work together to achieve them, but reproductive rights does not go far enough to get reproductive justice.
Birth, Birth Trauma, Obstetric Violence, Reproductive Justice

Today’s Take

In a great article in Psychology Today, Dr. Alana Siegel discusses the important issue of Post Traumatic Stress as a result of traumatic child birth.

For most people the term “birth trauma” brings to mind trauma to babies, but the Reproductive Justice Movement is helping to raise awareness of an insidious form of trauma that happens with great frequency: obstetric violence.  This violence, in the form of psychological coercion (“I’ll call child service and take your baby if you don’t consent”), to verbal insults, to physical assault, is far too common in the American Maternity care system.

While well-meaning people respond to stories of birth trauma with “well, a healthy baby is all that matters,” Dr. Siegel’s article cuts to the heart of the problem: a healthy baby is great, but it isn’t all that matters.  When mom’s not health, the family isn’t healthy.

PTSD related to child birth has short term negative outcomes such as an increase in post-partum depression, a decrease in mother-child bonding, and a (often) decrease in breast feeding.  Long term consequences include women being unable (from physical trauma) or unwilling (from psychological trauma) to have more children.

Understanding that these things happen, and that they happen frequently, is the first step in stopping them.  Most mothers, babies, and families depend on the maternity care industry, and its time the industry provided that care in a responsible and respectful way.

Birth, Reproductive Justice

Today’s Take

Thanks to Olga Khazan for this well-sourced and important piece!

Her article in the Atlantic brings up a great point about insurance companies.  Rising deductibles are making birth even more expensive and saddling families with debt from day 1. (My daughter and I were each charged our full $2000 copay for her birth. With good insurance, my 2 day old got a bill. 😮)

Around the world, birth is free (in places with better outcomes than the US, so they’re not sacrificing on quality).

Interestingly,certified nurse midwives have better mother and child outcomes in hospitals and are much cheaper for insurance companies and families. But they’re the first on the chopping block when hospitals are losing money (which is also when c sections rates increase, especially when insurance companies reimburse cesareans at higher rates).

This is bad policy that’s hurting families.

I’m working now on a dataset the includes insurance policies and economic barriers to equal birth access.




The B(irth) Word

I’m a researcher and PhD student at the University of Massachusetts.  I study public law and the social determinants of health, particularly the ways in which laws and policy contribute to disparate birth outcomes.

Don’t think birth has anything to do with politics? Let me bend your ear for a minute as we talk about the other B word.

Check out my blog for links to my thoughts and research and work from other great researcher.