Think Global, Birth Local

(editorial from the new issue of The Birth Project Issue VI Spring 2008)

This spring ACOG (American College of Obstetrics and Gynocology) released their updated statement on home birth (reprinted on pg. 12), generally reiterating that they oppose homebirth as well as individuals and organizations who offer or support such options for women and families. We have a few great articles responding to this ACOG statement. This statement is not supported by much of the research; in contrast, research shows that homebirth and freestanding birth centers are statistically safe and actually produce better outcomes overall.

Also this spring many meetings were held by home birth midwives and those who support them discussing The Big Push for Midwives (see pg. 26 for web link), debating the future of midwifery in the United States. Check out their website for more information about the issues around the legislating midwives. Some are in favor of this movement towards “legalization” and some are against it. There are members of the “medical” community opposed to anything that would support homebirth options but also within the homebirth community some see legislation not as progress but as restriction on their practice and how they are able to serve women and families.

What most people don’t realize is that in some states the right to make the decision to birth at home and birth centers have been taken away from women and families. As seen on Good Morning America on January 2008 unassisted homebirth is something that women are turning to when they cannot find a midwife to attend to them at home. Some also make the decision to have an unassisted homebirth in areas where midwives are available for personal or sometimes financial reasons since homebirth care is usually paid out of pocket. Like other women’s reproductive rights issues, we need to ask: should it be a case of choice, availability and safety? One would think...

On the internet many bloggers are also discussing/debating these hot birth topics and more. There is a buzz of something going on. We are talking about it too, here in The Birth Project.

Most think or assume that birth and birth culture is fine and dandy (more or less outside of the fear of pain that the majority of women have). Many times I end up having conversations about birth with expecting parents, in either doula consultations or in my childbirth education class, friends and family, or even sometimes strangers (although I don’t go out of my way to get on this topic with strangers, it just sometimes comes up). I can see it in their faces that they are realizing that birth, birth culture, birthing decisions, and birth politics are not fine and dandy. They are complicated, multi-layered, politically charged shades of gray, with the eye of the storm - mothers, babies and their families, usually unaware of the huge conflict spinning around them. There are issues- health care issues, human rights issues, women’s rights issues, safety issues, ethical issues, legal issues, psychological issues, emotional issues, physical issues, even environmental issues.
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One of the many books on my reading list this spring is actually not about birth. It is Animal, Vegetable, Miracle by Barbara Kingsolver. It makes a ”passionate case for putting the kitchen back at the center of family life and diversified farms at the center of the American diet”. This book speaks to the idea of eating local and seasonal to, among other things, reduce one’s carbon footprint. So what do agricultural sustainability, and carbon footprints have to do with birth politics you ask?

It is all about how we live and think. Like sustainable agriculture, birth is about business. If we eat more local and seasonal it causes economical issues for the businesses (corporate farms, trucking, packaging, etc.) and employees of those businesses that grow and transport food all over the world. On the flip side local farmers, markets, dairies etc. would be more supported. If more women birth at home or in birth centers a large portion of hospital revenue will take a economical hit along with the companies that make and distribute much of the equipment used at hospital births as well as the income of the doctors that do deliveries in the hospitals. Again on the flip side community midwives would be supported and if the demand were higher for these birth settings momentum could be made for insurance coverage and more accessibility for all who seek alternative birth options, potentially reducing insurance premiums. The waste byproduct from the equipment and apparati at hospital births is many times that of home and birth centers. So again, it is also an environmental issue - reducing the human carbon footprint.

On this beautiful spring-y day (finally!) I ask you to open your mind to the big picture. Think big and also with empathy for the whole picture on both sides. The only way we can hope to move forward is to work together (see the well written open letter to ACOG on page 13). I also ask you to incorporate this kind of thinking to other aspects of your life - how you eat, if you recycle, speak of politics, how you parent, and so on.

Act with thought and empathy for all.

We are dedicating this issue to midwives since May 5th is National Midwife Day. If you have had a midwife in your life and feel so inclined, send her a letter of appreciation this May. It is hard, amazing work that these women take on ~ send them some love to help get through that next sleepless night. The month of May is also International Doula month so send them warm fuzzies too.