Image courtesy of SQUAT Birth Journal
Home birth has gotten some play in a few blogs recently where it’s not really been seen before. Pharyngula (usually an interesting and thoughtful blogger) describes the “crazy kooky weird world of homebirthers — people who, just like anti-vaxxers and HIV denialists, refuse to recognize that modern medicine is actually incredibly powerful and useful, and have these bizarre myths about what is ‘natural.’” This description was based off the work of a singular other blogger, and many of the comments in support of his opinion reference the Wax study and/or the same other blogger.
Before that, though, there was a blog by Dr. Isis, in response to a Ms. Magazine article profiling The Feminist Hulk (who recently had a home birth). The post, entitled “Your Home Birth is Not a Feminist Statement,” was apparently a direct result of The Feminist Hulk’s description of her home birth. Dr. Isis quotes, in particularly, this portion of the interview:
Why did you decide to have a home birth? What were some of the challenges you faced in making that happen?
While I value the ways that obstetrical science has made birth safer for women with high-risk pregnancies, mine was a low-risk pregnancy and I was compelled by the many studies that show the midwifery model of care is as safe as hospital birth, often with fewer interventions and post-birth complications. Unfortunately, though Certified Nurse-Midwives legally practice in all 50 states, I gave birth in one of the handful of states which still does not license Certified Professional Midwives. I am active in attempts to push midwifery licensure through our state legislature. I still chose home birth, though, and am so lucky to have labored in an environment that made me feel relaxed and safe, with a birth team that gave me tons of love and support. And for anyone who asks, “What if something goes wrong?” all I have to say is, “Something did go wrong.” I suffered a postpartum hemorrhage and lost about a quart of blood. My birth team responded with speed and skill to stop the bleeding (and they would have transferred me to a hospital without hesitation if they encountered a complication that required additional resources). I owe them my life, and I have nothing but faith in the quality of their care.
From this, Dr. Isis responds,
“Home birth as a way to find a loving supportive environment and fight the enslavement of the patriarchy is absolute, utter nonsense. It’s one of the only medical scenarios I can think of where women place health and welfare in jeopardy in order to feel “in control” and avoid intervention.”
Now, I’m going to go ahead and confess that I had to read the post a few times to try and figure out how she got her comment out of The Feminist Hulk’s description of choosing a home birth. The Feminist Hulk had a low-risk pregnancy, did some research, and decided on a home birth, and CPMs are not legal where she is located…therefore she’s not a feminist? I was…confused. I continued to read, and only became more confused.
Dr. Isis evidently feels - based on the same “other blogger” as described above, and the Wax study - that home birth is, in fact, very very dangerous. Fair enough. I disagree with her characterization, and reliance on only those sources, but, hey, she’s a smart woman and can make her own decisions, right? And surely she’d agree, as a feminist, that other women can make their own educated decisions, right? Eh…instead she describes those who choose home birth as “dedicated to [their] own empowerment, for which she will judge you (and you probably aren’t coming out on her good side).
The problem here is that yet another person is conflating all women who choose home birth as wanting the best happy fluffy empowered birth experience. In fact, many women choose home birth (or a VBAC, or a breech vaginal birth) because they have consulted their chosen providers, researched, and have decided that their choice is best for them and their children - born or not. This may be due to physical reasons (such as a desire to not risk additional complications through a C-section), psychological reasons (such as trauma suffered previously in a hospital/birth center), or religious reasons. Some women choose home birth because they feel it’s their only option.
The confusing part for me is that Dr. Isis declares that women should birth in hospital because it is “the safest place to deliver” and “[i]f feminists care about empowering women during child birth, they should do so in an evidence-based manner” (which she describes as hospital birth). Now, while I can agree that home birth is not a feminist statement (I don’t necessarily think it’s a statement of any kind), I fail to see how feminism would mean all women birth in hospitals (even assuming that the generic statement “hospital is the safest place to deliver” is true).
Feminism (according to my trusty Wikipedia) is “a collection of movements aimed at defining, establishing, and defending equal political, economic, and social rights and equal opportunities for women.” Now, correct me if I’m wrong, but that doesn’t seem to say anything about making choices for other women either. Feminism means, at its crux, that a singular woman should be able to have the same rights at any other singular person (regardless of gender or sex) and should be able to make the decisions SHE feels are appropriate for her.
However, Dr. Isis seems to be describing a situation where women should all birth in hospitals, because someone has declared it safer. She says, “I can think of no other women’s health area – Pap screening, breast cancer treatment, HPV vaccination, in which forgoing a treatment shown to improve health outcomes would be flown on a feminist banner.” Except, there’s some confusion here. First, women who home birth are not “forgoing a treatment.” I would not dare speak for all home birthers (despite the willingness of others to do so), but many do not “forgo” treatment at all, but simply choose a different method of childbirth, as suits their risk level. I know many a home birth mother who has transferred before or during labor, or even after, as needed to their health and the health of their child/child-to-be - and many may receive a “treatment” while birthing at home. These women are not passing on other medical care altogether, but simply using it only when necessary. Do some women choose to forgo medical care? Yes, of course, as many people forgo treatment for cancer, annual Paps (either entirely or relying on them less than annually), or blood transfusions. This is not a choice that occurs only in home birth, and home birth is not, for many women, a choice to refute medical care; a significant portion of women who birth at home seek shadow/backup care from hospital or birth center providers throughout their pregnancy, in addition to their home birth provider, to make certain that they are healthy and prepared for the birth. There is a subset of home birthing women, of course, who eschew all medical care, and some who choose to birth entirely unassisted; but how is this different than a subset of atheists who deliver in a Catholic hospital, or Jehovah’s Witnesses who refuse some medical care? Those subsets, those groups, do not represent all women in the hospital, just as no one subset of women birthing at home can represent all the rest.
To state that this is, in fact, the case, denigrates women who researched widely, thought hard, and made a choice that they thought was right for them. The fact that she concludes by saying, “And if you still insist on a home birth, you should have to do it as it was truly intended to be done…” and linking to a Patton Oswalt video where he states that all those wanting a home birth should have to build their own birth hut and have nine children “because you know that five are going to die from rickets,” just drives home her contempt for women making choices other than that which she feels are best…as determined by a blog post and the Wax study (described by two bloggers).
In the midst of her rant against home birth, however, Dr. Isis does toss out something I think we can all agree with: “We should be continuing to ask how can we make women feel empowered in an environment that offers the best chance of survival for their offspring.” As a feminist, as an attorney, as an advocate, I think that choices are not a bad thing, and that women should have the choice to birth at home, or at a birth center, or at a hospital, as their needs and comfort level require. I think that as a part of this, each of these locations should be made a valid choice. Yes, this includes making home birth safer through integration of care and advances in education and treatment as appropriate. Yes, this includes creating more birth centers and increasing availabilty for women who wish to birth out-of-hospital but is not comfortable at home. Yes, this includes making hospital birth more comfortable and more supportive of autonomy. No one should be forced to birth at home, but no one should be forced to birth in hospital, either, even under “the feminist banner.”
What do you think? Is home birth a feminist statement? What about hospital birth, or induction and/or elective C-section? Is birth even a feminist issue at all?