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Monday
Sep122011

Feminism, what is it good for? Absolutely nothin'?!

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By ANaturalAdvocate 

 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?

 

 

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Reader Comments (45)

"Is birth even a feminist issue at all?"

Pretty much anything a woman does with her body, esp. her reproductive organs, is taken as a political statement these days, whether she wants it to be or not.

Autonomy, though, is most definitely a feminist statement, of the most basic kind.

September 12, 2011 | Unregistered Commenteremjaybee

It's both ridiculous and entirely predictable that people get their knickers in a twist over whether or not a woman's birth choices link with her politics. For some women, birth--in whatever way they do it--is a political act. For others, it isn't. However, even those who choose not to think about the politics of birth do give birth within a political context that includes feminism among a variety of other ideological perspectives, with both positive and negative effects. Anyway, I wrote about this once: http://bit.ly/ju5Hdy. I connect my choice/attempts to avoid over-medicalization of my births (I've had one c/s and one vaginal birth) with my feminism. I make no apologies for that.

September 12, 2011 | Unregistered CommenterAlisa

Yes, feminism is about choice; women can make whatever choices they deem best for themselves, regardless of society's view of what is "proper" for women. But that doesn't mean that every choice made by a woman is a feminist choice. It is not a feminist choice to wear a burqa; it is not a feminist choice to remove your daughter's clitoris with a dirty razor blade; and it is not a feminist choice to declare that you are subservient to your husband.

Just because a woman chooses homebirth does not mean it is a feminist choice, particularly because most women who choose homebirth lack a basic understanding of science, statistics and medicine. And that's primarily because of the anti-feminist belief that science and math are "too hard" for women. It's not a coincidence that the homebirth movement is led by women who either have no education in much of anything: Ricki Lake, Henci Goer and Ina May Gaskin, and certainly no education in science like Robbie Davis-Floyd, Sheila Kitzinger etc.

Choosing to study science is a feminist choice. Choosing to ignore science is not.

September 12, 2011 | Unregistered CommenterAmy Tuteur, MD

"researched widely, thought hard, and made a choice that they thought was right for them."

This sounds like the very definition of a woman taking control of her own life- whether she is Michele Duggar or the Feminist Hulk or something in between (and there are so many things in-between!) the point is that she doesn't simply acquiesce to whatever she's told to do. She thinks about it and makes her own choice.

I find it pretty amusing the range of belief systems that lead us to natural birth or home birth or any unusual birth choice. The point is that it's motivated by lots of things, but rarely is it simply a political, or feminist statement. It is a deeply personal choice, and women need to research widely and think hard about it.

September 12, 2011 | Unregistered CommenterChara

While I don't consider myself a feminist, it seems to me that homebirth could certainly be construed as a feminist issue. Certainly, the question of physical autonomy and the ability to make choices about one's body comes into play in both the feminist and homebirth movements. During labour with my first child, once we transferred to the hospital after a 36 hour attempt to homebirth with a midwife, I was not "allowed" to use the bathroom to urinate. I had all kinds of procedures "done to me" that I didn't want and were not medically necessary (e.g., and IV, which was only necessary because I was refused water--you know, "just in case" they needed to do a cesarean...) All in all, it was quite traumatic, as I lost all ability to make decisions about what would happen to my own body, all while being conscious and fully able to articulate what I did and did not want! Again, I'm not a feminist, but as far as I'm aware, women retaining autonomy over their bodies remains a part of the feminist agenda. And certainly a desire to maintain some agency in the birthing process, rather than being rendered a passive, bed-ridden patient was what motivated me to have a homebirth with my second daughter, as well as a desire to honour birth as the sacred thing it is, which was a perspective entirely absent to the medical practitioners involved in my hospital birth. I don't think feminism is a necessary component of homebirthing--treating birth as sacred and women as agents doesn't have to be feminist in my books--but the two movements certainly seem compatible to me.

September 12, 2011 | Unregistered CommenterMMB

This was a nice thoughtful post. I honestly don't think that the choice to birth at home should really be called a feminist choice. When a low-risk woman researches her options and chooses a home birth, viewing it as the best option for her and her baby in terms of health, it is a very human choice. It's not because she's feminist, it's because she's rational and cares for herself and her child. I'm a conservative Catholic woman, and therefore would not label myself as feminist in the modern sense of the word (I'm pro-life), and I chose a home birth. For me, it was because I trust my body and know from my research what is the safest and most comfortable choice for my child and for me. I think the reason this issue is one that people from many backgrounds and philosophies can agree on is precisely because it's not fundamentally a feminist issue (in the modern sense) - and the fact that feminist women can disagree so vehemently about it indicates the same thing. I have very conservative Catholic friends who disagree with me as well, and we're coming from the same background!

September 12, 2011 | Unregistered CommenterMCantu

I think the statement made previously by another poster that women who choose home births are not well versed in science, statistics or medicine is completely untrue. The women I know who have elected home births are all very well educated women who have often undertaken research of their own outside of labour and birthing as part of their professional lives. These women can read a study, understand their antenatal test results and have widely read about home birth. Some have concerns for statistics that link interventions with poor maternal/infant outcomes. Some just don't see the need to involve a hospital for pregnancy as they do not view themselves as sick or in need of aid. Most mothers want the best for their children and for many home birthing provides that environment. Statistics show more babies die in hospital than at home. Unfortunately some stats have been skewed over the years with miscarriages and terminations being lumped in to the 'out of hospital deaths' stats.

I don't believe the way a woman chooses to birth is political but it soon becomes that way when she needs to defend her choices. In no other realm do you have to defend what you choose to do with your body, the care you receive or when to terminate the professional relationship. No one shows up to their physiotherapist with a long list of why they feel they no longer need their input and no one is accused of selfishly fulfilling their own wishes if the no longer want to see their chiropractor but when it comes to child birth, it's everyone's business and if it doesn't fit the medical model then the woman is deemed irrational, selfish and reckless.

Unfortunately birth has become a feminist issue I believe. Not once has an obstetrician asked me about what I think, what I feel comfortable with or if I have any opinion on the diagnosis he may provide or the options for treatment. If I voice it anyway I will be deemed difficult and creating risk. You go to hospital if you are sick or broken. Unless you have a condition that impacts on your pregnancy and makes you sick or broken then why on earth would you go and be with other sick and broken people in a time when you need to be as healthy and as able as possible?

September 12, 2011 | Unregistered CommenterBianca

" The women I know who have elected home births are all very well educated women who have often undertaken research of their own outside of labour and birthing as part of their professional lives. "

Reading websites and books written by lay people is not "research." Research is reading the scientific literature, all of it, not just the stuff cited by homebirth advocates.

The American Academy of Pediatrics opposes homebirth as unsafe. Do you think they failed to do their research?

The ONLY people who think homebirth is as safe as hospital birth are homebirth advocates, no one else. There's a reason for that. The people that are extremely well versed in science, statistics and human physiology know that the scientific evidence shows that homebirth is not safe.

In my experience, most women who think they have done "research" have watched BOBB by Ricki Lake, who has absolutely no idea what she is talking about. They've read one or more books by Henci Goer who is considered an "expert" by no one other than herself and doesn't even have an advanced degree. They've read something by Ina May Gaskin who has no education in midwifery at all and let one of her own children die at a homebirth. That's not research; that's indoctrination.

September 12, 2011 | Unregistered CommenterAmy Tuteur, MD

Feminism is not just about "choice." It is about advocating for equality, for women to be treated as full human beings and not second class citizens. And even with regard to reproductive choice, it doesn't mean "anything goes," it means "women's safety and health must be foremost." While direct entry midwives and homebirth advocates may indeed feel "empowered" and like they are working for a feminist cause, I have trouble seeing anyone comfortable taking these kinds of egregious risks with women's health and lives as a true feminist:

http://oregonmidwifereviews.blogspot.com/2011/09/game-of-risk.html

The risk creep isn't about "women's choice." It's about midwives' egos. Just because midwives are women too most of the time does not make this a feminist statement.

September 12, 2011 | Unregistered CommenterAstraea

It's fascinating to me how in this area the goals of women who identify as feminist and those who adamantly *don't* overlap. But then, the desire to have a say in what happens to your own body doesn't require a political label to be embraced.

It's mystifying to me how hard it is for some people to understand that this is not about rejecting science, but about seizing autonomy from a profession that has repeatedly and viciously used the cover of science to perpetuate abusive practices. If doctors are feeling the heat from angry patients refusing to take their word as holy scripture, well, they have several decades of routine episiotomies, twilight sleep, and enforced lithotomy positions to blame.

September 12, 2011 | Unregistered Commenteremjaybee
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