Happy Mother’s Day: On Choice and Childbirth in the U.S.

I’m writing this Mother’s Day post through a fog of a nasty sickness, so I can’t guarantee it will be as polished as I intend. My hope is that it will make a modicum of sense! I am here on this day to write about the issue of childbirth, choice, maternal healthcare and the violations that are rampant in the U.S. regarding all of these things. I want to open the conversation up about an aspect of women’s choice that I have not heard discussed even once in mainstream feminist circles: The choices that women should have to decide how and where they want to have their babies.

Yesterday, with my throat too sore and my brain to busy to sleep, but my body too sick and tired to do much of anything I came across the documentary “Pregnant in America: A Nation’s Miscarriage” on netflix, available for instant view. Despite the fact that the average childbearing age in the U.S. is 29.4 years old, and I am a mere 25 years old, I can think of a dozen women around my age who are my good friends who have kids (many of them have more than 1 by now) or are pregnant. And that is just off the top of my head! “Why the heck not, I thought. This will be illuminating if nothing else,” so I watched it. And mind = blown, a little bit.

The thesis of the film is, essentially, that there is a huge problem in the U.S. regarding women’s healthcare and childbirth. Childbirth has become medicalized in the past century, which means birth has moved from homes into hospitals and has moved from the sole purview of midwives to come under the jurisdiction of doctors. I don’t have energy or enough clear brain cells right now to explain all the nuances of this shift and why it has disadvantaged women, or to list some of the benefits of this shift. All I can say is this: It is more dangerous to give birth in the U.S. than it is in any developed country in the world. We spend more money on health care and prenatal care for women than any country in the whole world, and yet have dismal rates of maternal health, c-section, and women who have complications from childbirth. How does this make sense?

Well, it doesn’t actually make sense, and you should really watch the documentary because even though it has some quirks and problems in its presentation* there are so many excellent interviews with experts on pregnancy and childbirth both in and outside of America. I would recommend this film for anyone who wants a basic survey of how difficult it is to give birth on your own terms in the U.S., how it has gotten more difficult over time, and how many mothers are experiencing this defining experience of their lives on the terms of the doctors who seek convenience and control rather than on the terms of their bodies, and their desires.

For me, this film wasn’t my first exposure to these issues. I am part of an online message board community that has been around and kicking for over ten years now. It is small (there are maybe 50 active members), but vibrant, and has a good amount of young mothers on it. It was in this space that I first came across the questions and issues that come up during pregnancy. These include the following: how to deal with doctors that want you to take pitocin (a drug used to induce labor that has some horrible side effects); how to deal with forced, unwanted and sometimes unnecessary c-sections; the difficulties that are involved in advocating for yourself before, during and after labor and delivery; questions about risks of epidurals; the legality of home-births, and a host of other issues. These are all issues that the film covers, but issues I also personally have names and faces to put to, which for me made the commentary of the experts so much more powerful. I have also learned through watching my friends talk about their births that the experience of childbirth doesn’t end when the baby is in your arms, especially if you had a negative experience. The effects of traumatic childbirth can echo for a very long time, and can affect the relationship between mother and baby in ways that neither of them want or deserve.

So yes, there are so many issues regarding what choices women have, and how women need to have more choices, more education, more access to quality healthcare but also access to healthcare that will work on their behalves and not just the behalf of doctors who want a convenient schedule or insurance companies that want to make more money. This kind of healthcare barely exists in the U.S. I’m not here to be fully anti-medicine or anti-hospitals. I’m not pregnant: I can’t say what is best or what is necessary. But if I have learned anything from this film and my friends, it is that doctors can be patronizing bullies who have their interests rather than the health and well being of the mother in mind. This quote from the film sums up my perspective:

“Thank goodness for C-sections. Thank goodness for technology. Once in awhile there is a reason to have an epidural to lower a woman’s blood pressure if it is too high. Or to use pitocin to get a labor started that has been stalled because a woman is tired and so is her uterus. Thank goodness for all of this stuff. But, in countries where they don’t use it just as a normal management of labor technique or protocol they have much better statistics, much better outcomes and we can learn from that. We should learn from that.”

I would like to add “thank goodness for community” to this post as well, because I have been so inspired watching the mothers in my message board community help empower each other, talk through strategies regarding advocating for themselves with doctors, processing through painful emotions, and celebrating the victories and miraculous experience of childbirth together. They inspire me so much, even though only a few of them would even consider identifying as a feminist. They are engaged in feminist consciousness raising and community empowerment every single time they open their mouths.

I want to end this really all-over-the place post (I’m so sorry I can’t make a more smashing and coherent argument!) with a quote from one of favorite people and a dear feminist friend of mine, who is currently pregnant with her second child. I wrote to her yesterday when I was thinking about this post, and here is what she wrote back:

“This is one of those subjects that just makes me feel so sick inside.  Not so much the landscape of pregnancy and birth and infant care in America- there are so many good people doing so many amazing things that I can’t help but be heartened and glad.  What upsets me is when ‘pro-choice’ becomes ‘anti-motherhood’ and feminists focus on making abortion accessible rather than taking on the larger task of making healthy birth and fulfilling motherhood a possibility for all women who choose it.  It makes me so sick.  And not because I hate abortion so much, but because I love motherhood so much.  And I feel so abandoned by mainstream feminism as a mother.  I hate that.  I really do.”

I hate that too, more than I can say. I don’t think “pro-choice” needs to be dichotomized into working for abortion OR working for mothers. If we take on one, I think we need to take on the other. Every person with a uterus is affected by this matter of choice in so many innumerable, unjust and abusive ways. Thus, I think it is really time for us to directly take on childbirth and maternal health as part of our feminist politics in a more outspoken way than we have done so far.

Happy Mother’s day everyone.


*It is a very white film, and though there are a few women of color present at times, it revolves around the white perspective; it is narrated from the perspective of a man rather than his pregnant wife herself (their story line felt kind of voyeuristic in moments); it doesn’t take on issues of class and choice. Steve, who makes the film, is just obnoxious and a bit melodramatic and I could have done without him for most of the film, honestly. But it was still worth it! Hear me say that!

2 thoughts on “Happy Mother’s Day: On Choice and Childbirth in the U.S.

  1. mmmmm. this is good, katrina. thank you for writing it. and amen to whomever of your friends wrote that quote toward the end – well said. thanks for furthering the conversation; it’s an important one.
    after every appointment with my homebirth midwives, i feel so refreshed and hopeful. it’s a model of care that is utterly unlike anything you’d get from an MD/hospital, and it’s affirming, empowering, personal, and womanly. i hope there’ll be a day when homebirth midwife care is a real option for all women.

  2. Great article. I think if and when Lisa (my wife) and I decide to try to have children (if we don’t just adopt) we’ll try as hard as possible to have a midwife.

    US Healthcare in itself is pretty broken. Most Hospitalist MDs are productivity-paid employees and hospital administrators always push the staff to meet the bottom line. Unfortunately that means shorter stays, more medicines and tests, and ultimately a quick, jarring, and sometimes painful and scarring experience for the patient.

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