Rocking the Birth Dogma Boat

How did this happen?

August 16, 2011
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As one of my friends said recently, how is it that we live in a culture where words like birth trauma are so common, yet we measure a woman by how she gives birth? How did we get started throwing women into a hostile system, and then judging them by whether or not they sink, how fast they hit bottom? Why does the natural birth community, with its rhetoric of Empowering Women To Make Good Choices For Themselves not see the injustice in this?

I think it is part naivety, and part control.  Naivety that the system is good because the individuals in it are good, or that if we do good, we will be rewarded, measure by measure, false hope that life is like a predictable machine where input translates exactly to output.  Admitting that an institutional foundational to our culture is built on disregard for half the population would rock lots of boats, and, as I can attest, no one likes a boat rocker.  We cling to our naivety, our desire to believe that the foundations of medicine (and therefore the foundation of our culture) do not include un-anesthetized experiments on enslaved women, racism driving midwives out of practice, the belief that women should not learn to read because brain activity will make them infertile, and a woman’s worth is the same as her childbearing, historical abuse after historical abuse…We like ourselves better when we are naive about this aspect of our past, when we choose to ignore its legacy.  (More about this later, the legacies that follow me around everywhere I go.)

And part control, the idea that if an individual makes good choices and Empowers Herself (whatever that means, exactly), she will have control, not just over the unstoppable and elemental forces of birth, but over a system that trains people to view her body as broken, to the point that her baby’s life is in danger the whole time it is inside her.  If an individual becomes a casualty of a system that views women’s bodies first and foremost as revenue streams, and it’s because she made a bad choice, well, it sucks for her, but the rest of us are still in control, in that we can choose something different.  And this is simply not true, as choice implies access, choice implies that we grew up in a culture supportive of women, grew up with the opportunity to believe in ourselves.  And it implies that the systems we have created have not gotten away from us, growing out of control despite good intentions.

Birth will always beyond our control, but we create the system, and we choose to avoid history.

We are so afraid, afraid to give up control, afraid to define women as more than birth and judge them by more than their choices in a hostile system, afraid to look at history because we might see ourselves.  And fear is overwhelming, and I am still asking us to fight through it…

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August 15, 2011

I learned to be a woman by scurrying around bringing full plates of food to old men, who did not look up at me.  These are men like my grandpa, men who think coffee comes from women, not from a package, a store or a kitchen, and that women are as ubiquitous and interchangeable as coffee mugs.  But still.  A good woman scurries around, feeding these men, cleaning up after them, making their lives comfortable as they fall asleep at the table, eating later, if there is enough, once they are all fed.  These men are a strong presence in my head, and my life has a lot of scurrying to it, fed by the knowledge that the men are always hungry, though they don’t say it, and ungrateful, and I will never be enough until every last plate is full, at which point I will do the dishes.  But I will never be enough.  Which leads to more scurrying, trying to be more, trying to keep my mind off the inequity.

It was these men in my head who led me to be a midwife, a strong woman who struggles uphill to feed women in a broken system, to make it somehow ok through endless nights putting plates on tables, feeding a system that does not look up at me, perpetuating the very beliefs that keep me scurrying around trying to be enough, keep me distracted from the powerful truth of my own completeness.

After days at a time at births, trying desperately to fill all the plates, I come home finally, exhausted, and think I should do the dishes.  And at births when I fought the system and I didn’t win, as often happens when you go out on a limb in the hostile and profit-driven world of maternity care, the men in my head look up for once, look at me with pleading eyes, as if they are noticing me for the first time and judging me inadequate, and so I stay awake to keep fighting the good fight, a little more discouraged each time.  The natural birth world finds it’s footing in the idea that birth is a pinnacle experience, that good women deserve good births and so to be a good woman, you must give birth a certain way, that your birth defines you, is your one chance to get being a woman right, despite the uphill battle and the hostile system, despite the fight.  This makes the hungry eyes hungrier, and the plates emptier, and I try so hard to fill the plates, ignoring my exhaustion, carrying trays while my back gives out and tears stream down my face and I am so tired I forget my own name, forget why I am here, forget where I live and where I come from. I become disposable in my quest to fill the plates.

I grew up with strong women who laughed in the kitchen as we chopped onions and arranged the food just so on the serving platters.  They loved me, and taught me to listen through the kitchen door for the punchline to their jokes as they sent me to the table with full platters, to put my hand on my sister’s back as she did the dishes I brought her, to draw out the telling of a story so that we laughed a little longer as we scrubbed.  I learned to love the company of women, and to be defined by it.  In the kitchen, we were good women, we got being women right just by laughing together.  We scurried, but we were not disposable, and I became the kind of woman who loves women, who will fight for women, who will go out on a limb for the idea that women have inherent worth, even when my knowledge of my own worth is obscured by the scurry, by the hungry eyes, by trying to be enough in a system that has no place for complete women, that would lose money if women were whole.

Midwifery talks a good game, purports to hold women  front and center, purports to value women inherently.  And we had such good intentions when we created this model,  putting the pregnant woman front and center, scurrying around to feed her, to fill her plate over and over so that she feels valued.  Trying to gain credibility, we have made birth into the central event of a woman’s life, the one day she better get right, and we have to help her get right, for her to be a good woman.  We defined pregnancy as central to womanhood, the most womanly expression possible, and hoped that if women were honored in pregnancy, it would somehow trickle over into the rest of life. But there are so many ways of being a woman, so much more than birth, and, in our scurry to get birth right, we have forgotten about women’s inherent worth on every other day of their lives, and our own inherent worth on every day of our lives.  We have made birth into a sacred alter, an endless table; we have made pregnant women into old men sitting at tables, old men who don’t know how to make coffee and don’t know how to ask.  And in doing so, we have made ourselves disposable, without the kitchen full of laughter and women who love us as they chop the onions.

As a midwife, the model I work in tells me that I am a better midwife the more I give, the more I scurry around denying myself and my own worth, in service to “women”, though increasingly really just the midwifery model.  And it breaks down here: I am also a woman.  Birth is not everything.  It is miraculous, as miraculous as the way my grandmother used to arrange food on serving platters, just so, as miraculous as my hand on my sister’s back as I bring her more dishes to wash, as her smile looking up at me with her hands submerged in sudsy water.  But the idea that birth is everything, and I should scurry around serving it, as women don’t look up, well, it does not sit well with the part of me who learned to draw out a story as the women around me laughed.  It does not sit well with the part of me that loves the companionship of women, and knows that deep down, pregnant women know that they were women before they were pregnant, and have worth past their pregnancy.  When all the dishes are done, when I can look up from the old men who are always in my head, demanding that I be more, I realize that switching around who is sitting in what role does not make the roles any less harmful, any more feminist.

Throughout my whole career, I have been told, and sometimes believed, that midwifery is a solution to a broken maternity care system, to a world that does not value women, and that midwifery as a concept is should be fought for. I challenge this.  I applaud our good intentions, but I want more than a changing of who is occupying harmful roles.  I want the roles themselves to change.  Somehow, fighting for a model has replaced fighting for women, and really for the idea that  coffee comes from packages and the plates could go empty and we would still have inherent worth, that we are defined not by one day in our lives, one event, but by our laughter, that as long as we have ourselves, we do not need to scurry.  As long as we have ourselves, we are enough, and we can close the kitchen door and talk all night, all days of our life.

And so I am moving on, trying to get back to the kitchen where I am enough, where my sister knows my name, my favorite color, my irrational and rational fears, where my grandmother waits for me to tell the story best, and I am neither ubiquitous or disposable.  I am not sure how. The men in my head are a thundering chorus.  The letters from clients saying how I changed their lives by filling their plates over and over til I could hardly walk build up and I don’t know if I should treasure them or bury them, or simply ask my clients if they are ready to see both of us as just human, on all the days of our lives. The women in the kitchen like the image of someone out on a limb fighting for them, at least on the day they give birth, and sometimes the laughter stops when I walk in, as they know I am contemplating something different.  I have always been passionate, and I am trying to learn to stop letting my passion overtake my life, to be passionate and still be me.  I have never been the kind of woman to give myself away to a man, but I have given myself away to this fight, this model, this scurrying.  Just as there is more to women than birth, I need there to be more to me than midwifery, and this fight.

While I like to write, I have never blogged, but I am starting this because I think there are more of us than we admit in person, more maternity care workers who sense and reject the idea that we are disposable, that we only have inherent worth if we are in labor or serving people who do not look up at us.   We are a marginalized community, us birthworkers who believe in women, including ourselves.  We don’t know what to do with ourselves.  I worry our model’s weak foundation is crumbling, and I rejoice, too, though change is never easy.  I want our model to change.  I want us to change.  I want us to work together to leave the chorus of hungry old men, to find something with women’s worth truly at the foundation of everything we do.  Like I said, I don’t know how.  I welcome your thoughts.

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