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Birth Work as Care Work: Stories from Activist Birth Communities: A Review

Alana Apfelby Dr Denis Walsh

This is a challenging and thought-provoking book, mostly coming out of the US context of the experience of black women in particular. It unashamedly takes the position of the oppressed and marginalised and applies a radical, anti-capitalist critique to the business of reproduction. In other words, starting with marginalised women’s experience of either birthing or working as a birth supporter, it critiques structures that undermine both women’s agency over their body and the commodification of birth in neo-capitalist systems.

Birthing is a social justice issue when any type of systemic discrimination is experienced by women, often layered because of patriarchy, racism and classism. The chapters are personal accounts of that experience from the inside, using informal interviewing and personal narrative. Though emerging out of the USA which is arguably more medically controlled than maternity systems in most western European countries, it is relevant for the UK context where gender, race, sexuality still intersect in oppressive ways.

There is a sociological tone to the writing but that is a strength as it brings incisive critique to taken-for-granted assumptions about how maternity care is organised and enacted, even within a publicly funded model. It also adopts an optimistic tone that bottom-up change is possible when grassroots activists band together and reminded me of how much social capital exists across various lobby  groups and how that could be harnessed for change – a recommended read!

Dr Denis Walsh
Associate Professor in Midwifery
Nottingham University

Denis was born and brought up in Queensland, Australia but trained as a midwife in Leicester, UK and has worked in a variety of midwifery environments over the past 25 years. His PhD was on the Birth Centre model and is now Associate Professor in Midwifery at The University of Nottingham. He lectures on evidence and skills for normal birth internationally and is widely published on midwifery issues and normal birth. He authored the best seller - Evidence & Skills for Normal Labour and Birth

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