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Birth Work as Care Work: A Review

Alana Apfelby Holly Scudero
May 13th, 2016

These days, more and more pregnant people are starting to spend time researching birth before actually giving birth. They’re researching where they’ll give birth, who their care providers will be, who their support team will consist of.

And yet, as a society we still have a long way to go. A long, long way.

It’s easy for those of us who benefit from societal privileges to be completely blind to the advantages we have. It’s easy to forget that some birth givers don’t have access to the “good” hospitals because of location, insurance, or financial means. For some pregnant people, a higher risk of unwanted interventions or unnecessary surgery is unavoidable. For some, home birth is not an option. For some, hiring a doula is either impractical or impossible. For some, prejudice is faced at every turn due to skin color or gender identity.

For some, it’s a blessing simply to be able to give birth without being chained to the bed.

There are many issues that those who perform birth work need to be concerned with. Midwives, doulas, and childbirth educators are always learning, always reading. A new book to add to the “to read” pile is Alana Apfel‘s Birth Work as Care Work: Stories from Activist Birth Communities.

This anthology delves into a lot of sensitive ideas that are not often discussed in more mainstream birth communities, although there are certainly individuals and groups out there that are working in these areas.

“Ultimately the anthology is conceived as a platform through which to honor birth–in all its forms–as itself a profoundly radical act that holds the potential for deep transformative change.”

For example, many sections discuss the idea of white privilege with regards to birth, although those aren’t the exact words used. But there are discussions about how birth is experienced by racial minorities, and how marginalized groups have less options and less choice, and often face a certain amount of judgment simply for who they are. In addition, these people must sometimes deal with more affluent birth workers–because birth work often tends to draw in white, wealthier women–and the stigma of being “saved.”

“One such problematic narrative relates to the language of ‘choice’ within modern maternity care. The danger of celebrating the rise of choice within transactional birthing environments lies in masking ongoing forms of coercion that result in a denial of choice for marginalized communities and those with less access to the kinds of choice-making power enjoyed by more privileged counterparts.”

Also discussed is how birth is shaped by a person’s gender identity. Sure, plenty of white, hetero, cisgendered women give birth every day, but that doesn’t mean that birth is restricted only to straight women or even to those who identify as women. This book is sure to get readers thinking about ideas that some may have never encountered before.

And of course, Birth Work as Care Work talks about some of the issues that are widely known about among birth workers of all stripes, such as how the institutionalized medical model of care affects birth outcomes, the value of midwives, our society’s implicit (but not always well-deserved) trust in medical professionals.

“People see their doctors as authorities with complete control over their bodies and their babies–to the extent that they expect to be raped. The word rape might sound extreme, but I am quick to point out that when someone does something to your genitals without your consent, that is rape.”

Readers will get an overview of some basic herbal medicine–just a discussion of herbs, but no recipes–because of the importance of reclaiming medicine for ourselves. There is also a wonderful, straightforward glossary: the “Political Dictionary.” This gives readers an easy understanding of some terms they may be less familiar with, which makes this book even more accessible to everyone.

There are discussions of how doulas can serve different kinds of pregnant people, and readers will learn about groups they may not have heard about before: volunteer doulas, prison doulas, doula training programs, doulas that work in areas of reproductive health not normally associated with doulas at all (like abortion or adoption).

There are also a number of birth stories, which readers will love. Birth is beautiful, and these stories celebrate it in all of its messy, myriad forms. This is the kind of birth the author and others are fighting for, and readers will enjoy getting to experience it up close.

Overall, Birth Work as Care Work is a book that will leave readers thinking and questioning, and perhaps wanting to get involved (if they’re not already). This is a fascinating and thoughtful collection of stories, questions, and essays, and a book that any birth worker would benefit from picking up.

“Transformation happens when we come together and meet each other where we actually are, not where others perceive us to be.”

 

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