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Alana Apfel

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Alana is a birth worker, writer, and community gardener. She is a graduate of the Anthropology and Social Change program of the California Institute of Integral Studies. As a birth justice activist she has been involved with the San Francisco General Hospital Doula Program, BirthWays community education center in Berkeley, and the growing international BirthKeepers coalition. She now lives and works in Bristol, UK, where she is part of the Positive Birth Movement and is training to be a midwife in the National Health Service. Birth Work as Care Work is her first book. Check out her personal website HERE.

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Birth Work as Care Work: Stories from Activist Birth Communities
Author: Alana Apfel • Foreword: Loretta J. Ross • Preface: Victoria Law • Introduction: Silvia Federici
Publisher: PM Press
ISBN: 978-1-62963-151-6
Published: 05/01/2016
Format: Paperback
Size: 8x5
Page count: 152 
Subjects: Health-Childbirth/Politics 

Birth Work as Care Work presents a vibrant collection of stories from the front lines of birth activist communities. The personal has once more become political, and birth workers, supporters, and doulas now find themselves at the fore of collective struggles for freedom and dignity.

The author, herself a scholar and birth justice organizer, provides an engaging platform to explore the political dynamics of birth work, drawing connections between birth, reproductive labor, and the struggles of caregiving communities today. Articulating a politics of care work in and through the reproductive process, the book brings diverse voices into conversation to explore multiple possibilities and avenues for change.

At a moment when agency over our childbirth experiences is increasingly centralized in the hands of professional elites, Birth Work as Care Work presents ways to radically reimagine the trajectory of our reproductive experiences, providing a unique and creative entry point into the essence of all human struggle—the struggle over the reproduction of life itself.


“I love this book, all of it. The polished essays and the interviews with birth workers dare to take on the deepest questions of human existence.”
—Carol Downer, cofounder of the Feminist Women’s Heath Centers of California and author of A Woman’s Book of Choices

“This volume provides theoretically rich, practical tools for birth workers and other care workers to collectively and effectively fight capitalism and the many intersecting processes of oppression that accompany it. Birth Work as Care Work forcefully and joyfully reminds us that the personal is political, a lesson we need now more than ever.”
—Adrienne Pine, author of Working Hard, Drinking Hard: On Violence and Survival in Honduras

“All we are doing in this world is living and dying, creating and destroying. We generate new life in our children and in our ideas. Becoming a birth supporter, getting to be an attendant to the miracle of childbirth, has transformed my social justice work. Our visions for justice are what we are birthing in this world. Learning to listen, learning to trust the body and the people, and learning to breathe will transform our movement work. Birth Work as Care Work demonstrates these lessons through showing us ways we can learn together to support the birth of new worlds.”
—Adrienne Brown, coeditor of Octavia’s Brood: Science Fiction Stories from Social Justice Movements

“This book places the doula—as a caring birth activist—at the heart of reproductive care work in our modern society. Doula, a new name for an ancient traditional role, reappears today as women daring to reclaim their power through birthing and caring for their children.”
—Valérie Dupin, cofounder and cochair of the Association Doulas de France

“Alana Apfel is an artist and a robust one. Weaving the logic behind birth, care, and reproduction together, Birth Work as Care Work documents how caregivers and communities are marginalized in society on a daily basis whilst working to sustain themselves and ironically, to sustain life itself. Her thesis seeks to put the human back into being.”
—Chitra Subramaniam, editor in chief of The News Minute

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What Others are Saying

Mentions & Interviews


birthworkBirth Work as Care Work: A Review
By Karen Hall
May 30th, 2017

Birth Work as Care Work is an important introduction to the subject of intersectionality in the birth movement, drawing out themes of oppression and inequality through the stories of women.

Alana Apfel and her contributors identify the challenges of a profit-driven healthcare system dominating birth, and a society where “white volunteerism” overlooks the real lived diverse experience of birthing women in communities that are not their own. Apfel creates a space for birth workers to be heard on both a personal and a political level, including four beautiful birth stories.

I found this book challenging to read as a white middle class straight cis woman, because although I am steeped in a culture of empowerment, of being “with woman,” and of respect and awe of the birthing body, the contributors are quite deliberately not talking to me. Reading it has been a good lesson in making myself aware of the water I swim in, and not trying to “fix” others’ experience from within my own frame of reference.

This is a recommended read for anyone interested in the broad political and social context of birth, and wiling to feel like our work is radical, valuable, and important.
[Disclaimer: The author sent me a free copy of her book]. We will be chatting with Alana in Sprogcast Episode 27.

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birthworkBirth Work as Care Work: A Review
by Holly Scudero
May 13th, 2016

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.”

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birthworkBirth Work as Care Work: A Review
by Angela Anderson
April 2016

Break out the tissues and breathe deeply. Alana Apfel imbues Birth Work As Care Work with intimacy, empathy, and buckets of love.

I had the great honor to witness the development of this anthology. While working towards our Master’s degrees in Anthropology and Social Change at California Institute of Integral Studies, I cried tears of awe on many a train ride as I read the drafts of these stories...

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birthworkBirth Work as Care Work: A Review
by 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...

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