Pushing for Midwives and the Reproductive Rights Movement

In this blog entry, Christa Craven, author of Pushing for Midwives: Homebirth Mothers and the Reproductive Rights Movement, explains what prompted her to write a book linking homebirth, midwifery, and reproductive rights activism.

When I met a midwife for the first time, we were both volunteering at a Planned Parenthood clinic.  She was an aspiring midwife in Florida, where direct-entry midwives (DEMs), those who attend the majority of homebirths in the United States, are legal, and student midwives are required to have clinical experience prior to applying for state licensure.  Both of us were working with Planned Parenthood’s program to educate high school students about HIV/AIDS.  We talked with “sex ed” classes and did pre- and post-test counseling for young women and men being tested for HIV.  Perhaps because my first exposure to midwives was in this context, I assumed a strong link between those who struggled for a woman’s right to access the practitioner of her choice for childbirth and the larger reproductive rights movement.

Yet when I decided to conduct research with midwives and homebirth mothers, it turned out that the link between midwives and reproductive rights was far more complicated.  In fact, the feminist movement had done relatively little to support midwives.  It was only in 1999, for instance, that the National Organization for Women (NOW) issued a resolution to expand “reproductive freedom” to include the support of women’s choice to homebirth and to seek midwives as their birthcare providers.

As I met more midwives and their supporters, I also discovered the religious and political diversity that characterize this movement.  Some linked their support of midwives to progressive causes, such as anti-racist organizing, environmentalist campaigns, as well as the reproductive rights movement.  Yet just as many saw their support of midwives directly connected to their strong religious convictions, pro-life politics, and commitment to “traditional roles” for women in the home.   As Katie Prown, the campaign manager of the national organization The Big Push for Midwives has explained, “’We’re one of the few movements that’s succeeded in bringing together pro-life and pro-choice activists, liberal feminists and Christian conservatives.  In every state we manage to recruit Republican and Democratic co-sponsors [for bills supporting midwives] who normally would never be on the same bill together.'”

It was this distinctive strength of the midwifery movement that prompted me to explore the relationship between homebirth mothers’ advocacy for midwives and the broader reproductive rights movement.  Although DEMs are legal and plentiful in Florida, where I first encountered midwives, women seeking homebirth in other areas of the country are frequently unable to find practitioners to attend them.  In fact, direct-entry midwives are only legally available in about half of the U.S.  In many other states, homebirth mothers—including those in Virginia, where I conducted the research for this book and Certified Professional Midwives, a national certification for DEMs, were legalized in 2005—are mobilizing to support midwives.  Women have also been central in the support of Certified Nurse-Midwives (CNMs), who attend approximately 7% of U.S. births primarily in hospitals, but also in birthcenters and in the home.  Although CNMs are legal throughout the U.S., they are often restricted by legislation that requires physician supervision and limits prescriptive authority. 

Yet despite the recent growth of this movement for midwives, there still remains little discussion of women’s experience of childbirth among reproductive rights activists.  And although the midwifery movement has been successful in organizing across religious and political lines, they have been less successful at incorporating women from diverse racial and socioeconomic backgrounds (a charge frequently leveled at reproductive rights activists as well).  As we consider the historical marginalization of women of color and poor women in the U.S. regarding access to healthcare, as well as the uneven gains garnered by the reproductive rights movement, it becomes essential for feminist scholars, as well as activists, to consider the challenges women face in gaining access to reproductive services (even once “reproductive rights” are legal), including the important care that midwives provide to a broad range of women and their families.

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