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Did you know that the healthcare industry is the largest producer of waste in the United States? And the United States is the largest polluter in the world, producing a total of 236 million tons of waste annually. Although we make up only 5% of the world’s population, we produce a whopping 30% of the world’s waste. It is sobering to think about how much of that waste is generated by hospitals and the health care system. We are currently in the most dire period of climate change in human history. NASA states that the carbon dioxide levels are up 409 parts per million, meaning that CO2 levels are at their highest in the last 650,000 years on this planet. The global temperature has risen 1.8 degrees Fahrenheit since 1880. 13.2% of arctic ice melts every decade. The UN Environment Programme estimates that 200 species go extinct every day. Climate change doesn’t affect everybody equally, however. Environmental racism plays a central role in the climate change crisis. The people affected most by the natural disasters resulting from the rising temperatures of our planet are people of color in the Global South. While the “first world” produces most of the world’s pollution, the poor people in the “third world” are the hardest hit. Even in the United States, people of color are much more likely than white people to live near polluters, breathe polluted air, and drink poison water. Similar inequities exist in our healthcare system, particularly when it comes to maternity care. Did you know that black women/birthing people are 3 to 4 times more likely to die in childbirth than white women/birthing people? In cities like New York, black women/birthing people are actually 12 times more likely to die in childbirth. The inequities of our healthcare system mirror the inequities of climate change- the most disenfranchised are the most likely to be injured or die.  While Capitalism has benefits for many, it is also a system causing death and destruction for most- including our planet. Since the Industrial Revolution in the 18th Century, greenhouse gases have risen 260%.  Interestingly, this was about the same time that doctors and the Western Medical System began gaining a foothold in the United States. (White, male) doctors began replacing community healthcare providers and midwives, completely altering the collective approach to healthcare and gaining control over populations. In 1844, Samuel Morse invented the telegram, allowing for rapid communication and unprecedented industrial expansion in the United States. The American Medical Association was founded just three years later, an organization which lobbied extensively against midwives and other community healthcare workers. They insisted, through new legislation, powerful connections with the government, and effective slander campaigns, that the population’s healthcare move under their domain. These newly powerful white male doctors assumed that nature was flawed, and that they could improve human birth by intervening in the process with drugs and technology. This assumption led to the (supposed feminist) invention of twilight sleep in the early 1900s, which was the practice of sedating a woman to unconsciousness during childbirth. This intervention necessitated the routine use of forceps (because birthing people could not push). Thousands of birth injuries resulted from the common misuse of forceps during deliveries. Doctors also began the practice of separating babies and mothers at the time of birth due to a completely imagined risk of infection, and managed to essentially eliminate breastfeeding for a time, thinking that factory-made formula could provide better nutrition to human babies than human milk. This erroneous assumption that the female body needed technologies and interventions to birth and feed our babies coincided with the societal trend towards industrialization. In the same decades that more medicalized childbirth grew in popularity, Orville Wright made the first powered airplane flight and Henry Ford created the Model T. As humans invented more and more technologies and the world became reliant on fossil fuels, we began to deeply medicalize birth in our society. Nestlé, the largest producer and distributor of formula in the world, got cozy with the American Medical Association in 1932 when the AMA passed a law stating that the formula industry could only advertise to the medical profession. In the 1930’s, about 77% of infants were breastfed; by 1972 the number dropped drastically to 22%. In the late 1970s when the general public and many medical professionals realized that breast is best (surprise!), Nestlé and other large formula companies began a powerful campaign in the Global South for women to feed their babies with formula. The same places that are the hardest hit by climate change are the countries that have the highest rates of formula use. And first world companies continue to profit. The global baby formula market is expected to be worth about $62.5 billion dollars by 2020. We can no longer afford to waste so many resources. The oceans are filling with plastic and our water supply is becoming increasingly contaminated with pharmaceuticals and other chemicals. Not only are we wasting incomprehensible amounts of material resources- we are wasting whopping amounts money. It is estimated that the US healthcare system wastes $765 billion annually- about a quarter of what it actually spends. It’s time we reinvent the healthcare system so that we can heal ourselves, and mitigate the damages we have caused our planet. We need to cut unnecessary wastefulness in our healthcare system (NPR provides some great ideas here). We need to invest more in preventative forms of healthcare, including non-Western modalities such as acupuncture and other forms of eastern medicine. We need to re-center midwives as the primary providers for low-risk birthing people (the countries that do this have much better outcomes than the countries that don’t). It’s time to reform our healthcare system. The planet depends on it. Female bodies (and humanity in general, birthed from these bodies) depend on it. Scientists estimate that by 2035 we will hit an unprecedented change in the earth’s atmosphere. Our home is changing rapidly. We have already seen huge climate transitions in our lifetimes, and many of the world’s powers have yet to make committed decisions to get behind renewable energy sources and leave fossil fuels behind. Let’s ameliorate climate change disasters as much as possible. Let’s re-learn how to respect our earth, the original Mother. And with this, may we remember to respect the female body again. 
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 One thing the whole Dr. Christine Blasey Ford and Kavanaugh process reiterates: we live in a violent and sexist culture. But, things are changing.
Never before have conversations about sexual harassment and sexual violence been so frequently spoken in our media or political sphere. People everywhere are getting behind the #BelieveWomen and #MeToo platforms. And while we have a very long way to go, I feel hopeful we will get there, eventually. One thing that the courageous Dr. Ford’s testimony shows is how traumatic experiences can affect us for our entire lives. Anybody with an ounce of compassion could see, during her testimony, how the trauma and violation of her experience with Kavanaugh as a teenager still haunts her deeply. It goes without saying that sexual traumas are far too common in our society. Another trauma that is all too prevalent in the United States and throughout the globe is birth trauma. Although the two are related, I would argue that birth trauma is the most common hurt people experience in our society, because it affects each and every one of us. Almost everybody in our modern society has experience with birth trauma. Those born in the 1930s-1960s experienced the trauma of having mothers who were unconscious from twilight sleep, being pulled out by forceps, separated from their mothers for up to a week, and/or denied the benefits of breastfeeding. While most of these practices have evolved or changed since the 1960’s, birth trauma persists. Birthing people report being verbally abused by their care providers during labor, given unnecessary surgical procedures like episiotomies or c-sections, and/or generally emotionally dissatisfied with their prenatal care and birth experiences. Babies born under these conditions (a.k.a. most of the humans in this world), have our first experiences of this world marred by this painful and confusing phenomenon. We are affected by these traumas in more ways than we consciously know. Sexual and birth traumas are inextricably connected. Of course a society that does not respect or value the female body will relate to birth the way we do. The Western Medical System is deeply sexist and patriarchal, controlled by the some of the same old white men who are running our country. The good news is- humans have an innate and powerful capacity to heal ourselves. Whether it relates to birth, sexual trauma, or any other form of hurt, we are absolutely capable of healing. And not only are we capable of healing ourselves- we help each other heal. We are getting more and more connected, building movements which offer hope to future generations. For the first time in history, white men are the minority of house Democratic nominees. Women of color and trans folks are winning key elections. Birth justice is finally a part of the conversation, with states like New York and California creating initiatives to attempt to address the birth disparities facing black birthing people and other birthing people of color. We have so much more to do in changing the hospital system, making midwifery care more accessible to more people, and eliminating sexual violence from our culture. But, things are changing. Blessings to Dr. Ford, everybody healing from sexual traumas, and all of us healing from our births. In the wake of the #MeToo movement, there is one group of people’s voices that still remain silent: birthing people. It’s wonderful that more and more women, female-bodied, queer, and trans people are speaking out against the sexual harassment and violence they have endured and continue to experience in our society. It’s wonderful that this information is so public that it is hard, even for the most privileged, to ignore. Sure, we won’t see an immediate end to sexism, male violence, and harassment. But it’s a step in the right direction. I am concerned, however, about a huge blind-spot that our culture has: birth. Birth is an intimate, vulnerable, and intensely human experience. UNICEF estimates that about 353,000 babies are born each day around the world. And every day, thousands (or hundreds of thousands) of birthing women experience violence during the births of their children. Birthing people are often coerced, threatened, and violated during their labors, births, or postpartum times. They are separated from their babies, ignored, or forced to experience any number of inhumane acts perpetrated by the patriarchal hospital system. Obstetric violence is yet another form of sexual violence female-bodied people are consistently experiencing in our society. There have been many stories coming out in the last 5 years where women or birthing people have reported cases of obstetrical violence. Caroline Malatesta won her lawsuit against the hospital where she gave birth after suffering PTSD and permanent nerve damage when the nurse forcefully held her baby in her vagina while she waited for the doctor to come into the room. “Kelly” sued her obstetrician for assault and battery after he conducted a multiple-cut episiotomy even though she explicitly sad “no.” Doulas report a “hidden epidemic” of doctors abusing women in labor. However, there are still millions of cases globally where the rights of birthing people are ignored, where their genitals are touched or cut without their consent, or their bodies are used in ways they explicitly refused. It is not uncommon to see doctors forcefully conduct vaginal exams on women during labor, even while they explicitly tell them to stop, for no medical reason whatsoever. This is, by definition, rape. Especially for immigrants, people of color, and poor folks, these stories all too often go unsaid and/or unheard. It takes privilege to stand up and say that one has suffered sexual harassment, abuse, and rape. With every story told with the #metoo hashtag, thousands of stories go unheard by women around the world who are not able to tell their stories for fears of greater violence or disenfranchisement. With every story about obstetrical violence we hear, thousands of other stories go unheard, getting internalized in women’s bodies and passed on to future generations. My partner’s mother was raped when she went to her doctor for a routine prenatal checkup. She stopped going to that doctor, but she didn’t report him to the hospital because of the race and class dynamics that made her feel (rightly so) that the institution wouldn’t listen to her. My grandmother, who survived the Auschwitz concentration camp when she was 15 years old, is more willing to talk about the horrible atrocities she suffered during the Holocaust than she is about her first birth experience in a hospital in Brooklyn, New York, in 1962. The experience of being strapped to a bed, verbally abused, and locked in a room alone during the birth of her first child was, for her, torture. She was then separated from her baby for a week and discouraged from breastfeeding. Subconsciously, she never forgave my aunt for having to live through that experience, and it continues to affect their relationship 56 years later. There are some wonderful obstetricians in this world. Many male, female, queer and trans doctors advocate strongly for patient rights and autonomy and provide excellent, respectful, and compassionate care to their birthing patients. Unfortunately, these doctors are not the norm. They have managed to hang on to their sense of humanity through their journeys through medical school and their participation in the Western Medical System. It’s not that doctors are bad people. The vast majority of doctors have good intentions, and want to take care of their patients as best they can. But they work in a system that does not prioritize consent, that positions their patients as less knowledgeable about their own bodies than they are, and that sets up a power dynamic where doctors can exploit their knowledge to get inappropriate access to their patient’s bodies. Did you know that James Marion Sims, known as “the father of modern gynecology,” conducted experiments on female slaves, without their consent and without anesthesia? Did you know that medical students are sometimes taught to perform pelvic exams on anesthetized women, without their knowledge or consent? And that this is only illegal in four states? The Western Medical System has an abominable track record for prioritizing consent.  James Marion Sims We need to start connecting the dots between the sexism, the violence of the patriarchy, and the Western Medical System. We need to start calling obstetric violence what it is. Just as men who are true allies to women need to be actively engaging with other men to end rape culture, so must obstetricians, doctors, and other influential members of the Western Medical System band together to stop obstetric violence. Just as men need to stop thinking that they deserve control over female bodies, doctors need to stop thinking that they know better than their patients, and that they can do anything they want to their bodies under the guise of practicing medicine. The midwifery model of care offers a much-needed alternative to Western obstetrics. Midwifery, a century-old craft, means “with woman,” and it does exactly that. The midwifery model of care prioritizes holistic female well-being (along with caring for the safety of the fetus/newborn). It is not only about keeping the birth safe. It is about keeping the birthing person feeling safe, which is an important part of protecting the physiological process of birth. Just as cis- and trans- women in our modern society need advocates leading us to a world where we are not vulnerable to gender-based violence, birth needs midwives and other birth advocates to be a voice for the truth. The health and healing of humanity depends on us changing the way we see birth in our society. After all, we are ALL born. If mothers feel unsafe, violated, or abused during births, their newborn babies will store those experiences in their nervous systems. Medical research agrees: birth affects us in deep, lasting, and powerful ways. Whether we are born through a cesarean section, vaginally in a hospital with an epidural, or at a homebirth, our birth experiences affect us for the rest of our lives.  Photo of a home water birth in Oakland, California Tarana Burke, the founder of the #MeToo movement, said, "I see all these people who are interested in this issue. Sexual violence is deeply pervasive and touches everyone across race, class, gender and ability and we have to find a way to move the needle." Similarly, obstetric violence affects women and birthing people across race, class, gender, and ability. While every woman is vulnerable to obstetric violence, we are not all affected equality. Because of racism, women and babies of color are more vulnerable to the horrors of obstetric violence. In the United States, black women are dying in childbirth three to four times as often as white women, and Latina women die twice as often as white women. Black babies are more than twice as likely as white babies to be born prematurely.
We need more midwives, especially midwives of color, caring for more birthing people in this country. We need more women and birthing people to know what their options are around giving birth. We need our society to provide empowering images of birth to everybody, especially young people. We need people to know how mighty the female body is- that it can grow a life, and birth it into this world, with power and grace. When we are empowered to have our children in this way, we will birth a new generation that understands consent, body autonomy, and true empowerment. And that’s exactly what our world needs. Let’s build on the momentum the #MeToo movement has built and end obstetric violence. Let’s make birth the safe, empowering, and connected event it should be. #BirthMatters. Marea Goodman is a licensed midwife living in the California Bay Area. She is passionate about the liberatory power of birth and sees it as a key feminist issue. Marea believes that if we can change the way this society views birth, that it will have a key and lasting effect on the health and healing of future generations. |
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