Where Are Pro-Choice Organizations in Birth Activism?


As a former employee of Planned Parenthood of Metropolitan Washington and the National Family Planning and Reproductive Health Association; as a mother and a wife and a daughter and a sister and a friend; as a student of history, I have never questioned my dedication to the pro-choice movement. I am pro-choice to my core and have proudly pledged my time, effort and energy into making sure that access to abortion, birth control and preventive services are within easy reach for every American. 

It is with sadness, then, that I question the movement’s dedication to me.

I am a woman “of childbearing age.” I know Planned Parenthood, NOW, Choice USA, et al, will defend my right to choose abortion if I were to get pregnant and needed that option. I know they would provide me with subsidized birth control and pap smears if I didn’t have insurance and couldn’t afford to pay full price, or they would at least direct me where to go. And I know they will fight hard to ensure that legislators cannot stomp out my right to choose, or my access to subsidized birth control and yearly exams. Yet, when it comes to where I choose to give birth, they are silent. It would appear, in their eyes, that ensuring “choices” essentially ends with the decision to have a baby–more specifically of where and with what kind of attendant to give birth.

How is that possible? The birth of her child is for many women one of, if not the, most transformative moment in her life. And the circumstances surrounding it can be just as empowering or disempowering as those surrounding a woman accessing her right to an abortion.

The right to choose how a woman gives birth is not confined to just whether she’ll have a cesarean or a vaginal delivery, or whether she’ll have an epidural or go natural. In many states, the right to choose the very place where a woman gives birth is a contentious subject. While maternal and infant mortality rates in the United States continue to rise, legislatures continue to refuse to grant licenses to Certified Professional Midwives, the most common type of midwife who attends home births. And even in states where home birth is legal, hospital policies can prevent a woman from being accompanied by her midwife should she need to be transferred during or after the birth. Women are ostensibly free to make the choice—in most states it is only midwife-attended home birth that is illegal—but the choice often comes down to going to a hospital and risking losing their autonomy or planning a home birth and losing their advocate (and the person with the medical knowledge) if something goes wrong.

The hesitation on the part of the major pro-choice groups is understandable. The right to make the choice where and how one gives birth, and especially to choose a home birth, is often seen as outside of the mainstream or more often, the choice of the uber-religious (the oldest Duggar child’s first baby was born at home), not exactly a natural ally of the pro-choice camp. And with access to abortion growing harder and harder to guarantee, it’s hard to find energy to devote to other aspects of reproductive choice. And it goes both ways, too. I saw a recent exchange on Facebook where a pro-lifer expressed their concern that if pro-choice groups began to take up the call for choices in childbirth, the cause would be lumped under “abortion rights,” a possibility that vexes many anti-abortion activists who nevertheless fully support having a choice when it comes to childbirth.

As a pro-choicer, I have to admit that I find the hesitation on the part of the anti-choicers rather short-sighted and naive. It is not our side, after all, that continues to propose and pass legislation granting fetuses “personhood,” that doctors then cite to get court orders for women to remain on bed rest or to be forced into having cesarean sections, all in the name of “fetal rights.” A recent editorial in the newspaper of the city in which I live appealed to those “who believe in the rights of the unborn” as a reason for denying licenses to Certified Professional Midwives. Translation: the unborn baby has the right to the best care (only available at the hospital), and the silly women who choose home birth are endangering their babies just as much as if they’d laid down to have a D&C.

It is clear, though, and has been clear to even anti-choicers (Jennifer Block, in her book “Pushed: The Painful Truth About Childbirth and Modern Maternity Care” about modern obstetrics in the US, describes such a couple who, despite their deeply held belief that abortion is wrong, nevertheless attended the 2004 March for Women’s Lives in Washington, DC, because they realized it is the pro-choice side that is best-suited for championing their cause) that these indomitable organizations like Planned Parenthood and NOW are the ones that can best advocate for the right of a woman to choose how and where she gives birth.

The key to the abortion debate is the old NARAL standard: that it is the woman who is best suited to make her own reproductive choices. Childbirth is such a choice. Those of us who advocate for the rights of women to make their own choices, about birth control, about abortion and about childbirth need them officially on our side.

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  • navelgazingmidwife

    You’ve said what I’ve thought for years, but didn’t have the eloquence to write. Thank you so, so much for this! I will pass this around and make a raucous noise right along with you. Thank you!

  • suchada-mama

    I’ve been wanting to broach this subject on my blog for a while but wasn’t sure how to approach it. Well-written and insightful. I’ll be passing it along. Thank you!

  • heidi-d

     

    I have been a midwife 10 years, and have served many women in birth and in homes and started a birth center that supports a lively birth community… all because of the information and support I received from women’s organizations. 

    I think it is incorrect to say women’s health advocates and organizations have not considered midwifery and birth. I became a midwife after becoming interested in birth and reproductive justice because of articles I read in Ms. magazine in the early 1990′s while in high school. I will never forget my first pictures of birth from the Our Bodies Ourselves book used as a text in a Women’s Health class in college. I later had many people use me for their births who learned about midwives in the same class. 

    Jennifer Block came from Ms. as well. 

    The Boston Women’s Health collective http://www.ourbodiesourselves.org/ has written not only our Bodies Ourselves but also a great pregnancy book. They were part of the 60s and 70s consciousness raising groups, and many of those women went on to be part of the birth movement. Books like Raven Lang’s birth book came from this movement…

    My direct entry midwife school was a feminist collective project. I would not have had a midwifery education, or a law to practice under if not for the birth advocates in the feminist movement in Florida in the 80s and 90s.  

    I made a presentation to my local NOW chapter in 1996 about midwifery, and the chapter members got behind me and rewarded me with a scholarship to my private midwife school. 

    NOW made a proclamation in 1999 to include the Midwifery Model of care in reproductive rights. http://www.now.org/nnt/fall-99/resolutions.html#midwifery

    One of the founders of NOW Sonia Pressman Fuentes helped our local birth activists bring Ina May Gaskins to town to make a presentation to the hospital and local birth community about maternal mortality. http://borninsarasota.blogspot.com/2009/07/sarasota-to-host-maternal-health-care.html

    National Advocates for Pregnant Women is a feminist organization working on all kinds of reproductive justice. http://www.advocatesforpregnantwomen.org/ 

    The work is being done, the birth activists have to take their message to their local groups and make it part of the consciousness in your community if it is not.

    Women who want to see this on the National Agenda, what group are you part of? How are you bringing the issues you face as a birthing woman, a mother to the national groups? 

    If you are part of Planned Parenthood, start there. We had very good support and many referrals to the birthing center from our Planned Parenthood in Florida, they were happy to send people who wanted to have babies to midwives. They give away birthing center brochures. I did much of my gyn training for direct entry midwife school in Planned Parenthood and at a 1970′s women”s co op abortion clinic. 

    Be the change you wish to see in the world. You are the one you have been waiting for. 

    And recognize the birth work that has been done by women is the work of feminists….know your history….there is always much more to do, but the ground work is all there. 

    For each person in the feminist movement who was not interested in birth, there was also a Barbara Ehrenreich writing ‘Witches Nurses and  Midwives’ or starting a midwife school. 

     http://books.google.com/books?id=bdPxROdAPlAC&printsec=frontcover&dq=barbara+ehrenreich+witches+nurses&source=bl&ots=XIyC6NuLvr&sig=BYYKg7HEYgKGn2-1J5QemWF_TNw&hl=en&ei=HGW0TIeJOYOgOtfrpYwK&sa=X&oi=book_result&ct=result&resnum=2&ved=0CB4Q6AEwAQ#v=onepage&q&f=false

     

     

  • heidi-d

    And remember, Margret Sanger was a midwife.

    Planned Parenthood was born of her work doing home births in tenement houses in New York City.

    The roots of it all are in birth, and in women’s experiences in birth. 

    Here was an interesting article on Rh reality check about Margret Sanger’s lessons in leadership from a leader of Planned Parenthood….  

    http://www.rhrealitycheck.org/blog/2010/02/17/audio-convictions-action-lessons-margaret-sanger

  • gina-crosleycorcoran

    There may not be many of us, but there are pro-choice feminists who are outraged that full-spectrum reproductive health care isn’t on the radar of “mainstream” feminists.

    http://thefeministbreeder.com/ive-been-annoyed-with-feminists-this-week/

    I get my panties bunched every time abortion becomes the sole media focus, while homebirths, skyrocketing cesarean rates, and birth rape go completely unnoticed (or unanalyzed) by the most vocal “Pro-Choicers”.

  • shewho

    That’s the point I would raise. The fact that many of us aren’t aware of the herstory behind homebirth isn’t the fault of the feminist activists who’ve been part of that movement, as well as the choice movement. It’s just another manifestation of patriarchal control of our stories.

     

    Not all women who give birth at home are feminists, and not all women who practice in the homebirth community are, either. A homebirth can be every bit as expressive of patriarchal control of our options as a hospital birth.

     

    I had 4 homebirths and a birth center birth. I thought I understood, going in, the kinds of limits placed on my friends at the birth center, and I made a personal commitment (to myself) not to do anything that would compromise their standing in the community. That was more difficult than I anticipated. Perhaps, if I’d been coming from a background of hospital birth I would have appreciated the “freedoms’ of the birth center more… but that wasn’t my background. It seemed to me a very rigid environment, but I didn’t disrespect that it was a valuable option for women in the community.

     

    Still, anyone would recognize that the work they did there was essential feminism… and compared favorably to the attitude of the first homebirth midwife I’d ever interviewed, who told me she became a homebirth midwife because she had been an L&D nurse and “the doctors never listened to me, so I got my own practice where *I* would be in charge.” *shudder*

  • arekushieru

    While I don’t like it, I can understand it.  Each issue requires an equal reaction to it’s own power.  Abortion opponents are certainly louder and more effective than activists on other forms of opposition to other issues.  Which is why ProChoicers, in this case, must be just as loud, if not louder.  And why the media marks this as the ‘mainstream’ issue, unfortunately.  They only go to the loudest sources, after all….

  • mamadank

    I appreciate all of the comments about the feminist background of reproductive rights.  However, it’s important to understand how far we’ve wandered from that.  When I went to go get a pregnancy test at Planned Parenthood and told them I was going to “keep it”, the nurse didn’t do a very good job at hiding her shock.  It must have thrown her off so much that she forgot to give me any offer for counseling, information on how to apply for Medicaid, WIC, etc.  She just handed me my documentation and told me where to pay my bill. 

    So because I decided I wanted to have a baby, Planned Parenthood gave me a swift kick in the pregnant ass.  After supporting and trusting them after so many years, and relying on them for access to birth control as a teenager, this experience has left me pretty disenchanted with PP, and seriously doubting the feminist movement’s commitment to true reproductive justice.  I’m waiting to see how this pans out with a new movement of feminist birth workers and awareness of the limitations to birth rights.  Thanks for posting this.

  • courtroom-mama

    mamadank, I am sorry that you had such a poor experience with Planned Parenthood. I personally have had experiences with women’s health clinics that leave much to be desired (to put it in the nicest possible terms). The conclusion that I came to in my own experience is that they are so under-resourced and so beseiged by harrassment and abuse from anti-woman groups, that sometimes the human touch can be lacking. I can definitely see how this would be the case where a woman decides to try to bring a pregnancy to term, since many women’s health centers don’t offer prenatal care.

     

    My perspective has come around a little bit – instead of tilting at windmills and wondering “where are the prochoicers/feminists/whoever and why don’t they ‘get it,’” I try to build the bridge from both sides. As a voice for reproductive justice, I try to always connect the issues for birth activists (e.g. those regulations that they are trying to pass to put your birth center out of business are the same ones they use to push out the abortion clinics, so you have mutual interests), as well as trying to teach people concerned about access to abortion and contraception about other barriers to care that women face during birth, including access to VBAC, vaginal breech birth, and out-of-hospital care.

     

    In addition to the rich history of the holistic women’s health movement (BWHBC and others), newer projects such as the Doula Project (which brings doula support into other pregnancy situations, including abortion, loss, and adoption) easily cross the barrier of the false dichotomy between women who have babies and women who have abortions.

     

    I recognize that Planned Parenthood and the many other clinics out there do the best they can under some pretty terrible circumstances. As a birth activist, I see it as my job to reach out to them to let them know that I support them because we are serving the very same women, and we can work together to provide seamless care for women no matter what the outcome of their pregnancy. I hope that on a macro, advocacy level, all the women’s health groups can someday work together so that we can stop ghettoizing abortion as a “different” form of healthcare or birth as “not-quite” women’s health, but that is going to take folks on both sides reaching out to join hands.

     

  • kangaroo

    Dear Erin:

    I’ve been unable to post a comment to your blog because the system isn’t working and I can’t get a password, so I’ve asked my good friend, Laura Gilkey, to post this for me.

    I am a co-founder of NOW and until last year, I had never given a thought to maternal health care in the U.S. I always discuss the problems of maternal health care in underdeveloped nations in my speeches but thought all was hunky dory in this country. My eyes were opened by a letter to the editor in the Sarasota “Herald Tribune” by Laura last year discussing the U.S.’s low ranking vis-à-vis maternal health care. As a result, Laura and I put together a program called “Maternal Health Care in the 21st Century, Sarasota and Beyond” on November 1, 2009, at the Sarasota Hyatt that drew an audience of 250 and was a huge success. Laura prepared an excellent Resource and Program Guide in connection with this program. We had a top-flight panel to discuss the issues, including Ina May Gaskin.

    Recently, Patricia Ireland, a former president of NOW, wrote me that NOW had been involved in maternal health care in the US over the years. I did not know this and just e-mailed Patricia asking her to send you the facts on this. I just found that I think I’m wrong in thinking Patricia Ireland sent me this information. I just looked in my Maternal Health Care File and found an e-mail to me and others from Laura about this 1999 resolution by NOW:

    EXPANSION OF REPRODUCTIVE FREEDOM TO INCLUDE THE MIDWIFERY MODEL OF CARE

    WHEREAS, the National Organization for Women (NOW) has long supported reproductive freedom as a priority issue; and

    WHEREAS, NOW believes that women should have complete authority over their reproductive lives; and

    WHEREAS, reproductive freedom not only includes the ability to decide whether or when to bear children, but also the right to devise a birth plan with a medical provider of their choice in either a hospital or an alternative setting such as a freestanding birth center or private residence; and

    WHEREAS, women have historically given birth with midwives; and

    WHEREAS, the practice of midwifery has many benefits including lower costs, lower rates of premature births, higher rates of breastfeeding; and greater satisfaction with the birthing experience; and has been endorsed by the World Health Organization; and

    WHEREAS, midwifery has a lower incidence of medical interventions during the birthing process, including the routine use of episiotomies and Caesarean sections; and

    WHEREAS, women’s access to midwifery and traditional birthing practices many times is limited by restrictive laws and non-coverage by private insurance companies and state-subsidized funding;

    THEREFORE BE IT RESOLVED, that NOW’s policy statements, brochures, and fact sheets concerning reproductive freedom include references to birthing choices, safe childbearing practices, midwifery; and

    BE IT FINALLY RESOLVED, that NOW work in cooperation with state and national midwifery organizations to increase women’s access to midwifery and community awareness of childbirth, pregnancy, and early parenting choices.

    ————————-

    It was submitted by NOW’s Health and Reproductive Rights Hearing at the National Conference, Beverly Hills CA, July 3, 1999, chaired by Shiela (misspelling?) Moore and submitted by Linda McCabe from the Sonoma County NOW. Apparently a Midwifery Childbirth Awareness Project of the California Association of Midwives was also involved. Laura wrote to me and others this past July 5 suggesting that this resolution to resurrected and that NOW revisit this resolution. I don’t know if anything has been done on that.

    Sonia Pressman Fuentes

  • darline-tunerlee

    I agree that it may seem like many of the pro-choice organizations don’t care about maternal health, I have found that this really isn’t the case.

    By many standards, I am a newcomer to this “party”. I was a PA by profession for 8 yeares and felt that health care delivery in this country was adequate. Sure, at times we clinicians ignored patients’ questions in order to “stay on schedule”. That just came with the territory. All was adequate until I had reproductive health issues of my own. Then I got to see first hand many of the problems of which you all speak. As a result of my own experiences, I started a small business, Mamas on Bedrest and Beyond, to support high risk pregnant women (of which I was one!!)

    I think one thing that we all have to keep in mind is that there are so many attacks on women’s health and reproductive rights it’s hard for any of us to keep track and advocate for all of them. One day they are scaling back screening mammography (when we have clear evidence that mammography saves lives) and the next they are removing contraception as a covered benefit on insurance policies. With the assination of Dr. Tiller, abortion clinic bombings, crazy-assed statements from the likes of Sharon Engle and others it’s hard to know where to focus efforts. One thing that is certain, we are out there, all of us, standing in the gap for women’s health and reproductive rights. Should Planned Parenthood and others be more vocal? Perhaps, but do they have the womanpower or resources to attack each and every issue? Probably not.

    I agree with Courtroom Mama, we are all going to have to stand in the gap for women’s health and reproductive rights. We can’t leave it up to Planned Parenthood, the Boston Women’s Health Collective, NOW or other pro-women’s health organizations. Each of us has to stand up and defend what we believe in. I focus on high risk pregnancy and maternal and fetal health but that doesn’t mean that I don’t also stand for choice and other reproductive freedoms. If called upon, I will certainly lend my voice for the cause, but my focus is on high risk pregnancy. I am sure that other folks have had to make similiar decisions on which to focus. But this is not a bad thing. Knowing that we all stand together on women’s health issues, by “fanning out” if you will, we will actually cover more ground and present a more proactive and protective front in defense of women’s health and reproductive rights.

  • colleen

    Thank you for this excellent post. If I could rate it a 20 I would do so.

     

  • arekushieru

    As ALways, CM, a well-thought out and -written post! 

  • crowepps

    Thank you for your great post.

     

    It is very important for women (and everyone else) to understand that the responsibility to address our concerns can’t be sloughed off onto ‘somebody’.  If there is an issue out there that we feel is really important based on our personal experiences, WE are the ones who are most knowledgeable and who need to publicize the problem and advocate for a solution.

     

    Not only does complaining about how ‘they’ aren’t working on a particular issue distract from actually addressing the problem, it is really, really disheartening to those who are already putting a great deal of effort into addressing a different area.

  • ecr319

     

    Ms. Fuentes, thank you for taking the time to read and comment. I think your description of birth activism, access to midwives, etc, as being off your radar is emblematic of what I believe is going on.  When I was at PPMW, one of the things I was involved in was helping to set our legislative agenda. This was based on PPFA’s goals as well as issues that affected our particular geographic area, which includes DC, Northern Virginia and Montgomery County and Prince George’s County in Maryland. Looking at the candidate questionnaires prepared and disseminated by the 501(c)(4) this year, they are almost identical to the ones we sent out. Certified Professional Midwives are legal in VA, but are not in DC or MD. There is no question in my mind that granting licenses to CPM in DC would help to close the gap in access to care that exists between socio-economic groups there. Yet, we never even considered expanding our agenda to include access to midwives, even as we changed it to address specific legislation during sessions.

     

    Heidi D brought up Jennifer Block’s Ms. background. In Pushed, Block specifically addresses the point that the major PC groups are silent when it comes to childbirth choices. She talked about it in an interview with Amie Newman for this website. NAPW challenged PC groups three years ago to start standing up for access to midwives and VBAC, and where is the evidence that they have (aside from the NOW program in Sarasota and a renewed move to make this a priority that Ms. Fuentes mentioned, which is amazing)? I look through the emails that I got while debate was raging around the healthcare bill, and the only group that mentioned including midwives in it was The Big Push for Midwives. I get that Planned Parenthood and NARAL and NOW were concerned with Stupak and access to abortion coverage and then access to contraception and that those came first. But it doesn’t take a lot of effort to stick something in your legislative agenda and ask people to support it. When the HPV vaccine came out, it took about a day for us to decide to advocate that it become mandatory so that Medicaid and CHIP would cover it in the District. It is not a complicated process. 

     

    It’s amusing to me that some of the attitude is essentially “do it yourself if you want it done.” Of course. But imagine the unique position advocates for midwives and choices in childbirth are in: they do not fall into a strictly pro-life or pro-choice camp. As I wrote in the post, many are vehemently anti-choice, but, legislatively, are on the opposite side of the anti-choice lobby. Their legislative goals would line up more closely with the PC lobby, but they haven’t exactly been welcomed into the fold (and yes, some don’t want to be there). Have you ever had to testify before a committee with no other clear supporters to back you up, and your opposition are members of ACOG and the AMA and AAP? One of the most important aspects of getting legislation passed is coalition building because legislators like group support. I don’t think there’s anyone—and I certainly don’t—who thinks that PC groups are lazy or not adequately standing up for women. The point is that their advocacy is incomplete if it does not include bodily autonomy during pregnancy and childbirth. 

     

  • arekushieru

    Hmmm, it seems to me that CM outlined quite well what the problem is.  When she pointed out that every one has their niche.  So, those who advocate for birthing choices won’t necessarily push as hard on the abortion spectrum and vice versa.  That we must join our hands together, so to speak, to provide a full spectrum of support on EITHER end. 

    Btw, I believe you delineated quite clearly how this falls within the purview of the ProChoice camp although, originally, there seemed to be some confusion within the first part of your last paragraph…?

  • ecr319

    What I’m talking about are specific policy and legislative points regarding choices in childbirth. NAPW does an excellent job at being both pro-abortion rights and pro-childbirth choices, but they are only one organization. If you look at Planned Parenthood or NOW’s candidate “priority issues” (http://www.nowpacs.org/candidates.html and http://www.plannedparenthoodaction.org/positions/our-policy-positions.htm), choices in childbirth and access to midwives are not listed. Taken directly from NOW PAC’s site: “Reproductive freedom also includes access to reproductive health services, effective birth control and emergency contraception, the right to comprehensive sex education, and the right to decide whether to have, or not to have children. “

    I can’t speak specifically to each and every Planned Parenthood affiliate in the US, but it is not a part of PPFA’s, nor was it a part of the one for which I worked. I think it’s wonderful that a chapter of NOW in FL started to re-look at these issues, and that NOW is considering adding them as a priority. Right now, though, if you look at PP or NOW, it is clear that the only “choice” for which they publicly advocate is for a woman to legally and safely terminate her pregnancy. 

  • heidi-d

     “It’s amusing to me that some of the attitude is essentially “do it yourself if you want it done.” Of course. But imagine the unique position advocates for midwives and choices in childbirth are in: they do not fall into a strictly pro-life or pro-choice camp……The point is that their advocacy is incomplete if it does not include bodily autonomy during pregnancy and childbirth. “

    Why is it amusing? That is how stuff gets done. You see the issue, you know the players and the field, who else is fit to do it? As mentioned both movements are small and made up over worked people facing giants. The number of people who can fully grasp both issues and act as a bridge is even smaller. 

    My point is I have never brought birth issues to the attention of a women’s group and been received with anything less than full support. 

    If the message of the birth activists is not on the wider feminist agenda, then the question to me is why is the birth community not reaching out more to build support so they do not face those hearings alone, not where are people we have never asked for help who are drowning in their own work. 

    It is one thing for NAPW to make blanket request and that is awesome, but change happens in the board room not from a proclaimation.  Birth activists need to be on the circuit with some brief bullets points and specific requests about birth. The issues in birth are big and difficult to understand if it is not your life work, and the agendas of the main groups that lobby for midwives like ACNM, AABC, and Big Push in are conflict with each other over CNM vs CPM and educational routes. The birth community needs to do the work of explaining who are we and what kind of help are we asking for.  Then one of us needs to systematically present the requests to the groups that could help, and see it through until the policy is a reality.

    This is where I stand by what I said, we have to do the work, if you are in Planned Parenthood and help set agenda, and know how easy it can be, go out there and do the coalition building. Get birth choices on planned parenthood national agenda. 

     Florida midwives are  facing some tough issues now as well, it is a good idea to take my own advice and enlist support from groups outside of just birth or healthcare for help.

  • shewho

    tend to be involved in the issues that are current, for them. That means that dedicated lactivists move on to issues in education, and doulas start talking about elder abuse. The woman who is inspired by safe-sex campaigns becomes the point person on PPD, or an activist in the fertility community, or the leading light of her mothers of multiples group. As our lives change, our message may.

    Few and far between are people whose focus is narrowly on one topic, unless they are employed in it. When I showed up at the state capitol in support of home-birth legislation, they were delighted to see me. I was the only ‘merely’ homebirth mother in the room. I’d read something in the paper and driven down.

    Of course, no one has contacted me since. ;)

    We may look at all this stuff as the glacial movement of big institutions. But much of it is volunteers. And it kind of annoys me, actually, to have people bitch about what a poor job women are doing supporting them in whatever their stage is when I know so many women who have been fighting and organizing in women’s issues for 40 years.

    People grew up in a world with Title IX and Roe v Wade. You have no idea how miraculous that is.

  • alison-cole

    At Aurora Medical Services a small private abortion & repro health provider in Seattle, WA where I’ve worked for the past 7 years, we are always happy to work with the local midwifery community.  We often refer our patients who are happily pregnant for prenatal care with midwives.  Dr Oyer, our owner and medical director, is a regular lecturer with the Nurse Midwifery program at the University of Washington.  We also host students from the local direct-entry midwifery school, formerly Seattle Midwifery, now a part of Bastyr University, in the clinic to observe both surgical and GYN clinics with our doctors and nurse practitioners.  We’ve seen many referals from local midwifery practices as well, for treatment of incomplete miscarriage and for termination of unwanted pregnancy. This year, we were a proud sponsor of Seattle’s Miles for Midwives midwifery awareness walk/run.  We believe that our clinic shares many values in common with midwives, including evidence-based practice, client-centered care, and informed choice.  As clinicians, our providers and midwives work together as equals.  Here’s to allopathic docs like Dr. Oyer who recognize the value of midwives, and a world where we can all ccess abortion & midwifery care with ease (no, I won’t hold my breath).