In the more abortion-focused circles of the pro-choice movement, birthing rights often go unaddressed. My mentions of home birth rights specifically have brought varying responses, from supportive to ambivalent to outright hostile (“Well that is not safe!”).
But let’s be clear about something. Reproductive justice means that everyone has complete control over if, when, where, how, and with whom they bring a child into the world. It means that people have accurate, unbiased access to information regarding all facets of their reproductive lives, from contraception to pregnancy options, from practices surrounding birth to parental rights. It means that our choices are not constrained by politics, financial barriers, or social pressure. In other words, how can the right to give birth at home – safely and legally – not be on a reproductive justice advocate’s radar?
I mention this because we in North Carolina are enduring yet another vicious attack on the rights of pregnant and childbearing individuals. Women seeking home births may have the legal right to do so, but just like the women seeking abortion care, these laws do nothing to protect access. As far as home birth attendants go, our state only recognizes certified nurse midwives (CNMs), and in order for these phenomenal women to legally attend births, they must be supervised by an MD currently licensed to practice obstetrics in the state. As you can imagine, physicians that will supervise home-birth CNMs are few and far between, and this week one of them was advised (under threats of sanction) that he cannot sign off on CNMs who are not under his direct employment. Even though the law does not dictate these terms, the medical board’s sanction left seven of our eleven home birth CNMs without a licensing MD, and countless women without a care provider.
The research is abundantly clear: when labor is progressing normally, a woman under the care of a trained midwife is as safe giving birth at home as she would be under the care of an obstetrician in a hospital.
Anti-abortion birth advocates are already taking a hypocritical stance on the matter as they decry abortion rights while asking why women’s reproductive decisions are limited. I’ve been biting my tongue while reading the Facebook comments of fellow birth professionals all week. One such statement went, “It is legal to have an abortion but a woman can’t choose to have a home birth with a midwife! This is crazy!” Another, “A mother can kill her baby in all three trimesters but can’t give birth at home. The government is nuts.” [Fact-Check Sidebar: North Carolina restricts abortion access after the 20th week of pregnancy (hardly “all three trimesters”); additionally, this ruling didn’t come from the government, it came from the NC Board of Medicine, an agency independent from the state’s governing body.] These ramblings are usually followed by the contradictory co-opting of pro-choice language, ripe with phrases like “right to choose” and “my body, my choice.”
The abortion rift amongst birth advocates is really nothing new. After all, to simply be an advocate for varying birthing options does not encompass any official position on the politics of pregnancy itself. Birth advocates come to the work for a variety of reasons, and while it certainly seems odd to me that a person could support the “right to choose” in one pregnancy outcome but not another, the social stigma surrounding abortion means that this rift is bound to exist.
That home birth rights are not at the forefront of the reproductive justice movement, on the other hand, is beyond me. The struggles are just too similar. Every time someone points out that women might have to cross state lines to access a home birth midwife, I think of the women who still — in the year 2012 — have to seek abortion care in a state with fewer restrictions or more providers. When we worry that women will have to give birth with midwives who operate illegally (or go unassisted), I think of the women who risked their lives going to see illegal abortion providers with no public credentials, or the women who simply did it themselves. Medicaid and many private insurers restrict access to home birth midwives just like they restrict access to abortion, making both more or less a privilege to those with the means to pay out of pocket.
Reproductive justice advocates who are involved in birthing rights see both — the right to an abortion and the right to give birth at home –as the same struggle. We understand that any assault on reproductive freedom comes from a system of patriarchal self-interest that sees women not as autonomous beings, but as objects to be regulated and “fixed.” We know that women who choose home birth have done their research and don’t need “warnings” from government institutions, just like women seeking abortions don’t need the ideological jargon in “Right To Know” legislation. We know that women and their families are capable of making the best possible decisions regarding the births of their children, and we seek to create a world where access, stigma, and social pressure don’t sway these decisions. In other words, we live up to the full spectrum of our ideology… we Trust Women.
I call on the reproductive justice movement to make birthing rights a part of their pro-choice consciousness. If we are to create a world that ensures sexual and reproductive well-being for all women and girls, no struggle to protect our choices or desires can go unsupported.