How to Talk to Pregnant People: 10 Dos and Don'ts

I often hear stories from clients about how casual remarks from friends, family or strangers have disrupted their day or caused them to doubt themselves or the health of their pregnancy. Exercise discernment, and know that usually less is more.


1. Don’t ask if they are pregnant

Okay, I’ve broken this one with good friends who I know are trying - it’s so exciting! But in general, if you run into someone and they look a little big around the tummy or are declining drinks, sit with your curiosity and wait for them to tell you when they’re ready. There’s many reasons someone might not be ready to share the news - they might be waiting on results of genetic screening, or feel ambivalent about the pregnancy - or maybe just gained some weight! DO exercise patience and wait for their announcement.

2. Don’t comment on their appearance in detail

Saying “You look small”, “You look big”, “You’re starting to show”, “You’ve gained a lot of weight”, “You’re carrying high”, “You look like you’re about to pop” or “Do you have twins” often creates worry for the pregnant person and make them question the normalcy of their pregnancy. These are all unwelcome comments people have said to my clients. DO simply say “You look wonderful”.

3. Don’t give unsolicited advice

What worked for you or someone you know is not the solution for everyone. Also, when someone is really struggling with an ailment or discomfort, physical or otherwise, hearing your advice (that they’ve probably already tried, along with a zillion other things) is usually just frustrating. Remember that you’re not their care provider! DO trust that if someone wants advice, they will ask for it, or ask if they want advice before you give it and be willing to accept a “No”.

4. Don’t tell them your traumatic pregnancy or birth experience

Sharing negative experiences can heighten and compound any fear that may exist for them and is usually harmful. I counsel my clients to respond to the beginning of such stories with “I care about you and I want to hear your story but I need to take a raincheck until after the birth because I’m trying to keep things positive”. Don’t take it personally. DO find support for processing your own trauma with a therapist, others with a similar experience, and/or friends.

Hey! Don’t touch me, even in utero, without asking!

Hey! Don’t touch me, even in utero, without asking!

5. Don’t touch their belly without permission

I am shocked by the number of stories I still hear from my clients about people (and strangers!) feeling entitled to touch their pregnant bellies without even asking. Be judicious with who you ask - a stranger probably doesn’t want your hands on them and may feel obligated to say yes out of social nicety. DO express your appreciative joy at the new life they are bringing into the world.

6. Don’t ask if they’ve had the baby or are in labor yet

You can ask if they want to go see a movie, or if there’s anything they need, but the constant checking in only adds to any anxiety they might have about when the baby will come. The number one complaint I hear from clients who go past their due date is how much they are pestered by family and friends. They will tell you if they’ve had the baby when they are ready! DO give them space at the end of their pregnancy, except invitations for fun or offers of help.

7. Don’t comment on their eating or other prenatal choices

Again, you’re not their care provider, and it’s not your job to monitor or even note their food, beverage, or other life choices. Pregnant people are often judged for what they put into their bodies and how they exercise, sleep, etc. You can’t possibly know what is healthiest or best for them and their baby. DO approach their choices with curiosity and a willingness to learn if invited to listen.

8. Don’t assume that someone isn’t pregnant or is in good health

In the Bay, I have clients who have to take the subway regularly in early pregnancy and need a seat at that stage more than in mid-pregnancy when they may be feeling great. If someone asks for your seat on public transportation, unless you need it yourself, give it to them. There are also many auto-immune and other conditions that could cause someone to feel unwell even though they look healthy. DO act generously towards everyone, and keep in mind that someone could be pregnant even if you can’t see a baby bump.

9. Don’t ask if it’s a boy or a girl

If they have found out the sex of the baby, they will usually share it happily on their own if it is not a secret. If they haven’t found out, or don’t want to gender their baby, that question can be annoying. If you want to get them baby gear, buy something gender neutral. DO act excited to love on their baby no matter what.

10. Don’t ask closed questions that make assumptions

If you’re trying to connect, asking, “Are you excited for the birth” or “Are you scared” closes off avenues for them to share the full complexity and nuance of their emotional world. They may feel both excited and scared (and many other things as well) but you’re less likely to find out when you ask a leading question. DO ask open ended questions like “how are you feeling about the birth?” and genuinely be interested in hearing their answers.


Home Birth: Just as Safe as Birth Centers

We bring equipment too! Note the oxygen tank in the background.

We bring equipment too! Note the oxygen tank in the background.

Thank you for the recent spotlight on birth centers - I wholeheartedly agree that they are an appropriate option for many families.

I’ve worked in both birth centers and home birth and I take issue with only one line in the article.

The author, Alice Callahan, implies that birth centers differ from home birth in that birth centers have “basic equipment on-site and a plan to transfer to the hospital if necessary”. Home birth midwives carry identical equipment and similarly transport when needed. The safety of both has been well established.

In fact, almost every I midwife I know working in a birth center has also done home birth. Most, like me, go back and forth between the two environments over the course of their careers.

There is no need to denigrate home birth to promote birth centers - they are both necessary components of any comprehensive maternity care system.


Reflections on Motherhood

Reflections on Motherhood: Lenea Kalima Salde-Azzam (11/18/17)

Lenea: Heavenly Flower (Hawaiian)

Kalima: Speaker; Mouthpiece (Arabic); “The formal declaration of faith” in Islam.

The Huge Decision

We prepared as much as we knew how to. My partner and I are community organizers, and we know how to plan! We know how to put together outlines and benchmarks and work lists, etc. We had binders of research, and tracking forms, and food and exercise plans. We documented midwife visits, came with questions, did acupuncture, took the herbs, went to birth education class. And yet, the only thing we were pretty sure about was that we weren’t really sure what we were doing. Even with all the support, love, and care from Marea, our midwife, there was really no way we could have prepared for this beautiful chaos.

The process was hard. I had had a miscarriage in 2017 and when I got pregnant six months later, I was afraid to be excited. My partner and I went to the hospital the first time around for an intrauterine insemination (IUI) procedure, and when we went back the second time around they were no longer doing IUI’s. We were totally heartbroken because we thought that that was our only option. We sort of stumbled upon midwifery, did our research and called one midwife and asked her a series of questions and then decided to work with her for the the IUI procedure. We were shocked at how different the experience was and how grounded we both felt during the process. When we found out that I was pregnant, we immediately called our midwife, who then talked to us about home birth and invited us to a movie screening and roundtable discussion.

We decided to “entertain” this idea, but were definitely not sold until we watched The Business of Being Born and talk to other midwives, doulas, and pregnant women at the screening. We both agreed that night that we felt we could provide the space in our home to bring the baby into the world the way we wanted — in a calm, warm, musical environment. After deciding to work with a midwife and have a home birth, our midwife informed us that she too was pregnant. So, she referred us to Marea Goodman, whom we grew to love very much. Marea held space for our family to go through this process in such an incredible way. She not only provided the knowledge and medical support that we needed, but she did it in a way that was thoughtful and caring. She upheld our rights when we hadn’t even realized that we had had experiences in healthcare that were both humiliating and traumatizing. Marea treated us with dignity and supported us through worry and fear. Our family is eternally grateful for the love that Marea helped bring into our lives.

Reflections on the Labor

This was the most intense “moment” of my life. What I remember now, four months later, are shades of memories. I am reminded of the time we spent in our beloved space at home, so carefully arranged so that we might bring life into it. The lights are dim and my partner is looking deeply into my eyes, waiting for me to tell her what to do, how to help. But, I gaze back at her and without words she knows that her presence and the ways she is squeezing my hips is enough. I look at her and think, “everything is about to change my love.” The words won’t come out, but we both know the moment is upon us.

My last day of work was Wednesday; I remember I also had a meeting that evening. I checked in about how excited we were and how nervous I was to have 2 weeks off before the baby would be here. But she had her own plans. That night I woke up to contractions. I felt a little sick and felt sweaty while going through each one. By the morning I was only experiencing some tightening, so thought whatever it was, had passed. I drove my partner to work in the morning and went home. I started to have more contractions, so tried to get in touch with Marea to see if it would be okay to go to get acupuncture. I went to see Marea that evening and she confirmed that I was in early labor. We went to eat and then went home.

That night the contractions intensified, coming every 6 minutes. With each surge, I felt more empowered to get our baby here. I felt ready and aware of all that was around me - every ancestor and every candle lit for the welcoming of our little one. Around 3:00am, the contractions started to spread out to every 8 minutes, and then increased in time to every 20 minutes by 7:00am. I felt disappointed and tired. The next day was difficult. My best friend and partner stayed with me in our bedroom. I remember the smell of mom cooking spaghetti in the kitchen and the sounds of Jeanelle and Nikki sitting on the bed talking about how the night had gone. I hadn’t slept more than 20 minutes at a time the night before, so Nikki went to get me Benadryl so that I’d be able to get some shut eye. I buried my face in the pillow and felt comforted by Nikki’s lingering smell.

4:00PM approaches and by now I’m getting scared. The contractions are starting to get closer together and it makes my heart beat faster. All of sudden I’m overwhelmed by fear. I’m afraid that I won’t be able to do this, so I tell Nikki to call Marea and tell her I want to go to the hospital. Marea gets on the phone and talks me down and says that she’s going to come over. I pray that she will get to the house soon, and help me. I can barely keep half a banana and a bite of spaghetti down as the contractions start to get closer together. They have stayed at 8 minutes apart for hours and hours. I’m so exhausted and now Nikki and Jeanelle are talking about putting on Star Wars. I stand next to the bed so that I can watch too — but the surges are just too strong. I can’t concentrate on anything but the baby. Marea comes behind me and rubs my back and gives me water. Hours have passed and the lights have been dimmed. I look up and see the prayer flag that my community has given us. I look around at the confirmations that Nikki and I have written: “God is with us.” I rock on my bouncy ball, head in Nikki’s arms, thinking about the women that we met in the Philippines, who gave birth in grave conditions, women who were taken from their babies when they became political prisoners, women who died giving birth at checkpoints. I lift my eyes to the sky and breathe. In this moment I’m overwhelmed. I feel like my heart is going to fall out of my chest. I pray that my own mother and mother figures in my life know the love we share. I feel their life in my veins.

I climb into the water, but am too exhausted to keep myself up. I stay there, laying back in the water to rest, and come up to the side, embracing each surge as it prepares me to bring forth life.

I struggle through each one. But, I can’t anymore. I climb onto the bed and the women around me hold me as I push. I trust when she tells me to push. I trust when she tells me to push down. I trust when she tells me not to be afraid. And then. Then she is here. “She’s healthy.” WHAT?? We had a girl? And then the tears come. The hyperventilating silence and awe. I am feeling her on my skin, breathing and looking up at me.

When I think of how I might be as a mother, I hope that my daughter knows that she was raised collectively, and that she is a product of hundreds of years of resilience and strength that she might know in her lifetime, collective liberation. I hope that she knows the love of community and works for the good of the people. I pray that she will have a spirituality that connects her to God and all that is beloved. I hope that she stays connected to the earth and the water and loves to be in the water as much as she loves to splash around during bath time. I hope that she has passion for what she loves and uses her voice in the same way she takes her pacifier out to say what she wants to and then puts it back in by herself so that she can rest more easily. I pray that stay connected to her mother/father/parent figures so that they may give each other life.



Midwives For Every Body

Midwifery care is not only for pregnant people. Midwives perform basic health checks for people of all ages and sexes, offer screening for sexually transmitted diseases, order labwork, and provide our children with thorough, accurate, and compassionate sexual education. Throughout history and across cultures, midwives have held many different roles in societies. We have cared for people through the generations- from birth to death. We have helped to support everybody, regardless of age, sex, and gender, to be healthy and connected to themselves.

For centuries, humans held control over our own healthcare. We used food and herbs and different traditions to help keep us healthy and to nurture future generations. Midwives were, in most cultures, some of the most appreciated and respected for our practical and spiritual knowledge of health and wellbeing. As community members, our roles were to empower others with the knowledge of what they needed to be healthy and well, so that they in turn would become their own best caretakers.

Today, in American society, we have lost the collective ability to care for ourselves. We are trained to look outwards for health: to doctors, to pharmaceutical medications, and to ever-changing technologies aimed to make us healthier and happier. Low-income and communities of color are the hardest hit with limited or no access to fresh fruits and vegetables, increased exposure to environmental toxins, and a lack of preventative healthcare options. As a culture, we no longer revere midwives as bedrocks of community healthcare, and we have lost the trust in our own bodies that we once had. This decline in respect for midwives and autonomy over our own healthcare is entirely intertwined.

In the United States in the early 1900’s, the newly formed American Medical Association began gaining power. They conducted a smear campaign against midwives, painting us as dirty, untrained, and inferior, and introduced the culture of looking to (male) doctors and hospitals for care. Not only did they dishonor midwives: they sowed the seeds of fear and mistrust in our own bodies. A new culture of medicine was born. One in which we thought that we needed doctors to tell us when we were healthy or unwell. Where we thought that we needed obstetricians to keep us and our babies safe during childbirth. Where we needed machines, professionals in white coats, and medications to keep us alive.

Western medicine has created this absurd idea that the female body would not be able to give birth without doctors to keep them safe. If that were true, how could we have possibly survived as a species? There have absolutely been some important advancements in birth that the Western medical system has offered. Antibiotics have protected babies and birthing people from infections, anti-hemorrhagic medications have saved countless lives, and cesarean sections have allowed many babies to live when they would not have been able to be born vaginally.

Unfortunately, we often take the benefits of Western medicine too far. We have gotten to the point in our society where we have overused antibiotics for humans and animals resulting in the creation of super-bacteria which are resistant to all of the medications we have. In the US, we perform major surgeries for the births of 32% of our babies, where only about 10% are considered necessary by the World Health Organization. Almost 10% of our children between ages 6-17 are on some type of psychiatric medication, with proportions increasing for low-income children of color.

When hospitals and doctors took the place of community healthcare and midwives, we forgot how to care for ourselves. We began to fear birth, even though our ancestors had done it successfully for thousands and thousands of years. We began to control and regulate the female body, to conceal sexual knowledge from our children, and to insist that everything be treated with pharmaceutical medications.

We lost autonomy over our own healthcare, because the power of our autonomy was more that our patriarchal society could withstand.

Imagine we lived in a world where children grew up knowing about their bodies and how they work, where they learned about the local plants that could help keep them healthy, and where they had healthcare providers who had known and cared for them since before they were born. Imagine we lived in a world where men took it upon themselves to teach young boys about consent and intimacy, and where all children had community members they could talk to about their changing bodies and sexualities. Imagine women and other people with uteruses knew how to strengthen or restrict their own fertility. That when they decided to have a baby, they could be supported and accompanied by someone in their own community who knew best how to care for them because of their longstanding and trusting relationship. Imagine that when people died, they could be surrounded by the friends and family they were closest to, cared for by loved ones with a sense of connection and whole-ness.

This reality is not so far-fetched. In today’s modern world, where the internet connects us globally like never before, we have access to unbelievable quantities of the information we need to take back our healthcare. Online health forums, medical blogs, and high-quality research is accessible to anyone with curiosity and basic technological skills. The internet is packed with online parenting groups and discussion boards for people considering unassisted homebirths or attempting to heal cancer naturally. We need to learn the critical skills to sort through various qualities of information and determine what actually applies to us and our communities. The knowledge is here: both through written knowledge and ancestral wisdom, ready and ripe for us to remember.

In this moment in US history when our collective access to healthcare is being threatened to an even greater extent than it already has, we need to re-learn how to keep ourselves and each other well. We must take our healthcare back into our own hands. I am not advocating to disregard Western medicine and the tools and technology we already have. I am, however, arguing for a change in our collective paradigm of healthcare. We need to re-create a culture where we are connected to our bodies, our babies, the earth, and our humanity. We need midwives to again become central parts of our communities’ healthcare systems, and to teach us how to care for ourselves and each other. No doctor can save us. Let’s support each other to save ourselves.


Do you have ideas on how to create and support community-based healthcare that is accessible to everyone? Please comment below!


Julian's Birth Story

Part I:

Reflections on Birth and Society

Written before the birth

Why do we have so much trouble giving birth these days? The rate of c-section, induction, and other medical interventions is surreally high. I desperately did not want to become one of those statistics. When I got pregnant I learned about natural birth, and felt empowered. I wanted my body and my experience to prove something to myself and to everyone I knew: that our bodies “are not lemons,” as Ina May Gaskin writes; that birth can be a smooth natural process if only you let it, if you believe in it.

I thought that taking certain steps would ensure my desired outcome: deciding on a home birth, coming to trust my body and the process of pregnancy, vanishing the fear of labor from my soul, responding to my pregnancy challenges with diet, acupuncture, chiropractics, walking, swimming, yoga, herbs, patience, and trust.

Perhaps all is not lost. Even though I have chosen not to go down the natural path, I take comfort in knowing that my body could theoretically have represented what I dreamed it would if I had been able to give it more time. Or, sometimes nature just needs a little help. Perhaps I am unfortunately just one of those “sometimes.” If induction happens 23% of the time and should truly happen 10% of the time, perhaps I’m one of the 10% and not one of the 23%. If c-sections should only happen 3% of the time as opposed to 30%, perhaps I’m one of the unlucky 3%.

In the end all we can do is accept and move forward. As Amy Tuteur says, “Love your birth as it is.” Love your birth as it is, I repeat to myself, if it goes how I planned, if it doesn’t go how I planned, or if it ends up somewhere in between.

What I shouldn’t do is use my body to prove, or disprove, some sweeping ideal.

Perhaps gestating beyond 42 weeks is still natural. It’s likely that if I turned down induction and just waited, the baby would come, and the baby would be healthy. Perhaps now it is precisely my choice to get induced that is placing me as just the kind of statistic I was trying to avoid becoming. Perhaps by making this choice to go to the hospital I am relinquishing my last opportunity to realize my goal. Up until now I’ve done everything in my control. And this is one last choice I do have control over. But I will never know, because if I kept waiting, perhaps my baby wouldn’t be born healthy. Perhaps he would become the stillbirth statistic they hold over your head about babies who gestate beyond 42 weeks, a rare occurrence that does happen in nature, that we now have the technology to avoid. And all for what? To try to prove a point.

That’s a risk no mother is willing to take.

I guess by becoming a statistic myself, I am ensuring that my baby not: the maternal sacrifice that is made over and over and over, in countless different forms and contexts countless times by countless mothers.

I vow to stop judging birth and using it to represent some point. Pregnancy and birth, and all human physical and psychological function, is complex and nuanced. Judgement is not helpful to anyone. I vow never to feel envious of smooth births, but rather to see them as hope. And even further, perhaps to not let them symbolize anything, to let them simply represent that particular birthing woman’s personal experience and that woman’s experience ONLY.


Part II

My High-Tech Birth;

and You, My Mystery Miracle

Written after your birth

“What does that mean, anyway,” my mom said, forever the protector of her daughter’s psyche. “A ‘natural’ birth,” as if yours was ‘unnatural.’” “Yeah, I chime in, instead we can call it...high-tech! There are low-tech births and high-tech births!”

Two months ago I was oohing and ahhing over natural birth stories and preparing a box of supplies for my low-tech home birth. If someone had told me that in the wee hours of September 10, 2017 (19 days past my due date), I would find myself, after a 54-hour induction attempt at Kaiser, immobile in a hospital bed, flat on my side, diagnosed with an infection and preeclampsia, inhaling from an oxygen mask to help your periodically dropping heart rate, hooked up to saline, pitocin, an epidural, a catheter, antibiotics, magnesium sulfate, a fetal heart rate monitor, an intrauterine contraction monitor, a heart rate monitor under the skin of your head, and asking for a c-section, I would have been absolutely crushed. On the spectrum of birth technology, I had planned on placing my family on the far left. We ended up landing on the far right. In fact though, and this is what made it palatable, instead of landing out of thin air like an airplane, we gradually crawled like inch worms, making our way along the branches of the decision tree. First I didn’t go into labor by 42 weeks, at which point, after having tried everything under the sun that we could do at home and in the offices of my acupuncturist and chiropractor, I was legally forced to say goodbye to my home birth. Then I went to the hospital for an induction (should I have waited longer?). We started with misoprostol (should we have started with a foley balloon?)...etc...etc… until I ended up as described above, beyond doubt and with full confidence requesting a c-section. I suddenly realized that I was no longer giving birth. I was no longer in a place to push you through my pelvis and out of my vagina. Ellah, our midwife, estimated your weight at nine pounds when I was 40 weeks pregnant, so I knew that at 42 weeks and five days, you could easily be ten pounds. And we knew you weren’t dropping. I didn’t trust the hospital doctors with a tricky vaginal birth. I would have trusted Ellah with the birth of a ten-pound, five-ounce baby through small me. The midwives know all the tricks (many of them not even possible for me in my current state had I wanted to attempt them on my own in the hospital). Instead, visions of forceps and episiotomies and broken bones (yours or mine) and emergency c-sections danced in the back of my mind and finally, everyone’s refrain about the most important thing being a healthy baby sunk deep into my heart. I had a strong gut feeling that you and I would be safest with a c-section, and my mother always taught me to trust my intuition.

Birth is ultimately still a mystery. Why do some women and their babies have one-and-a-half-hour births while others have 54-hour births? Why do some women feel no pain in labor while others beg for relief amidst tears and vomit? Why do some women hardly notice they are pregnant, while others are fraught with nausea, placenta previa, preeclampsia, repeated miscarriage? Why do some couples conceive after one month, some after one year, some only with high-tech treatments, and some never?

Experts have hypotheses and theories to answer these questions, but there are individual exceptions in all cases. No explanation applies to everyone. This is why I, a firm atheist and scientific-minded liberal, call you my Mystery Miracle.

In a purely “natural” world, before medical technology existed, I would be living in a small Russian village and would have copulated with a small Russian Jew, about the height of my Jewish father, grandfather. Instead, I live in America and got hitched to a tall, well built part Scandinavian part Irishman. Could this “unnatural, cross-breeding” phenomenon have created a baby too large for me to birth? (Yet many small women can birth big babies. And yet again, not always.) In that small Russian village I would have been eating a traditional diet of grass-fed animal fat and protein, fermented or soaked grains, foods and drinks rich in probiotics, no processed foods, nor white sugar, nor empty calories. According to Dr. Weston Price, this diet would have allowed me to grow a strong, wide pelvis, leading to an easier birth. (Yet many women who grow up on junk food can birth their babies vaginally. And yet again, not always.)

It’s true what they say, that you forget. As one wise family friend told me, a fog descends over the birth memory. Julian, I’ll probably never forget how hard it was, physically and emotionally, to bring you into the world; or how dramatically different it was from what I had wished for us. But with every day that I get to know you better, with every day that I bond further with you, with every day that I fall deeper and deeper into a love that is so deep it’s almost unrecognizable, the memory fades. Or rather, the importance of the memory fades. You are the important thing now. You are more important to me than anything. You are frighteningly precious. It’s a dark thought, but I realize that I now have someone for whom I wouldn’t hesitate to give my own life.

When you were three days old I was still getting to know you. I was still trying to figure things out. I woke up that morning and thought, “Oh! Right! I have a baby! Oh geez, another day of struggle, of crying and nursing, crying and nursing, not knowing how to soothe you, not knowing what your cries mean, wet diaper after wet diaper. Fatigue, no time to write emails, answer texts, do laundry, clean up the kitchen, take a shower. Will it feel like this, will I feel like this, every morning? Now you are three weeks old and I greet you with glee every morning. Julian!

My Mystery Miracle! How beautiful you are. Your sounds and cries pull on my heart strings. Come soothe yourself on my breast, come nourish yourself from my body as I stare lovingly at you, your adorable face and little body wrapped like a burrito in a special grey and yellow blanket. When you’re done nursing you suddenly unlatch from my breast, toss your head back, and fall fast asleep, with the most serene look on your beautiful newborn face. At two weeks old, you sleep through the night, my little Miracle.

Ellah said that she loves how you take your time with things and sleep deeply. You came into the world 19 days after your due date. Your umbilical cord finally fell off weeks after most. Sometimes you nurse for 45 minutes, drifting off to sleep then waking up and sucking with a renewed eagerness, your small, perfect feet hanging off my lap, your little hands slowly wiggling into spontaneous, uncalculated positions.

Ellah also said disappointment is easier to deal with than regret. How right she was. You have guided me easily and peacefully past my disappointment. It has melted away, like a sand castle washed away by the waves. The sand still exists in the world, but it is no longer recognizable as a formidable castle. You are the waves Julian, washing over me day in and day out, the strength of your pull creating a love in me and an instinct to protect so powerful it knocks me off my feet. The part of the birth that I regret--allowing the doctor to sweep my membranes, causing more discomfort than my strongestcontraction as well as the premature breaking of your amniotic sac, which felt devastating for several reasons--is the only piece that still haunts me. It’s the last bit, hanging from a thread. It will take more to cut it loose than it did to get past my disappointment. But I know you will do it. I didn’t expect this but you are healing me. I think that’s what people meant when they said the baby makes it all worth it. Resilience, reflection, time, and support from my midwife, doula, family, friends, and your father, each play an important role, but mostly I’m healed by the power of you.

What White Midwives Can Do To Be Better Accomplishes in Birth Justice

To be a part of the out-of-hospital birth community in the United States means that we must constantly wrestle with complicated race dynamics in the midwifery world and in our own communities. Most of us are aware of the staggering inequities that exist in this country when it comes to maternity care. In the United States, black birthing people are 4 times more likely to die of pregnancy-related complications than white birthing people, and black babies are 2.5 times more likely than white babies to die in their first year. Rates of maternal morbidity and mortality for Indigenous and Latinx birthing people are about 3 and 2 times higher than those for white birthing people, respectively. Even when controlling for class and access to health care, people of color have higher rates of complications than white people. This is attributable to the experience of racism and the impact this has on their bodies and souls. As white midwives living and working in the United States, we must also acknowledge that we are benefitting from the past and present genocide of the people indigenous to this land. So how can we, as white midwives working in out-of-hospital birth, become better allies in the struggle for racial justice? What can we do to address these inequities? Below are some suggestions in becoming more reliable accomplices in the fight for birth justice.


1. Educate ourselves (and each other) about racism. Everybody raised white in the United States has been indoctrinated with racism. It is our inheritance from living in a racist society. Our racism is not our faults, but it is our responsibility. And we can absolutely undo it! Below are some resources specifically for white people who are working on unlearning racism.

             1. Books:                         

                         i. Uprooting Racism: How White People Can Work for Racial Justice by Paul Kivel

                         ii. Understanding and Dismantling Racism: A Booklist for White Readers

                    2. Articles:

                         i. White Fragility: Why It’s So Hard to Talk to White People About Racism

                         ii. I’m Not White, I’m Jewish. But I’m White: Standing as Jews in the Fight for Racial Justice

                    3. National organizations:

                         i. Safety Pin Box

                         ii. Black Lives Matter


2. Understand the internalized and institutional realities that families of color face in maternity/midwifery care. We have to educate ourselves about the actual experiences of birthing people of color in this country and in our communities, without expecting people of color to educate us. Pregnant people of color in the United States face many barriers to accessing health care, due to racist and classist institutions and a systemic lack of care providers who understand their experiences. Show up for events put on by people of color in your area that address these issues. Check out the following resources that educate around the experiences of people of color and their struggle for birth justice in this country. Become members of these organizations and compensate people of color for the concrete and emotional work that they do.

          1. Birthing Justice: Black Women, Pregnancy, and Childbirth

          2. International Center for Traditional Childbearing (ICTC)

         3. Ted Talk: Miriam Zoila Pérez: How racism harms pregnant women-- and what can help


3. Understand models of care already created by people of color that are addressing these issues in your community. Don’t try to reinvent the wheel! Chances are, birth workers in communities of color have already created amazing organizations that are addressing their communities’ needs. Build meaningful and authentic relationships with these birth workers and ask them if you can support their work in any way. Follow their lead. Here are some examples of models by and for people of color that are successfully empowering communities of color around pregnancy, birth, and postpartum:

      1. Jennie Joseph and the JJ Way.


      2. The Community Birth Center in Los Angeles, California 


      3. Black Women Birthing Justice 


        4. Changing Woman Initiative



4. When working with families of color, check our privilege. It’s not enough to say that our practices are open to people of color. In order to be good midwives for families of color, we need to do the lifelong work of dismantling our own racism. When caring for clients of color, we need to remember that they have had to deal with racism their whole lives (in particular around their bodies and the healthcare system). As white people in the US, we can never fully relate to the experiences of people of color; we can hold space and listen with an open heart.


5. Consider referring clients of color to midwives of color. Often, pregnant people of color want the option of having a care provider who looks like them. When interviewing with a client of color, consider referring them to a local midwife of color so that they can meet each other and have the option of working together. It may sound scary to risk giving up a potential client, but it’s actually a reflection of understanding and allyship that will inevitably support your midwifery practice and the wider midwifery community in your area.


6. Support financially. One of the realities of out-of-hospital midwifery in the US is that a large portion of our clients are white and reasonably well-off. Consider donating a percentage of the fees that you charge to organizations in your area that are directly working with these communities. Or, ask your clients to donate to a community fund that supports birth workers of color in your area.


7. Say no to midwifery tourism. There is a phenomenon in the birth community of white birth workers traveling to foreign countries to gain experiences. It is a heartbreaking reality that birthing people and babies all over the world are dying unnecessarily and generally receiving inadequate care. Of course we, as caring midwives part of an international community, want to help however we can. However, we need to check our white savior complexes and acknowledge the power dynamics involved in birth tourism. Our white, American identities carry with them centuries of oppressive history and complicated social dynamics. Although so many international communities need more resources, they don’t necessarily need us. Instead of going abroad, consider donating money to organizations that are training providers in those communities so that they can be self-sustaining. If you do go abroad, make sure that you are responding to an invitation coming directly from the community you plan to support.


8. Talk to your white clients about race and racism. Midwives have the immense pleasure and responsibility to accompany new families during this beautiful time of growth and transition. We often build close, intimate relationships with our families and are therefore well-equipped to have these important conversations with our clients. Consider sharing resources around parenting in anti-racist ways with your white clients, or organizing a support group for new parents around raising anti-racist children. Below are some resources to share with your clients.

It’s My Job to Raise Children Who Are Not Only Not Racist But Actively Anti-Racist

  1. The 6-Step Guide to Raising Anti-Racist White Kids


9. Avoid culturally-appropriative names for our practices. One of the ways that racism functions is that it allows white people to feel entitled to consume aspects of another culture or ethnic group without much thought or context. Make sure that your practice’s name does not appropriate language or values from a culture that isn’t your own. This also goes for avoiding cultural appropriation in our language, logos, the ways we dress, wear our hair, etc.
10. Teach midwifery skills to students of color. The US has a disproportionate number of white midwives to midwives of color. In order to help address these inequities, we need to prioritize educating student midwives of color. If you are a midwife, consider becoming a preceptor for student midwives of color, or support doulas of color in their practices. Make sure to care for the power dynamics at play in these cross-race, preceptor-student relationships.
11. Build relationships with birth workers of color in your area, and follow their lead. Being an effective white ally and active accomplice in the fight for birth justice means following the lead of birth workers of color. As midwives, we come from a long history of serving our communities with humility and devotion. These are the same qualities required of us in this struggle for racial justice so that every parent and baby in the world can have the care that they deserve from providers within their own communities.
12. Continue to do active anti-racism work in your life, for yourself. White people need to do active anti-racism work for the benefits of our own lives, not out of a sense of guilt or obligation. Racism hurts us, by dehumanizing us and separating us from the majority of the people in the world. Unlearning racism and becoming an effective accomplice is a lifelong process that will inevitably make our lives more rich, beautiful, and connected. Consider this the start of early labor.

By Marea Goodman, Licensed Midwife

***Author's Note: I by no means consider myself an expert in this work. I am constantly learning, growing, making mistakes, and trying to be a better person and ally than I was yesterday. I am deeply grateful to all of the people in my life- friends, family, ex-partners, and colleagues- who have spent their valuable time and emotional energy educating and teaching me. Special thanks to Sumayyah Franklin for editing this article. ***

Claudia's Birth Story

June 23rd, 2017, was not only the birth a baby girl, but also the birth of a mother: Me! 

I had always envisioned pregnancy to be such a joy, just like in the movies. Although I felt happy to be a mother, my first trimester was extremely difficult. Let’s just say “morning sickness” was an under-exaggeration. It forced me to drop everything: all with zero support from my OBGYN. In fact, a direct quote from her was “everyone gets morning sickness.” I soon found myself completely disconnected and disgusted by the medical system.

I started to toy around with the idea of going to a well-developed city in Mexico to give birth to my child, all to avoid being here. After weeks of research I realized that was too far-fetched. Plus, nobody understood or supported that idea. So back to square one I went, trying to do research on a new doctor that would accept me at 22 weeks pregnant. I found myself feeling helpless because either I couldn't find someone to accept me and or they wouldn't take my insurance. So one day I decided to tell everyone to go to hell. I started doing research on midwives in the Oakland area. I have to admit that even then, I didn’t really know what I was doing. All I knew is that I needed someone who cared! 

I found Marea through Yelp. At first I felt attracted to her because I read that she spoke Spanish and that she had done a lot of her work in Latin American Countries. Immediately after doing a phone chat, I knew this was the way to go. 

I have to say I was not opposed to medication and or an epidural in any way. However, after meeting my midwife I suddenly found myself doing way more research around birth than I could have ever imagined. I was determined to work hard to make my birthing experience MY experience.  Marea has always given me amazing bedside manner. I always felt like she legitimately cared about me, my unborn child, cared about meeting my husband, my step-kids and my closest friends. I was always free to ask as many questions at our hour+ appointments. 

I always talked about how excited I was to give birth. I felt like it would be the only time I would feel fully in my body and my experience. Although I knew it was going to hurt, I was not scared one bit! I looked forward to it very much. My midwife gave me confidence and reassurance. I felt like: "I can do this! I will do this! Everything will be fine! ...and if we have to go to hospital, we will just get in the car and go.” 

So the morning of my birth day I went to whole foods and ate a terrible breakfast, yet I remember the day being so perfect. It was beautiful and sunny. Around noon Marea came over and she gave me an amazing castor oil massage on my belly. She told me to watch a funny/happy movie to release the oxytocin. I started a movie, and about half-way through I started feeling some activity. I was home alone, so I reminded myself of all the tools I had to prepare myself for the big experience that was building. Within a few hours I was completely in labor.  With my team by my side, I stayed focused. In fact it's like I went into a different world. I barely remember anyone being around. When I think back I just see myself, my labor, my breathing, my baby.

When I started pushing, my midwife was concerned that the baby’s heart rate was dropping with the contractions. She monitored for a while, and had me try some different positions to see if that helped the baby. After a while, she very calmly looked at me and told me she was going to call an ambulance to transfer me to hospital. Although for a second I felt like I failed, I knew she was doing the right thing. Yes of course I envisioned my perfect water birth, the flower petals and the essential oils, the perfect playlist and the birth of my baby on video. But at the moment the best I could do was take the words of affirmation I had previously taped in my bathroom along the ride with me.

Being inside an ambulance going so fast down the hill can be nerve racking, but I remember constantly looking into my midwife's eyes to find reassurance once again. Never once did she worry me. Once we arrived at Highland Hospital everything happened so fast. It felt pre-meditated. Within a couple of hours I held Colette in my arms. I did it. I really did it!
When asked I always say I couldn't have asked for a better birth story. I still don't think it was bad at all. My midwife gave me positivity, she prepared me fully for this day. I most definitely could not have done it without her. I would have been just another number, numbed from the waist down.  I thank her and my support team very much. I encourage everyone to “feel” what its truly like to give birth.  Feel it!!! I did and I have zero regrets.  

Lavinia's Birth Story: Pine Needles and a Tidal Wave

Part of me was hiding.

Not all of me; Jemima’s birth was amazing, and I only came away from it strengthened and empowered and fuller – more myself than I’d ever been before. But there were still those niggling doubts and flutters of nervousness that are always present when something difficult looms.

Birth is transforming. And being transformed requires undergoing enough depth of experience to be forever changed. Change is hard, and so is birth.

So part of me hid. 

But you can’t hide forever.


On Saturday I told my mom that I thought tomorrow (Sunday) would be the day it all happened. I knew I was stalling, and had mentally held it off as long as I could, but on Saturday I felt like it was time to allow my baby to come and my body to work beautifully with her to make it happen. I went to bed on Saturday night, and things started Sunday morning. It came a lot like it did last time. Birthing waves woke me periodically in the night, but this time I decided to ignore them. “If I’m going to give birth, I’m going to do it tomorrow when I’m awake!” I told myself. And then I’d go back to sleep. My attitude about this birth felt different. I was trying to accept what the birthing process would bring me, but I wanted some things to be different this time, and I felt like to some extent making changes would be up to me.

Chase came in to kiss me goodbye and head off to his meetings, and I told him briefly that I’d been having waves for a while. He seemed surprised, asked me if I wanted him to stay, and I said no. “We’ll see how things progress, and what happens,” I said. He agreed, told me he was proud of me for being calm, asked me to keep in touch, and left. Mom and I got breakfast for Jemima, and started the day normally. Sometimes I would pause for a wave, sometimes I would go lay down and turn off, and things stayed about 15 minutes apart. Mom and I straightened a little, thinking that if this was the day, it would be better if the house was clean, and decided that we would still go to church. Chase came home and I told him that things had stayed consistent, but we were still going to church. He was a little surprised, but totally supportive. I think I was in denial a little bit that this could really be happening, and pretending it wasn’t happening was the first way I decided to cope.

My waves felt manageable, and I continued to pretend that everything was normal. We got to church and I had waves consistently through sacrament meeting. I would turn off for each wave and close my eyes and relax into my oblivion. Every time this happened I could feel the intensity of Chase’s gaze from the stand. After the wave would pass, I would open my eyes to find his boring into mine. Even from across the room I could feel his support and strength. He is always there every step of the way.

About halfway through the meeting it hit me like a train. I realized that I was literally going to have this baby today. I just knew.

And then I panicked.

 A thousand thoughts streamed through my mind, twisting and twining – colors and smells and plans and doubts and second guesses…flashes of moments and memories and excitement and fear. The emotional culmination of nine months of waiting is hard to process. It’s the beginning of the end and the beginning of the real beginning. That moment of realization holds more emotions than I feel like my body can process or contain without bursting. Once my mental storm cleared a little, I realized that my foremost feeling was an almost maniacal need to sleep. I knew the time when sleep was possible would be limited, and that no matter how long this went, I would surely need it. So I started watching the clock.

That was seriously the longest meeting of my life.

Chase raced to my side the minute it was over. I’m sure my eyes had already told him everything he needed to know, but I quietly informed him I was leaving to rest because this was really happening. The excitement and anticipation between us was palpable. He asked me more detailed questions about what I was feeling, and agreed that rest was the best choice right now. Then he walked me home, tucked me in, and left. I got two blissful hours of sleep, and it felt like heaven.

Everyone came home, and we decided it was time to evaluate: my waves were still consistent, they were getting stronger, but weren’t super close yet. Ok. So we decided to keep going about our day and make dinner. I helped, but would head out to the couch and turn off whenever a wave came. Dinner was good, and we were eating and laughing when I suddenly had a few waves fairly close together. The tone changed a little, and we decided it was time to call Renee and chat about what was going on. I didn’t want to talk on the phone, so Chase and Mom talked. Mom came back and told me that Renee wanted to come and observe me and check in. For some reason that made me feel really nervous. I felt stupid saying no, and I couldn’t actually pinpoint a reason why that wouldn’t be ok, (except that maybe it made things feel more real) so I said that was fine.

At this point it all broke over me, and I became emotional. I was kneeling by the couch having a wave, and Jemima came over and gently started rubbing my back. I looked at her sweet little face and realized that it was the last night I would be only HER mommy. From now on and forever, I would always be shared. I started to cry. I needed to mourn that loss like I never had before. Welcoming our sweet Lavinia would be so joyous, but with change always comes the loss of how things were, and would never be again. Jemima, my firstborn, my sweet, tender girl, the baby that made me a mother – our time alone together was going to be over in just a few hours. How had it ended so quickly? Where had the time gone? I held on to her, and that moment, and cried.

I asked Chase to call Mel. She would be photographing our birth, and although things weren’t really serious yet, it was getting close to Jemima’s bedtime and I wanted her in some of the pictures, since I was sure she would be sleeping when the time came.

I decided to change. It felt like time to accept more of what was coming, to shed my normal clothes and don something more suited to this time. A uniform, a suit of armor – to become who and what I needed to be during birthing time: instinctual, primal, strong, grounded…ready to fight and win and pass through to the other side of this experience. I put on a super comfy sports bra I had purchased just for this occasion, and my favorite yoga pants. I still remember that my mom came in just after I had changed and said with a catch in her voice, “Honey, you look so beautiful.” I was surprised; with that huge belly and those swollen feet it had been so long since I’d felt pretty. But on this night it wasn’t the beauty of makeup and perfectly fitting clothes and curled hair that mattered, it was the beauty of stretch marks and pulled back hair, an enormous belly and yoga pants, and the amazing, volcanic miracle my body was about to perform as I brought forth life. And that is beautiful.

The midwives arrived and for some reason I couldn’t pinpoint my feelings. I was a jumble of nervousness and shyness and…I don’t know…confusion? Maybe torn between how I thought I should feel and how I actually DID feel. I knew this was how it would be, but it was like I didn’t know how to proceed ahead while I was being watched.

Renee brought and exuded the calming presence I so adore about her. She asked how I was doing, and we talked things over while I sat on the ball. She listened to Lavinia’s heart and they started filling the tub. I felt a fearful fascination as I watched. The tub drew my eyes again and again, but for some reason I skirted around it when I walked, and tried to avoid looking at it. It represented the climax, the culmination of all of this, and even though giving birth in the tub was exactly what I wanted, for some reason it was the elephant in the room. It was the reminder that this was really really going to happen, and that I was still not ready.

I looked around the living room with the filled tub and the midwives busily setting up their stuff, and it felt too real, so I retreated. I ran away to my room.

Mel came and took pictures of us on the bed. Jemima was so sweet, rubbing my back with Chase and quietly taking it all in. I was trying to relax deeply, and loved being surrounded by my little family. But when it was bedtime, I got up. I wanted to put Mima to bed myself on this last night before everything changed.

I rocked Jemima and read her books and cried the whole time. I ignored my waves and tried to give everything of myself to Jemima this one last time. She was tender and sweet and would wipe my tears and snuggle closer. I held on to every moment. Change was coming so fast and all of the sudden I didn’t know anymore: were we ready?

After a hundred tears, and even more hugs and kisses, I left her room to let Chase finish. I stepped out into the living room and Esther asked me, “Are you ready now? I feel like that’s what you were waiting for.” In a wave of realization I knew she was partially right. “Yes,” I said.

I needed to love and snuggle and give everything to Jemima one more time, and then let go of the life we had.  But now that I had done that, I could give everything for Lavinia, and accept the new family we would be.

The scene that waited for me in the living room still felt overwhelming. I remember Renee asking me if I felt like a watched pot. I laughed it off and said I didn’t think so, but I should have been honest. I was trying so hard to act like none of this was fazing me, hoping that by projecting confidence my fears would disappear. But my fears won out, and I ran away to my room again. I told everyone I wanted to be alone with Chase, and they agreed that I should sleep if I could.

The next few hours are a blur of hypnosis CDs, gentle check-ins by the midwives, Chase’s support, and strong birthing waves in the darkness. It was getting harder and harder to run away in the face of the ever-increasing wave intensity, so I started mentally running away. After every wave I would tell myself, “That was strong, but it’s not happening yet, so I am going to sleep.” I would doze off between each wave and repeat the process the next time. At one point Renee came in to check how things were going, and she stayed for a while, asking me to let her know every time a wave came. They were getting stronger, but she was checking length between waves, which was staying fairly consistent, and I think she was trying to gauge whether or not this was going anywhere.

Chase, as always, was my rock. Every wave he was there; strong, supportive, touching me in whatever way was helpful, talking me through this, and laying next to me while I dozed between waves. After a few hours, I stopped sleeping between waves, and started thinking. I thought about my fears, my worries, my deepest secret concerns that I was hiding…and hiding from. I went round and round in mental circles until I knew that something had to change. Something had to happen to free me from my mind game. I needed help. I sat straight up in the darkness and asked Chase to go get my mom.

She quietly came in and knelt next to me. The words started gushing out. “I...I think I’m scared. Or nervous? Or…I haven’t let go of my fears, and they’re keeping me from letting this go anywhere. I’m stopping it! I don’t know how to release, to let go.” I cried and tried to explain what I still didn’t quite understand myself.

My mom is amazing. Always. And just like she always does, she knew what to say. She told me it was ok. All of it. She comforted me and talked to me for a while, but what I remember most was when she suggested Chase and I go for a walk. I latched on to the idea and nothing has ever sounded so heavenly. “Yes,” I said, “I want to go for a walk.” It felt like a lifeline, an escape. I wanted to run away from this bed that had been changed to have the birthing sheets on it, and the midwives waiting for me to give birth in the living room, and the birthing tub that simultaneously fascinated and terrified me. I had arranged everything to be exactly the way I wanted it, but because I hadn’t faced my fears yet, I wasn’t ready for any of it.

I threw on a shirt and Chase and I left. I knew I was running away, but I didn’t care.

It was midnight, and I’ve never seen such a beautiful night. Chase and I both agreed it felt like that night was made for us. It was balmy and still and some delicious temperature that made it feel like my skin was being caressed, but it was never cool or warm. It was perfect. I’ve never felt air like that before.

Suddenly I felt lighthearted. We strolled hand in hand and laughed. We chatted about random things, and heard people snoring through their windows, which made us laugh. I had to stop and work through a few waves while Chase leaned over and supported me, but they were infrequent, about 15 minutes apart. It felt so freeing to escape for a while. Maybe I’ll always need to run away for a bit during my births. We walked and talked and soaked in the beauty of that night, until I started to feel the weight of what was waiting for me back at the apartment begin to press down on me again. I had another wave, slightly stronger, and told Chase I wanted to walk a little bit more. My waves were getting farther apart, and I knew it was time to decide.

We slowed by a tree that faces the balcony of our apartment. I could see inside. My heart started racing. I asked Chase to give me a minute alone, but stay where I could see him. Always supportive and sweet, he told me he would do whatever I needed, squeezed my hand and moved a little ways up the path. I stood there and looked up at that tree, and cried.

“How do I do this?” I asked myself. “How do I let go?” I suddenly felt an urge to do something symbolic, anything that could help me process these feelings and release them. My thoughts jumped from one thing to another: “I could improv right here…I could try and dance it out.” Movement was always so cathartic, but with my body feeling so big and awkward, and a little sore because of birthing waves, I discarded that idea pretty quickly. I cast about for other ideas and then I knew exactly what I needed to do. I looked around me, and saw a bunch of pine needles on the ground. I carefully selected a few, and held them in my hand. Tears ran down my face as I picked one and whispered, “This one represents how scared I am that this birth could go as long as my last one did.” I grabbed another one. “This one,” I said, “is my fear about the pain of birth.” I held up the last one. “And this one,” I whispered, “is my fears about how hard it is to care for a newborn and never sleep.” I held the needles tightly in my hand and trembled and cried in the shadow of that tree. I knew what I had to do but I still wasn’t sure I could do it.

I walked to Chase and reached for his hand. I held up my pine needles, and sobbed, “These are my fears.” He searched my face and nodded. “And…I need you to watch me let them go.” He gripped my hand. "Ok honey." I could feel his support, tangibly strengthening me at this crossroad. I cried harder than ever, clutching my needles tighter and tighter.

It’s terrifying to let go of fear. Fears are comfortable in a way. They give us something to hide behind. Our fears keep us from doing the only things that are more terrifying than fear: the things that could show us how powerful we are. I knew that I had to really, REALLY mean it when I let those needles go. I truly had to let my fears evaporate, because something else was more important than hiding. I had to strip my soul of all the fear I harbored so I could move forward.

I stood there for a while, crying, holding onto Chase, and gripping my pine needles. A battle was being waged inside of me; my fears grappled with my hopes – my hope that this birth could be different, shorter. My weakness attacked my strength – the strength that told me that I had done this before and could do it again. My desire for control sought to overpower the necessity of letting go and stepping into the unknown.  While my mind screamed all of the reasons why it was logical to want to run from this, something deeper tugged at my heart, begging me to accept that I could not control how long this labor went, or the pain involved, or how much this baby would sleep, and that that could be ok. And that I could be strong enough and brave enough to embrace and face it.

I waffled back and forth, back and forth. I felt everything within me reach a climax of so much emotion I thought I would burst, and I let go.

I still vividly remember the feeling as I uncurled my fingers and let those pine needles fall to the ground in front of me.

I had done it. It was over.

I leaned into Chase and he held me and whispered words of encouragement and love while I cried. It felt like a sacred moment; my experience had hallowed the spot where something so cleansing had taken place. After a bit I eased away and felt profound peace and strength fill me. “Ok.” I said. “I’m ready.” He wiped away my last tears, told me he loved me, and we walked away hand in hand.

I didn’t look back.

As we walked I felt lighter, and at the same time fuller. Ready and aware of what was coming, but not scared anymore. I could do this. I WOULD do this. We walked up the stairs and opened the door. The first thing I saw was my mom’s face. She and Renee were sitting at the table and my mom’s eyes found mine immediately. Of course, I started crying again. We walked towards each other and I’ll never forget what she asked me: “How are you? Do you feel…whole?”

Whole. It was such a perfect way to put it. Yes, I finally did feel whole, not broken into pieces and sections anymore. No more confidence cracked by fear, or a calm visage hiding a circular gauntlet of questions and control issues. I was one. Whole. Ready. And not just ready to accept this, but to grab this with both hands and DO it.

I smiled through my tears. “Yes,” I said. We hugged while Renee checked in with Chase about how my waves were progressing. Still pretty far apart, farther than they had been, actually. She asked how I felt about her leaving. I felt great about it. I wanted to be alone with mom and Chase and this heady, newfound feeling of strength that made me feel powerful.

Renee suggested I eat something and left. It was one in the morning. I grabbed some cereal and we all went to my room and I ate while we talked. We told mom what had happened outside, and I couldn’t believe how lighthearted and relaxed I felt. We were laughing and joking and then a wave came. I decided to change how I was approaching this. No more laying on the bed trying to relax, or breathing through them on the ball. I had truly and honestly released all my fears relating to this birth, and this feeling of fearlessness gave me this desire to push through and finish this on my terms. I turned to my instincts. I hopped off the bed and knelt really low on the ground. I told Chase to lay on the bed and hold my hands. I pulled on him through the wave, and made whatever sounds felt natural and good.


When it was over, I stood up, and sat back down on the bed. I resumed my cereal eating, and within a couple minutes was back down in my kneeling position. I was pulling on Chase and mom was at my back. This happened a few times in succession, and happened so quickly that I was about two-thirds of the way through my cereal when I told Chase I didn’t want any more. I remember Mom saying that the fact that I didn’t want to finish my food told its own story. About two quick, STRONG waves later my mom said, “I hate to sound like a broken record, but do you think we should call the midwife?” I agreed. I didn’t feel nervous about her being here anymore. I was ready to do this, and she should definitely be here when it all reached the crescendo.

Things were going fast. My waves were speeding up, just a couple minutes apart, and were back-breakingly strong. Every wave was stronger than the last. But I didn’t shrink from them. This was what I wanted, to take charge and change things. I didn’t want to have a 36-hour birth again. I was conquering my first fear.

I love ocean imagery when it comes to birth. I feel like during Jemima’s birth I was calm, accepting, waiting. I envisioned myself sitting on the beach and letting the tide gradually come in, cover me, and take me out with it to the deep waters of birth.

With Lavinia’s birth, I feel like I was naked and running head-first into a tidal wave.  I had mentally ripped off everything that could come between me and this experience, and although this time I knew how deep and turbulent the water would be, I was unwilling to wait for it to carry me away.

I would run out to meet it.

With this image in my head, I pushed mentally and physically into my waves. They came faster and faster and I welcomed them and worked with them. I was moving a lot and my feet were going crazy! I was pulling on Chase and slapping my feet against the floor. For some reason having every bit of me reacting to the pressure felt good. At one point I rocked back on my heels and panting, asked my mom, “Does this look like transition to you?” She said it looked like very active birthing time, and was maybe even close to transition. I was glad. I was throwing myself at this, racing for the finish.

Every wave I pulled on Chase – his shirt, his neck, his hands. It was so intense and so all-encompassing and I was being pulled and thrashed by this tidal wave of birth, but I kept pushing back.

Renee showed up, she said she had gotten home and just crawled into bed when we called. She couldn’t believe how quickly things had changed. She started getting everything prepped for birth.

It felt like a huge step, but I told her I wanted to get in the tub. It had been waiting for me and now I was ready.

I was surprised at how warm the water felt, and how good it felt on that summer night. But it did. The warmth did wonders on my back, and helped me relax. Like I had in the bedroom, I had Chase stay up by my head. I was pulling and yanking on him like crazy, but the movement was what I needed and he didn’t complain. My hands were fisted on the front of his shirt, and I would pull him towards me, and push him away, again and again and again. The sliver of my brain that was still functioning normally registered how hilarious it was to see him being throttled while trying to comfort and support me. Back and forth back and forth - but the intensity was crazy; even with all that Jemima’s birth had been, I had never felt intensity like this. I needed the movement.

I continued to push back, to rush into it all, instead of shrinking away. The intensity was consuming me as things progressed rapidly, and I began being very vocal. Chase asked if I wanted Mel there. I must have agreed because she came soon after. Mom poured water on my back, and I felt like I was going to die whenever she had to stop and refill. Mel came, I heard her voice, and I registered her movement around me. My eyes were clamped shut, and I started saying, “It’s so hard! It’s SO hard!” Over and over and over again. Everyone validated me repeatedly. But none of it really reached me until I heard Mel say quietly to my right, “It is hard. It is so hard.” For some reason that helped. I appreciated everyone’s support, but for some reason Mel’s words penetrated my thoughts like no one else’s had. Her words brought calm.

I continued to pummel Chase over the edge of the tub, when things reached a peak. I started pushing. “I’m pushing!” I yelled through gritted teeth, “I’m pushing! Is that ok?!” “Do whatever your body tells you to do.” Renee said calmly. Sometimes amidst the vulnerability of birth, I think I am looking for affirmation that taking the next step is ok, and that was all I needed to hear. I pushed. And just like last time, I felt like I would explode into a million pieces from the pressure. But I didn’t hide. I didn’t stop. All of the sudden I felt like I lost control as my body took over and ran away from me, faster than I could go. Waves were crashing upon waves with no room to breathe in between. I was vocalizing and pushing and my noises would go on forever, and I heard mom say, “Breathe -BREATHE!” When I finally caught my breath I said, “I can’t! It’s not me! I can’t control it!” I had run far enough into my tidal wave that it swept my feet out from under me and took control. My body was pushing without my help, and I felt like I was just bobbing in the water trying to find my footing. I screamed and was so loud that in the back of my mind I thought, “Wow. That is really loud. I think the screen door is still open. Hm.” I felt Lavinia move down, crown, and her head start to come out, and it was a climax of pressure and feeling and opening that is awe-inspiring and unbelievable. I thrashed and trembled and pushed and pushed. Her head came out. I thought I would burst…one last push and her body was born.

I collapsed against the side of the tub panting, crying – it was over. Time stopped for a moment. Sudden relief from such extreme pressure is hard to process. It’s like waking up in the middle of a dream – it’s jarring, disorienting. I took a breath as everyone helped me turn over, and Renee placed Lavinia on my chest. The turbulence had subsided, and we were surrounded by calm water. I held her, and felt her slippery warmth as we breathed together. New life had been born, and a mother reborn. I had experienced power and cleansing in that tub - a baptism of fire and water and spirit - and I was changed forever. Transformed and made new. I had given everything, including my fears, and I made it. I conquered. We had crossed over to the other side and she was in my arms.

We were together.

And whole.

And it was beautiful.

*Note: The mind/body connection is amazing, and I think Lavinia’s birth demonstrates the power of that connection. Things stayed fairly consistent for 18-20 hours, but after I released my pine needles and my fears, things escalated quickly and she was born four hours later. We don’t do vaginal checks, but if I had to guess I would say I was at about 3-4 centimeters when that happened, and that I traveled through the rest of dilation, transition, and pushing in that small time span. It’s incredible how interconnected our bodies and emotions and minds are!

7 Reasons to Support Midwives in the Age of Trump

We are in a time when our goodness as humanity is being questioned. Borders are militarized and becoming stronger, refugees are denied access to needed resources, and hate crimes are on the rise.

In this country, we are unquestionably seeing the results of generations of trauma and segregation.

For about a hundred years, humans have routinely birthed our babies in hospitals. During this time, the medical community, as an oppressive institution, has been interfering with many of the physiological process of birth, performing often unnecessarymisogynistic interventions and separating babies from their parents.

These practices have laid the foundation for many generations of traumatized and isolated human beings.

Fortunately, midwifery care offers a much-needed contradiction.

Imagine: dim lighting, the familiarity of your own home, and care providers who you trust medically and emotionally and who have spent your entire pregnancy getting to know you and what you want for your birth.

Consider a world where all pregnant people are treated with the utmost autonomy and respect and the bond between children and parents is passionately supported. Where babies are born with trust, connection, and safety.

Of course, not everyone has access to homebirthing. Many factors – including disability, income and access to health care, and even cultural acceptability – affect a person’s access to and desire for homebirth. And we would never want to suggest that this is the only, or even the best, option. The best option is always the one that makes sense for you.

We do want to make space to talk about how midwifery can be a radical choice that rebels against an oppressive institution, especially in a world where more and more, we’re realizing that our day-to-day choices make a difference.

The way we’re born is one thing that can be considered in our movements of resistance. As we fight against the inhumane policies of the current administration, our work to reclaim our humanity is both personal and political.

So here are seven reasons why homebirth with midwives is one human(e) and anti-oppressive way to give birth.

1. Homebirth Is a Contradiction to Oppression

In today’s world, the forces of capitalism, racism, sexism, and classism work to isolate us. Oppression functions by disconnecting us from our bodies, each other, and the natural world.

When we are fully in touch with our own humanity, it is easy for us to see the humanity in others. Homebirth is a contradiction to oppression because it supports our humanity above all else in a way that the medical industrial complex often doesn’t.

Homebirth can be a safe haven. It offers the opportunity for pregnant people and families to craft the experience of pregnancy and birth that they most want and deserve, where consent is the highest priority and safety is not only physical, but emotional and spiritual as well.

Homebirth offers an opportunity to experience birth outside of the institutions of society that all too often cannot see or respect us in all of our human complexities.

And for those who want to choose this option, it can be incredibly powerful.

When a cis woman chooses midwifery care, she can opt out of the culture of patriarchy that insists that her body should be manipulated and controlled.

When a person of color chooses to birth with a trusted provider in their own home, they can carve a space for themselves outside of the racist institutions that have never cared about the wellbeing of their bodies or their babies.

When a trans or gender non-conforming person chooses a midwife who is a true ally, they might feel free to experience their bodies and babies as they are, outside of pervasive expectations of sex and gender.

2. The Way We’re Born Affects Us for the Rest of Our Lives

There is substantial evidence that the way we’re born affects us – mentally, physically, and emotionally.

In the US, medical interventions have taken over our evolved physiological process of birth. In some ways, we can argue, this is a good thing: After all, we’ve seen a huge dip in childbirth mortality rates.

But with one in three babies born through cesarean section, 60-80% of pregnant people birthing with epidurals, and astronomically high rates of use of synthetic oxytocin, it’s worth questioning whether or not all of these procedures are always necessary.

Many studies are now proving that the way we are born correlates with our physical health later in life. There is some evidence linking cesarean birth with health conditions such as asthma, type 1 diabetes, and other chronic health problems.

The concerns are not only physical.

Babies need caregivers, physically and emotionally, to transition into extra-uterine life, so the immediate separation following a cesarean birth can have profound effects on babies’ nervous systems.

Research shows that our early imprints of attachment have lasting emotional and psychological effects in later years.

The important question to ask ourselves as a society is: What are the results of all of this meddling with the physiological process of birth?  

Are the interventions common in the birth industrial complex inhibiting our own production of bonding hormones and affecting our capacity to love and bond with future generations?

These questions are necessary now, more than ever, while our president enacts policies that promote separation and isolation in the name of “safety,” building walls and anti-immigration policies that are inhumane and ineffective.

3. Isolation Is the Main Foundation of Oppression

Human beings have an innate physiological need for connection. Compared to other mammals, human babies are born remarkably premature, and we remain extremely dependent on our caregivers for years (physically and emotionally).

When we interfere with the vitally important process of connection between babies and caregivers, we are denying each baby’s innate need for connection and negatively affecting their normal growth process.

The way the institution of medicine manages birth in this country can reflect be isolating to our children. And this matters now more than ever because totalitarianism itself is a result of isolation.

Despotic, divisive leaders are elected when anger and disconnection abound and anything “other” is seen as a threat and an enemy. A sense of isolation causes people to feel hopeless about their lives and the world, allowing power-hungry dictators to capitalize on their vulnerability and gain control.

People in the US have become deeply disconnected, from ourselves and from each other, and the result is an epidemic of xenophobia, racism, and fear.

The result is a president whose entire campaign was based on slander, fear-mongering, and verbal abuse.

There are many different interwoven threads of history that have brought us to this political moment. One of them, I think, and arguably one of the most important and the most often overlooked, is birth.

Because being born is the most fundamental experience that we all have in common.

And in this culture so prone to mistrust, fear, and disconnection, we rarely acknowledge the systemic issues around the birth industrial complex that perpetuate these dynamics.

4. Rates of Morbidity and Mortality in the US Are Distressing – And Racialized

The US ranks 33rd in the world in our rates of parental morbidity and mortality (last among all other developed nations), and 26th in our statistics of neonatal morbidity and mortality.

Although we are the wealthiest country in the world, we are not, in general, taking good care of our pregnant populations and our future generations.  

The statistics are extremely racialized as well. Pregnant people of color (specifically Black populations) suffer the poorest outcomes.

According to data from the National Center for Health Statistics, Black babies are twice as likely as white babies to die within the first year of life. They are twice as likely as white babies to be born with low birth weight and three times as likely as white babies to be born very premature.

This discrepancy still holds when we control for differences in class and access to healthcare.

It is clear from the research – and, of course, people of color’s experiences – that racism and white supremacy play a major role.

Too many people are coming away from birthing in the hospital feeling disempowered and disappointed by their birth experiences – and then dismissed for those feelings.

Too many parent/baby dyads are being separated at birth, and too many major surgeries are being performed unnecessarily.

Too many people’s desires and needs around their birth experiences are being systematically ignored, which can result in disappointed or traumatized new parents and families.

The institution of medicine could learn a lot from midwifery, in terms of how to create a system more respectful of people’s needs. Because even when folks (and especially marginalized folks) choose hospital birth, shouldn’t they leave that experience feeling safe?

5. Western Obstetrics Arose From a Violent History

It’s not that hospitals are inherently bad places or that medicine is malintentioned: It’s that the system was never built to treat birthing people as self-directed individuals.

Modern obstetrics has a harrowing history.

James Marion Sims, considered the “father of modern gynecology,” gained his knowledge by conducting experiments on slaves, often without anesthesia.

In the mid 1800s, ether-based anesthesia was introduced into the delivery ward, resulting in unconscious birthing people, lethargic babies, and the implementation of forceps to pull babies out when their parents were unable to push.

People giving birth were often strapped to a bed and partners were denied entry into the delivery rooms; all the while, in the public sphere, the Association of Obstetricians conducted a very successful slander campaign against midwives and nurses, effectively orienting the future of birth towards hospitals.

This history matters.

This lack of humanity that was the history of modern obstetrics continues into hospitals today and is connected to the thread guiding our current political moment.

Today, there is a myth that having babies outside of the hospital is unsafe. Actually, research shows that for low-risk women (which is an important distinction), homebirth with a trained provider is as safe or safer than birthing in the hospital.

6. The Statistical Differences Between Hospital Birth and Homebirth Are Striking

While a direct comparison between homebirth and hospital birth statistics is not entirely accurate – because homebirth clients are, by definition, healthy and low risk – the disparate trends are significant.

  • Babies born at home receive all of their needed blood due to delayed cord clamping, a practice which is not routinely performed in the hospitals
  • Homebirth parents report high rates of satisfaction from their care, while in the hospital, 25-34% of birthing parents report experiencing birth trauma

For babies, immediate and constant skin-to-skin contact and a calm environment help them transition into this world with a more relaxed nervous system and, potentially, an unbroken sense of trust in their connection with their birth parent.

As midwives, our primary goal is to guard the health and safety of the pregnant person and baby while protecting the physiological intimacy that occurs between parent and child at the moment of birth and immediately after.

Our aim is to do as little as possible to disturb this bonding process.

In the midwifery model of care, we see the birth process as an everyday – albeit miraculous – part of life.

7. Homebirth Offers an Opportunity for Liberation and Healing

For the low-risk pregnant people for whom out-of-hospital, midwifery care is appropriate, homebirth can offer an opportunity to birth their families with fierce and loving self-determination.

Homebirth is a potential alternate option for people who are marginalized by this country’s major institutions and for anyone who wants personalized and intimate care.

When people have a trusted midwife with them as they go through the intensely transformative processes of pregnancy, birth, and postpartum, they may feel better equipped to lay the foundations for healthy, connected, and radical relationships with their children and with themselves.

Assata Shakur said, “Love is contraband in Hell, because love is an acid that eats away bars.”

We need to break the bars that keep us isolated from one another and cultivate trust and intimacy as our first step in our movements of liberation.

While there is much to do in the next four years to protect ourselves from – and thrive in spite of – the hungry forces of oppression, we must weave trust and connection into the foundations of our work.

Where better to start than at the moment of birth, if we have the option and the desire?

Homebirth is not just a trend. It is not a chic movement or a badge that proves how naturally minded or alternative one is.

Homebirth is, and has always been, part of our nature. It is so much more than the location where a baby is born, or the credentials of their birth attendant.

It is, in fact, the expression of our deepest humanity, allowing for early imprints of intimacy and connection – which are not only our birthrights, but our greatest hopes for change.

Marea Goodman is a homebirth midwife practicing in the San Francisco Bay Area. She strongly believes in the liberatory power of homebirth and midwifery care, and imagines a world where each person gets complete choice over every aspect of their reproductive experiences.