Manifesta

I stand for the empowerment of women. I am a woman and have found birth and motherhood to be among the most affirmative, empowering experiences of my life. So I teach, write and coach on empowerment in and through birth and motherhood.

That means I find myself standing for structures that I am persuaded support women well in those contexts; namely:

• Nature – our hormones – which orchestrate physiologic birth, bonding and breastfeeding;
• The midwifery model of care – sometimes practiced by obstetricians, sometimes not practiced by midwives – which supports Nature and women;
• Collectives of social support to women and families.

I also find myself standing against systems that do not support women in these contexts as well as they claim to; namely:

• An American maternity care system that does not know how to support physiologic birth and overuses medicine;
• A society that devalues motherhood;
• A consumerist culture that comes between mothers and their children.

It’s systems and cultures that I critique, not individuals. I know there is not one “right” way to birth – you don’t have to have or even want a natural birth. There is not one “right” way to mother – you don’t have to breastfeed or wear your baby or share sleep if that is your authentic choice. Yes, they have been my path to empowerment, but they may not be yours. I respect alternative choices.

Yet I do question whether everything we call an “individual choice” is, in fact, an authentic choice – one arising from the woman’s own values – or rather is something compelled by an unsupportive system. For example:

• About 80% of women in the U.S. have an epidural during labor. Epidurals certainly have their place, but are they really the authentic desire of 80% of American women? Or are they so popular because most hospitals don’t offer anything else – no doulas on staff, no water immersion, no hypnosis, even though these are scientifically proven therapies? Or because the environment and routine practices of Labor & Delivery wards make labor hurt more than it’s meant to? Or because we’ve frightened women into believing that it’s crazy to do anything else?
• About 20% of mothers don’t breastfeed at all and about 50% who start breastfeeding stop within three months. Given the well-publicized benefits of breastfeeding and taking for granted that mothers are strongly invested in the wellbeing of their babies, do a full 20% of mothers truly want nothing to do with nursing? Or do they have no help at home, to look after them while mother and baby are learning to breastfeed? Do they have no one to turn to – no lactation consultant or La Leche League or friend to call – when their nipples are sore and baby is crying and so they stop before they really want to? Do they have no choice but to get back to work immediately?

I want women and their babies to have social and institutional support for the full range of choices, not just the ones that are easiest for the systems currently to provide. Women are empowered when the systems that support them accurately reflect their values.

Women’s empowerment matters not just for them and their families personally. It matters because the world urgently needs their voices, their perspectives. Feminism has so far allowed women in the game, but I think it’s time for us mothers to start changing the rules, to reflect our values. Here are a few changes in systems I would love to see:

• Greater institutional support for physiologic birth (Nature). Let’s begin with training more midwives to be the primary caregivers to expectant mothers, training obstetricians in the midwifery model of care, and creating the infrastructure for safe and easy transfers of home births into hospital.  More independent birth centers, and, in hospitals, on-staff doulas, birthing tubs and softer environments would also help.
• Postpartum support from the same caregivers mother grew to rely on prenatally. Currently, a mother is not seen until six weeks postpartum. This is a drastic falling off of interest in her when she is most vulnerable. Let’s have regular visits by a nurse who is trained in lactation support at home for her first six weeks.
• A work culture that does not simply tolerate family life, but supports it, through paid and extended family leave policies, expanded job sharing, the option of reduced hours and on-site childcare. Currently, mostly lip service is paid to the contributions of mothers; changes like these would put money where the mouth is.
• Socially, an emphasis on birth as a rite of passage into motherhood and, with it, postpartum as a time for nurturing the new family with attention and acts of service. Currently, birth is seen as a medical transaction and its existential dimensions are largely ignored. Expectant mothers are showered with support in the form of purchased baby things prenatally, and then left much too alone postpartum, when they really need their community.

When women are empowered, families thrive.

Who’s with me?