Brace yourself. The Moment has finally arrived. You know the one – that inevitable choice point in human history when the human race will either decide to stand upright and save itself through moral and ethical deeds, or else bear witness to the quickening of its own demise. Never before have the decks been stacked so evenly. Never before has complacency been so lethal. I realize this is pretty heavy-handed stuff, but I have a daughter now, so there’s not much room in my psyche for evasion of the facts of existence these days.
What facts am I talking about? How about the fact that, in the modern era, humanity has set the world on fire with greed, fear, war, massive ecological destruction and species extinction? Or the fact that super-viruses, low-grade plastics and dirty lettuce can kill you in your own home? Or that nobody I know can afford adequate health care? And here’s one that sends a chill down my spine – in the state of Georgia, should you wish to have a baby at home, it is illegal for a midwife to assist you – a fact which effectively makes a homebirth nearly impossible for Georgian mothers.
Before I go any further, I suppose I should back up and say that my daughter was born at home one fine night this past June. I suppose, too, I should tell you that I’m a 33-year-old Southern gentleman who, prior to having my own child, didn’t know a damn thing about birthing babies in the Peach State. I learned quick, though. And when I researched the stats, I learned that homebirthing remains a safe, traditional practice quite common all around the world (about 75 percent of Western European births alone are attended by midwives, primarily) and that only fairly recently did it cease to be the dominant method of delivery in the U.S. The hows and whys of this are fascinating, complex and debatable. But the end result remains: birth was medicalized (i.e., co-opted and made part of the jurisdiction of medical authorities) around the middle of the last century. Around that same time, the millennia-old practice of midwifery started to become stigmatized and seen as an antiquated, folksy and just-shy-of-barbaric anachronism. Most state legislatures, however, still continued to allow midwives to practice their art. Georgia, it turns out, would not be one of them.
Exactly how this came to pass is also a little complicated. In order to explain, it helps to know that, in the U.S., there are two basic kinds of midwives: nurse midwives and direct-entry midwives. A nurse midwife is trained in nursing, primarily, with an emphasis in midwifery. They work for medical doctors, and most often, in hospital labor and delivery units. A direct-entry midwife, however, is the modern analog to the midwives who have supported mothers throughout human history. This is because her certification does not require her to be a nurse or work for a doctor, which thus enables her to be free of the profiteering and bureaucratic strongholds that bedevil our troubled managed healthcare system. She has been well-trained, has attended legions of births, and makes her living by overseeing, facilitating and supporting women not only in the physical act of birthing, but in the psychological, social and spiritual aspects of pre- and post-natal life as well.
The Georgia Department of Human Resources stopped certifying direct-entry midwives back in the 1960s, and hasn’t certified one since. Numerous attempts, in the forms of activism, lobbying and petitioning, have been made by supporters of Georgia’s direct-entry midwives to try and revive their credentials. Governmental red tape, the stigma and bias against midwifery, and the medical establishment’s relative dominion over birthing in this state has, however, led to the exclusion of homebirthing as an option for Georgia’s mothers and fathers. At present, it is a misdemeanor for a direct-entry midwife to attend and facilitate a homebirth.
Now, as I said, this is a choice point in human history. The world is on fire and it’s on us to make do. That said, whenever I hear about somebody taking a stand for what’s right in the Time of Millennial Malaise and Torpor, I get excited and hopeful about the human race. It’s plain to see the inner workings of the Department of Human Resources are the antiquated and folksy things in this picture – not midwifery. And since a lot of Georgian women and men want to have their babies at home (and thus far from pitocin, spinal blocks, sedatives, forceps, vacuums and unnecessary C-sections), many direct-entry midwives practice a form of civil disobedience that would’ve pleased both Harriet Tubman and Martin Luther King, Jr. – they quietly practice their art in spite of the law, hoping that eventually, the law will be refitted to meet the needs of Georgia’s mothers and fathers.
My wife and I are both psychotherapists. Our daughter’s name is Eleanor. When she came into the world, I was forced into a unique position. It was/is no longer enough to support the causes of feminism, womanism, human rights and egalitarianism. I now owe it to my daughter to speak up and act out when I see women getting the short end of the stick – not just because it’s the right thing to do, but because I’m the father of a baby girl. She needs her mama and me to help make the world better for her, if we can. The 19 hours that my wife labored with Eleanor were a wild ride. My wife and I forged a bond beyond description as we navigated a rite of passage as old as humanity itself. Our home was dimly lit. Our midwife and doula tended to us gently, minimally and expertly. One of my best friends sat on post in our front yard, listening to Steve Earle on his tape deck. “Keep watch,” I had told him, “our baby’s being born tonight. I don’t want any door-to-door salesmen or nosy neighbors dropping by.” Eleanor showed up about the time the fireflies were coming out. When she did, time stopped.
You might wonder why on earth anybody would want to have a baby outside of a hospital – and that’s a good point of departure. The only response I can give is to say, at the risk of sounding fatuous, that I can’t imagine why a healthy mother would want to have a baby in a hospital setting – other than the fact that over the past 100 years we’ve all been generally conditioned to think that hospitals are where babies should be born. I tend to agree with the World Health Organization, which affirms that, across the board, midwives are the most appropriate birth attendants and caregivers for childbearing women worldwide. Apparently I’m not the only Georgia papa who feels this way. Georgia Friends of Midwives estimates that 500 to 700 homebirths take place in Georgia every year.
The midwife who attended Eleanor’s birth began meeting with my wife and me long before Eleanor was born. We met twice a month, on average, for over an hour each time. Our midwife made herself available between meetings by giving us her cell phone number. “Call me any time,” she told us. We did. I’d get curious about some aspect of birthing and my wife would say, “Call the midwife.” Over the prenatal period, my wife and baby’s progress and health were closely monitored. I asked a million questions and was met with intelligent answers, good humor and total support. Before long, my wife and I felt a close connection and kinship with her. This meant that, during Eleanor’s birth, having our midwife in our home was easy and natural. By then, she knew us well – our moods, temperaments and style of communication – and vice versa. The care she gave us and our new baby was rooted in a personal relationship that took months to build, and it showed. In short, it was the opposite of the average American’s birthing experience.
In the U.S., less than 6 percent of births are homebirths. The vast majority are institutional, hospital births. Because the U.S. uniquely tends to view birth not as a natural biological event with deeply significant psycho-spiritual implications, but rather a medical procedure to be carried out in an expedited fashion, homebirthing will likely never again be the dominant mode of child birth in this country. That’s a sad fact, too, because I’ve met a lot of midwives in the past year or so, and they’d all really like to be given the opportunity to help bring your baby into the world. Also, I am certain that if more of Georgia’s parents were aware of the birthing experience their babies are being denied by governmental bureaucracy and professional bias, there would be outrage.
It is crucial that Georgia’s mothers and fathers are at least given the legal option to have midwife-assisted homebirths. Until that option becomes a reality, we must acknowledge that the only people making Georgian homebirths possible at present are a handful of midwives – and their supporters – who actively stand opposed to the dominant politics of birthing in this country. If you’d like to get more informed about those politics, you can start by dropping by Ciné on May 5 for a screening and panel discussion of The Business of Being Born [see sidebar]. Also, visit www.gamidwifery.org for more information on homebirthing.
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