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Transforming birth: How advocacy and sharing stories can shape policy and empower families

Tiffani Marie, PhD
Conditions
April 11, 2023
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Musical genius and mogul Rihanna recently graced the Oscars stage for her second performance after the birth of her son, with a baby bump indicating her second pregnancy. She described her first birth as “blessed” and “beautiful.” While many expecting parents long to describe their birthing process similarly, there are realities within the medical system that complicate this narrative for those who are not celebrities. When my partner and I received notice that we couldn’t proceed with our long-awaited home birth and instead needed to have a C-section, we vowed to bring the values and ethics we envisioned for our home birth to the hospital procedure. Our experience was surprisingly transformative, and as we began to share our story with other parents, we were reminded that the U.S. medical system prioritizes profit over people; empowering hospital births become outliers. Over half of the families we spoke with carried immense unprocessed grief from their birthing experiences. Here’s what I learned from their stories.

The pace by which our birthing system operates devalues the sacred nature of pregnancy. Once most expecting families reach the second trimester, their prenatal visits are capped at 15 minutes. Within our home birthing community, prenatal visits lasted 1 to 2 hours. There, we holistically discussed our experiences as expecting parents, were offered numerous resources, and drafted and revised our birthing plan. I could only imagine the ignorance and fear we would have brought to our birthing experience if our visits were capped at 900 seconds.

The U.S. birthing system intervenes more than it inspires. Sadly, hospitals are encouraged to enforce C-sections because they generate higher monetary intake. In California, hospitals can increase their revenue by 82 percent on average by performing a C-section rather than a vaginal birth. These procedures make newborns and families more susceptible to complications and even death.

This data informed my partner’s and my fears when we found out at 20 weeks that a fibroid was pushing against my partner’s cervix, and a C-section might be the safest option for our family. Parents within our community supported us to advocate for ourselves, sharing gems that they employed when their birthing plan took a dramatic shift. We then prepared immensely, creating our list of non-negotiable for procedures: our own clothes, low lights, silence in the operating room, allowing our voices to be the first our newborn baby heard. Prior to the procedure, we held a ceremony with our birthing team. With ten medical practitioners crammed into our room, we opened with gratitude for their ancestors, gave context for our grief, prayed with the staff, and one midwife even joined in to sing my partner the Misheberach, a Jewish prayer for healing and the renewal of spirit. Sadly, most birthing parents have had experiences antithetical to ours. They didn’t feel heard, had procedures enacted on them that they didn’t consent to, and were forced to make split-second decisions in the face of fatigue and fear.

Our birthing system cares very little about what happens to birthing parents once they leave the hospital. Guidelines for perinatal care suggest over ten checkups before birth but often only one after birth. During this time, many birthing parents experience complications and die. In the United States, 65 percent of pregnancy-related deaths occur in the year after delivery, with nearly 85 percent of pregnancy-related deaths being preventable. When our child came home from the hospital, our midwife visited twice in the first week & once a week for the next five subsequent weeks. My partner was given a womb closing ceremony to honor the sacred nature of birth, and we were provided with an abundance of tools ranging from critical readings to recipes to support lactation. After the fanfare wanes from the birthing experience, families still need an abundance of education and support. We can do more to ensure that postpartum is not synonymous with depression and death.

I am grateful for the medical practitioners who broke the rules for us, and who challenged their training to provide, as they said, “the next ideal” birth for our child. One hospital midwife shared: “Your family’s presence has left a powerful ripple effect of promoting autonomy, listening, respectful care, and ceremony in our labor and delivery unit.” We must work toward a future where critical care in birth work is not an outlier. The first step is advocacy. Parents: share your birthing stories. I believe that the more we share our stories, the more we can shape policy to better support families. The future of our children’s health starts with our empowerment.

Tiffani Marie is an education professor.

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Transforming birth: How advocacy and sharing stories can shape policy and empower families
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