Photo by Mikhail Nilov from Pexels

For the first time in 100 years, Illinois babies can be born in their own homes. With midwives who no longer worry about being arrested. To families that no longer risk being reported to social services. Community midwifery is returning to the Midwest, as Illinois is the 37th state to license certified professional midwives (CPM).   

Trained specifically for out-of-hospital birth, CPMs offer an alternative to birth-as-usual. This model of care brings a safety record for babies and birthing persons, and high levels of satisfaction. 

For 20 years, I attended births as a community midwife, bringing the beautiful sound of a newborn crying back to the hillside houses of Duluth, MN. It was joyous, exhausting work – work that was more of a calling than a profession. It was a radical act of social justice, of feminism. 

Becoming a midwife wasn’t so much about delicious baby cheeks or the hormone high of birth. What moved me was the justice issues: The cutting, the money, the technocracy, the fear. What drove me was a deep call to create space for safe, low-tech birth in a culture that treats birth as a dangerous medical event.  

I gave birth at home in 1996, when the Minnesota Attorney General’s office was issuing cease and desist orders to midwives. Under a veil of secrecy and after a long night of laboring, my family, a few friends, and I met Charlie. His father carried him downstairs to the table for breakfast, big pieces of birthday cake made by my mom while I labored. 

How could this be illegal? My experience was so joyful, so delicious, so normal. We had a baby. Something shifted inside me, and I became more curious. I started reading while I nursed, my journalism degree kicked into high gear. I requested a series of titles from the local library, one book leading to another. Then I started reading textbooks. Within months, I was giving labor support to friends. In a few years, I was attending births as a certified doula. Within a decade, I was a credentialed and licensed midwife driving around the forests of northeastern Minnesota, catching 40 babies a year. 

I don’t tell you this to impress you, or tempt you with the heady scent of lavender or the warm waters of the birth pool. (Who knew birth could be so sensuous and gentle?) I tell you this because when we talk about reproductive justice, we rarely include the politics, culture and experience of birth. Birth–so central to the human experience–is one of the last frontiers of feminism and reproductive justice. 

The Grim Realities of Childbirth

When you do the math, about every 12 hours, a woman in the U.S. dies of childbirth complications. If you’re a black woman, you are twice as likely as a white woman to die. If you live in Alabama (9.3 per 1,000) or Washington, D.C (7. 8), your baby is more likely to die than babies born in Bahrain (6.9) or Russia (5.8). 

When you do a different kind of math, you find that birth is a cash cow in a for-profit healthcare system. America spends more than any nation on childbirth, and yet the outcomes are shockingly poor. The number one reason for hospitalization in the U.S.? Birth. The second most commonly performed surgery? Cesarean section. Without exception, when compared to other industrialized countries, pretty much everyone else does it better

In fact, America lags so far behind other high-income countries that alarming numbers of women reporting trauma and even PTSD symptoms after giving birth is not even news. 

This is not surprising. We know that the countries with the best outcomes for mom and baby have two things in common: universal health care and midwives. In these countries, obstetricians are restricted to caring for women who risk out of midwifery care. Compare this model to America’s broken system, and you see that women–and their babies–are being sold a bill of goods, and are literally financing an obstetrical industry. 

Community Midwifery Works

We know what works: Midwives. Midwifery works. The Midwifery Model of Care works. We have evidence that skilled midwifery care is uniquely nurturing and protective, and provides the best outcomes for less money. We know midwives keep cesarean rates within the World Health Organization target of 10-15%. In fact, for healthy women giving birth in out-of-hospital settings, the c-section rate is just 5.8%. The U.S. rate hovers at 31.7%, even higher in states such as Florida.

Increasingly, American women are choosing to buy their way out of the medical system. A study found that between 2004 and 2010, the number of home births in the U.S. rose by 41%. We ought to be talking about women’s options, and building birth centers, and training midwives. What more evidence do we need?

I’m no longer a baby catcher. Now I teach. But I watch ‘my babies’ grow up, and continue to calculate the effects of a one-birth-at-a-time approach to show women that it can be different. These families created a wave that commanded change at local hospitals, filled a new set of nature-based preschools, and formed weekly mother groups that have extended into menopause. I had no idea how transformative choice could be.

Who is your community midwife? 

A previous version of this article incorrectly listed CDC statistics, and has been fixed.

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