Midwives of the Revolution

Explorations, analysis, and reflections on reproductive health, birth, and midwifery from a feminist, marxist lens

An Actual! Nearly-Realistic! Homebirth! Scene! On TV!

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If you’re not a birth worker, and you’ve ever watched any narrative on television/in a movie that involves birth, you know the drill. You know it’s coming — your birth worker friend is about to give the laundry list of every lie about birth that depiction has unleashed through its powerful platform!

Ugh! It’s never like that! No one’s labor progresses like that!

Can you believe it? That midwife didn’t even call in an assistant!*

For real? Her water broke, and the baby was born 5 minutes later?

Why is the OB the star of the birth?!?!

Anyway, I’m used to being that bitch that ruins movies for my boo/child/friend with such comments. I mean! I’m sure oncologists can’t stand most cancer diagnosis/treatment segments, and cardiology and other acute care nurses probably cringe over all the inaccuracies of heart attack scene…but this is birth!

The portrayal of birth in popular media has pernicious effects on how people understand this major event. Of course, people who have had babies can recognize the lie, and many people can just see birth scenes as the plot device they actually are. Birth scenes in mass media contribute to weaving the fabric of fear around birth and pathologizes labor pain — often justifying the medicalization of birth.

But for those of us that are invested in the power of birth and horrified by the perinatal health crisis in the US, particularly for BIPOC birthing people, unrealistic birth scenes usually represent so much more than just a way to move along a story, and we want to have a say in the cultural narrative around birth.

A Real and Powerful Birth — at Home, to Boot!

photo downloaded from: https://alexusrenee.com/the-chi-recap-season-4-episode-5-the-spook-who-sat-by-the-door/

…Which is why I was blown away by the unexpected turn toward home birth and how well it was treated in one of my favorite shows, The Chi. Seriously, if you’re not watching it already, catch tf up on it!

Look — it’s not everything. I can still give loads of critiques about how The Chi tells the story of Kiesha’s pregnancy and eventual home birth, so I’ll get that negativity out of the way! Like with most birth scenes you get on TV (etc.), Kiesha’s contractions appear to never give her any breaks — adds to the drama of the scene, but in reality she would have breaks to catch her breath, doze, take a sip of water, cry, whatever. It’s also not clear how she went from being pretty unengaged with her health and prenatal care during the pregnancy (made sense, given her character and the circumstances of her pregnancy) to being prepared to roar her baby into the world at home.

But that’s exactly what happens, where she is surrounded by loving women, including a badass midwife (and apparent midwife assistant, who is not really introduced). It’s beautiful!

I don’t know who the show used as a midwife (or other really smart) consultant on the episode (none is cited on the episode’s IMDB page), but clearly the writers knew some key elements of physiologic birth — and about Black birth in particular as a family event. The calm, confident, and loving midwife centers Kiesha in a way that recognize that the birth is not a medical emergency, and that the work Kiesha is doing is part of a legacy of millennia of childbearing people (“women” in the show). This is a powerful intervention to reclaim the power of a Black birthing woman, who an episode earlier nearly consented to a what turned out to be an unnecessary medical induction of labor with a white obstetrician resident.

We are never privy to the negotiations around the adoption plan other than Kiesha’s choice to name Octavia as the adoptive mother (and apparently work on birth intentions with her and invite her to the birth). When the birth assistant whisks off the baby to Octavia after the birth — without clear consent from Kiesha as the birthing parent — the shift to silence in the birth space felt as eerie to me as that immediately following a stillbirth. Both the baby and Kiesha would have benefited from immediate skin-to-skin time together in the tub, and in real life, the birth team would have been involved in making a plan around these details. The omission of this step forecloses a step in Kiesha’s grieving of the motherhood she seems to wrestle with losing — something I of course wish the midwife had played a role in.

Black Birth Matters

There’s such a myth of home birth as a bourgie choice for white people and hippies** — a myth that erases a powerful history of BIPOC midwifery, while naturalizing the disparity in access to culturally concordant home birth care (stay tuned for more from me about this). I love that this episode highlights a Black family (headed by strong queer women, at that) choosing a birth provider and setting that makes them feel safe, out of the hospital.

This show is continuously responding to various aspects of the movement for Black lives***, and by demonstrating the power of Black midwifery, they also seem to be uplifting the voices of BIPOC birth workers around the urgency of increasing access to culturally concordant care for birthing people. Research points to the life-saving ability of concordant care, in contrast to the harms of racism and implicit bias in perinatal health care. The perinatal health crisis will be solved in part by increasing the numbers of BIPOC birth workers, so that birthing people like Kiesha can access quality, concordant care — with a critical impact on the health of the next generation as well.

The work of reproductive justice also means addressing so many of the social issues that this show engages (in sometimes cheesy ways, but usually pretty thoughtfully) — education access, food justice, housing justice, community safety, sex workers’ rights, and of course, policing and the prison system. The writers’ choice to showcase an empowered birth — and for a young woman whose pregnancy is a result of rape and who plans an adoption — feels in line with their commitment to portraying and building Black resiliency.

Kiesha’s home birth not only does not involve any of the emergencies (including the emergency of racism) that too often cause severe morbidity and trauma for, not to mention take the lives of, a disproportionate number of BIPOC birthing people. It also helps her be fully part of the process in a way that she wants to be.

And for all that, this birth snob is delighted to have a labor and birth scene to celebrate for its contribution to shifting the narrative around birth. Let’s keep making Black birth matter.

-QMM

*Actual and incredibly upsetting account of home birth in Netflix’s atrocious midwife-fuck-up film, Pieces of a Woman. (Critiqued well with input from health professionals here, but without any engagement of the midwife’s utter unpreparedness, which would be highly unlikely for a professional midwife.)

**To help combat this myth, consider supporting badass birth worker China Tolliver by purchasing and rocking one of these rad shirts she designed: “Homebirth Isn’t Just for Hippies.”

***I really cannot stop swooning over Lena Waithe for this and all the reasons.

Author: queermarxistmidwife

I am a nurse-midwife practicing in full-scope (reproductive health and birth care) in a community birth setting in the Midwest. My clinical practice is an extension of my longtime commitment to social reproduction (a close cousin and friend to intersectional -- perhaps synonymous to, depending on who you talk to!) marxist feminism and reproductive justice activism. I write anonymously to protect my job security and make clear that these are my personal opinions, and to make clear that I am also a professional whose personal opinions can also be separate from the care I provide. (While I personally believe in abolition of the prison industrial complex, I still have clients that are cops/married to cops [etc.] and maintain respectful, compassionate clinical relationships with them.) I was called to midwifery circuitously, through my love for reproductive rights and an interest in providing abortion care. Then I met midwives and learned about the intertwined legacy of midwifery and abortion, and I fell in love with birth. In my practice, I have worked as a primary care midwife in a Federally Qualified Health Center and campaigned fiercely for true midwifery in a hospital setting rife with obstetrical violence (and lost that fight!). I have learned how to bring midwifery care from the belly of the beast in a large teaching hospital that functions in many ways as an assembly line of medicalized birth. I have also had my heart broken by my own midwife when I realized that my dream job in home birth was actually a nightmare in many ways. I have found healing through communities of midwives that work to support each other through the traumas of toxic healthcare workplaces. I am constantly learning, working on my personal and professional growth, and striving for accountability, particularly as an anti-racist that benefits from white privilege. Midwives of the Revolution is meant as a nod to Marx and Engles's writing on the process of social revolution, as well as an aspiration to be among the midwives fighting to transform the perinatal health system in the context of the struggles for reproductive justice. The social revolution it will take to win reproductive justice will have to involve birth workers, other health workers (unionized, and not; professionals and not), educators, abolitionists, environmentalists, and of course childbearing people and families. I love the way that Marx's collaborator Engles (a brilliant philosopher and activist in his own right) describes the dialectical process of childbirth, which, for me, also undergirds my commitment to bodily autonomy and reproductive justice. To paraphrase, some of the events that midwives are called to may be "violent" or forceful, like childbirth -- not unlike revolution and social struggle: The fetus is negated by the neonate, who can only be brought about by the force of childbirth. The midwife facilitates that transition, as force (or social struggle) facilitates the transition from one form of social relations to another. Scolding the philosopher Duhring, Frederick Engles defends the social force required to fundamentally transform society: "Force, plays yet another role in history, a revolutionary role; that, in the words of Marx, it is the midwife of every old society pregnant with a new one, that it is the instrument with the aid of which social movement forces its way through and shatters the dead, fossilised political forms." (Anti-Duhring, found here: http://www.marxists.org/archive/marx/works/1877/anti-duhring/ch16.htm#087)

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