As soon as I began entertaining the notion of pregnancy, I wanted to learn all I could about birth. I watched The Business of Being Born. I devoured The Thinking Woman’s Guide to a Better Birth. I listened incessantly to birth podcasts.
I learned, through this self-education, that our medical system routinely mismanages birth, causing women unnecessary pain and trauma. A question began to form in my mind: Where is feminism on birth? Having been in pro-woman spaces throughout my collegiate and professional life, I was familiar with the most-discussed topics: sexual and domestic violence, the pay gap, lack of representation, abortion. It felt like birth advocacy was a significant missing piece of the feminist agenda.
There have certainly been advocates who have helped improve American women’s experiences of birth and early motherhood. Norma Swenson, author of Our Bodies, Ourselves; Marian Thompson, founder of La Leche League; Dick Grantly-Read, an obstetrician who advocated for intervention-free birth; Ina May Gaskin, the “mother of American midwifery”: these and others fought in their own ways for respect of the maternal body. However, their work has not been widely understood as feminist. In the 1970s, for example, Gaskin was booed off the stage during a talk at Yale when she began discussing birth.
Birth is still not widely regarded as a feminist cause. Rather, a primary cry of modern feminism is that women should have the right not to have children. Yet the majority of women still desire to do so. Given this reality, and given the still-dire state of standard labor and delivery care, improving women’s birth experiences should be a top priority for American feminists.
A Renewed Movement
Not long after the birth of my first child—during which I still experienced disrespect and mismanagement, despite my preparation—I came across the 2008 book Pushed: The Painful Truth about Childbirth and Modern Maternity Care. “The problem isn’t that women are failing to give birth the right way. It’s that the system is failing women,” writes Jennifer Block. Yes! I thought, and in between naps and diaper changes, I devoured my copy in a few days’ time.
Though I looked, I didn’t see another mainstream feminist book critiquing American birth practices for years. Many touched on the issues, but they were preparing-for-birth books, not the needed cultural commentary. Some grassroots organizations like Birth Monopoly were speaking about birth trauma and obstetric violence, but it was very niche. It still seemed as if mainstream feminism was neglecting something incredibly central to women’s well-being.
In 2023, Allison Yarrow’s Birth Control: The Insidious Power of Men Over Motherhood was published. Brilliant and comprehensive, it covers the myriad issues in American maternal care, from too many cesareans to the infantilizing way pregnant and birthing women are treated. Yarrow discusses the way our medical system frames birth as a crisis that needs to be managed rather than a natural process during which a woman’s body is to be respected and trusted. She also outlines how this mentality grew from the rise of obstetrics, a male-centric profession, and the subsequent decline and demonization of midwifery. It makes an excellent feminist case for modern birth advocacy.
This way of thinking about birth seems to be gaining traction. Author and feminist Sarah Menkedick, in a recent Substack piece, explained why advocacy for more woman-centered birth practices should be seen as a feminist issue. Liberal feminism centers the concept of choice, yet, as she writes, “the way most of us do end up birthing is often pretty antithetical to choice, ease, confidence, and empowerment.” This experience has long-lasting consequences. “Often,” Menkedick observes, “women emerge from this crucible not competent and capable but weak, vulnerable, and humbled into perpetual submission.” Pointedly, Menkedick asks, “How can we fight so hard in other spheres and surrender our autonomy so easily in this one?”
The tide is changing, it seems. Yet an emphasis on autonomy above all can easily go awry. The story of The Free Birth Society (FBS) illustrates the need to integrate respect for birth with an understanding that sometimes medical intervention is needed, even if it is not wanted.
A Cautionary Tale
FBS is a popular and influential online birth advocacy group that was founded in 2017. I remember when I first became aware of their work. I was captivated.“Free Birth Society: where women think for themselves.” “What’s possible when birth is returned to women, family, and the wild intelligence of the body.” The founders spoke with poignancy about the negative experiences of women in the U.S. medical system. It all felt wonderfully feminist, and their words resonated deeply with me—and with many others. Yet the ideas were extreme. Their answer to the dysfunction of the system was to birth totally on one’s own, with no medical professionals present, and often without having received any prenatal care at all.
The Free Birth Society has recently come under intense fire, for issues from bad business and relational practices to ideological rigidity. The conversation online in the last year has been prolific, and recent coverage in The Guardian was particularly damning, illustrating the way unassisted birth was put on a pedestal and intervention viewed as failure.
In a medical system that treats women’s bodies as broken by default and birth as a dangerous emergency, the popularity of FBS among informed, intelligent women is understandable. Menkedick describes how an appetite for the truth about birth led her to their content:
I read books on homebirth and midwifery and birth culture; I read studies in anthropology and sociology and bioethics on obstetric violence and female autonomy in medical systems; I read scientific research about electronic fetal monitoring and c-sections and episiotomies and induction and common hospital practices.
And I binged the Free Birth Society podcast.
FBS encourages women to trust in their own bodies, and they boldly denounce the harmful and anti-female practices of American hospital systems during an experience most women will have at least once in their lives. These are things that modern feminism has largely failed to do. Instead, there’s been a clear reluctance to admit any problems in our medical system and a penchant to dismiss those who desire to do things differently as victims of misinformation.
It’s no mystery why FBS became so influential. There was a need for a movement that demands respect for women’s birthing bodies, and they met that need.
Magic, Medicine, and Maternal Intuition
The Free Birth Society was also willing to say that birth is not just a physical, scientific event, but a spiritual one as well. This aspect of birth must be acknowledged and valued. In Birth Control, Yarrow writes: “When I hear that a friend or loved one is pregnant… I pray the coercion, manipulation, and needless suffering won’t touch them. Then, I wish for them support and the gift of being left alone to do the work of labor, to experience its magic and power.”
It’s absolutely true, in my experience, that birth contains a sort of magic. There’s something transcendent about it, and I believe it should be treated much more as a sacred rite of passage than a medical emergency. Yet birth is also a physiological event that can go awry. As women’s experiences with The Free Birth Society show, it’s all too easy to swing to an extreme and idolize intervention-free birth. We should tell the truth about the way birthing women are treated within the medical establishment, and we should acknowledge the spiritual power of the birth experience. But as we do so, we must resist the temptation to demonize the system.
The truth is that birth sometimes requires medical support. Leah Jacobson, founder of the woman-centered healthcare network The Guiding Star Project, recently gave birth to her eighth child. Jacobson has long been a fierce advocate for physiological birth and has given birth at home in the past. Yet, this time, she felt an instinctive pull to deliver with an OB at a hospital, and she ended up needing a c-section. In a powerful recent reflection, she wrote:
intuition does not always lead us toward the birth we want, but sometimes toward the care we need. It has reminded me that preparation is not a lack of faith, and surrender is not failure. Advocacy for physiologic birth and readiness for medical intervention are not opposites; they are both acts of reverence for life.
This is much-needed wisdom. Birth with no or few interventions is a worthy goal and often has profoundly positive outcomes for both women and babies. But we mustn’t overcorrect by adopting a mindset that shuns the medical system completely. In fact, there’s a spiritual truth that can be learned through birth: that of our human frailty. Whether support in birth comes from the divine or from a medical intervention, an openness to help profoundly illustrates, as Leah Libresco Sargeant might put it, the dignity of dependence.
The Way Forward
Birth is incredibly nuanced—like women themselves—and therefore a feminism for birth is indeed a tricky matter. However, I see some clear ways to move forward.
First, a feminism for birth would encourage women to understand how birth works. Author and educator Lisa Hendrickson-Jack writes, “To keep a population illiterate is an act of systematic disempowerment. So what does it mean that in our society most women are kept illiterate of their own bodies?” Just as La Leche League helped women understand their lactating bodies, we need a similarly powerful education movement that helps women understand their birthing ones. Birth is mysterious and surprising, and it’s also a physiological process women can—and should—learn about.
Next, as Yarrow outlines so well in her book, a feminism for birth would work to establish midwifery as the gold standard for low-risk pregnancy, just as countries with the best maternal care outcomes have. The philosophical underpinnings of midwifery differ from obstetrics, encouraging practitioners not to pathologize birth but rather to understand and support it. Furthermore, midwifery is woman-centered. Midwives prioritize both mother and baby, knowing that both deserve the utmost reverence and care.
Third, as we work for broader change, a feminism for birth would help women to understand how to advocate for themselves in a broken system. All women will have different experiences with medical providers. Nonetheless, at a structural level, our healthcare system does not truly honor women’s bodies. The field of obstetrics, in particular, is saturated in paternalism. Women need to be empowered to use their voices to help ensure that they receive quality care and retain the agency they deserve.
Fourth, a feminism for birth would inspire women to challenge the extremist rhetoric of both mainstream feminists and natural birth influencers. Birth is certainly not a dangerous medical emergency, but it is also not something that will always go perfectly if “left alone.” We must reject the narrative that birth is inherently dangerous—and the one that says it’s inherently safe. Neither of these simplistic stories are true or helpful to women, and sex-realist feminists should push back against both.
Finally, a feminism for birth would encourage women to celebrate birth as the positive, transformative experience it often is. Yarrow writes toward the end of her book, “The most power I’ve ever felt was during birth,” and I nodded with a sense of woman-to-woman truth as I read that line. Birth has the capacity to teach women to embrace their uniquely female strength, something feminism has sometimes, even if inadvertently, avoided. Birth and breastfeeding helped instill pride in my female body the way nothing else has, and it shouldn’t feel un-feminist to celebrate that.
It’s been almost a decade since I pondered the feminism and birth question. I see progress, and I’m so glad for that. But we still have work to do, and as we do it, we must tread carefully, fighting for birthing women in a broken system but not overcorrecting by ignoring the complexity birth inherently carries.
The task remains: feminists must advocate for women as they do what only women can do. A movement for women cannot forget birth.
