Where Are Pro-Choice Organizations in Birth Activism?

Erin Rockwell

Pro-choice groups work strenuously to protect our rights and provide affordable, essential care. But when it comes to choosing where and with which kind of provider to give birth, they are silent. Why?

As a former employee of Planned Parenthood of Metropolitan Washington and the National Family Planning and Reproductive Health Association; as a mother and a wife and a daughter and a sister and a friend; as a student of history, I have never questioned my dedication to the pro-choice movement. I am pro-choice to my core and have proudly pledged my time, effort and energy into making sure that access to abortion, birth control and preventive services are within easy reach for every American. 

It is with sadness, then, that I question the movement’s dedication to me.

I am a woman “of childbearing age.” I know Planned Parenthood, NOW, Choice USA, et al, will defend my right to choose abortion if I were to get pregnant and needed that option. I know they would provide me with subsidized birth control and pap smears if I didn’t have insurance and couldn’t afford to pay full price, or they would at least direct me where to go. And I know they will fight hard to ensure that legislators cannot stomp out my right to choose, or my access to subsidized birth control and yearly exams. Yet, when it comes to where I choose to give birth, they are silent. It would appear, in their eyes, that ensuring “choices” essentially ends with the decision to have a baby–more specifically of where and with what kind of attendant to give birth.

How is that possible? The birth of her child is for many women one of, if not the, most transformative moment in her life. And the circumstances surrounding it can be just as empowering or disempowering as those surrounding a woman accessing her right to an abortion.

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The right to choose how a woman gives birth is not confined to just whether she’ll have a cesarean or a vaginal delivery, or whether she’ll have an epidural or go natural. In many states, the right to choose the very place where a woman gives birth is a contentious subject. While maternal and infant mortality rates in the United States continue to rise, legislatures continue to refuse to grant licenses to Certified Professional Midwives, the most common type of midwife who attends home births. And even in states where home birth is legal, hospital policies can prevent a woman from being accompanied by her midwife should she need to be transferred during or after the birth. Women are ostensibly free to make the choice—in most states it is only midwife-attended home birth that is illegal—but the choice often comes down to going to a hospital and risking losing their autonomy or planning a home birth and losing their advocate (and the person with the medical knowledge) if something goes wrong.

The hesitation on the part of the major pro-choice groups is understandable. The right to make the choice where and how one gives birth, and especially to choose a home birth, is often seen as outside of the mainstream or more often, the choice of the uber-religious (the oldest Duggar child’s first baby was born at home), not exactly a natural ally of the pro-choice camp. And with access to abortion growing harder and harder to guarantee, it’s hard to find energy to devote to other aspects of reproductive choice. And it goes both ways, too. I saw a recent exchange on Facebook where a pro-lifer expressed their concern that if pro-choice groups began to take up the call for choices in childbirth, the cause would be lumped under “abortion rights,” a possibility that vexes many anti-abortion activists who nevertheless fully support having a choice when it comes to childbirth.

As a pro-choicer, I have to admit that I find the hesitation on the part of the anti-choicers rather short-sighted and naive. It is not our side, after all, that continues to propose and pass legislation granting fetuses “personhood,” that doctors then cite to get court orders for women to remain on bed rest or to be forced into having cesarean sections, all in the name of “fetal rights.” A recent editorial in the newspaper of the city in which I live appealed to those “who believe in the rights of the unborn” as a reason for denying licenses to Certified Professional Midwives. Translation: the unborn baby has the right to the best care (only available at the hospital), and the silly women who choose home birth are endangering their babies just as much as if they’d laid down to have a D&C.

It is clear, though, and has been clear to even anti-choicers (Jennifer Block, in her book “Pushed: The Painful Truth About Childbirth and Modern Maternity Care” about modern obstetrics in the US, describes such a couple who, despite their deeply held belief that abortion is wrong, nevertheless attended the 2004 March for Women’s Lives in Washington, DC, because they realized it is the pro-choice side that is best-suited for championing their cause) that these indomitable organizations like Planned Parenthood and NOW are the ones that can best advocate for the right of a woman to choose how and where she gives birth.

The key to the abortion debate is the old NARAL standard: that it is the woman who is best suited to make her own reproductive choices. Childbirth is such a choice. Those of us who advocate for the rights of women to make their own choices, about birth control, about abortion and about childbirth need them officially on our side.

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